54.167.122.208
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>11/28/2014</StartDate>
  <EndDate>12/01/2014</EndDate>
  <DestinationPlan>Macao</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Rebecca</Firstname>
    <Middlename>A</Middlename>
    <Lastname>Hinds</Lastname>
    <Age>23</Age>
    <Dob>06/16/1991</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>11/28/2014</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>601 Van Ness Ave.</Address1>
      <Address2>Unit 26</Address2>
      <Country>United States</Country>
      <State>California</State>
      <City>San Francisco</City>
      <Postcode>94108</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>alarocque@rogers.com</Email>
    <Phone>
      <Home>6508685811</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Anne La Rocque</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Mother</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4520885016517614</CreditcardNumber>
      <NameonCreditcard>Anne LaRocuqe</NameonCreditcard>
      <CreditcardExpirationMonth>7</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2016</CreditcardExpirationYear>
      <CreditcardAmount>4.25</CreditcardAmount>
      <CreditcardCodeNumber>996</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
0c8a34d1
ARS-01-0018856
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0018856</PolicyNumber><UserName>0c8a34d1</UserName><Password>0c8a34d1</Password></PolicyDetails></RegistrationRes>