34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>12/25/2016</StartDate>
  <EndDate>01/11/2017</EndDate>
  <DestinationPlan>South Africa</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Jeremy</Firstname>
    <Middlename/>
    <Lastname>Quinn</Lastname>
    <Age>34</Age>
    <Dob>08/23/1982</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>12/25/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>24 Dunham Pl</Address1>
      <Address2>3C</Address2>
      <Country>United States</Country>
      <State>New York</State>
      <City>Brooklyn</City>
      <Postcode>11249</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>jeremy.quinn@amasiagroup.org</Email>
    <Phone>
      <Home>3476059771</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Thuyha Pham</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Significant other</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4246315207913151</CreditcardNumber>
      <NameonCreditcard>Jeremy  Quinn</NameonCreditcard>
      <CreditcardExpirationMonth>10</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2017</CreditcardExpirationYear>
      <CreditcardAmount>16.2</CreditcardAmount>
      <CreditcardCodeNumber>918</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
d1efe215
ARS-01-0031374
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0031374</PolicyNumber><UserName>d1efe215</UserName><Password>d1efe215</Password></PolicyDetails></RegistrationRes>