34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>100</DeductibleAmount>
  <MaximumLimit>110000</MaximumLimit>
  <StartDate>12/10/2017</StartDate>
  <EndDate>12/17/2017</EndDate>
  <DestinationPlan>Mexico</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Gilton</Firstname>
    <Middlename>R</Middlename>
    <Lastname>Bolanos</Lastname>
    <Age>55</Age>
    <Dob>06/20/1962</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>12/10/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>8323 Huntly Lane</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Louisiana</State>
      <City>Harahan</City>
      <Postcode>70123</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>l.g.bolanos@hotmail.com</Email>
    <Phone>
      <Home>5044010044</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Laurie Bolanos</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Discover</CreditcardType>
      <CreditcardNumber>6011208875095211</CreditcardNumber>
      <NameonCreditcard>Laurie L. Bolanos</NameonCreditcard>
      <CreditcardExpirationMonth>3</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2022</CreditcardExpirationYear>
      <CreditcardAmount>26.58</CreditcardAmount>
      <CreditcardCodeNumber>615</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
be78d5be
ARS-01-0038222
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0038222</PolicyNumber><UserName>be78d5be</UserName><Password>be78d5be</Password></PolicyDetails></RegistrationRes>