34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>1100000</MaximumLimit>
  <StartDate>03/10/2018</StartDate>
  <EndDate>03/17/2018</EndDate>
  <DestinationPlan>Austria</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Yosef</Firstname>
    <Middlename/>
    <Lastname>Agmon</Lastname>
    <Age>64</Age>
    <Dob>02/19/1954</Dob>
    <Gender>Male</Gender>
    <SportsRider>yes</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>03/10/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>25937 Sardinia Ct.</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>California</State>
      <City>Valencia</City>
      <Postcode>91355</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>yossi.systems@gmail.com</Email>
    <Phone>
      <Home>6613133668</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Kathy Grant</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147202267742151</CreditcardNumber>
      <NameonCreditcard>Yosef  Agmon</NameonCreditcard>
      <CreditcardExpirationMonth>8</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>49.4</CreditcardAmount>
      <CreditcardCodeNumber>538</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
260649d1
ARS-01-0039755
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0039755</PolicyNumber><UserName>260649d1</UserName><Password>260649d1</Password></PolicyDetails></RegistrationRes>