ridleyandhall.smith.co.uk Open in urlscan Pro
18.135.151.56  Public Scan

Form analysis
1 forms found in the DOM

POST https://test.ipg-online.com/connect/gateway/processing

<form method="POST" action="https://test.ipg-online.com/connect/gateway/processing" class="form-horizontal pay-form">
  <input name="checkoutoption" type="hidden" value="combinedpage">
  <input name="currency" type="hidden" value=""><!-- See onClick event. -->
  <input name="hashExtended" type="hidden" value=""><!-- Change parameter name to "hash" if using "SHA256" algorithm.-->
  <input name="hash_algorithm" type="hidden" value=""><!-- || -->
  <input name="mode" type="hidden" value="payonly">
  <input name="responseFailURL" type="hidden" value="failure.síte">
  <input name="responseSuccessURL" type="hidden" value="success.síte">
  <input name="storename" type="hidden" value=""><!-- || -->
  <input name="timezone" type="hidden" value="Europe/London">
  <input name="txndatetime" type="hidden" value=""><!-- || -->
  <input name="txntype" type="hidden" value="sale">
  <fieldset class="fieldset">
    <legend>
      <h3>Payment details</h3>
    </legend>
    <div class="grid-x grid-padding-x align-middle">
      <label class="small-4 cell control-label" for="bname">*Name:</label>
      <div class="small-7 cell">
        <input type="text" id="bname" name="bname" value="" placeholder="Your Name Here">
      </div>
    </div>
    <div class="grid-x grid-padding-x align-middle">
      <label class="small-4 cell control-label">*Amount (GBP):</label>
      <div class="small-7 cell">
        <div class="input-group">
          <span class="input-group-label">£</span>
          <input type="number" class="input-group-field" id="currency" name="chargetotal" value="13.00" required="" data-parsley-type="number" data-parsley-required-message="Please insert the amount" data-parsley-errors-container="#amount-msg"
            onchange="formatCurrency()">
        </div>
        <div id="amount-msg"></div>
      </div>
    </div>
    <div class="grid-x grid-padding-x align-middle">
      <label class="small-4 cell control-label" for="phone">*Phone</label>
      <div class="small-7 cell">
        <input type="tel" id="phone" name="phone" value="" placeholder="Phone" required="">
      </div>
    </div>
    <div class="grid-x grid-padding-x align-middle">
      <label class="small-4 cell control-label" for="email">*Email</label>
      <div class="small-7 cell">
        <input type="email" id="email" name="email" value="" placeholder="Email" required="">
      </div>
    </div>
    <div class="grid-x grid-padding-x align-middle">
      <label class="small-4 cell control-label" for="invoicenumber">*Invoice Number</label>
      <div class="small-7 cell">
        <input type="text" id="invoicenumber" name="invoicenumber" value="" placeholder="Invoice Number" required="">
      </div>
    </div>
    <div class="grid-x grid-padding-x align-middle">
      <label class="small-4 cell control-label" for="comments">*Notes</label>
      <div class="small-7 cell">
        <input type="text" id="invoicenumber" name="comments" value="" placeholder="Notes" required="">
      </div>
    </div>
  </fieldset>
  <fieldset class="fieldset">
    <legend>
      <h3>Contact details</h3>
    </legend>
    <div class="grid-x grid-padding-x align-middle">
      <label class="small-4 cell control-label" for="baddr1">*Address Line 1:</label>
      <div class="small-7 cell">
        <input type="text" id="baddr1" name="baddr1" value="" placeholder="Address Line 1" required="">
      </div>
    </div>
    <div class="grid-x grid-padding-x align-middle">
      <label class="small-4 cell control-label" for="baddr2">*Address Line 2:</label>
      <div class="small-7 cell">
        <input type="text" id="baddr2" name="baddr2" value="" placeholder="Address Line 2" required="">
      </div>
    </div>
    <div class="grid-x grid-padding-x align-middle">
      <label class="small-4 cell control-label" for="bcity">*City</label>
      <div class="small-7 cell">
        <input type="text" id="bcity" name="bcity" value="" placeholder="City" required="">
      </div>
    </div>
    <div class="grid-x grid-padding-x align-middle">
      <label class="small-4 cell control-label" for="bcity">*Postal Code</label>
      <div class="small-7 cell">
        <input type="text" id="bzip" name="bzip" value="" placeholder="Postal Code" required="">
      </div>
    </div>
  </fieldset>
  <input onclick="javascript:submitForm();" type="submit" value="Pay Now" class="button primary">
</form>

Text Content

test4


ORDER FORM


PAYMENT DETAILS

*Name:

*Amount (GBP):
£

*Phone

*Email

*Invoice Number

*Notes



CONTACT DETAILS

*Address Line 1:

*Address Line 2:

*City

*Postal Code