34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>500</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>07/14/2017</StartDate>
  <EndDate>07/21/2017</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Marcial</Firstname>
    <Middlename/>
    <Lastname>Garbanzo-Salas</Lastname>
    <Age>36</Age>
    <Dob>09/02/1980</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>07/14/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>VIVE SABANILLA 355</Address1>
      <Address2>MONTES DE OCA</Address2>
      <Country>Costa Rica</Country>
      <State/>
      <City>SAN JOSE</City>
      <Postcode>N/A</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>mgarbanzopcm@gmail.com</Email>
    <Phone>
      <Home>150684739762</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>DIANA JIMENEZ-ROBLES</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5235920203488759</CreditcardNumber>
      <NameonCreditcard>Marcial  Garbanzo S</NameonCreditcard>
      <CreditcardExpirationMonth>4</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2021</CreditcardExpirationYear>
      <CreditcardAmount>11.81</CreditcardAmount>
      <CreditcardCodeNumber>027</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
3b08e4a7
ARS-02-0035558
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0035558</PolicyNumber><UserName>3b08e4a7</UserName><Password>3b08e4a7</Password></PolicyDetails></RegistrationRes>