34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>10/05/2017</StartDate>
  <EndDate>10/22/2017</EndDate>
  <DestinationPlan>Australia</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Thomas</Firstname>
    <Middlename/>
    <Lastname>Polk</Lastname>
    <Age>32</Age>
    <Dob>12/08/1984</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>10/05/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>111 sandra muraida way </Address1>
      <Address2>Unit 17N</Address2>
      <Country>United States</Country>
      <State>Texas</State>
      <City>Austin</City>
      <Postcode>78703</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>thomas.r.polk@gmail.com</Email>
    <Phone>
      <Home>3237909378</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4003448432573301</CreditcardNumber>
      <NameonCreditcard>Thomas  Polk</NameonCreditcard>
      <CreditcardExpirationMonth>9</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2021</CreditcardExpirationYear>
      <CreditcardAmount>16.2</CreditcardAmount>
      <CreditcardCodeNumber>254</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
e3e7a820
ARS-01-0037307
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0037307</PolicyNumber><UserName>e3e7a820</UserName><Password>e3e7a820</Password></PolicyDetails></RegistrationRes>