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app-staplespay.quill.com Open in urlscan Pro
23.45.109.235  Public Scan

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URL: https://app-staplespay.quill.com/STPayWeb/views/card/addNew/QUILLWEBPRD01/6tgt6kap8g7jkv/3QPdZEzAudReuBgL7lrADE0KXjD3dFjeTof6ghe7...
Submission: On February 02 via manual from US — Scanned from DE

Form analysis 1 forms found in the DOM

<form class="stp--grid">
  <div id="customCard" class="stp--cell stp--cell100 custom-card MB_l">
    <div class="padright20 L stp--width1"><label id="cardLabel" class="allLabels formLabel"><span class="custom-span formLabel padBottom txtBold">*</span><span id="cardTxt">Credit Card:</span></label> <span id="cardSpan" class="card-type"></span>
      <input type="text" class="cardNumber form6 formText" id="cardNum" name="CardNumber" maxlength="19" oncopy="return false" ondrag="return false" ondrop="return false" onpaste="return false" onkeyup="$cc.validate(event)"
        onblur="$cc.validation.call(this,event)">
      <div id="cardOptions" class="card-options"><span class="stp--icon visa"></span> <span class="stp--icon mastercard"></span> <span class="stp--icon amex"></span> <span class="stp--icon discover"></span></div>
      <div class="error-wrapper">
        <div id="cardError" class="error-container">
          <div class="arrow-up"></div>
          <p id="cardErrMsg"></p>
        </div>
      </div>
    </div>
    <div class="CreditCardImg stp--cell50"><span class="formLabel link" onclick="toggleToolTip(true)">Using a Prepaid Gift Card?</span>
      <div style="display:none" id="toolTipMsg" class="toolTip">
        <p>Using a Prepaid Gift Card</p><span class="popUpClose" onclick="toggleToolTip(false)"></span>
        <p>When using a prepaid gift card as your method of payment, enter your own name, address and zip code in the required cardholder name, address and zip code entry fields.</p>
        <p>At this time, our online checkout process allows only 1 method of payment. If the amount of your gift card is less than your order total, and your order does not qualify for Open Account credit terms, we will contact you for an additional
          form of payment before we release your order.</p>
        <p>We apologize for any inconvenience this may cause.</p>
      </div>
    </div>
  </div>
  <div id="customDate" class="stp--cell stp--cell32 custom-date clear MB_l">
    <div class="padRight20"><label id="expLabel" class="allLabels formLabel padBottom"><span class="custom-span txtBold">*</span><span id="expTxt">Expiration Date:</span></label> <input type="text" class="dblock form6 formText" maxlength="5"
        placeholder="MM/YY" id="expDate" name="ExpirationDate" onkeyup="$cc.expiry.call(this,event)" onblur="$cc.expiryErrMsg.call(this,event)">
      <div class="error-wrapper">
        <div id="dateError" class="error-container">
          <div class="arrow-up"></div>
          <p id="expErrMsg"></p>
        </div>
      </div>
    </div>
  </div>
  <div id="customCode" class="stp--cell stp--cell32 custom-code MB_l">
    <div class="padRight30"><label id="secLabel" class="allLabels formLabel padBottom"><span id="secCodeRequired" class="custom-span txtBold">*</span><span id="secCodeTxt">Security Code:</span></label>
      <div class="code-input"><input type="password" class="form3 formText" maxlength="4" id="secCode" name="SecurityCode" onkeyup="$cc.codeValidation.call(this,event)" onblur="$cc.codeErrMsg.call(this,event)"></div>
      <div class="error-wrapper">
        <div id="codeError" class="error-container">
          <div class="arrow-up"></div>
          <p id="codeErrMsg"></p>
        </div>
      </div>
    </div>
  </div>
  <div id="customCardHolder" class="stp--cell stp--cell50 custom-name MB_l">
    <div class="padRight30"><label id="cardhdlLabel" class="allLabels formLabel padBottom"><span class="custom-span txtBold">*</span><span id="cardhdlrTxt">Cardholder Name</span></label> <input type="text" class="dblock form6 formText"
        id="nameOnCard" name="CardholderName" onblur="$cc.cardholderNameValidation.call(this,event)">
      <div class="error-wrapper">
        <div id="cardholderError" class="error-container">
          <div class="arrow-up"></div>
          <p id="cardhldrErrMsg"></p>
        </div>
      </div>
    </div>
  </div>
</form>

Text Content

*Credit Card:




Using a Prepaid Gift Card?

Using a Prepaid Gift Card

When using a prepaid gift card as your method of payment, enter your own name,
address and zip code in the required cardholder name, address and zip code entry
fields.

At this time, our online checkout process allows only 1 method of payment. If
the amount of your gift card is less than your order total, and your order does
not qualify for Open Account credit terms, we will contact you for an additional
form of payment before we release your order.

We apologize for any inconvenience this may cause.

*Expiration Date:



*Security Code:




*Cardholder Name