54.226.34.195
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>12/18/2014</StartDate>
  <EndDate>12/27/2014</EndDate>
  <DestinationPlan>Canada</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Nicholas</Firstname>
    <Middlename/>
    <Lastname>Peric</Lastname>
    <Age>40</Age>
    <Dob>12/17/1974</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>12/18/2014</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>330 East 56th St</Address1>
      <Address2>Apt 605</Address2>
      <Country>United States</Country>
      <State>New York</State>
      <City>NYC</City>
      <Postcode>10022</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>nicholas.peric@hotmail.com</Email>
    <Phone>
      <Home>6468245629</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName></AdDBeneficiaryName>
    <AdDBeneficiaryRelationship></AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5466160261845331</CreditcardNumber>
      <NameonCreditcard>Lois  Loroscil</NameonCreditcard>
      <CreditcardExpirationMonth>1</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>28.0</CreditcardAmount>
      <CreditcardCodeNumber>305</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
648406d3
ARS-02-0019104
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0019104</PolicyNumber><UserName>648406d3</UserName><Password>648406d3</Password></PolicyDetails></RegistrationRes>