54.167.122.208
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>11/22/2014</StartDate>
  <EndDate>12/23/2014</EndDate>
  <DestinationPlan>Canada</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Joshua</Firstname>
    <Middlename>m</Middlename>
    <Lastname>Gold</Lastname>
    <Age>34</Age>
    <Dob>05/30/1980</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>11/22/2014</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>29 Hamilton St</Address1>
      <Address2></Address2>
      <Country>Australia</Country>
      <State></State>
      <City>Brighton</City>
      <Postcode>3186</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>findjoshgold@gmail.com</Email>
    <Phone>
      <Home>61395966513</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Yolande gold</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Mother</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147202159154374</CreditcardNumber>
      <NameonCreditcard>Joshua m Gold</NameonCreditcard>
      <CreditcardExpirationMonth>2</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2015</CreditcardExpirationYear>
      <CreditcardAmount>60.16</CreditcardAmount>
      <CreditcardCodeNumber>206</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
78870949
ARS-02-0018818
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0018818</PolicyNumber><UserName>78870949</UserName><Password>78870949</Password></PolicyDetails></RegistrationRes>