52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>500</DeductibleAmount>
  <MaximumLimit>110000</MaximumLimit>
  <StartDate>04/30/2019</StartDate>
  <EndDate>05/08/2019</EndDate>
  <DestinationPlan>Ukraine</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Scott</Firstname>
    <Middlename/>
    <Lastname>Palmer</Lastname>
    <Age>62</Age>
    <Dob>12/10/1956</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>04/30/2019</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>132 Natoma ave apt b</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>California</State>
      <City>Santa Barbara</City>
      <Postcode>93101</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>drscottpalmer@yahoo.com</Email>
    <Phone>
      <Home>8082558117</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Scott Palmer</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Estate</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>American Express</CreditcardType>
      <CreditcardNumber>379753819911006</CreditcardNumber>
      <NameonCreditcard>scott r palmer</NameonCreditcard>
      <CreditcardExpirationMonth>3</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2020</CreditcardExpirationYear>
      <CreditcardAmount>29.16</CreditcardAmount>
      <CreditcardCodeNumber>4525</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
e75ab529
701933629

<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>701933629</PolicyNumber><UserName>e75ab529</UserName><Password>e75ab529</Password></PolicyDetails></RegistrationRes>