34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>550000</MaximumLimit>
  <StartDate>09/24/2018</StartDate>
  <EndDate>10/03/2018</EndDate>
  <DestinationPlan>Portugal</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Donald </Firstname>
    <Middlename>M</Middlename>
    <Lastname>Brink</Lastname>
    <Age>37</Age>
    <Dob>10/21/1980</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>09/24/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>2930 Camino Capistrano </Address1>
      <Address2>A</Address2>
      <Country>United States</Country>
      <State>California</State>
      <City>San Clemente </City>
      <Postcode>92672</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>donald@brinksurf.com</Email>
    <Phone>
      <Home>9495843781</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Emily Brink</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>American Express</CreditcardType>
      <CreditcardNumber>377228295872016</CreditcardNumber>
      <NameonCreditcard>Donald  M Brink</NameonCreditcard>
      <CreditcardExpirationMonth>9</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2020</CreditcardExpirationYear>
      <CreditcardAmount>13.5</CreditcardAmount>
      <CreditcardCodeNumber>1377</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
eeba89d9
701817288

<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>701817288</PolicyNumber><UserName>eeba89d9</UserName><Password>eeba89d9</Password></PolicyDetails></RegistrationRes>