184.72.211.106
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>1100000</MaximumLimit>
  <StartDate>11/01/2016</StartDate>
  <EndDate>11/04/2016</EndDate>
  <DestinationPlan>United Kingdom</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Benzion</Firstname>
    <Middlename/>
    <Lastname>Zenwirth</Lastname>
    <Age>29</Age>
    <Dob>04/09/1987</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>11/01/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>1466 50th Street </Address1>
      <Address2>Apt 5-O</Address2>
      <Country>United States</Country>
      <State>New York</State>
      <City>Brooklyn </City>
      <Postcode>11219</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>jz1565@optonline.net</Email>
    <Phone>
      <Home>7186333506</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4179030001937055</CreditcardNumber>
      <NameonCreditcard>Jacob Zenwirth</NameonCreditcard>
      <CreditcardExpirationMonth>6</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2020</CreditcardExpirationYear>
      <CreditcardAmount>5.9</CreditcardAmount>
      <CreditcardCodeNumber>574</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
02dc04a3
ARS-01-0030309
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0030309</PolicyNumber><UserName>02dc04a3</UserName><Password>02dc04a3</Password></PolicyDetails></RegistrationRes>