54.83.122.65
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>07/29/2015</StartDate>
  <EndDate>08/26/2015</EndDate>
  <DestinationPlan>United Kingdom</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Leon</Firstname>
    <Middlename/>
    <Lastname>Malisov</Lastname>
    <Age>20</Age>
    <Dob>08/29/1994</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>07/29/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>165 Bennett Avenue Apt 3-K </Address1>
      <Address2></Address2>
      <Country>United States</Country>
      <State>New York</State>
      <City>New York</City>
      <Postcode>10040</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>malisov@earthlink.net</Email>
    <Phone>
      <Home>9177562684</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName></AdDBeneficiaryName>
    <AdDBeneficiaryRelationship></AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4207670135461542</CreditcardNumber>
      <NameonCreditcard>Mikhail Malisov</NameonCreditcard>
      <CreditcardExpirationMonth>3</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>24.65</CreditcardAmount>
      <CreditcardCodeNumber>578</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
181c1493
ARS-01-0022355
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0022355</PolicyNumber><UserName>181c1493</UserName><Password>181c1493</Password></PolicyDetails></RegistrationRes>