52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>110000</MaximumLimit>
  <StartDate>04/22/2017</StartDate>
  <EndDate>04/28/2017</EndDate>
  <DestinationPlan>Israel</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Dan</Firstname>
    <Middlename/>
    <Lastname>Hochberg</Lastname>
    <Age>49</Age>
    <Dob>05/21/1967</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>04/22/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>32 Hickory Ln</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>New Jersey</State>
      <City>Closter</City>
      <Postcode>07624</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>DAN_HOCHBERG@HOTMAIL.COM</Email>
    <Phone>
      <Home>2012143008</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Iris Hochberg</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4257040020065676</CreditcardNumber>
      <NameonCreditcard>Dan  Hochberg</NameonCreditcard>
      <CreditcardExpirationMonth>7</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>12.6</CreditcardAmount>
      <CreditcardCodeNumber>340</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
a2717f26
ARS-01-0033498
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0033498</PolicyNumber><UserName>a2717f26</UserName><Password>a2717f26</Password></PolicyDetails></RegistrationRes>