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Submitted URL: https://www.canarytechnologies.com/authorization/property/DQBB3ETX6T
Effective URL: https://secure.canarytechnologies.com/authorization/property/cc/DQBB3ETX6T
Submission: On September 05 via manual from US — Scanned from DE
Effective URL: https://secure.canarytechnologies.com/authorization/property/cc/DQBB3ETX6T
Submission: On September 05 via manual from US — Scanned from DE
Form analysis
1 forms found in the DOMPOST https://secure.canarytechnologies.com/authorization/property/cc/DQBB3ETX6T
<form role="form" id="payment-form" action="https://secure.canarytechnologies.com/authorization/property/cc/DQBB3ETX6T" method="POST">
<input type="hidden" name="csrfmiddlewaretoken" value="znLOtdfx3Y4xwIQUZVmAXYgpKjkPPgPk7NBiPwV2waMcTlhjXupkwSYEiiOuOeKh">
<legend class="credit_card_info">Credit Card information</legend>
<div class="row">
<div class="col-xs-24">
<div class="form-group">
<div class="input-group">
<span class="input-group-addon">
<i class="fa fa-credit-card">
<img class="cclock_img" src="https://static.cdn.canarytechnologies.com/static/images/cclock.875691e02986.png" alt="Icon of a Lock">
</i>
</span>
<input type="text" name="card_number" aria-label="Credit Card Number" placeholder="Credit Card Number *" class="form-control" autofocus="autofocus" data-stripe="number" required="" id="id_card_number">
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-md-12">
<div class="form-group">
<input type="text" name="exp_month" aria-label="Credit Card Expiration Month" placeholder="MM *" class="form-control col-md-11" autocomplete="off" data-stripe="exp_month" id="expiration_month" required="">
<span class="col-md-1 slash_cls"> / </span>
<input type="text" name="exp_year" placeholder="YY *" class="form-control col-md-11" autocomplete="off" data-stripe="exp_year" aria-label="Credit Card Expiration Year" id="expiration-year" required="">
</div>
</div>
<div class="col-xs-8 col-md-8 pull-right">
<div class="form-group">
<input type="text" name="cvc" aria-label="CVC" placeholder="CVC *" class="form-control" id="cvv2" autocomplete="off" data-stripe="cvc" required="">
</div>
</div>
</div>
<br><br>
<legend class="billing_info">Billing Information</legend>
<div class="row">
<div class="col-xs-24 col-md-24">
<div class="form-group">
<input type="text" name="full_name" aria-label="FullName on Credit Card" placeholder="Full Name on Credit Card *" class="form-control" autocomplete="off" data-stripe="name" required="" id="id_full_name">
</div>
</div>
</div>
<div class="row">
<div class="col-xs-24 col-md-24">
<div class="form-group">
<input type="text" name="address_line1" aria-label="Billing Address - Line 1 - Street address, P.O. box, company name, c/o" placeholder="Address 1 * - Street address, P.O. box, company name, c/o" class="form-control" id="address-1"
autocomplete="off" data-stripe="address_line1" required="">
</div>
</div>
</div>
<div class="row">
<div class="col-xs-24 col-md-24">
<div class="form-group">
<input type="text" name="address_line2" aria-label="Billing Address - Line 2 - Apartment, suite, unit, building, floor, etc" placeholder="Address 2 - Apartment, suite, unit, building, floor, etc" class="form-control" id="address-2"
autocomplete="off" data-stripe="address_line2">
</div>
</div>
</div>
<div class="row">
<div class="col-xs-24 col-md-24">
<div class="form-group">
<input type="text" name="address_city" maxlength="50" aria-label="Billing Address - City" placeholder="City *" class="form-control" autocomplete="off" data-stripe="address_city" required="" id="id_address_city">
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-md-12">
<div class="form-group">
<input type="text" name="address_state" aria-label="Billing Address - State / Province / Region" placeholder="State / Province / Region" class="form-control" autocomplete="off" data-stripe="address_state" id="id_address_state">
</div>
</div>
<div class="col-xs-12 col-md-12 pull-right">
<div class="form-group">
<input type="text" name="address_zip" aria-label="Billing Address - ZIP / Postal Code" placeholder="ZIP / Postal Code *" class="form-control" autocomplete="off" data-stripe="address_zip" id="address-zip" required="">
</div>
</div>
</div>
<div class="row">
<div class="col-xs-24 col-md-24">
<div class="form-group">
<select name="address_country" aria-label="Billing Address - Country" placeholder="Country" class="form-control" autocomplete="off" data-stripe="address_country" required="" id="id_address_country">
<option value="" selected="">Select a Country *</option>
<option value="United States">United States</option>
<option value="Afghanistan">Afghanistan</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antarctica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivia, Plurinational State of">Bolivia, Plurinational State of</option>
<option value="Bonaire, Sint Eustatius and Saba">Bonaire, Sint Eustatius and Saba</option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cabo Verde">Cabo Verde</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Congo, The Democratic Republic of the">Congo, The Democratic Republic of the</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Curaçao">Curaçao</option>
<option value="Cyprus">Cyprus</option>
<option value="Czechia">Czechia</option>
<option value="Côte d'Ivoire">Côte d'Ivoire</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="France">France</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guernsey">Guernsey</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard Island and McDonald Islands">Heard Island and McDonald Islands</option>
<option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iran, Islamic Republic of">Iran, Islamic Republic of</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Isle of Man">Isle of Man</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jersey">Jersey</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Korea, Democratic People's Republic of">Korea, Democratic People's Republic of</option>
<option value="Korea, Republic of">Korea, Republic of</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libya">Libya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macao">Macao</option>
<option value="Macedonia, Republic of">Macedonia, Republic of</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Micronesia, Federated States of">Micronesia, Federated States of</option>
<option value="Moldova, Republic of">Moldova, Republic of</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestine, State of">Palestine, State of</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Pitcairn">Pitcairn</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Réunion">Réunion</option>
<option value="Saint Barthélemy">Saint Barthélemy</option>
<option value="Saint Helena, Ascension and Tristan da Cunha">Saint Helena, Ascension and Tristan da Cunha</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Martin (French part)">Saint Martin (French part)</option>
<option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Seychelles">Seychelles</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Sint Maarten (Dutch part)">Sint Maarten (Dutch part)</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="South Georgia and the South Sandwich Islands">South Georgia and the South Sandwich Islands</option>
<option value="South Sudan">South Sudan</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syrian Arab Republic">Syrian Arab Republic</option>
<option value="Taiwan, Province of China">Taiwan</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Tanzania, United Republic of">Tanzania, United Republic of</option>
<option value="Thailand">Thailand</option>
<option value="Timor-Leste">Timor-Leste</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United States">United States</option>
<option value="United States Minor Outlying Islands">United States Minor Outlying Islands</option>
<option value="Uruguay">Uruguay</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Venezuela, Bolivarian Republic of">Venezuela, Bolivarian Republic of</option>
<option value="Viet Nam">Viet Nam</option>
<option value="Virgin Islands, British">Virgin Islands, British</option>
<option value="Virgin Islands, U.S.">Virgin Islands, U.S.</option>
<option value="Wallis and Futuna">Wallis and Futuna</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
<option value="Åland Islands">Åland Islands</option>
</select>
</div>
</div>
</div>
<div class="alert alert-danger" id="payment-errors">
</div>
<div class="row">
<div class="col-xs-24 col-md-24">
<button id="next_btn" class="btn btn-primary btn-lg next_btn" type="submit"> Next </button>
<script>
$("#next_btn").prop("disabled", false);
</script>
<img src="https://static.cdn.canarytechnologies.com/static/images/grey-spinner.0560b6d4ab67.gif" class="spinner" alt="Loading">
</div>
</div>
<br>
<p class="note"> In order to verify your card, there may be a temporary authorization for $1.00 on your statement. <br>This will be immediately removed. You will not be charged anything. </p>
<div class="row payment_error_div">
<div class="col-xs-24">
<p class="payment-errors"></p>
</div>
</div>
</form>
Text Content
Hampton Inn Weston Secure Authorizations (Step 1 of 2) WELCOME, ARIANA GARCIA PLEASE PROVIDE YOUR BILLING INFORMATION BELOW AND CLICK NEXT TO SELECT AUTHORIZED CHARGES AND PROVIDE GUEST INFORMATION JavaScript is required for submission and is currently disabled. Please enable JavaScript in your browser to continue. Credit Card information / Billing Information Select a Country * United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia, Plurinational State of Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic of the Cook Islands Costa Rica Croatia Cuba Curaçao Cyprus Czechia Côte d'Ivoire Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia, Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Romania Russian Federation Rwanda Réunion Saint Barthélemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela, Bolivarian Republic of Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Åland Islands Next In order to verify your card, there may be a temporary authorization for $1.00 on your statement. This will be immediately removed. You will not be charged anything. GDPR NOTICE - EFFECTIVE MAY 25TH, 2018 We are constantly striving to provide a seamless and secure service for your property. To that end, we want to give you an overview of our updated privacy policy. In order to address the upcoming EU General Data Protection Regulation (GDPR), we have updated our privacy policy to reinforce our commitment to the privacy and security of user data. These changes go into effect starting May 25, 2018 and you can find the new policy here. In addition, we have made the following udpates: * (1) We have appointed a Data Protection Officer, who can be reached at privacy@canarytechnologies.com. * (2) We have Data Processing Agreements that include standard contractual clauses which are the mechanism for GDPR-compliant data transfer. * (3) We have updated our cookie policy and you can find the new policy here. Please direct any questions to privacy@canarytechnologies.com OK Privacy Policy Cookie Policy Terms of Service