34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>110000</MaximumLimit>
  <StartDate>08/10/2017</StartDate>
  <EndDate>08/26/2017</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Perizat</Firstname>
    <Middlename/>
    <Lastname>Zhakupova</Lastname>
    <Age>36</Age>
    <Dob>10/24/1980</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>08/10/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>PNUD Residence</Address1>
      <Address2>c/o Bob Tannehill and Barbara Tull</Address2>
      <Country>Chad</Country>
      <State/>
      <City>N'Djamena</City>
      <Postcode>000000</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>peri.zhakupova@gmail.com</Email>
    <Phone>
      <Home>23566903739</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Stephen Mitchel Tull</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Fiance</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4003032706181643</CreditcardNumber>
      <NameonCreditcard>Perizat  Zhakupova</NameonCreditcard>
      <CreditcardExpirationMonth>12</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2021</CreditcardExpirationYear>
      <CreditcardAmount>35.36</CreditcardAmount>
      <CreditcardCodeNumber>835</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
dc46b691
ARS-02-0036218
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0036218</PolicyNumber><UserName>dc46b691</UserName><Password>dc46b691</Password></PolicyDetails></RegistrationRes>