52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>0</DeductibleAmount>
  <MaximumLimit>1100000</MaximumLimit>
  <StartDate>06/14/2017</StartDate>
  <EndDate>06/27/2017</EndDate>
  <DestinationPlan>France</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Simcha</Firstname>
    <Middlename/>
    <Lastname>Barkai</Lastname>
    <Age>32</Age>
    <Dob>02/26/1985</Dob>
    <SportsRider>yes</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>06/14/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>1715 E 55TH ST</Address1>
      <Address2>APT 2</Address2>
      <Country>United States</Country>
      <State>Illinois</State>
      <City>CHICAGO</City>
      <Postcode>60615</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>SBARKAI@CHICAGOBOOTH.EDU</Email>
    <Phone>
      <Home>7737261684</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147202308012945</CreditcardNumber>
      <NameonCreditcard>Simcha  Barkai</NameonCreditcard>
      <CreditcardExpirationMonth>5</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2020</CreditcardExpirationYear>
      <CreditcardAmount>31.4</CreditcardAmount>
      <CreditcardCodeNumber>552</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
1ba11585
ARS-01-0034732
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0034732</PolicyNumber><UserName>1ba11585</UserName><Password>1ba11585</Password></PolicyDetails></RegistrationRes>