52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>1100000</MaximumLimit>
  <StartDate>06/20/2019</StartDate>
  <EndDate>06/28/2019</EndDate>
  <DestinationPlan>Czech Republic</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>James</Firstname>
    <Middlename/>
    <Lastname>Pellegrin</Lastname>
    <Age>40</Age>
    <Dob>03/14/1979</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>06/20/2019</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>1814 Coastal Way </Address1>
      <Address2/>
      <Country>United States</Country>
      <State>California</State>
      <City>Costa Mesa </City>
      <Postcode>92626</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>jamie.pellegrin@gmail.com</Email>
    <Phone>
      <Home>4085960522</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Liz Pellegrin</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Sister</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4037840038033633</CreditcardNumber>
      <NameonCreditcard>James  Pellegrin</NameonCreditcard>
      <CreditcardExpirationMonth>8</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2020</CreditcardExpirationYear>
      <CreditcardAmount>18.0</CreditcardAmount>
      <CreditcardCodeNumber>754</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
2859c589
701937212

<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>701937212</PolicyNumber><UserName>2859c589</UserName><Password>2859c589</Password></PolicyDetails></RegistrationRes>