<InsuranceRequest xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema">
	<AffiliateInfo>
		<PartnerID>3</PartnerID>
		<Token>G15QncRptYzJftqUauVyodKvsoZWxArrfsgdetg</Token>
		<TrackingCampaign>MyCampaign</TrackingCampaign>
		<LeadSourceID>InHouse</LeadSourceID>
		<LeadIdToken>3DDAB3DF-978B-4E65-D2C6-79A3BC71D155</LeadIdToken>
		<ProductionEnvironment>true</ProductionEnvironment>
	</AffiliateInfo>
	<LeadMetaData>
		<LeadBornOnDateTimeUtc>2016-06-01T01:00:01</LeadBornOnDateTimeUtc>
		<IpAddress>75.27.97.10</IpAddress>
		<UserAgent>
			Mozilla/5.0 (Windows NT 6.3; WOW64; Trident/7.0; rv:11.0) like Gecko
		</UserAgent>
		<TcpaCompliant>true</TcpaCompliant>
		<TcpaText>
			By submitting your quote request, you represent that you are at least 18 and agree to our Privacy Policy and Terms of Use. You also authorize us and/or its marketing partners to contact you for marketing/telemarketing purposes at the number and address provided above, including your wireless number if provided, using live operators, automated telephone dialing systems, pre-recorded messages, text messages and/or emails. You are not required to consent as a condition of purchasing goods or services and may revoke consent at anytime.
		</TcpaText>
	</LeadMetaData>
	<LeadTypeID>10</LeadTypeID>
	<ZipCode>43215</ZipCode>
	<ContactInfo>
		<FirstName>John</FirstName>
		<LastName>Doe</LastName>
		<Address>123 Main St</Address>
		<ZipCode>43215</ZipCode>
		<City>Columbus</City>
		<County>FRANKLIN</County>
		<State>OH</State>
		<PhoneDay>9122074914</PhoneDay>
		<PhoneEve>9128524606</PhoneEve>
		<PhoneCell>9122074914</PhoneCell>
		<Email>Johndoe@test.com</Email>
	</ContactInfo>
	<MedicareSupplement>
		<MedSupInfo>
			<DOB>1956-05-03</DOB>
			<Gender>Male</Gender>
			<Marital>Married</Marital>
		</MedSupInfo>
	</MedicareSupplement>
</InsuranceRequest>