52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>12/17/2016</StartDate>
  <EndDate>12/31/2016</EndDate>
  <DestinationPlan>Canada</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>GHISLAINE</Firstname>
    <Middlename>P</Middlename>
    <Lastname>VAMPRE</Lastname>
    <Age>63</Age>
    <Dob>10/21/1953</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>12/17/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>RUA DR FLAQUER 115 APT 42B</Address1>
      <Address2>PARAISO </Address2>
      <Country>Brazil</Country>
      <State/>
      <City>SAO PAULO</City>
      <Postcode>04006010</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>ghivam@hotmail.com</Email>
    <Phone>
      <Home>5511988981991</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5415550323415770</CreditcardNumber>
      <NameonCreditcard>GHISLAINE P M M VAMPRE</NameonCreditcard>
      <CreditcardExpirationMonth>7</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2024</CreditcardExpirationYear>
      <CreditcardAmount>67.5</CreditcardAmount>
      <CreditcardCodeNumber>417</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
04e066b2
ARS-02-0031011
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0031011</PolicyNumber><UserName>04e066b2</UserName><Password>04e066b2</Password></PolicyDetails></RegistrationRes>