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>12/16/2016</StartDate>
  <EndDate>12/28/2016</EndDate>
  <DestinationPlan>Poland</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Anna</Firstname>
    <Middlename/>
    <Lastname>Szenk</Lastname>
    <Age>49</Age>
    <Dob>09/22/1967</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>12/16/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>118-14 83rd Ave Apt.6B</Address1>
      <Address2>Apt. 6B</Address2>
      <Country>United States</Country>
      <State>New York</State>
      <City>Kew Gardens</City>
      <Postcode>11415</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>anna.szenk@gmail.com</Email>
    <Phone>
      <Home>3476826122</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Zbigniew Chojnowski</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Brother</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5199550001960214</CreditcardNumber>
      <NameonCreditcard>Anna  Szenk</NameonCreditcard>
      <CreditcardExpirationMonth>3</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2018</CreditcardExpirationYear>
      <CreditcardAmount>19.5</CreditcardAmount>
      <CreditcardCodeNumber>121</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
31337d08
ARS-01-0031180
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0031180</PolicyNumber><UserName>31337d08</UserName><Password>31337d08</Password></PolicyDetails></RegistrationRes>