34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>50000</MaximumLimit>
  <StartDate>11/05/2017</StartDate>
  <EndDate>11/30/2017</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Nuhad</Firstname>
    <Middlename>S</Middlename>
    <Lastname>Matalka</Lastname>
    <Age>74</Age>
    <Dob>09/05/1943</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>11/05/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>1711 Tweed St</Address1>
      <Address2/>
      <Country>Jordan</Country>
      <State/>
      <City>Rockville</City>
      <Postcode>20851</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>jeffandnatasha@neckofwoods.com</Email>
    <Phone>
      <Home>2407530505</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Natasha Tynes</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Daughter</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4388576053583368</CreditcardNumber>
      <NameonCreditcard>Jeffrey S Tynes</NameonCreditcard>
      <CreditcardExpirationMonth>7</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2018</CreditcardExpirationYear>
      <CreditcardAmount>187.2</CreditcardAmount>
      <CreditcardCodeNumber>246</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
eaf4a5cc
ARS-02-0037743
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0037743</PolicyNumber><UserName>eaf4a5cc</UserName><Password>eaf4a5cc</Password></PolicyDetails></RegistrationRes>