epay.beaconhillsg.com Open in urlscan Pro
160.238.41.56  Public Scan

Form analysis
2 forms found in the DOM

POST /Account/Login

<form action="/Account/Login" class="form-horizontal" method="post" role="form" novalidate="novalidate">
  <h2>Login to ePay Client Payment Portal</h2>
  <div class="form-group">
    <label class="col-md-2 control-label red-field text-red" style="white-space:nowrap">User Name</label>
    <div class="col-md-10">
      <input class="form-control" data-val="true" data-val-required="User Name is required." id="UserName" name="UserName" type="text" value="">
      <span class="field-validation-valid text-danger" data-valmsg-for="UserName" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-md-2 control-label red-field text-red" for="Password" style="white-space:nowrap;">Password</label>
    <div class="col-md-10">
      <input class="form-control" data-val="true" data-val-required="Password is required." id="Password" name="Password" type="password">
      <span class="field-validation-valid text-danger" data-valmsg-for="Password" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group" style="display: none">
    <div class="col-md-offset-2 col-md-10">
      <div class="checkbox">
        <input data-val="true" data-val-required="The Remember me? field is required." id="RememberMe" name="RememberMe" type="checkbox" value="true"><input name="RememberMe" type="hidden" value="false">
        <label for="RememberMe">Remember me?</label>
      </div>
    </div>
  </div>
  <div class="form-group">
    <div class="col-md-offset-2 col-md-10">
    </div>
  </div>
  <div class="form-group">
    <div class="col-md-offset-2 col-md-10 ">
      <input type="submit" value="Login" class="btn btn-primary btn-sm">
      <input type="button" onclick="Register();" value="Register" class="btn btn-primary btn-sm">
    </div>
  </div>
  <div class="form-group">
    <div class="col-md-offset-2 col-md-10">
      <a href="/Account/ForgotUserName">Forgot your user name?</a><br>
    </div>
    <div class="col-md-offset-2 col-md-10">
      <a href="/Account/ForgotPassword">Forgot your password?</a>
    </div>
  </div>
</form>

POST /

<form action="/" class="form-horizontal" id="customerForm" method="post" role="form" novalidate="novalidate">
  <div class="form-group">
    <label class="col-lg-4 control-label" for="CustomerNumber">Customer Number:</label>
    <div class="col-lg-8">
      <div id="divCustomerNumber"></div>
      <input id="CustomerNumber" name="CustomerNumber" type="hidden" value="">
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-4 red-field control-label text-red" for="CustomerName">Name:</label>
    <div class="col-lg-8">
      <input class="form-control" data-val="true" data-val-length="Name must not exceed 64 characters." data-val-length-max="64" data-val-required="Name is required." id="CustomerName" maxlength="64" name="CustomerName" type="text" value="">
      <span class="field-validation-valid" data-valmsg-for="CustomerName" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-4 red-field control-label text-red" for="AddressName">Address Name:</label>
    <div class="col-lg-8">
      <input class="form-control" data-val="true" data-val-length="Address Name must not exceed 15 characters." data-val-length-max="15" data-val-required="Address Name is required" id="AddressName" maxlength="15" name="AddressName" type="text"
        value="">
      <span class="field-validation-valid" data-valmsg-for="AddressName" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-4 red-field control-label text-red" for="Name">Contact:</label>
    <div class="col-lg-8">
      <input class="form-control" data-val="true" data-val-length="Contact must not exceed 60 characters." data-val-length-max="60" data-val-required="Contact is required." id="Name" maxlength="60" name="Name" type="text" value="">
      <span class="field-validation-valid" data-valmsg-for="Name" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-4 red-field control-label text-red" for="Address1">Street:</label>
    <div class="col-lg-8">
      <input class="form-control" data-val="true" data-val-length="Street must not exceed 60 characters." data-val-length-max="60" data-val-required="Street is required." id="Address1" maxlength="60" name="Address1" type="text" value="">
      <span class="field-validation-valid" data-valmsg-for="Address1" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-4 control-label" for="Address2">Address Line2:</label>
    <div class="col-lg-8">
      <input class="form-control" data-val="true" data-val-length="Address 2 must not exceed 60 characters." data-val-length-max="60" id="Address2" maxlength="60" name="Address2" type="text" value="">
      <span class="field-validation-valid" data-valmsg-for="Address2" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-4 control-label" for="Address3">Address Line3:</label>
    <div class="col-lg-8">
      <input class="form-control" data-val="true" data-val-length="Address 3 must not exceed 60 characters." data-val-length-max="60" id="Address3" maxlength="60" name="Address3" type="text" value="">
      <span class="field-validation-valid" data-valmsg-for="Address3" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-4 red-field control-label text-red" for="City">City:</label>
    <div class="col-lg-8">
      <input class="form-control" data-val="true" data-val-length="City must not exceed 35 characters." data-val-length-max="35" data-val-required="City is required." id="City" maxlength="35" name="City" type="text" value="">
      <span class="field-validation-valid" data-valmsg-for="City" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-4 red-field control-label text-red" for="State">State:</label>
    <div class="col-lg-8">
      <input class="form-control" data-val="true" data-val-length="State must not exceed 29 characters." data-val-length-max="29" data-val-required="State is required." id="State" maxlength="29" name="State" type="text" value="">
      <span class="field-validation-valid" data-valmsg-for="State" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-4 red-field control-label text-red" for="Zip">Zip Code:</label>
    <div class="col-lg-8">
      <input class="form-control" data-val="true" data-val-length="Zip Code must not exceed 10 characters." data-val-length-max="10" data-val-required="Zip Code is required." id="Zip" maxlength="10" name="Zip" type="text" value="">
      <span class="field-validation-valid" data-valmsg-for="Zip" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-4 red-field control-label text-red" for="Country">Country:</label>
    <div class="col-lg-8">
      <input class="form-control" data-val="true" data-val-length="Country must not exceed 60 characters." data-val-length-max="60" data-val-required="Country is required." id="Country" maxlength="60" name="Country" type="text" value="">
      <span class="field-validation-valid" data-valmsg-for="Country" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-4 control-label" for="EmailAddress">Email Address:</label>
    <div class="col-lg-8">
      <input class="form-control" data-val="true" data-val-length="Email must not exceed 50 characters." data-val-length-max="50" id="EmailAddress" maxlength="50" name="EmailAddress" type="text" value="">
      <span class="field-validation-valid" data-valmsg-for="EmailAddress" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-4 red-field control-label text-red" for="Phone1">Phone Number:</label>
    <div class="col-lg-8">
      <input class="form-control" data-val="true" data-val-length="Phone must not exceed 14 characters." data-val-length-max="14" data-val-required="Phone is required." id="Phone1" maxlength="14" name="Phone1" type="text" value="">
      <span class="field-validation-valid" data-valmsg-for="Phone1" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <div class="col-lg-4">
    </div>
    <div class="col-lg-4">
      <button class="btn btn-primary pull-left" name="btnSave" type="button" value="Save" onclick="saveCustomer()">Save</button>
    </div>
  </div>
</form>

Text Content

Menu
Menu
 * Make Payment
 * Invoice History
 * Payment History
 * Wallet
 * Account Summary
 * Process Prepayment
 * Profile
 * Logout

ONLINE EPAY CLIENT PAYMENT PORTAL AND INVOICE PRESENTMENT




LOGIN TO EPAY CLIENT PAYMENT PORTAL

User Name

Password

Remember me?


Forgot your user name?

Forgot your password?

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


xClose


LOOKUP CUSTOMERS

Type Customer Name Email

Back to customer list



Customer Number:

Name:

Address Name:

Contact:

Street:

Address Line2:

Address Line3:

City:

State:

Zip Code:

Country:

Email Address:

Phone Number:

Save

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CONFIRM

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