34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>550000</MaximumLimit>
  <StartDate>12/30/2016</StartDate>
  <EndDate>01/06/2017</EndDate>
  <DestinationPlan>Mexico</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Kristen</Firstname>
    <Middlename/>
    <Lastname>Vaz</Lastname>
    <Age>32</Age>
    <Dob>03/15/1984</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>12/30/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>420 W Wilson Ave Unit 204</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>California</State>
      <City>Glendale</City>
      <Postcode>91203-3513</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>kristenvaz@gmail.com</Email>
    <Phone>
      <Home>5205488363</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Mariette Vaz</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Mother</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>American Express</CreditcardType>
      <CreditcardNumber>377256973913000</CreditcardNumber>
      <NameonCreditcard>Kristen  Vaz</NameonCreditcard>
      <CreditcardExpirationMonth>7</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2021</CreditcardExpirationYear>
      <CreditcardAmount>10.8</CreditcardAmount>
      <CreditcardCodeNumber>7610</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
5e9a3e8a
ARS-01-0031442
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0031442</PolicyNumber><UserName>5e9a3e8a</UserName><Password>5e9a3e8a</Password></PolicyDetails></RegistrationRes>