54.167.122.208
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>50000</MaximumLimit>
  <StartDate>12/01/2014</StartDate>
  <EndDate>03/01/2015</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Samuel</Firstname>
    <Middlename>J</Middlename>
    <Lastname>McCrudden</Lastname>
    <Age>79</Age>
    <Dob>08/19/1935</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>12/01/2014</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>#1237  5328 Calgary Trail NW</Address1>
      <Address2></Address2>
      <Country>Canada</Country>
      <State>Alberta</State>
      <City>Edmonton</City>
      <Postcode>T6H-4J8</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>samnrby@gmail.com</Email>
    <Phone>
      <Home>7802981540</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Ruby McCrudden</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5191230170729108</CreditcardNumber>
      <NameonCreditcard>Samuel J McCrudden</NameonCreditcard>
      <CreditcardExpirationMonth>3</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2017</CreditcardExpirationYear>
      <CreditcardAmount>738.92</CreditcardAmount>
      <CreditcardCodeNumber>780</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
39ac57d0
ARS-02-0018858
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0018858</PolicyNumber><UserName>39ac57d0</UserName><Password>39ac57d0</Password></PolicyDetails></RegistrationRes>