184.72.211.106
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>1000</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>09/02/2016</StartDate>
  <EndDate>09/17/2016</EndDate>
  <DestinationPlan>Dominican Republic</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Theodore</Firstname>
    <Middlename>J</Middlename>
    <Lastname>KIM</Lastname>
    <Age>51</Age>
    <Dob>12/12/1964</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>09/02/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>3410 75 Street</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>New York</State>
      <City>Jackosn Heights</City>
      <Postcode>11372</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>tjkim2000@cs.com</Email>
    <Phone>
      <Home>6462467800</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>American Express</CreditcardType>
      <CreditcardNumber>372575634674007</CreditcardNumber>
      <NameonCreditcard>Theodore J KIM</NameonCreditcard>
      <CreditcardExpirationMonth>2</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2021</CreditcardExpirationYear>
      <CreditcardAmount>33.28</CreditcardAmount>
      <CreditcardCodeNumber>3447</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
c9a46112
ARS-01-0029314
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0029314</PolicyNumber><UserName>c9a46112</UserName><Password>c9a46112</Password></PolicyDetails></RegistrationRes>