live.poolservice.software Open in urlscan Pro
3.228.235.72  Public Scan

Form analysis
2 forms found in the DOM

/admin/invoice/saveclientcard

<form id="change-autopay-card" action="/admin/invoice/saveclientcard" novalidate="novalidate">
  <input type="hidden" name="emailtoken" id="emailtoken" value="0b5b020573778cea4ba0a81b7667a48a1becdf6e">
  <div class="form-inline">
    <label class="my-1 mr-2" for="selectcard-input">Select card</label>
    <select id="autopay-cardtype" name="autopay-cardtype" class="custom-select my-1 mr-sm-2 w-100 required" placeholder="Card" onchange="onSelectCard();" aria-required="true">
      <option value="">Choose...</option>
    </select>
  </div>
</form>

/invoice/processpayment

<form id="pay-online" action="/invoice/processpayment" novalidate="novalidate">
  <input type="hidden" name="invoice_id" id="invoice_id" value="292795">
  <div class="modal-body">
    <div class="row align-items-end">
      <div class="form-group col-6 pr-2">
        <label for="payamount">Amount($)</label>
        <!-- <input type="text" class="form-control" id="amountInput" aria-describedby="emailHelp" placeholder="Enter your amount"> -->
        <input type="text" style="width: 100%" class="form-control required" id="payamount" name="payamount" aria-describedby="emailHelp" placeholder="Enter your amount" min="0" onchange="setProcessingFeeText()" aria-required="true">
      </div>
      <div class="form-group col-6 pl-0">
        <div id="processing-fee-text" style="color: #ffa726; margin-bottom: -3px; font-style: italic;"></div>
      </div>
    </div>
    <div class="form-inline mb-3">
      <label class="my-1 mr-2" for="selectcard-input">Select card</label>
      <select id="cardtype" name="cardtype" class="custom-select my-1 mr-sm-2 w-100" placeholder="Card" onchange="onCardChange();">
        <option value="new">New Card</option>
      </select>
    </div>
    <div id="card-details-container">
      <div class="dropdown-divider mt-4 mb-4"></div>
      <div class="form-group">
        <label for="name">Credit Card Name</label>
        <input id="nameoncard" name="nameoncard" type="text" value="abakb bakbab" class="form-control required" placeholder="Enter your name" aria-required="true">
        <!-- <input class="form-control" id="name" type="text" placeholder="Enter your name"> -->
      </div>
      <div class="form-group">
        <label for="ccnumber">Credit Card Number</label>
        <div class="input-group">
          <input id="cardno" name="cardno" class="form-control required card-input" type="text" placeholder="0000 0000 0000 0000" autocomplete="email" aria-required="true">
          <div class="input-group-append">
            <span class="input-group-text">
              <i class="fal fa-credit-card-blank"></i>
            </span>
          </div>
        </div>
      </div>
      <div class="row">
        <div class="form-group col-sm-4">
          <label for="mm">Month</label>
          <input id="mm" name="mm" type="text" class="form-control required" maxlength="2" placeholder="MM" aria-required="true">
          <!-- <select class="form-control required" id="mm">
											<option>1</option>
											<option>2</option>
											<option>3</option>
											<option>4</option>
											<option>5</option>
											<option>6</option>
											<option>7</option>
											<option>8</option>
											<option>9</option>
											<option>10</option>
											<option>11</option>
											<option>12</option>
										</select> -->
        </div>
        <div class="form-group col-sm-4">
          <label for="yy">Year</label>
          <input id="yy" name="yy" type="text" class="form-control required" maxlength="2" placeholder="YY" aria-required="true">
          <!-- <select class="form-control required" id="yy">
											<option>2014</option>
											<option>2015</option>
											<option>2016</option>
											<option>2017</option>
											<option>2018</option>
											<option>2019</option>
											<option>2020</option>
											<option>2021</option>
											<option>2022</option>
											<option>2023</option>
											<option>2024</option>
											<option>2025</option>
										</select> -->
        </div>
        <div class="col-sm-4">
          <div class="form-group">
            <label for="cvv">CVV/CVC</label>
            <input class="form-control required" id="cvvno" name="cvvno" type="text" placeholder="123" aria-required="true">
          </div>
        </div>
      </div>
      <div class="form-group row">
        <div class="col-sm-10">
          <div class="form-check">
            <input class="form-check-input" type="checkbox" id="savecard" value="1" name="savecard">
            <label class="form-check-label" for="savecard"> Save Card </label>
          </div>
        </div>
      </div>
    </div>
    <div class="form-group row">
      <div class="col-sm-10">
        <div class="form-check">
          <input class="form-check-input" type="checkbox" id="markasautopay" name="markasautopay" value="1" onclick="onClickAutoPay()">
          <label class="form-check-label" for="markasautopay"> Mark as Auto Pay </label>
        </div>
      </div>
    </div>
  </div>
</form>

Text Content

INVOICE #1

Due in 14 days
PDF Print
Paid: $0.00

From:

400 Bizzell St, College Station, TX 77843-1372, United States

--------------------------------------------------------------------------------

Invoice ID:

1

Invoice For:

abakb bakbab

Issue Date:

Oct 08, 2023

Due Date:

Oct 23, 2023



Subject:

Pool Service Invoice

--------------------------------------------------------------------------------

Description

Quantity

Unit Price

Amount

Product





1.00 $0.00 $0.00 Subtotal $0.00 Amount Due $0.00

--------------------------------------------------------------------------------

Notes

YOUR OTHER INVOICES

CHANGE AUTOPAY SETTINGS

×
Select card Choose...
Close Save changes

PAY NOW

×
Amount($)

Select card New Card
Credit Card Name
Credit Card Number

Month
Year
CVV/CVC
Save Card
Mark as Auto Pay
Close Pay Now