52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>07/01/2019</StartDate>
  <EndDate>07/04/2019</EndDate>
  <DestinationPlan>Belarus</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Elizabeth</Firstname>
    <Middlename/>
    <Lastname>Jubera</Lastname>
    <Age>38</Age>
    <Dob>10/01/1980</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>07/01/2019</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>3261 Cape Cod Ct</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>California</State>
      <City>Alameda</City>
      <Postcode>94501</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>ejubera@gmail.com</Email>
    <Phone>
      <Home>4083753615</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Matthew Jubera</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Brother</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147098764692257</CreditcardNumber>
      <NameonCreditcard>Elizabeth Jubera</NameonCreditcard>
      <CreditcardExpirationMonth>3</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2023</CreditcardExpirationYear>
      <CreditcardAmount>4.5</CreditcardAmount>
      <CreditcardCodeNumber>269</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
df007fc3
701937742

<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>701937742</PolicyNumber><UserName>df007fc3</UserName><Password>df007fc3</Password></PolicyDetails></RegistrationRes>