52.91.53.224
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>12000</MaximumLimit>
  <StartDate>12/20/2015</StartDate>
  <EndDate>01/14/2016</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Tam</Firstname>
    <Middlename/>
    <Lastname>Nguyen</Lastname>
    <Age>92</Age>
    <Dob>10/25/1923</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>12/20/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>168 John Street Apt # 503</Address1>
      <Address2/>
      <Country>Canada</Country>
      <State>Ontario</State>
      <City>Toronto</City>
      <Postcode>m5t2x9</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>lynnvy@yahoo.com</Email>
    <Phone>
      <Home>2676881051</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>hung nguyen</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Son-in-law</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4388576088802734</CreditcardNumber>
      <NameonCreditcard>Hung  Nguyen</NameonCreditcard>
      <CreditcardExpirationMonth>7</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2018</CreditcardExpirationYear>
      <CreditcardAmount>369.98</CreditcardAmount>
      <CreditcardCodeNumber>976</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
9ce00038
ARS-02-0024094
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0024094</PolicyNumber><UserName>9ce00038</UserName><Password>9ce00038</Password></PolicyDetails></RegistrationRes>