52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>2500</DeductibleAmount>
  <MaximumLimit>550000</MaximumLimit>
  <StartDate>02/25/2017</StartDate>
  <EndDate>03/04/2017</EndDate>
  <DestinationPlan>Israel</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>ALEXANDER</Firstname>
    <Middlename/>
    <Lastname>ZABYSHNY </Lastname>
    <Age>69</Age>
    <Dob>09/08/1947</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>02/25/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>PO Box 360946</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>California</State>
      <City>Milpitas </City>
      <Postcode>95036</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>zabyshny@gmail.com</Email>
    <Phone>
      <Home>4088295123</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Natela Zabyshny </AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>American Express</CreditcardType>
      <CreditcardNumber>372353859391008</CreditcardNumber>
      <NameonCreditcard>ALEKSANDR  ZABYSHNY </NameonCreditcard>
      <CreditcardExpirationMonth>5</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2020</CreditcardExpirationYear>
      <CreditcardAmount>27.55</CreditcardAmount>
      <CreditcardCodeNumber>1762</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
43053d33
ARS-01-0032418
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0032418</PolicyNumber><UserName>43053d33</UserName><Password>43053d33</Password></PolicyDetails></RegistrationRes>