34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>110000</MaximumLimit>
  <StartDate>05/24/2017</StartDate>
  <EndDate>06/10/2017</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Douglas</Firstname>
    <Middlename>R</Middlename>
    <Lastname>Da Silva</Lastname>
    <Age>44</Age>
    <Dob>02/17/1973</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>05/24/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>Rua Lauro Muller, 306 Apt 1902</Address1>
      <Address2/>
      <Country>Brazil</Country>
      <State/>
      <City>Itajai</City>
      <Postcode>88301400</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>douglas@daunebr.com</Email>
    <Phone>
      <Home>13053323525</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Priscila Karen Martins Goncalves</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>American Express</CreditcardType>
      <CreditcardNumber>376529246822005</CreditcardNumber>
      <NameonCreditcard>Douglas R Da Silva</NameonCreditcard>
      <CreditcardExpirationMonth>2</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2018</CreditcardExpirationYear>
      <CreditcardAmount>53.64</CreditcardAmount>
      <CreditcardCodeNumber>7192</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
30cebb93
ARS-02-0034418
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0034418</PolicyNumber><UserName>30cebb93</UserName><Password>30cebb93</Password></PolicyDetails></RegistrationRes>