54.226.61.71
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>12000</MaximumLimit>
  <StartDate>01/01/2015</StartDate>
  <EndDate>02/02/2015</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Mustafa</Firstname>
    <Middlename>K</Middlename>
    <Lastname>Rostom</Lastname>
    <Age>93</Age>
    <Dob>01/01/1921</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>01/01/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>510-1705 playfair dr</Address1>
      <Address2></Address2>
      <Country>Canada</Country>
      <State>Ontario</State>
      <City>ottawa</City>
      <Postcode>K1H 8P6</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>krostom@yahoo.com</Email>
    <Phone>
      <Home>6135210967</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>kamilia rostom</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Daughter</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4538180250933150</CreditcardNumber>
      <NameonCreditcard>Jon Alexander</NameonCreditcard>
      <CreditcardExpirationMonth>11</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2017</CreditcardExpirationYear>
      <CreditcardAmount>469.59</CreditcardAmount>
      <CreditcardCodeNumber>123</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
d36b1bc9
ARS-02-0019123
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0019123</PolicyNumber><UserName>d36b1bc9</UserName><Password>d36b1bc9</Password></PolicyDetails></RegistrationRes>