1 <form id=
"paymentMethodForm" name=
"paymentMethodForm" method=
"post" class=
"styled_forms modalForms">
2 <p class=
"size18 float-left">Debit / Credit Card Information
</p>
3 <p class=
"float-right PadTop3 botMar0">
4 <span class=
"redtxt font12" aria-hidden=
"true">*=Required
</span>
6 <div class=
"ClearNew botMar0"></div>
7 <div class=
"errorMsg box botMar20" id=
"errorPageDiv" style=
"display: none;">
8 <p class=
"botMar0" id=
"errorUL"></p>
10 <input type=
"hidden" name=
"selectedMethodName" id=
"selectedMethodName" value=
"Add Credit/Debit Card">
12 <div class=
"row-seamless botMar0 styled_forms modalForms">
14 <div class=
"tipPad safariComp botMar15" style=
"overflow:hidden">
15 <div class=
" right MarRight5 float-left w150">
16 <label class=
"rel top0">Method
<span style=
"visibility:hidden" class=
"colorRed" aria-hidden=
"true">*
</span></label>
19 <div class=
" MarTop4 ie7MarTop0 helpDiv "><a href=
"#tipcr10" aria-describedby=
"tipcr10" class=
"lnk-help tooltips" title=
"" onclick=
"return false"><img src=
"/olam/images/brand30/global/icn-help.png" alt=
"Help "></a>
20 <span class=
"tips" id=
"tipcr10">We accept the following forms of payment:
<br><br>
21 <strong>ATM debit cards
</strong><br>
22 STAR, Pulse, ACCEL, NYCE
24 <strong>Debit / credit cards
</strong><br>
25 Visa, MasterCard, American Express, Discover Network, JCB, Diners Club, AT
&T Universal
26 <br><img src=
"/OLAM_PROD_CMS/English/images/brand30/olam_creditCards_PinlessCards.gif" height=
"110px;" alt=
"Pinless Cards" border=
"0"></span></div>
28 <div class=
"float-left">
29 <span class=
"statictxt top4px">
33 <div class=
"ClearNew"></div>
36 <div class=
"tipPad safariComp botMar20">
37 <div class=
" right MarRight5 float-left w150">
38 <label class=
"rel top0 " for=
"paymentMethodForm.newCreditCardCustomerName">Name on card
<span class=
"colorRed" aria-hidden=
"true">*
</span></label>
40 <div class=
"MarTop3 ie7MarTop0 helpDiv"> </div>
41 <div id=
"divNameOnCard" class=
"MarBot0 PadRight2 float-left"><!-- for error case MarBot0 PadRight2 error float-left -->
42 <div class=
"emailInput">
43 <span class=
"textInput-wrapper"><span class=
""><input type=
"text" name=
"paymentMethodForm.newCreditCardCustomerName" maxlength=
"25" size=
"35" value=
"" onblur=
"validateNameOnCard(this.value, true)" class=
"popupinput text inline-error" id=
"paymentMethodForm.newCreditCardCustomerName" aria-required=
"true" aria-invalid=
"false"></span></span>
45 <div style=
"display: none;" id=
"" tabindex=
"0" class=
"focusable EmailAlertsDiv"><span style=
"display:block;height:0;width:0;color:transparent;z-index:-1;position:absolute" role=
"presentation">alert
</span>
46 <div class=
"email-error-top-image"></div>
47 <div style=
"display:block;" class=
"email-error-mid-image" id=
"EmailAlert1">
48 <p class=
"rederr-Msg font11imp lineHeight15 PadTop3imp" id=
"pNameOnCardErrorMessage"></p>
51 <div class="email-error-mid-image" style="display:none;" id="EmailAlertMidPassDiv1"> </div>
52 <div class="email-error-mid-image" style="display:none;" id="EmailAlertMidPassDiv2"> </div>
53 <div style="display:none;" class="email-error-mid-image" id="EmailAlert2">
54 <p class="rederr-Msg">Caps Lock on</p>
56 <div class=
"email-error-bot-image"></div>
59 <div class=
"ClearNew"></div>
62 <div class=
"tipPad safariComp botMar20">
63 <div class=
" right MarRight5 float-left w150">
64 <label class=
"rel top0 " for=
"paymentMethodForm.cardNumber">Card number
<span class=
"colorRed" aria-hidden=
"true">*
</span></label>
66 <div class=
" MarTop3 ie7MarTop0 helpDiv "> </div>
67 <div id=
"divCardNumber" class=
"MarBot0 PadRight2 float-left error"><!-- for error case MarBot0 PadRight2 error float-left -->
68 <div class=
"emailInput">
69 <span class=
"textInput-wrapper"><span class=
""><input type=
"text" name=
"paymentMethodForm.cardNumber" maxlength=
"19" size=
"35" value=
"" onkeypress=
"return validatePmtNumericKeyPress(event)" onblur=
"validateCardNumber(this.value, true)" class=
"popupinput inline-error text" id=
"paymentMethodForm.cardNumber" aria-required=
"true" aria-invalid=
"true"></span></span>
71 <div style=
"" id=
"" tabindex=
"0" class=
"focusable EmailAlertsDiv"><span style=
"display:block;height:0;width:0;color:transparent;z-index:-1;position:absolute" role=
"presentation">alert
</span>
72 <div class=
"email-error-top-image"></div>
73 <div style=
"display:block;" class=
"email-error-mid-image" id=
"EmailAlert1">
74 <p class=
"rederr-Msg font11imp lineHeight15 PadTop3imp" id=
"pCardNumberErrorMessage">Enter card number
</p>
77 <div class="email-error-mid-image" style="display:none;" id="EmailAlertMidPassDiv1"> </div>
78 <div class="email-error-mid-image" style="display:none;" id="EmailAlertMidPassDiv2"> </div>
79 <div style="display:none;" class="email-error-mid-image" id="EmailAlert2">
80 <p class="rederr-Msg">Caps Lock on</p>
82 <div class=
"email-error-bot-image"></div>
85 <div class=
"ClearNew"></div>
88 <div class=
"botMar30">
89 <div class=
"float-left">
90 <div class=
"tipPad safariComp botMar20">
91 <div class=
" right MarRight5 float-left w150">
92 <label class=
"rel top0" for=
"paymentMethodForm.cardVerificationNumber">Security code
<span class=
"colorRed" aria-hidden=
"true">*
</span></label>
94 <div class=
" MarTop3 ie7MarTop0 helpDiv "> </div>
95 <div id=
"divCVV" class=
"MarBot0 PadRight2 float-left error"><!-- for error case MarBot0 PadRight2 error float-left -->
96 <div class=
"emailInput">
97 <span class=
"textInput-wrapper"><span class=
""><input type=
"text" name=
"paymentMethodForm.cardVerificationNumber" maxlength=
"4" size=
"35" value=
"" onkeypress=
"return validatePmtNumericKeyPress(event)" onblur=
"validateCardVerificationValue(this.value, true)" class=
"popupinput inline-error text" id=
"paymentMethodForm.cardVerificationNumber" aria-required=
"true" aria-invalid=
"true"></span></span>
99 <div id=
"" style=
"" tabindex=
"0" class=
"focusable EmailAlertsDiv"><span style=
"display:block;height:0;width:0;color:transparent;z-index:-1;position:absolute" role=
"presentation">alert
</span>
100 <div class=
"email-error-top-image"></div>
101 <div id=
"EmailAlert1" class=
"email-error-mid-image" style=
"display:block;">
102 <p class=
"rederr-Msg font11imp lineHeight15 PadTop3imp" id=
"pCVVErrorMessage">Enter security code
</p>
105 <div id="EmailAlertMidPassDiv1" style="display:none;" class="email-error-mid-image"> </div>
106 <div id="EmailAlertMidPassDiv2" style="display:none;" class="email-error-mid-image"> </div>
107 <div id="EmailAlert2" class="email-error-mid-image" style="display:none;">
108 <p class="rederr-Msg">Caps Lock on</p>
110 <div class=
"email-error-bot-image"></div>
113 <div class=
"ClearNew"></div>
115 <div class=
"tipPad safariComp botMar20">
116 <div class=
" right MarRight5 float-left w150">
117 <label class=
"rel top0 ">Card expiration date
<span class=
"colorRed" aria-hidden=
"true">*
</span></label>
119 <div class=
" MarTop3 ie7MarTop0 helpDiv "> </div>
120 <div class=
"Login_styled_forms fixSelect float-left">
123 <div id=
"divExpirationMonth" class=
"MarBot0 float-left w138"><!-- class=" MarBot0 PadRight2 error float-left w138" -->
124 <div id=
"divExpirationMonthSelect" class=
""><!--for error case class="error-selector" -->
125 <div class=
"selector" id=
"uniform-paymentMethodForm.expirationMonth"><span style=
"width: 75px;">04</span><select name=
"paymentMethodForm.expirationMonth" onblur=
"validateExpirationMonth(this.value, true)" class=
"inline-error jojoFix" id=
"paymentMethodForm.expirationMonth" title=
"Select month" aria-required=
"true" style=
"opacity: 0; width: 120px; height: 32px; top: 0px; left: -2px;"><!-- onchange="validateExpirationMonth(this.value, true) to make the consitent -->
126 <option value=
"" selected=
"selected">Select month
</option>
127 <option value=
"01">01</option>
128 <option value=
"02">02</option>
129 <option value=
"03">03</option>
130 <option value=
"04">04</option>
131 <option value=
"05">05</option>
132 <option value=
"06">06</option>
133 <option value=
"07">07</option>
134 <option value=
"08">08</option>
135 <option value=
"09">09</option>
136 <option value=
"10">10</option>
137 <option value=
"11">11</option>
138 <option value=
"12">12</option></select></div>
140 <div id=
"divExpirationMonthErrorMessage" style=
"display:none;" tabindex=
"0" class=
"focusable"><span style=
"display:block;height:0;width:0;color:transparent;z-index:-1;position:absolute" role=
"presentation">alert
</span>
141 <p class=
"rederr-text bold PadLeft7 MarTop5 botMar0 font11imp w100 PadTop3imp" id=
"pExpirationMonthErrorMessage"></p>
143 <div class=
"ClearNew"></div>
146 <div id=
"divExpirationYear" class=
" MarBot0 float-left w138">
147 <div id=
"divExpirationYearSelect" class=
"">
148 <div class=
"selector" id=
"uniform-paymentMethodForm.expirationYear"><span style=
"width: 65px;">2018</span><select name=
"paymentMethodForm.expirationYear" onblur=
"validateExpirationYear(this.value, true)" class=
"inline-error jojoFix" id=
"paymentMethodForm.expirationYear" title=
"Select year" aria-required=
"true" style=
"opacity: 0; width: 110px; height: 32px; top: 0px; left: -2px;"><!-- onchange="validateExpirationYear(this.value, true) to make the consitent -->
149 <option value=
"" selected=
"selected">Select year
</option>
150 <option value=
"2015">2015</option>
151 <option value=
"2016">2016</option>
152 <option value=
"2017">2017</option>
153 <option value=
"2018">2018</option>
154 <option value=
"2019">2019</option>
155 <option value=
"2020">2020</option>
156 <option value=
"2021">2021</option>
157 <option value=
"2022">2022</option>
158 <option value=
"2023">2023</option>
159 <option value=
"2024">2024</option>
160 <option value=
"2025">2025</option>
161 <option value=
"2026">2026</option>
162 <option value=
"2027">2027</option>
163 <option value=
"2028">2028</option>
164 <option value=
"2029">2029</option></select></div>
167 <div id=
"divExpirationYearErrorMessage" style=
"display:none;" tabindex=
"0" class=
"focusable"><span style=
"display:block;height:0;width:0;color:transparent;z-index:-1;position:absolute" role=
"presentation">alert
</span>
168 <p class=
"rederr-text bold PadLeft7 MarTop5 botMar0 w100 font11imp PadTop3imp" id=
"pExpirationYearErrorMessage"></p>
170 <div class=
"ClearNew"></div>
172 <div class=
"ClearNew"></div>
174 <div class=
"ClearNew"></div>
176 <div class=
"tipPad safariComp">
177 <div class=
" right MarRight5 float-left w150">
178 <label class=
"rel top0" for=
"paymentMethodForm.zip">Card billing ZIP Code
<span class=
"colorRed" aria-hidden=
"true">*
</span></label>
181 <div class=
" MarTop3 ie7MarTop0 helpDiv "><!-- --><a href=
"#tip52" id=
"atip52" aria-describedby=
"tip52" class=
"lnk-help tooltips" title=
""><img src=
"/olam/images/brand30/global/icn-help.png" alt=
"Help"></a>
182 <span class=
"tips" id=
"tip52">Enter the ZIP Code of the credit cardholder's billing address.
</span></div>
185 <div id=
"divCardZipCode" class=
" MarBot0 PadRight2 float-left"> <!--for error case class=" MarBot0 PadRight2 error float-left" -->
186 <div class=
"emailInput">
187 <span class=
"textInput-wrapper"><span><input type=
"text" name=
"paymentMethodForm.zip" maxlength=
"9" size=
"35" value=
"" onblur=
"validateCardZipCode(this.value, true)" class=
"popupinput inline-error text" id=
"paymentMethodForm.zip" aria-required=
"true"></span></span>
189 <div style=
"display:none;" id=
"" tabindex=
"0" class=
"focusable EmailAlertsDiv"><span style=
"display:block;height:0;width:0;color:transparent;z-index:-1;position:absolute" role=
"presentation">alert
</span>
190 <div class=
"email-error-top-image"></div>
191 <div style=
"display:block;" class=
"email-error-mid-image" id=
"EmailAlert1">
192 <p class=
"rederr-Msg font11imp lineHeight15 PadTop3imp" id=
"pCardZipCodeErrorMessage"></p>
195 <div class="email-error-mid-image" style="display:none;" id="EmailAlertMidPassDiv1"> </div>
196 <div class="email-error-mid-image" style="display:none;" id="EmailAlertMidPassDiv2"> </div>
197 <div style="display:none;" class="email-error-mid-image" id="EmailAlert2">
198 <p class="rederr-Msg">Caps Lock on</p>
200 <div class=
"email-error-bot-image"></div>
203 <div class=
"ClearNew"></div>
206 <div id=
"divCardImage" class=
"float-left focusable MarTopNeg15" tabindex=
"0"><!-- for error case class="float-left MarTopNeg15" -->
207 <img class=
" " border=
"0" src=
"/olam/English/brand30/img_card.png" alt=
"Code is 3 digits on the back, to the right. It's the 4 digits above account number for American Express.">
209 <div class=
"ClearNew"></div>
212 <div style=
"display: none;" id=
"paymentMethodFormCustCode">
213 <div class=
"row-seamless ">
214 <div class=
"botMarOCDPA0 TopDotBorder PadTop18">
215 <h3 class=
"font17">For Business, Corporate, or Purchasing Cardholders Only
</h3>
219 <div class=
"row-seamless botMar15 styled_forms modalForms">
220 <div class=
"botMar0 Padbot15"></div>
221 <div class=
"tipPad safariComp ">
222 <div class=
" right MarRight5 float-left w253">
223 <label class=
"rel top0" for=
"paymentMethodForm.custCode">Customer code
</label>
226 <div class=
" MarTop3 ie7MarTop0 helpDiv "> <a href=
"#tip53" id=
"atip53" class=
"lnk-help tooltips" aria-describedby=
"tip53"><img src=
"/olam/images/brand30/global/icn-help.png" alt=
"Help"></a>
227 <span class=
"tips" id=
"tip53">Up to
17 characters of optional information that eligible business, purchasing, and corporate cardholders use to identify transactions on their Visa, MasterCard, or American Express statements.
</span></div>
229 <span class=
"textInput-wrapper"><span><input type=
"text" name=
"paymentMethodForm.custCode" maxlength=
"17" size=
"35" value=
"" onkeydown=
"return validateAlphaNumericKeyDown(event)" class=
"popupinput text" id=
"paymentMethodForm.custCode"></span></span>
233 <input type=
"hidden" name=
"paymentMethodForm.storePaymentProfileInd" value=
"N">
235 <div class=
"btnInsideRowSeam botMar5" style=
"overflow:hidden">
237 <a href=
"#" title=
"Cancel" class=
"textLink" onclick=
"cancelMethod("Are you sure you want to cancel?");parent.enableNextBtn();">Cancel
</a>
239 <div class=
"btnRt PadRight1 PadBot3">
240 <a role=
"button" title=
"" class=
"button primary small" href=
"javascript:perfValidationBeforeSubmit('/pmt/addNewPayment.myworld','paymentMethodForm','payCommonActionForm')">Continue
</a>
242 <div class=
"ClearNew"></div>