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URL:
https://www.thepayplace.com/northcarolinadhhs/dhsr/ncrpsfees/challenge.aspx
Submission: On March 21 via manual from US — Scanned from DE
Submission: On March 21 via manual from US — Scanned from DE
Form analysis 1 forms found in the DOM
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<td><img id="ctl00_ConsumerLogo" src="https://adminuat.thepayplace.com/epayadmin/images/custom/RPSLogo.jpg" alt="North Carolina DHHS Logo" style="border-width:0px;"></td>
<td id="ctl00_cellTitleText" align="right" valign="bottom"><span id="ctl00_TitleText" class="TextTitle">Radiation Protection</span></td>
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<p><span style="font-family: times new roman, times, serif; font-size: 12pt;">There is a $3.95 fee for online payments.</span></p>
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<tbody>
<tr>
<td>
<table border="0" width="100%" cellspacing="0" cellpadding="2">
<tbody>
<tr id="ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_rowCustomData">
<td class="CellLabel"><label for="ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_Custom_1204251434190" id="ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_lblCustomData"
class="LabelText">* Invoice Number</label>:</td>
<td align="left"><input name="ctl00$MainContent$ChallengeData$CustomDataRepeater$ctl00$Custom_1204251434190" type="text" maxlength="10"
id="ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_Custom_1204251434190" class="InputTextBox" style="width:350px;"><span
id="ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl01" style="color:Red;display:none;"> ! </span><span
id="ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl00" style="color:Red;display:none;"> * </span></td>
</tr>
<tr id="ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_rowCustomData">
<td class="CellLabel"><label for="ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_Custom_1204251435271" id="ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_lblCustomData"
class="LabelText">* Registration / License #</label>:</td>
<td align="left"><input name="ctl00$MainContent$ChallengeData$CustomDataRepeater$ctl01$Custom_1204251435271" type="text"
id="ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_Custom_1204251435271" class="InputTextBox" style="width:350px;"><span
id="ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl01" style="color:Red;display:none;"> ! </span><span
id="ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl00" style="color:Red;display:none;"> * </span></td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td align="right">
<input type="submit" name="ctl00$MainContent$btnSubmit" value="Submit"
onclick="if (typeof(Page_ClientValidate) == 'function' && Page_ClientValidate('') == false) { return false; } this.disabled = true;WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$MainContent$btnSubmit", "", true, "", "", false, true))"
id="ctl00_MainContent_btnSubmit" class="Button">
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td align="center">
</td>
</tr>
</tbody>
</table>
</div>
<table border="0" width="100%" cellspacing="0" cellpadding="0" align="center">
<tbody>
<tr>
<td> </td>
</tr>
<tr>
<td valign="middle" align="right" style="padding: 5px;">
<input type="button" name="ctl00$MainContent$btnBack" value="Back"
onclick="if (typeof(Page_Validators) != 'undefined') { for(val in Page_Validators) { val.IsValid=true; } Page_ValidationActive = false; } this.disabled = true;__doPostBack('ctl00$MainContent$btnBack','')"
id="ctl00_MainContent_btnBack" class="Button"> <input type="button" name="ctl00$MainContent$btnExit" value="Exit"
onclick="if (typeof(Page_Validators) != 'undefined') { for(val in Page_Validators) { val.IsValid=true; } Page_ValidationActive = false; } this.disabled = true;__doPostBack('ctl00$MainContent$btnExit','')"
id="ctl00_MainContent_btnExit" class="Button">
</td>
</tr>
</tbody>
</table>
</div>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td>
<div id="ctl00_ContentFooterDIV">
<div id="ctl00_ContentFooter_ContentDIV">
<p align="center" class="addressline" style="text-align: center;">
<font size="1"><span style="color: #000000;">If you have any issues with an online payment email <a target="_blank" href="mailto:RPSPayments@dhhs.nc.gov">RPSPayments@dhhs.nc.gov</a> or call 919-814-2277</span></font>
</p>
<hr>
<p align="center" class="addressline" style="text-align: center;">
<font size="1"><span style="color: #000000;"><a target="_blank" href="http://www.ncradiation.net" shape="rect">Radiation Protection Section</a>, 1645 Mail Service Center, Raleigh, NC 27699-1600
919-814-2250 <a target="_blank" href="http://www.ncdhhs.gov/disclaimer.htm" shape="rect">Disclaimer</a></span></font><br>
</p>
</div>
</div>
</td>
</tr>
</tbody>
</table>
</div>
</td>
</tr>
<tr>
<td>
<div id="ctl00_Footer" class="ContentBox" role="contentinfo">
<div class="TextFooter" style="vertical-align: middle; text-align: center;">
<span style="text-align:left; float:left; width:45%;">
<span id="ctl00_FooterLeftText" class="TextFooter"></span>
</span><span style="text-align: right; float: right; width: 45%;">
<span id="ctl00_FooterRightText" class="TextFooter"></span>
</span>
</div>
<div style="clear: both;"></div>
</div>
<div id="ctl00_SubFooter" style="vertical-align: middle; font-size:smaller;" role="contentinfo">
<div id="ctl00_LeftSubFooter" style="text-align: left; float: left; width: 45%;">
<span id="ctl00_TrademarkText" class="TextFooter">All trademarks, service marks and trade names used in this material are the property of their respective owners.</span>
</div>
<div id="ctl00_RightSubFooter" style="text-align: right; float: right; width: 45%;">
<span id="ctl00_SubFooterText" class="TextFooter">Powered by PayPoint®</span>
</div>
<div id="ctl00_dvlnkPrivacy" style="text-align: right; float: right; width: 45%;">
<a id="ctl00_lnkPrivacy" href="https://www.firstdata.com/en_us/privacy.html" target="_blank" style="font-size:X-Small;">PayPoint Privacy Policy</a>
</div>
</div>
</td>
</tr>
</tbody>
</table>
<script type="text/javascript">
//<![CDATA[
var Page_ValidationSummaries = new Array(document.getElementById("ctl00_ctlValidationSummary"));
var Page_Validators = new Array(document.getElementById("ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl01"), document.getElementById("ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl00"), document.getElementById(
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<script type="text/javascript">
//<![CDATA[
var ctl00_ctlValidationSummary = document.all ? document.all["ctl00_ctlValidationSummary"] : document.getElementById("ctl00_ctlValidationSummary");
ctl00_ctlValidationSummary.headertext = "Please correct the following errors:";
var ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl01 = document.all ? document.all["ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl01"] : document.getElementById(
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ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl01.controltovalidate = "ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_Custom_1204251434190";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl01.focusOnError = "t";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl01.errormessage = "You must enter the 9 digit invoice number including the letter - no hyphen. (For Example : 123456789R)";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl01.display = "Dynamic";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl01.evaluationfunction = "RegularExpressionValidatorEvaluateHIsValid";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl01.validcssclass = "InputTextBox";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl01.errorcssclass = "ErrorInputTextBox";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl01.validationexpression = "^[a-zA-Z0-9]+$";
var ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl00 = document.all ? document.all["ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl00"] : document.getElementById(
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ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl00.controltovalidate = "ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_Custom_1204251434190";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl00.focusOnError = "t";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl00.errormessage = "You must enter the 9 digit invoice number including the letter - no hyphen. (For Example : 123456789R)";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl00.display = "Dynamic";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl00.evaluationfunction = "RequiredFieldValidatorEvaluateHIsValid";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl00.initialvalue = "";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl00.validcssclass = "InputTextBox";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_ctl00.errorcssclass = "ErrorInputTextBox";
var ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl01 = document.all ? document.all["ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl01"] : document.getElementById(
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ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl01.controltovalidate = "ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_Custom_1204251435271";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl01.focusOnError = "t";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl01.errormessage =
"You must enter the Registration /License # including any letter. (For Example : B001234 or 0000-**) (If you entered an X-ray registration that starts with a\"1\" try replacing that with an \"I\"";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl01.display = "Dynamic";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl01.evaluationfunction = "RegularExpressionValidatorEvaluateHIsValid";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl01.validcssclass = "InputTextBox";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl01.errorcssclass = "ErrorInputTextBox";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl01.validationexpression = "^[a-zA-Z0-9-]{6,8}$";
var ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl00 = document.all ? document.all["ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl00"] : document.getElementById(
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ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl00.controltovalidate = "ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_Custom_1204251435271";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl00.focusOnError = "t";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl00.errormessage =
"You must enter the Registration /License # including any letter. (For Example : B001234 or 0000-**) (If you entered an X-ray registration that starts with a\"1\" try replacing that with an \"I\"";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl00.display = "Dynamic";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl00.evaluationfunction = "RequiredFieldValidatorEvaluateHIsValid";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl00.initialvalue = "";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl00.validcssclass = "InputTextBox";
ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl01_ctl00.errorcssclass = "ErrorInputTextBox";
//]]>
</script>
<script type="text/javascript">
//<![CDATA[
(function() {
var fn = function() {
$get("ctl00_ScriptManager1_HiddenField").value = '';
Sys.Application.remove_init(fn);
};
Sys.Application.add_init(fn);
})();
var Page_ValidationActive = false;
if (typeof(ValidatorOnLoad) == "function") {
ValidatorOnLoad();
}
function ValidatorOnSubmit() {
if (Page_ValidationActive) {
return ValidatorCommonOnSubmit();
} else {
return true;
}
}
WebForm_AutoFocus('ctl00_MainContent_ChallengeData_CustomDataRepeater_ctl00_Custom_1204251434190'); //]]>
</script>
</form>Text Content
Radiation Protection There is a $3.95 fee for online payments. * Indicates required field The Invoice number and the Registration / License # are located in the top right corner of your invoice. * Invoice Number: ! * * Registration / License #: ! * If you have any issues with an online payment email RPSPayments@dhhs.nc.gov or call 919-814-2277 -------------------------------------------------------------------------------- Radiation Protection Section, 1645 Mail Service Center, Raleigh, NC 27699-1600 919-814-2250 Disclaimer All trademarks, service marks and trade names used in this material are the property of their respective owners. Powered by PayPoint® PayPoint Privacy Policy