34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>50000</MaximumLimit>
  <StartDate>02/10/2017</StartDate>
  <EndDate>02/18/2017</EndDate>
  <DestinationPlan>Canada</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Larry</Firstname>
    <Middlename>J</Middlename>
    <Lastname>Sowa</Lastname>
    <Age>73</Age>
    <Dob>07/13/1943</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>02/10/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>303 Rafael Osuna</Address1>
      <Address2>Racquet Club</Address2>
      <Country>Mexico</Country>
      <State/>
      <City>San Juan Cosala</City>
      <Postcode>45820</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>larrysowa@comcast.net</Email>
    <Phone>
      <Home>2064066224</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Shelley Caro</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4888937105516761</CreditcardNumber>
      <NameonCreditcard>Larry J Sowa</NameonCreditcard>
      <CreditcardExpirationMonth>6</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>64.8</CreditcardAmount>
      <CreditcardCodeNumber>879</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
3fb57506
ARS-02-0032106
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0032106</PolicyNumber><UserName>3fb57506</UserName><Password>3fb57506</Password></PolicyDetails></RegistrationRes>