52.91.53.224
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>500</DeductibleAmount>
  <MaximumLimit>110000</MaximumLimit>
  <StartDate>12/14/2015</StartDate>
  <EndDate>02/28/2016</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>2</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>David</Firstname>
    <Middlename>M</Middlename>
    <Lastname>Black</Lastname>
    <Age>60</Age>
    <Dob>12/09/1955</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
  <Applicant>
    <Firstname>Roberta</Firstname>
    <Middlename/>
    <Lastname>Black</Lastname>
    <Age>58</Age>
    <Dob>02/22/1957</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>12/14/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>261063 Range Road 22</Address1>
      <Address2/>
      <Country>Canada</Country>
      <State>Alberta</State>
      <City>Calgary</City>
      <Postcode>T3R1E8</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>phnxrizn@gmail.com</Email>
    <Phone>
      <Home>4038046519</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4514011601419631</CreditcardNumber>
      <NameonCreditcard>David M Black</NameonCreditcard>
      <CreditcardExpirationMonth>6</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2017</CreditcardExpirationYear>
      <CreditcardAmount>762.3</CreditcardAmount>
      <CreditcardCodeNumber>131</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
3a3a9663
92bcc33e
ARS-02-0024210
ARS-02-0024211
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