anzpayment.sfstaging.com.au Open in urlscan Pro
139.180.174.132  Public Scan

Form analysis
1 forms found in the DOM

POST process_payment.php

<form id="paymentForm" method="POST" action="process_payment.php" novalidate="novalidate">
  <!-- First Step -->
  <div class="form-step active" id="step1">
    <div class="form-row">
      <div class="form-group col-md-6">
        <label for="first_name">First Name:</label>
        <input type="text" class="form-control" id="first_name" name="first_name" required="">
      </div>
      <div class="form-group col-md-6">
        <label for="last_name">Last Name:</label>
        <input type="text" class="form-control" id="last_name" name="last_name" required="">
      </div>
    </div>
    <div class="form-row">
      <div class="form-group col-md-6">
        <label for="email">Email:</label>
        <input type="email" class="form-control" id="email" name="email" required="">
      </div>
      <div class="form-group col-md-6">
        <label for="phone">Phone:</label>
        <input type="tel" class="form-control" id="phone" name="phone" required="">
      </div>
    </div>
    <div class="form-row">
      <div class="form-group col-md-6">
        <label for="invoice_number">Invoice Number:</label>
        <input type="text" class="form-control" id="invoice_number" name="invoice_number" required="">
      </div>
      <div class="form-group col-md-6">
        <label for="amount">Amount (AUD):</label>
        <input type="number" class="form-control" id="amount" name="amount" required="">
      </div>
    </div>
    <div class="form-group">
      <label for="description">Description:</label>
      <textarea class="form-control" id="description" name="description" rows="3" required=""></textarea>
    </div>
    <div class="form-navigation d-flex justify-content-between">
      <button type="button" class="btn btn-primary" id="nextStep1">Next</button>
    </div>
  </div>
  <!-- Second Step -->
  <div class="form-step" id="step2">
    <div class="form-group">
      <label for="amount_display">Amount (AUD):</label>
      <input type="text" class="form-control" id="amount_display" name="amount_display" disabled="">
    </div>
    <div class="form-group">
      <label for="card_name">Cardholder Name:</label>
      <input type="text" class="form-control" id="card_name" name="card_name" required="">
    </div>
    <div class="form-group">
      <label for="card_number">Card Number:</label>
      <input type="text" class="form-control" id="card_number" name="card_number" required="">
    </div>
    <div class="form-row">
      <div class="form-group col-md-6">
        <label for="card_cvv">CVV:</label>
        <input type="text" class="form-control" id="card_cvv" name="card_cvv" required="">
      </div>
      <div class="form-group col-md-6">
        <label for="expiry_date">Expiry Date (MMYY):</label>
        <input type="text" class="form-control" id="expiry_date" name="expiry_date" required="">
      </div>
    </div>
    <div class="form-group">
      <div class="g-recaptcha" data-sitekey="6Lf0QD0qAAAAAO7NGN3z30X-wbcJs_AhAQQp2w7P">
        <div style="width: 304px; height: 78px;">
          <div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-u2vk0potzurz" frameborder="0" scrolling="no"
              sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
              src="https://www.google.com/recaptcha/api2/anchor?ar=1&amp;k=6Lf0QD0qAAAAAO7NGN3z30X-wbcJs_AhAQQp2w7P&amp;co=aHR0cHM6Ly9hbnpwYXltZW50LnNmc3RhZ2luZy5jb20uYXU6NDQz&amp;hl=en&amp;v=WV-mUKO4xoWKy9M4ZzRyNrP_&amp;size=normal&amp;cb=26lyqqe62w3q"></iframe>
          </div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
            style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
        </div><iframe style="display: none;"></iframe>
      </div>
    </div>
    <div class="form-navigation d-flex justify-content-between">
      <button type="button" class="btn btn-secondary" id="prevStep2">Previous</button>
      <button type="submit" class="btn btn-success" id="submitPayment">Submit Payment</button>
    </div>
  </div>
</form>

Text Content

AITKEN PARTNERS PTY LTD

First Name:
Last Name:
Email:
Phone:
Invoice Number:
Amount (AUD):
Description:
Next
Amount (AUD):
Cardholder Name:
Card Number:
CVV:
Expiry Date (MMYY):

Previous Submit Payment