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>03/29/2017</StartDate>
  <EndDate>04/10/2017</EndDate>
  <DestinationPlan>Czech Republic</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>barbora</Firstname>
    <Middlename/>
    <Lastname>jichova tyson</Lastname>
    <Age>39</Age>
    <Dob>08/11/1977</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>03/29/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>431 Classon ave #1C</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>New York</State>
      <City>Brooklyn</City>
      <Postcode>11238</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>bara.jichova.tyson@gmail.com</Email>
    <Phone>
      <Home>6462337998</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>richard tyson</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Brother</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4563310024231338</CreditcardNumber>
      <NameonCreditcard>barbora  kirkpatrick</NameonCreditcard>
      <CreditcardExpirationMonth>7</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>11.7</CreditcardAmount>
      <CreditcardCodeNumber>969</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
19e8cf27
ARS-01-0032968
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0032968</PolicyNumber><UserName>19e8cf27</UserName><Password>19e8cf27</Password></PolicyDetails></RegistrationRes>