34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>03/24/2017</StartDate>
  <EndDate>04/11/2017</EndDate>
  <DestinationPlan>Ukraine</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Vladimir</Firstname>
    <Middlename/>
    <Lastname>Pavlenko</Lastname>
    <Age>30</Age>
    <Dob>12/28/1986</Dob>
    <SportsRider>yes</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>03/24/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>433 Gaither St</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Maryland</State>
      <City>Gaithersburg</City>
      <Postcode>20877</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>mr.vlad.pavlenko@gmail.com</Email>
    <Phone>
      <Home>7033034754</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Vyacheslav Pavlenko</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Father</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4400669963044888</CreditcardNumber>
      <NameonCreditcard>Vladimir  Pavlenko</NameonCreditcard>
      <CreditcardExpirationMonth>6</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2020</CreditcardExpirationYear>
      <CreditcardAmount>22.23</CreditcardAmount>
      <CreditcardCodeNumber>586</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
762912e1
ARS-01-0032843
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0032843</PolicyNumber><UserName>762912e1</UserName><Password>762912e1</Password></PolicyDetails></RegistrationRes>