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>12/15/2015</StartDate>
  <EndDate>04/03/2016</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Joseph</Firstname>
    <Middlename/>
    <Lastname>Suckonic</Lastname>
    <Age>82</Age>
    <Dob>07/29/1933</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>12/15/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>662 Shepard Avenue E</Address1>
      <Address2>Building C, Apt 1502</Address2>
      <Country>Canada</Country>
      <State>Ontario</State>
      <City>Toronto</City>
      <Postcode>N2K3E6</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>joseph@msapera.com</Email>
    <Phone>
      <Home>4167858582</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4502200023117345</CreditcardNumber>
      <NameonCreditcard>Joseph Suckonic</NameonCreditcard>
      <CreditcardExpirationMonth>12</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2018</CreditcardExpirationYear>
      <CreditcardAmount>1579.53</CreditcardAmount>
      <CreditcardCodeNumber>588</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
069c54c4
ARS-02-0024252
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0024252</PolicyNumber><UserName>069c54c4</UserName><Password>069c54c4</Password></PolicyDetails></RegistrationRes>