52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>550000</MaximumLimit>
  <StartDate>09/24/2019</StartDate>
  <EndDate>10/02/2019</EndDate>
  <DestinationPlan>Ukraine</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Elliot</Firstname>
    <Middlename>J</Middlename>
    <Lastname>Rubin</Lastname>
    <Age>65</Age>
    <Dob>09/12/1954</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>09/24/2019</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>178 S Sycamore Ave</Address1>
      <Address2>Apt 1</Address2>
      <Country>United States</Country>
      <State>California</State>
      <City>Los Angeles</City>
      <Postcode>90036</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>elliotjrubin@gmail.com</Email>
    <Phone>
      <Home>2137120272</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>American Express</CreditcardType>
      <CreditcardNumber>378262670132034</CreditcardNumber>
      <NameonCreditcard>Elliot J Rubin</NameonCreditcard>
      <CreditcardExpirationMonth>8</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2024</CreditcardExpirationYear>
      <CreditcardAmount>44.28</CreditcardAmount>
      <CreditcardCodeNumber>664</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
0a12c4a7
701941004

<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>701941004</PolicyNumber><UserName>0a12c4a7</UserName><Password>0a12c4a7</Password></PolicyDetails></RegistrationRes>