34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>110000</MaximumLimit>
  <StartDate>08/11/2017</StartDate>
  <EndDate>09/02/2017</EndDate>
  <DestinationPlan>France</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Billy</Firstname>
    <Middlename>J</Middlename>
    <Lastname>Crouse</Lastname>
    <Age>66</Age>
    <Dob>02/17/1951</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>08/11/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>83 Misty Harbor</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Texas</State>
      <City>Montgomery </City>
      <Postcode>77356</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>bjcrouse@yahoo.com</Email>
    <Phone>
      <Home>2819284722</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Kathryn Crouse</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>American Express</CreditcardType>
      <CreditcardNumber>372356557073000</CreditcardNumber>
      <NameonCreditcard>BJ Crouse</NameonCreditcard>
      <CreditcardExpirationMonth>4</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2020</CreditcardExpirationYear>
      <CreditcardAmount>97.75</CreditcardAmount>
      <CreditcardCodeNumber>3983</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
8c73ed85
ARS-01-0036253
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0036253</PolicyNumber><UserName>8c73ed85</UserName><Password>8c73ed85</Password></PolicyDetails></RegistrationRes>