54.87.230.228
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>08/05/2016</StartDate>
  <EndDate>08/11/2016</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Miroslav</Firstname>
    <Middlename/>
    <Lastname>Pindjak</Lastname>
    <Age>32</Age>
    <Dob>07/17/1984</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>08/05/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>741 Amigos way</Address1>
      <Address2>apt 7E</Address2>
      <Country>Slovak Republic</Country>
      <State/>
      <City>Newport Beach</City>
      <Postcode>92660</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>piromindjak@googlemail.com</Email>
    <Phone>
      <Home>9495451747</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>denisa kenderova</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4342562257192870</CreditcardNumber>
      <NameonCreditcard>Miroslav  Pindjak</NameonCreditcard>
      <CreditcardExpirationMonth>4</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2020</CreditcardExpirationYear>
      <CreditcardAmount>13.16</CreditcardAmount>
      <CreditcardCodeNumber>445</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
dbe6b75e
ARS-02-0028584
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0028584</PolicyNumber><UserName>dbe6b75e</UserName><Password>dbe6b75e</Password></PolicyDetails></RegistrationRes>