52.91.49.203
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>2500</DeductibleAmount>
  <MaximumLimit>550000</MaximumLimit>
  <StartDate>12/18/2015</StartDate>
  <EndDate>12/28/2015</EndDate>
  <DestinationPlan>Israel</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Amit</Firstname>
    <Middlename/>
    <Lastname>Maimon</Lastname>
    <Age>32</Age>
    <Dob>07/09/1983</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>12/18/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>245 East 19th St. </Address1>
      <Address2>Apartment 11M</Address2>
      <Country>United States</Country>
      <State>New York</State>
      <City>NYC</City>
      <Postcode>10003</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>maimon.amit@gmail.com</Email>
    <Phone>
      <Home>6178381147</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Inbal Maimon</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5199550001587686</CreditcardNumber>
      <NameonCreditcard>Amit  Maimon</NameonCreditcard>
      <CreditcardExpirationMonth>9</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2017</CreditcardExpirationYear>
      <CreditcardAmount>11.86</CreditcardAmount>
      <CreditcardCodeNumber>911</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
771137cf
ARS-01-0024349
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0024349</PolicyNumber><UserName>771137cf</UserName><Password>771137cf</Password></PolicyDetails></RegistrationRes>