34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>500</DeductibleAmount>
  <MaximumLimit>110000</MaximumLimit>
  <StartDate>01/16/2018</StartDate>
  <EndDate>01/27/2018</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Joel</Firstname>
    <Middlename/>
    <Lastname>Chasnoff</Lastname>
    <Age>44</Age>
    <Dob>12/15/1973</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>01/16/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>Eliezer Yafeh 37</Address1>
      <Address2>Apt 18</Address2>
      <Country>Israel</Country>
      <State/>
      <City>Raanana</City>
      <Postcode>43104</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>jchasnoff@gmail.com</Email>
    <Phone>
      <Home>19179925879</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Joel Chasnoff</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Other</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147202262283623</CreditcardNumber>
      <NameonCreditcard>Joel  Chasnoff</NameonCreditcard>
      <CreditcardExpirationMonth>6</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>32.18</CreditcardAmount>
      <CreditcardCodeNumber>206</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
79ff50e4
ARS-02-0038847
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0038847</PolicyNumber><UserName>79ff50e4</UserName><Password>79ff50e4</Password></PolicyDetails></RegistrationRes>