52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>11/09/2016</StartDate>
  <EndDate>11/15/2016</EndDate>
  <DestinationPlan>Dominican Republic</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Lucia</Firstname>
    <Middlename/>
    <Lastname>Jakubikova</Lastname>
    <Age>37</Age>
    <Dob>11/28/1978</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>11/09/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>2523 Ohio Dr., Unit 208</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Texas</State>
      <City>Plano</City>
      <Postcode>75093</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>jakubikova@hotmail.com</Email>
    <Phone>
      <Home>4694277436</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Anna Jakubikova</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Mother</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4406321130170477</CreditcardNumber>
      <NameonCreditcard>Lucia  Jakubikova</NameonCreditcard>
      <CreditcardExpirationMonth>6</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2017</CreditcardExpirationYear>
      <CreditcardAmount>6.3</CreditcardAmount>
      <CreditcardCodeNumber>274</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
b75c9a3d
ARS-01-0030497
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0030497</PolicyNumber><UserName>b75c9a3d</UserName><Password>b75c9a3d</Password></PolicyDetails></RegistrationRes>