34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>01/18/2017</StartDate>
  <EndDate>04/02/2017</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Antonieta</Firstname>
    <Middlename>J</Middlename>
    <Lastname>Hernandez</Lastname>
    <Age>66</Age>
    <Dob>01/16/1951</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>01/18/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>Urb Cumbres de Curumo, Avenida Salto Caroni, Quinta El Descanso</Address1>
      <Address2>, Casa No. 2</Address2>
      <Country>Venezuela</Country>
      <State/>
      <City>Caracas</City>
      <Postcode>1080</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>antonieta@lecheymiel.org</Email>
    <Phone>
      <Home>584166321766</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5466160420403006</CreditcardNumber>
      <NameonCreditcard>Jose I Zambrano</NameonCreditcard>
      <CreditcardExpirationMonth>3</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2020</CreditcardExpirationYear>
      <CreditcardAmount>390.0</CreditcardAmount>
      <CreditcardCodeNumber>632</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
9b5014e7
ARS-02-0031812
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0031812</PolicyNumber><UserName>9b5014e7</UserName><Password>9b5014e7</Password></PolicyDetails></RegistrationRes>