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1 forms found in the DOM

POST /payments/live/acct_1FelgtGvY2g6ha8S/custinvc/2140542

<form id="js-payment-form" action="/payments/live/acct_1FelgtGvY2g6ha8S/custinvc/2140542" accept-charset="UTF-8" method="post"><input name="utf8" type="hidden" value="✓"><input type="hidden" name="authenticity_token"
    value="HZq7btOnBZ86XGnBq05m5vbG0dHsC9wRRmjcuHFNWw+kkpj+10YxNC19+xFZtSZHHY3IK6JOfm/lsNwudpK/Gg==">
  <input type="hidden" name="transaction_total" value="113094">
  <input type="hidden" name="transaction_currency" value="usd">
  <input type="hidden" name="transaction_number" value="ESO-50988">
  <input type="hidden" name="ns_customer_id" value="111695">
  <input type="hidden" name="plaid_account_id" id="js-plaid-account-id">
  <input type="hidden" name="plaid_account_token" id="js-plaid-public-token">
  <h3 class="mb-3 text-center">Pay Invoice ESO-50988</h3>
  <p>Here are the payment details and options for invoice ESO-50988 from <a rel="noopener noreferrer" target="_blank" href="https://www.eso.com/support">ESO</a>.</p>
  <div class="mt-3 mb-3">
    <p class="mb-1">Due Date: <b>04/03/2021</b></p>
    <p>Amount Due: <b>US$1,130.94</b></p>
  </div>
  <div class="card mt-3 mb-3" style="background: #f2f2f2; padding: 8px;">
    <div class="form-check">
      <label class="form-check-label"><input type="checkbox" name="store_payment_credentials" id="store_payment_credentials" value="true" class="form-check-input">Save payment information <span class="d-none d-sm-inline">for future use</span></label>
    </div>
  </div>
  <p class="mt-3"> Pay this invoice using a credit card, debit card, or bank transfer (ACH) using the buttons below. </p>
  <p class="text-center mt-3 mb-3">
    <script src="https://checkout.stripe.com/checkout.js" class="stripe-button active" data-key="pk_live_51FelgtGvY2g6ha8SVMe3radPpAXcBuxiXsTlh1sHPxseQqryie5AerAv7HLLXgEWXNc5zFmMowrwktp5O3k3vBWu00eIoX05RG" data-amount="113094" data-name="ESO"
      data-description="Invoice ESO-50988" data-currency="usd" data-email="kim.royer@providence.org" data-allow-remember-me="false" data-billing-address="false" data-zip-code="true" data-label="Pay with Card" data-locale="auto" nonce="">
    </script><button type="submit" class="stripe-button-el" style="visibility: visible;"><span style="display: block; min-height: 30px;">Pay with Card</span></button>
    <button type="button" id="js-stripe-ach" class="stripe-button-el">
      <span>Pay with Bank Transfer</span>
    </button>
  </p>
</form>

Text Content

PAY INVOICE ESO-50988

Here are the payment details and options for invoice ESO-50988 from ESO.

Due Date: 04/03/2021

Amount Due: US$1,130.94

Save payment information for future use

Pay this invoice using a credit card, debit card, or bank transfer (ACH) using
the buttons below.

Pay with Card Pay with Bank Transfer

Have Questions?
Call +1866-766-9471 or email AccountsReceivable@ESO.com