34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>0</DeductibleAmount>
  <MaximumLimit>550000</MaximumLimit>
  <StartDate>06/26/2017</StartDate>
  <EndDate>07/12/2017</EndDate>
  <DestinationPlan>Uganda</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Laura</Firstname>
    <Middlename>E</Middlename>
    <Lastname>Horak</Lastname>
    <Age>35</Age>
    <Dob>07/18/1981</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>06/26/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>423 Third Ave., Apt 1</Address1>
      <Address2/>
      <Country>Canada</Country>
      <State>Ontario</State>
      <City>Ottawa</City>
      <Postcode>K1S 2K6</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>laura.horak@gmail.com</Email>
    <Phone>
      <Home>16137967047</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Gunnar Iversen</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4537338037226014</CreditcardNumber>
      <NameonCreditcard>Laura Horak</NameonCreditcard>
      <CreditcardExpirationMonth>1</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2021</CreditcardExpirationYear>
      <CreditcardAmount>28.69</CreditcardAmount>
      <CreditcardCodeNumber>940</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
c85c5be6
ARS-01-0034851
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0034851</PolicyNumber><UserName>c85c5be6</UserName><Password>c85c5be6</Password></PolicyDetails></RegistrationRes>