52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>04/15/2017</StartDate>
  <EndDate>06/26/2017</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Irina</Firstname>
    <Middlename>R</Middlename>
    <Lastname>Smirnova</Lastname>
    <Age>64</Age>
    <Dob>03/28/1953</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>04/15/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>14 Petrisheva Street, apt. 632</Address1>
      <Address2/>
      <Country>Russian Federation</Country>
      <State/>
      <City>Dzerzhinsk</City>
      <Postcode>606037</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>jenyasm2001@gmail.com</Email>
    <Phone>
      <Home>5055012522</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Evgenya Simakov</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Daughter</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>American Express</CreditcardType>
      <CreditcardNumber>372352781814012</CreditcardNumber>
      <NameonCreditcard>Evgenya I. Simakov</NameonCreditcard>
      <CreditcardExpirationMonth>10</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>328.5</CreditcardAmount>
      <CreditcardCodeNumber>2232</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
77b3e84e
ARS-02-0033197
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0033197</PolicyNumber><UserName>77b3e84e</UserName><Password>77b3e84e</Password></PolicyDetails></RegistrationRes>