www.elpasoinc.com
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192.104.183.209
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URL:
https://www.elpasoinc.com/unicef-hk-thanks-artox-group-for-its-support-to-vulnerable-children-worldwide/article_61819cf8-8...
Submission: On December 03 via api from US — Scanned from CA
Submission: On December 03 via api from US — Scanned from CA
Form analysis 12 forms found in the DOM
POST https://www.elpasoinc.com/users/logout/
<form method="post" action="https://www.elpasoinc.com/users/logout/" id="user-logout-form-551103"><input type="hidden" name="tncms_csrf_token" value="438a6c22a91a706c5931e88088e312d83b89e237554caf448eea254e0ca093e4.f118cba953d218097921"><input
type="hidden" name="referer_url" value="https://www.elpasoinc.com/unicef-hk-thanks-artox-group-for-its-support-to-vulnerable-children-worldwide/article_61819cf8-8e5c-5e70-9a39-3fcab454c670.html"><input type="submit" name="logout" value="Logout"
class="hide">
</form>GET /search/
<form id="site-search-551099" aria-label="Site search" action="/search/" method="GET"><input type="hidden" name="tncms_csrf_token" value="438a6c22a91a706c5931e88088e312d83b89e237554caf448eea254e0ca093e4.f118cba953d218097921">
<input type="hidden" name="l" value="25">
<input type="hidden" name="sort" value="relevance">
<input type="hidden" name="f" value="html">
<input type="hidden" name="t" value="article,video,youtube,collection">
<input type="hidden" name="app" value="editorial">
<input type="hidden" name="nsa" value="eedition">
<div id="site-search-form-551099" class="site-search-form input-group default normal form-control">
<label for="site-search-551099-term" class="sr-only">Site search</label>
<input id="site-search-551099-term" name="q" title="Site search" type="text" placeholder="Search..." class="form-control" autocomplete="off">
<input type="submit" class="hide" value="Search">
<span class="input-group-btn">
<button id="site-search-551099-btn" class="btn btn-link" aria-label="Submit Site Search" type="submit">
<span id="site-search-button-551099" class="hidden-xs hidden-sm sr-only">Search</span>
</button>
</span>
</div>
<div class="clearfix"></div>
</form>POST https://www.elpasoinc.com/users/logout/
<form method="post" action="https://www.elpasoinc.com/users/logout/" id="user-logout-form-1398021"><input type="hidden" name="tncms_csrf_token" value="438a6c22a91a706c5931e88088e312d83b89e237554caf448eea254e0ca093e4.f118cba953d218097921"><input
type="hidden" name="referer_url" value="https://www.elpasoinc.com/unicef-hk-thanks-artox-group-for-its-support-to-vulnerable-children-worldwide/article_61819cf8-8e5c-5e70-9a39-3fcab454c670.html"><input type="submit" name="logout" value="Logout"
class="hide">
</form>GET /search/
<form id="site-search-551098" aria-label="Site search" action="/search/" method="GET" class="yamm-content"><input type="hidden" name="tncms_csrf_token" value="438a6c22a91a706c5931e88088e312d83b89e237554caf448eea254e0ca093e4.f118cba953d218097921">
<input type="hidden" name="l" value="25">
<input type="hidden" name="s" value="start_time">
<input type="hidden" name="sd" value="desc">
<input type="hidden" name="nfl" value="ap">
<input type="hidden" name="f" value="html">
<input type="hidden" name="t" value="article,video,youtube,collection">
<input type="hidden" name="app" value="editorial">
<input type="hidden" name="nsa" value="eedition">
<div id="site-search-form-551098" class="site-search-form input-group default input-group-lg ">
<label for="site-search-551098-term" class="sr-only">Site search</label>
<input id="site-search-551098-term" name="q" title="Site search" type="text" placeholder="Search..." class="form-control" autocomplete="off">
<input type="submit" class="hide" value="Search">
<span class="input-group-btn">
<button id="site-search-551098-btn" class="btn btn-primary" aria-label="Submit Site Search" type="submit">
<svg class="tnt-svg tnt-search tnt-w-16 hidden-xl hidden-lg hidden-md" aria-hidden="true" data-prefix="fas" data-icon="search" role="presentation" xmlns="https://www.w3.org/2000/svg" viewBox="0 0 512 512" data-fa-i2svg="">
<path fill="currentColor"
d="M505 442.7L405.3 343c-4.5-4.5-10.6-7-17-7H372c27.6-35.3 44-79.7 44-128C416 93.1 322.9 0 208 0S0 93.1 0 208s93.1 208 208 208c48.3 0 92.7-16.4 128-44v16.3c0 6.4 2.5 12.5 7 17l99.7 99.7c9.4 9.4 24.6 9.4 33.9 0l28.3-28.3c9.4-9.4 9.4-24.6.1-34zM208 336c-70.7 0-128-57.2-128-128 0-70.7 57.2-128 128-128 70.7 0 128 57.2 128 128 0 70.7-57.2 128-128 128z">
</path>
</svg>
<span id="site-search-button-551098" class="hidden-xs hidden-sm ">Search</span>
</button>
</span>
</div>
<div class="clearfix"></div>
</form>GET /search/
<form id="search-form" class="form-horizontal" action="/search/" method="GET"><input type="hidden" name="tncms_csrf_token" value="438a6c22a91a706c5931e88088e312d83b89e237554caf448eea254e0ca093e4.f118cba953d218097921">
<input type="hidden" name="l" value="25">
<input type="hidden" name="sd" value="desc">
<input type="hidden" name="s" value="start_time">
<input type="hidden" name="f" value="html">
<input type="hidden" name="t" value="article,video,youtube,collection">
<input type="hidden" name="app" value="editorial">
<div class="site-search-form input-group">
<input aria-label="Please enter a search" id="search-form-text" name="q" type="text" placeholder="Search..." class="form-control">
<input type="submit" class="hide" value="Search">
<span class="input-group-btn">
<button aria-label="Search" class="btn btn-primary btn-submit search-submit" type="submit">
<svg aria-hidden="true" class="tnt-svg tnt-search tnt-w-16" data-prefix="fas" data-icon="search" role="presentation" xmlns="https://www.w3.org/2000/svg" viewBox="0 0 512 512" data-fa-i2svg="">
<path fill="currentColor"
d="M505 442.7L405.3 343c-4.5-4.5-10.6-7-17-7H372c27.6-35.3 44-79.7 44-128C416 93.1 322.9 0 208 0S0 93.1 0 208s93.1 208 208 208c48.3 0 92.7-16.4 128-44v16.3c0 6.4 2.5 12.5 7 17l99.7 99.7c9.4 9.4 24.6 9.4 33.9 0l28.3-28.3c9.4-9.4 9.4-24.6.1-34zM208 336c-70.7 0-128-57.2-128-128 0-70.7 57.2-128 128-128 70.7 0 128 57.2 128 128 0 70.7-57.2 128-128 128z">
</path>
</svg>
</button>
</span>
</div>
</form>POST https://www.elpasoinc.com/users/signup/
<form id="user-register-form" class="user-login-form" role="form" method="post" action="https://www.elpasoinc.com/users/signup/" novalidate="novalidate"><input type="hidden" name="tncms_csrf_token"
value="438a6c22a91a706c5931e88088e312d83b89e237554caf448eea254e0ca093e4.f118cba953d218097921"><input name="referer_url" type="hidden" value="/">
<div class="alert alert-danger critical-error hide">
<p>Account processing issue - the email address may already exist</p>
</div>
<fieldset>
<legend class="sr-only">User information</legend>
<div class="form-group">
<label for="input-username" class="control-label hide"> Username (Optional) </label>
<div class="input-container">
<input id="input-username" class="form-control" type="text" name="screen_name" value="" data-check-url="https://www.elpasoinc.com/users/check/" placeholder="Username (Optional)" data-toggle="tooltip" data-placement="top" title=""
data-original-title=" This is the name that will be displayed next to your photo for comments, blog posts, and more. Choose wisely!">
<span class="sr-only"> This is the name that will be displayed next to your photo for comments, blog posts, and more. Choose wisely!</span>
</div>
</div>
<div class="form-group">
<label for="input-email" class="control-label hide"><span class="text-danger">*</span> Email Address</label>
<div class="input-container">
<input id="input-email" class="form-control" type="email" name="email" value="" placeholder="Email Address" data-toggle="tooltip" data-placement="top" title="" required=""
data-original-title="Your email address will be used to confirm your account. We won't share it with anyone else." aria-required="true">
<span class="sr-only">Your email address will be used to confirm your account. We won't share it with anyone else.</span>
</div>
</div>
<div class="form-group">
<label for="input-password" class="control-label hide"><span class="text-danger">*</span> Password</label>
<div class="input-container">
<input id="input-password" class="form-control" type="password" name="password" autocomplete="off" placeholder="Password" data-toggle="tooltip" data-placement="top" title="" required=""
data-original-title="Create a password that only you will remember. If you forget it, you'll be able to recover it using your email address." aria-required="true">
<span class="sr-only">Create a password that only you will remember. If you forget it, you'll be able to recover it using your email address.</span>
</div>
</div>
<div class="form-group">
<label for="input-confirm-password" class="control-label hide"><span class="text-danger">*</span> Confirm Password</label>
<div class="input-container">
<input id="input-confirm-password" class="form-control" type="password" name="password_verify" autocomplete="off" placeholder="Confirm Password" data-toggle="tooltip" data-placement="top" title="" required=""
data-original-title="Confirm your password." aria-required="true">
<span class="sr-only">Confirm your password.</span>
</div>
</div>
</fieldset>
<fieldset>
<legend class="sr-only">Mailing lists</legend>
<div class="form-group mailing-lists">
<label class="control-label">Join our mailing lists</label>
<div class="input-container">
<div class="checkbox">
<label>
<input type="checkbox" name="lists[]" value="e36eaf96-456c-11e1-b936-0019bb30f31a" checked=""> El Paso Inc. Headlines & Announcements<span class="help-block">
<p>Our top news stories delivered directly to your email inbox.</p>
</span></label>
</div>
<div class="checkbox">
<label>
<input type="checkbox" name="lists[]" value="5736ccaa-e148-11e8-83a1-cf8b69267783" checked=""> The B Section<span class="help-block">
<p>Plan out your weekend with our calendar of events, as well as lifestyle, community features, arts and culture, entertainment and sports stories from across the borderland every Friday.</p>
</span></label>
</div>
<div class="checkbox">
<label>
<input type="checkbox" name="lists[]" value="dcb45ce8-d884-11ed-a672-b3b0b3836a81" checked=""> Best of El Paso<span class="help-block">
<p><span>A monthly curated email filled with giveaways, coupons, upcoming events and features of the top places, people and things around town.</span></p>
</span></label>
</div>
<div class="checkbox">
<label>
<input type="checkbox" name="lists[]" value="c1305308-eb86-11ee-9351-ef200ef9824b" checked=""> What's Up Promotions<span class="help-block">
<p><span>Be the first to know about our monthly contests, giveaways and special events.</span></p>
</span></label>
</div>
</div>
</div>
</fieldset>
<div class="form-group">
<label for="tncms_captcha_response" class="sr-only">CAPTCHA</label>
<div class="input-container text-center">
<div class="tncms-recaptcha-wrapper">
<div class="g-recaptcha" data-sitekey="6LdvF8kSAAAAAHtjCXotWkt5byjdinh-RPyWTH5J" data-action="submit" data-widget-id="0">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-32posquj0m50" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/enterprise/anchor?ar=1&k=6LdvF8kSAAAAAHtjCXotWkt5byjdinh-RPyWTH5J&co=aHR0cHM6Ly93d3cuZWxwYXNvaW5jLmNvbTo0NDM.&hl=en&v=pPK749sccDmVW_9DSeTMVvh2&size=normal&sa=submit&cb=oftj0whqi4mg"></iframe>
</div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div>
</div>
</div>
</div>
</div>
<div class="user-register-submit form-group">
<div class="input-container text-center">
<button type="submit" class="btn btn-lg btn-primary">Create Account</button>
</div>
</div>
</form>POST https://www.elpasoinc.com/users/login/
<form id="access-modal-login-form" class="user-login-form" role="form" method="post" action="https://www.elpasoinc.com/users/login/"><input type="hidden" name="tncms_csrf_token"
value="438a6c22a91a706c5931e88088e312d83b89e237554caf448eea254e0ca093e4.f118cba953d218097921">
<div class="alert alert-danger critical-error hide">
<p>Invalid password or account does not exist</p>
</div><input type="hidden" name="referer_url" value="https://www.elpasoinc.com/unicef-hk-thanks-artox-group-for-its-support-to-vulnerable-children-worldwide/article_61819cf8-8e5c-5e70-9a39-3fcab454c670.html">
<div class="user-login-username form-group">
<label for="user-username" class="control-label hide">Email Address</label>
<div class="input-container">
<input id="user-username" class="form-control" name="username" type="text" value="" placeholder="Email Address" required="">
</div>
</div>
<div class="user-login-password form-group">
<label for="user-password" class="control-label hide">Password</label>
<div class="input-group">
<input id="user-password" class="form-control" name="password" type="password" autocomplete="off" required="" placeholder="Password">
<div id="user-password-toggle" class="input-group-addon password-toggle" title="Toggle password visibility">
<svg class="tnt-svg tnt-eye tnt-w-18" aria-hidden="true" data-prefix="fas" data-icon="eye" role="presentation" xmlns="https://www.w3.org/2000/svg" viewBox="0 0 576 512" data-fa-i2svg="">
<path fill="currentColor"
d="M572.52 241.4C518.29 135.59 410.93 64 288 64S57.68 135.64 3.48 241.41a32.35 32.35 0 0 0 0 29.19C57.71 376.41 165.07 448 288 448s230.32-71.64 284.52-177.41a32.35 32.35 0 0 0 0-29.19zM288 400a144 144 0 1 1 144-144 143.93 143.93 0 0 1-144 144zm0-240a95.31 95.31 0 0 0-25.31 3.79 47.85 47.85 0 0 1-66.9 66.9A95.78 95.78 0 1 0 288 160z">
</path>
</svg>
</div>
</div>
</div>
<div class="user-login-remember form-group row">
<div class="input-container col-xs-6">
<div class="checkbox">
<label>
<input name="remember_me" type="checkbox" checked="checked" value="1"> Remember me </label>
</div>
</div>
<div class="col-xs-6 text-right forgot-wrapper">
<a id="open-modal-forgot" class="" rel="nofollow" href="https://www.elpasoinc.com/users/forgot/?referer_url=https%3A%2F%2Fwww.elpasoinc.com%2Funicef-hk-thanks-artox-group-for-its-support-to-vulnerable-children-worldwide%2Farticle_61819cf8-8e5c-5e70-9a39-3fcab454c670.html">
Forgot your password?
</a>
</div>
</div>
<div class="user-login-submit form-group">
<div class="input-container text-center">
<button type="submit" class="btn btn-lg btn-primary">Log In</button>
</div>
</div>
<div class="text-center form-group">
<a id="open-modal-instant-login" class="btn btn-sm btn-default btn-instant-login" rel="nofollow" href="https://www.elpasoinc.com/users/instant-login/?referer_url=https%3A%2F%2Fwww.elpasoinc.com%2Funicef-hk-thanks-artox-group-for-its-support-to-vulnerable-children-worldwide%2Farticle_61819cf8-8e5c-5e70-9a39-3fcab454c670.html">
Email me a log in link
</a>
</div>
</form>POST https://www.elpasoinc.com/users/forgot/
<form id="user-modal-forgot-form" role="form" method="post" action="https://www.elpasoinc.com/users/forgot/"><input type="hidden" name="tncms_csrf_token" value="438a6c22a91a706c5931e88088e312d83b89e237554caf448eea254e0ca093e4.f118cba953d218097921">
<input type="hidden" name="referer_url" value="https://www.elpasoinc.com/unicef-hk-thanks-artox-group-for-its-support-to-vulnerable-children-worldwide/article_61819cf8-8e5c-5e70-9a39-3fcab454c670.html">
<div class="user-login-username form-group">
<label for="forgot-username" class="sr-only">Email or Screen Name</label>
<input id="forgot-username" class="form-control" name="username" type="text" placeholder="Email or Screen Name" value="" required="">
</div>
<div class="form-group">
<label for="tncms_captcha_response" class="sr-only">CAPTCHA</label>
<div class="input-container text-center">
<div class="tncms-recaptcha-wrapper">
<div class="g-recaptcha" data-sitekey="6LdvF8kSAAAAAHtjCXotWkt5byjdinh-RPyWTH5J" data-action="submit" data-widget-id="1">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-6zsbycjmfgyy" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/enterprise/anchor?ar=1&k=6LdvF8kSAAAAAHtjCXotWkt5byjdinh-RPyWTH5J&co=aHR0cHM6Ly93d3cuZWxwYXNvaW5jLmNvbTo0NDM.&hl=en&v=pPK749sccDmVW_9DSeTMVvh2&size=normal&sa=submit&cb=i6f2l2uy1uld"></iframe>
</div><textarea id="g-recaptcha-response-1" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div>
</div>
</div>
</div>
</div>
<div class="user-login-submit form-group">
<div class="text-center">
<button type="submit" class="btn btn-primary">Reset Password</button>
</div>
</div>
</form>POST https://www.elpasoinc.com/users/instant-login/
<form id="instant-login-form" class="form-horizontal" role="form" method="post" action="https://www.elpasoinc.com/users/instant-login/"><input type="hidden" name="tncms_csrf_token"
value="438a6c22a91a706c5931e88088e312d83b89e237554caf448eea254e0ca093e4.f118cba953d218097921">
<div class="form-group">
<div class="col-xs-12">
<label for="instant-login-email" class="sr-only">Account Email</label>
<input id="instant-login-email" class="form-control" name="email" type="email" value="" required="" placeholder="Account Email">
</div>
</div>
<div class="form-group">
<label for="tncms_captcha_response" class="sr-only">CAPTCHA</label>
<div class="input-container text-center">
<div class="tncms-recaptcha-wrapper">
<div class="g-recaptcha" data-sitekey="6LdvF8kSAAAAAHtjCXotWkt5byjdinh-RPyWTH5J" data-action="submit" data-widget-id="2">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-9am3hnplcbh2" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/enterprise/anchor?ar=1&k=6LdvF8kSAAAAAHtjCXotWkt5byjdinh-RPyWTH5J&co=aHR0cHM6Ly93d3cuZWxwYXNvaW5jLmNvbTo0NDM.&hl=en&v=pPK749sccDmVW_9DSeTMVvh2&size=normal&sa=submit&cb=x0ltz1m6h1b"></iframe>
</div><textarea id="g-recaptcha-response-2" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div>
</div>
</div>
</div>
<div class="user-login-link-submit form-group">
<div class="text-center">
<button type="submit" class="btn btn-primary">Send Email</button>
</div>
</div>
</form>GET https://www.elpasoinc.com/tncms/subscription/services/
<form id="service-promo-fetch" class="text-left service-promo-open form-horizontal" role="form" method="get" action="https://www.elpasoinc.com/tncms/subscription/services/"><input type="hidden" name="tncms_csrf_token"
value="438a6c22a91a706c5931e88088e312d83b89e237554caf448eea254e0ca093e4.f118cba953d218097921">
<fieldset class="col-xs-12">
<input type="hidden" name="serviceid" value="">
<div class="form-group">
<label for="promo" class="sr-only">Enter Promo Code</label>
</div>
<div class="form-group">
<div class="input-group col-sm-8 col-sm-push-2">
<input type="text" class="form-control" name="promoCode" placeholder="Enter Promo Code" value="">
<span class="input-group-btn">
<button type="submit" class="btn btn-primary">Redeem</button>
</span>
</div>
</div>
</fieldset>
</form>POST /tncms/subscription/buy_paypal/
<form id="tncms-paypal-super-purchase" action="/tncms/subscription/buy_paypal/" method="post" class="hide"><input type="hidden" name="tncms_csrf_token" value="438a6c22a91a706c5931e88088e312d83b89e237554caf448eea254e0ca093e4.f118cba953d218097921">
<input name="referrer_url" type="hidden" value="/unicef-hk-thanks-artox-group-for-its-support-to-vulnerable-children-worldwide/article_61819cf8-8e5c-5e70-9a39-3fcab454c670.html">
<input name="service_id" type="hidden" value="">
<input name="rate_id" type="hidden" value="">
<input name="email" type="hidden" value="">
<input name="password" type="password" value="">
<input name="password_verify" type="password" value="">
<input name="postal-postcode" type="hidden" value="">
<input name="postal-country" type="hidden" value="">
<input name="postal_code" type="hidden" value="">
<input name="country" type="hidden" value="">
</form>POST /tncms/subscription/buy/
<form id="form-super-purchase" class="form-horizontal spreedly-initialized" role="form" action="/tncms/subscription/buy/" method="post" data-taxable="false" onsubmit="submitPaymentFormSpreedly(); return false" novalidate="novalidate"><input
type="hidden" name="tncms_csrf_token" value="438a6c22a91a706c5931e88088e312d83b89e237554caf448eea254e0ca093e4.f118cba953d218097921">
<input type="hidden" name="referrer_url" value="/unicef-hk-thanks-artox-group-for-its-support-to-vulnerable-children-worldwide/article_61819cf8-8e5c-5e70-9a39-3fcab454c670.html">
<input type="hidden" name="service_id" value="">
<input type="hidden" name="rate_name" value="">
<input type="hidden" name="rate_id" value="">
<input type="hidden" name="rate_price" value="">
<input type="hidden" name="tnpay-token" id="tnpay-token-super-purchase"><input type="hidden" id="voight-kampf-super-purchase" name="recaptcha_token" value=""><input type="hidden" name="promoCode" value="">
<fieldset id="form-signup-super-purchase" class="col-xs-12 not-logged-in purchase-standard" style="display: block;">
<legend>What's your email address?</legend>
<div class="form-group">
<label for="email-super-purchase" class="control-label sr-only">Email</label>
<input id="email-super-purchase" type="email" name="email" class="form-control" placeholder="Email" data-required="" data-required-logged-out="" required="" aria-required="true">
</div>
<div class="form-group">
<div class="row">
<div class="col-xs-6">
<label for="password-super-purchase" class="sr-only">Password</label>
<input id="password-super-purchase" type="password" name="password" class="form-control" placeholder="Password" data-required="" data-required-logged-out="" required="" aria-required="true">
</div>
<div class="col-xs-6">
<label for="password-verify-super-purchase" class="sr-only">Confirm password</label>
<input id="password-verify-super-purchase" type="password" name="password_verify" class="form-control" placeholder="Confirm password">
</div>
</div>
</div>
</fieldset>
<fieldset id="form-gift-to-super-purchase" class="col-xs-12 purchase-gift">
<legend>Who is this gift for?</legend>
<div class="form-group">
<div class="row">
<div class="col-xs-12 col-md-6">
<label for="field-recipient-name-super-purchase" class="control-label sr-only">Recipient name</label>
<input id="field-recipient-name-super-purchase" class="form-control" type="text" name="recipient_name" placeholder="Recipient name" data-required="" required="" aria-required="true">
</div>
<div class="col-xs-12 col-md-6">
<label for="field-recipient-email-super-purchase" class="control-label sr-only">Recipient email</label>
<input id="field-recipient-email-super-purchase" class="form-control" type="email" name="recipient_email" placeholder="Recipient email" data-required="" required="" aria-required="true">
</div>
</div>
</div>
<div class="form-group">
<div class="row">
<div id="gift-message" class="col-xs-12">
<label for="field-gift-message-super-purchase" class="control-label sr-only">Optional message for the recipient</label>
<textarea id="field-gift-message-super-purchase" class="form-control" name="message" rows="4" placeholder="Optional message for the recipient"></textarea>
</div>
</div>
</div>
</fieldset>
<fieldset id="form-gift-from-super-purchase" class="col-xs-12 purchase-gift">
<legend>Who is this gift from?</legend>
<div id="purchaser-info" class="form-group-flex">
<div id="purchaser-name">
<label for="field-purchaser-name-super-purchase" class="control-label sr-only">Purchaser name</label>
<input id="field-purchaser-name-super-purchase" class="form-control" type="text" name="purchaser_name" placeholder="Purchaser name" data-required="" required="" aria-required="true">
</div>
<div id="purchaser-email">
<label for="field-purchaser-email-super-purchase" class="control-label sr-only">Purchaser email</label>
<input id="field-purchaser-email-super-purchase" class="form-control" type="email" name="purchaser_email" placeholder="Purchaser email" data-required="" required="" aria-required="true">
</div>
</div><template id="purchaser-zip-template">
<div id="purchaser-zip">
<label for="field-purchaser-zip-super-purchase" class="control-label sr-only">Purchaser zip code</label>
<input id="field-purchaser-zip-super-purchase" class="form-control" type="text" name="purchaser_zip" placeholder="Purchaser zip code" data-required="" required="">
</div>
</template>
</fieldset>
<fieldset id="form-gift-deliver-super-purchase" class="col-xs-12 purchase-gift">
<legend>Delivery date</legend>
<div class="form-group">
<div class="row">
<div class="col-xs-12">
<label for="field-gift-date-super-purchase" class="control-label sr-only">Delivery date</label>
</div>
<div class="col-xs-12">
<input id="field-gift-date-super-purchase" class="form-control" name="delivery_date" type="date" value="2024-12-02">
</div>
</div>
</div>
</fieldset>
<fieldset id="form-billing-location-super-purchase" class="col-xs-12 tnt-tax-detail">
<legend> What's your billing location? </legend>
<div class="form-group-flex">
<div id="billing-state">
<label for="field-postal-state-super-purchase" class="control-label sr-only"> State </label>
<select id="field-postal-state-super-purchase" class="form-control" name="postal-state" placeholder="State">
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX" selected="">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="DC">Washington D.C.</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
<option value="PR">Puerto Rico</option>
<option value="VI">US Virgin Islands</option>
<option value="AA">Armed Forces Americas</option>
<option value="AP">Armed Forces Pacific</option>
<option value="AE">Armed Forces Europe</option>
<option value="MP">Northern Mariana Islands</option>
<option value="MH">Marshall Islands</option>
<option value="AS">American Samoa</option>
<option value="FM">Federated States of Micronesia</option>
<option value="GU">Guam</option>
<option value="PW">Palau</option>
<option value="AB">Alberta, Canada</option>
<option value="BC">British Columbia, Canada</option>
<option value="MB">Manitoba, Canada</option>
<option value="NB">New Brunswick, Canada</option>
<option value="NL">Newfoundland, Canada</option>
<option value="NS">Nova Scotia, Canada</option>
<option value="NT">Northwest Territories, Canada</option>
<option value="NU">Nunavut, Canada</option>
<option value="ON">Ontario, Canada</option>
<option value="PE">Prince Edward Island, Canada</option>
<option value="QC">Quebec, Canada</option>
<option value="SK">Saskatchewan, Canada</option>
<option value="YT">Yukon Territory, Canada</option>
</select>
</div>
<div id="billing-postcode">
<label for="field-postal-postcode-super-purchase" class="control-label sr-only"> Zip Code </label>
<input id="field-postal-postcode-super-purchase" type="text" name="postal-postcode" maxlength="7" class="form-control" placeholder="Zip code" required="" aria-required="true">
</div>
<div id="billing-country">
<label for="field-postal-country-super-purchase" class="control-label sr-only"> Country </label>
<select id="field-postal-country-super-purchase" name="postal-country" class="form-control">
<option value="US" selected="">United States of America</option>
<option value="VI">US Virgin Islands</option>
<option value="UM">United States Minor Outlying Islands</option>
<option value="CA">Canada</option>
<option value="MX">Mexico, United Mexican States</option>
<option value="BS">Bahamas, Commonwealth of the</option>
<option value="CU">Cuba, Republic of</option>
<option value="DO">Dominican Republic</option>
<option value="HT">Haiti, Republic of</option>
<option value="JM">Jamaica</option>
<option value="AF">Afghanistan</option>
<option value="AL">Albania, People's Socialist Republic of</option>
<option value="DZ">Algeria, People's Democratic Republic of</option>
<option value="AS">American Samoa</option>
<option value="AD">Andorra, Principality of</option>
<option value="AO">Angola, Republic of</option>
<option value="AI">Anguilla</option>
<option value="AQ">Antarctica (the territory South of 60 deg S)</option>
<option value="AG">Antigua and Barbuda</option>
<option value="AR">Argentina, Argentine Republic</option>
<option value="AM">Armenia</option>
<option value="AW">Aruba</option>
<option value="AU">Australia, Commonwealth of</option>
<option value="AT">Austria, Republic of</option>
<option value="AZ">Azerbaijan, Republic of</option>
<option value="BH">Bahrain, Kingdom of</option>
<option value="BD">Bangladesh, People's Republic of</option>
<option value="BB">Barbados</option>
<option value="BY">Belarus</option>
<option value="BE">Belgium, Kingdom of</option>
<option value="BZ">Belize</option>
<option value="BJ">Benin, People's Republic of</option>
<option value="BM">Bermuda</option>
<option value="BT">Bhutan, Kingdom of</option>
<option value="BO">Bolivia, Republic of</option>
<option value="BA">Bosnia and Herzegovina</option>
<option value="BW">Botswana, Republic of</option>
<option value="BV">Bouvet Island (Bouvetoya)</option>
<option value="BR">Brazil, Federative Republic of</option>
<option value="IO">British Indian Ocean Territory (Chagos Archipelago)</option>
<option value="VG">British Virgin Islands</option>
<option value="BN">Brunei Darussalam</option>
<option value="BG">Bulgaria, People's Republic of</option>
<option value="BF">Burkina Faso</option>
<option value="BI">Burundi, Republic of</option>
<option value="KH">Cambodia, Kingdom of</option>
<option value="CM">Cameroon, United Republic of</option>
<option value="CV">Cape Verde, Republic of</option>
<option value="KY">Cayman Islands</option>
<option value="CF">Central African Republic</option>
<option value="TD">Chad, Republic of</option>
<option value="CL">Chile, Republic of</option>
<option value="CN">China, People's Republic of</option>
<option value="CX">Christmas Island</option>
<option value="CC">Cocos (Keeling) Islands</option>
<option value="CO">Colombia, Republic of</option>
<option value="KM">Comoros, Union of the</option>
<option value="CD">Congo, Democratic Republic of</option>
<option value="CG">Congo, People's Republic of</option>
<option value="CK">Cook Islands</option>
<option value="CR">Costa Rica, Republic of</option>
<option value="CI">Cote D'Ivoire, Ivory Coast, Republic of the</option>
<option value="CY">Cyprus, Republic of</option>
<option value="CZ">Czech Republic</option>
<option value="DK">Denmark, Kingdom of</option>
<option value="DJ">Djibouti, Republic of</option>
<option value="DM">Dominica, Commonwealth of</option>
<option value="EC">Ecuador, Republic of</option>
<option value="EG">Egypt, Arab Republic of</option>
<option value="SV">El Salvador, Republic of</option>
<option value="GQ">Equatorial Guinea, Republic of</option>
<option value="ER">Eritrea</option>
<option value="EE">Estonia</option>
<option value="ET">Ethiopia</option>
<option value="FO">Faeroe Islands</option>
<option value="FK">Falkland Islands (Malvinas)</option>
<option value="FJ">Fiji, Republic of the Fiji Islands</option>
<option value="FI">Finland, Republic of</option>
<option value="FR">France, French Republic</option>
<option value="GF">French Guiana</option>
<option value="PF">French Polynesia</option>
<option value="TF">French Southern Territories</option>
<option value="GA">Gabon, Gabonese Republic</option>
<option value="GM">Gambia, Republic of the</option>
<option value="GE">Georgia</option>
<option value="DE">Germany</option>
<option value="GH">Ghana, Republic of</option>
<option value="GI">Gibraltar</option>
<option value="GR">Greece, Hellenic Republic</option>
<option value="GL">Greenland</option>
<option value="GD">Grenada</option>
<option value="GP">Guadaloupe</option>
<option value="GU">Guam</option>
<option value="GT">Guatemala, Republic of</option>
<option value="GN">Guinea, Revolutionary People's Rep'c of</option>
<option value="GW">Guinea-Bissau, Republic of</option>
<option value="GY">Guyana, Republic of</option>
<option value="HM">Heard and McDonald Islands</option>
<option value="VA">Holy See (Vatican City State)</option>
<option value="HN">Honduras, Republic of</option>
<option value="HK">Hong Kong, Special Administrative Region of China</option>
<option value="HR">Hrvatska (Croatia)</option>
<option value="HU">Hungary, Hungarian People's Republic</option>
<option value="IS">Iceland, Republic of</option>
<option value="IN">India, Republic of</option>
<option value="ID">Indonesia, Republic of</option>
<option value="IR">Iran, Islamic Republic of</option>
<option value="IQ">Iraq, Republic of</option>
<option value="IE">Ireland</option>
<option value="IL">Israel, State of</option>
<option value="IT">Italy, Italian Republic</option>
<option value="JP">Japan</option>
<option value="JO">Jordan, Hashemite Kingdom of</option>
<option value="KZ">Kazakhstan, Republic of</option>
<option value="KE">Kenya, Republic of</option>
<option value="KI">Kiribati, Republic of</option>
<option value="KP">Korea, Democratic People's Republic of</option>
<option value="KR">Korea, Republic of</option>
<option value="KW">Kuwait, State of</option>
<option value="KG">Kyrgyz Republic</option>
<option value="LA">Lao People's Democratic Republic</option>
<option value="LV">Latvia</option>
<option value="LB">Lebanon, Lebanese Republic</option>
<option value="LS">Lesotho, Kingdom of</option>
<option value="LR">Liberia, Republic of</option>
<option value="LY">Libyan Arab Jamahiriya</option>
<option value="LI">Liechtenstein, Principality of</option>
<option value="LT">Lithuania</option>
<option value="LU">Luxembourg, Grand Duchy of</option>
<option value="MO">Macao, Special Administrative Region of China</option>
<option value="MK">Macedonia, the former Yugoslav Republic of</option>
<option value="MG">Madagascar, Republic of</option>
<option value="MW">Malawi, Republic of</option>
<option value="MY">Malaysia</option>
<option value="MV">Maldives, Republic of</option>
<option value="ML">Mali, Republic of</option>
<option value="MT">Malta, Republic of</option>
<option value="MH">Marshall Islands</option>
<option value="MQ">Martinique</option>
<option value="MR">Mauritania, Islamic Republic of</option>
<option value="MU">Mauritius</option>
<option value="YT">Mayotte</option>
<option value="FM">Micronesia, Federated States of</option>
<option value="MD">Moldova, Republic of</option>
<option value="MC">Monaco, Principality of</option>
<option value="MN">Mongolia, Mongolian People's Republic</option>
<option value="MS">Montserrat</option>
<option value="MA">Morocco, Kingdom of</option>
<option value="MZ">Mozambique, People's Republic of</option>
<option value="MM">Myanmar</option>
<option value="NA">Namibia</option>
<option value="NR">Nauru, Republic of</option>
<option value="NP">Nepal, Kingdom of</option>
<option value="AN">Netherlands Antilles</option>
<option value="NL">Netherlands, Kingdom of the</option>
<option value="NC">New Caledonia</option>
<option value="NZ">New Zealand</option>
<option value="NI">Nicaragua, Republic of</option>
<option value="NE">Niger, Republic of the</option>
<option value="NG">Nigeria, Federal Republic of</option>
<option value="NU">Niue, Republic of</option>
<option value="NF">Norfolk Island</option>
<option value="MP">Northern Mariana Islands</option>
<option value="NO">Norway, Kingdom of</option>
<option value="OM">Oman, Sultanate of</option>
<option value="PK">Pakistan, Islamic Republic of</option>
<option value="PW">Palau</option>
<option value="PS">Palestinian Territory, Occupied</option>
<option value="PA">Panama, Republic of</option>
<option value="PG">Papua New Guinea</option>
<option value="PY">Paraguay, Republic of</option>
<option value="PE">Peru, Republic of</option>
<option value="PH">Philippines, Republic of the</option>
<option value="PN">Pitcairn Island</option>
<option value="PL">Poland, Polish People's Republic</option>
<option value="PT">Portugal, Portuguese Republic</option>
<option value="PR">Puerto Rico</option>
<option value="QA">Qatar, State of</option>
<option value="RE">Reunion</option>
<option value="RO">Romania, Socialist Republic of</option>
<option value="RU">Russian Federation</option>
<option value="RW">Rwanda, Rwandese Republic</option>
<option value="WS">Samoa, Independent State of</option>
<option value="SM">San Marino, Republic of</option>
<option value="ST">Sao Tome and Principe, Democratic Republic of</option>
<option value="SA">Saudi Arabia, Kingdom of</option>
<option value="SN">Senegal, Republic of</option>
<option value="CS">Serbia and Montenegro</option>
<option value="SC">Seychelles, Republic of</option>
<option value="SL">Sierra Leone, Republic of</option>
<option value="SG">Singapore, Republic of</option>
<option value="SK">Slovakia (Slovak Republic)</option>
<option value="SI">Slovenia</option>
<option value="SB">Solomon Islands</option>
<option value="SO">Somalia, Somali Republic</option>
<option value="ZA">South Africa, Republic of</option>
<option value="GS">South Georgia and the South Sandwich Islands</option>
<option value="ES">Spain, Spanish State</option>
<option value="LK">Sri Lanka, Democratic Socialist Republic of</option>
<option value="SH">St. Helena</option>
<option value="KN">St. Kitts and Nevis</option>
<option value="LC">St. Lucia</option>
<option value="PM">St. Pierre and Miquelon</option>
<option value="VC">St. Vincent and the Grenadines</option>
<option value="SD">Sudan, Democratic Republic of the</option>
<option value="SR">Suriname, Republic of</option>
<option value="SJ">Svalbard & Jan Mayen Islands</option>
<option value="SZ">Swaziland, Kingdom of</option>
<option value="SE">Sweden, Kingdom of</option>
<option value="CH">Switzerland, Swiss Confederation</option>
<option value="SY">Syrian Arab Republic</option>
<option value="TW">Taiwan, Province of China</option>
<option value="TJ">Tajikistan</option>
<option value="TZ">Tanzania, United Republic of</option>
<option value="TH">Thailand, Kingdom of</option>
<option value="TL">Timor-Leste, Democratic Republic of</option>
<option value="TG">Togo, Togolese Republic</option>
<option value="TK">Tokelau (Tokelau Islands)</option>
<option value="TO">Tonga, Kingdom of</option>
<option value="TT">Trinidad and Tobago, Republic of</option>
<option value="TN">Tunisia, Republic of</option>
<option value="TR">Turkey, Republic of</option>
<option value="TM">Turkmenistan</option>
<option value="TC">Turks and Caicos Islands</option>
<option value="TV">Tuvalu</option>
<option value="UG">Uganda, Republic of</option>
<option value="UA">Ukraine</option>
<option value="AE">United Arab Emirates</option>
<option value="GB">United Kingdom of Great Britain & N. Ireland</option>
<option value="UY">Uruguay, Eastern Republic of</option>
<option value="UZ">Uzbekistan</option>
<option value="VU">Vanuatu</option>
<option value="VE">Venezuela, Bolivarian Republic of</option>
<option value="VN">Viet Nam, Socialist Republic of</option>
<option value="WF">Wallis and Futuna Islands</option>
<option value="EH">Western Sahara</option>
<option value="YE">Yemen</option>
<option value="ZM">Zambia, Republic of</option>
<option value="ZW">Zimbabwe</option>
</select>
</div>
</div>
</fieldset>
<fieldset id="form-location-super-purchase" class="col-xs-12 delivery-location-required" hidden="">
<legend>What's your delivery address?</legend>
<div class="form-group tnt-tax-detail">
<label>
<input id="same-info-super-purchase" class="same-info" type="checkbox" name="same_info">
<b style="position:relative;top:-2px;padding-left:10px;">Copy billing location</b>
</label>
</div>
<div class="form-group">
<label for="address-super-purchase" class="control-label sr-only">Address</label>
<input id="address-super-purchase" type="text" name="address" class="form-control" placeholder="Address">
</div>
<div class="form-group">
<label for="municipality-super-purchase" class="control-label sr-only">City</label>
<input id="municipality-super-purchase" type="text" name="municipality" class="form-control" placeholder="City">
</div>
<div class="form-group">
<div class="row">
<div class="col-xs-7 col-md-4">
<label for="region-super-purchase" class="control-label sr-only">State</label>
<select id="region-super-purchase" class="form-control" name="region" placeholder="State">
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX" selected="">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="DC">Washington D.C.</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
<option value="PR">Puerto Rico</option>
<option value="VI">US Virgin Islands</option>
<option value="AA">Armed Forces Americas</option>
<option value="AP">Armed Forces Pacific</option>
<option value="AE">Armed Forces Europe</option>
<option value="MP">Northern Mariana Islands</option>
<option value="MH">Marshall Islands</option>
<option value="AS">American Samoa</option>
<option value="FM">Federated States of Micronesia</option>
<option value="GU">Guam</option>
<option value="PW">Palau</option>
<option value="AB">Alberta, Canada</option>
<option value="BC">British Columbia, Canada</option>
<option value="MB">Manitoba, Canada</option>
<option value="NB">New Brunswick, Canada</option>
<option value="NL">Newfoundland, Canada</option>
<option value="NS">Nova Scotia, Canada</option>
<option value="NT">Northwest Territories, Canada</option>
<option value="NU">Nunavut, Canada</option>
<option value="ON">Ontario, Canada</option>
<option value="PE">Prince Edward Island, Canada</option>
<option value="QC">Quebec, Canada</option>
<option value="SK">Saskatchewan, Canada</option>
<option value="YT">Yukon Territory, Canada</option>
</select>
</div>
<div class="col-xs-5 col-md-3">
<label for="postal-code-super-purchase" class="control-label sr-only">Zip code</label>
<input id="postal-code-super-purchase" type="text" name="postal_code" maxlength="6" class="form-control" placeholder="Zip code">
</div>
</div>
</div>
<div class="form-group">
<div class="row">
<div class="col-xs-7">
<label for="select-country-super-purchase" class="control-label sr-only">Country</label>
<div class="input-container">
<select id="select-country-super-purchase" name="country" class="form-control">
<option value="US" selected="">United States of America</option>
<option value="VI">US Virgin Islands</option>
<option value="UM">United States Minor Outlying Islands</option>
<option value="CA">Canada</option>
<option value="MX">Mexico, United Mexican States</option>
<option value="BS">Bahamas, Commonwealth of the</option>
<option value="CU">Cuba, Republic of</option>
<option value="DO">Dominican Republic</option>
<option value="HT">Haiti, Republic of</option>
<option value="JM">Jamaica</option>
<option value="AF">Afghanistan</option>
<option value="AL">Albania, People's Socialist Republic of</option>
<option value="DZ">Algeria, People's Democratic Republic of</option>
<option value="AS">American Samoa</option>
<option value="AD">Andorra, Principality of</option>
<option value="AO">Angola, Republic of</option>
<option value="AI">Anguilla</option>
<option value="AQ">Antarctica (the territory South of 60 deg S)</option>
<option value="AG">Antigua and Barbuda</option>
<option value="AR">Argentina, Argentine Republic</option>
<option value="AM">Armenia</option>
<option value="AW">Aruba</option>
<option value="AU">Australia, Commonwealth of</option>
<option value="AT">Austria, Republic of</option>
<option value="AZ">Azerbaijan, Republic of</option>
<option value="BH">Bahrain, Kingdom of</option>
<option value="BD">Bangladesh, People's Republic of</option>
<option value="BB">Barbados</option>
<option value="BY">Belarus</option>
<option value="BE">Belgium, Kingdom of</option>
<option value="BZ">Belize</option>
<option value="BJ">Benin, People's Republic of</option>
<option value="BM">Bermuda</option>
<option value="BT">Bhutan, Kingdom of</option>
<option value="BO">Bolivia, Republic of</option>
<option value="BA">Bosnia and Herzegovina</option>
<option value="BW">Botswana, Republic of</option>
<option value="BV">Bouvet Island (Bouvetoya)</option>
<option value="BR">Brazil, Federative Republic of</option>
<option value="IO">British Indian Ocean Territory (Chagos Archipelago)</option>
<option value="VG">British Virgin Islands</option>
<option value="BN">Brunei Darussalam</option>
<option value="BG">Bulgaria, People's Republic of</option>
<option value="BF">Burkina Faso</option>
<option value="BI">Burundi, Republic of</option>
<option value="KH">Cambodia, Kingdom of</option>
<option value="CM">Cameroon, United Republic of</option>
<option value="CV">Cape Verde, Republic of</option>
<option value="KY">Cayman Islands</option>
<option value="CF">Central African Republic</option>
<option value="TD">Chad, Republic of</option>
<option value="CL">Chile, Republic of</option>
<option value="CN">China, People's Republic of</option>
<option value="CX">Christmas Island</option>
<option value="CC">Cocos (Keeling) Islands</option>
<option value="CO">Colombia, Republic of</option>
<option value="KM">Comoros, Union of the</option>
<option value="CD">Congo, Democratic Republic of</option>
<option value="CG">Congo, People's Republic of</option>
<option value="CK">Cook Islands</option>
<option value="CR">Costa Rica, Republic of</option>
<option value="CI">Cote D'Ivoire, Ivory Coast, Republic of the</option>
<option value="CY">Cyprus, Republic of</option>
<option value="CZ">Czech Republic</option>
<option value="DK">Denmark, Kingdom of</option>
<option value="DJ">Djibouti, Republic of</option>
<option value="DM">Dominica, Commonwealth of</option>
<option value="EC">Ecuador, Republic of</option>
<option value="EG">Egypt, Arab Republic of</option>
<option value="SV">El Salvador, Republic of</option>
<option value="GQ">Equatorial Guinea, Republic of</option>
<option value="ER">Eritrea</option>
<option value="EE">Estonia</option>
<option value="ET">Ethiopia</option>
<option value="FO">Faeroe Islands</option>
<option value="FK">Falkland Islands (Malvinas)</option>
<option value="FJ">Fiji, Republic of the Fiji Islands</option>
<option value="FI">Finland, Republic of</option>
<option value="FR">France, French Republic</option>
<option value="GF">French Guiana</option>
<option value="PF">French Polynesia</option>
<option value="TF">French Southern Territories</option>
<option value="GA">Gabon, Gabonese Republic</option>
<option value="GM">Gambia, Republic of the</option>
<option value="GE">Georgia</option>
<option value="DE">Germany</option>
<option value="GH">Ghana, Republic of</option>
<option value="GI">Gibraltar</option>
<option value="GR">Greece, Hellenic Republic</option>
<option value="GL">Greenland</option>
<option value="GD">Grenada</option>
<option value="GP">Guadaloupe</option>
<option value="GU">Guam</option>
<option value="GT">Guatemala, Republic of</option>
<option value="GN">Guinea, Revolutionary People's Rep'c of</option>
<option value="GW">Guinea-Bissau, Republic of</option>
<option value="GY">Guyana, Republic of</option>
<option value="HM">Heard and McDonald Islands</option>
<option value="VA">Holy See (Vatican City State)</option>
<option value="HN">Honduras, Republic of</option>
<option value="HK">Hong Kong, Special Administrative Region of China</option>
<option value="HR">Hrvatska (Croatia)</option>
<option value="HU">Hungary, Hungarian People's Republic</option>
<option value="IS">Iceland, Republic of</option>
<option value="IN">India, Republic of</option>
<option value="ID">Indonesia, Republic of</option>
<option value="IR">Iran, Islamic Republic of</option>
<option value="IQ">Iraq, Republic of</option>
<option value="IE">Ireland</option>
<option value="IL">Israel, State of</option>
<option value="IT">Italy, Italian Republic</option>
<option value="JP">Japan</option>
<option value="JO">Jordan, Hashemite Kingdom of</option>
<option value="KZ">Kazakhstan, Republic of</option>
<option value="KE">Kenya, Republic of</option>
<option value="KI">Kiribati, Republic of</option>
<option value="KP">Korea, Democratic People's Republic of</option>
<option value="KR">Korea, Republic of</option>
<option value="KW">Kuwait, State of</option>
<option value="KG">Kyrgyz Republic</option>
<option value="LA">Lao People's Democratic Republic</option>
<option value="LV">Latvia</option>
<option value="LB">Lebanon, Lebanese Republic</option>
<option value="LS">Lesotho, Kingdom of</option>
<option value="LR">Liberia, Republic of</option>
<option value="LY">Libyan Arab Jamahiriya</option>
<option value="LI">Liechtenstein, Principality of</option>
<option value="LT">Lithuania</option>
<option value="LU">Luxembourg, Grand Duchy of</option>
<option value="MO">Macao, Special Administrative Region of China</option>
<option value="MK">Macedonia, the former Yugoslav Republic of</option>
<option value="MG">Madagascar, Republic of</option>
<option value="MW">Malawi, Republic of</option>
<option value="MY">Malaysia</option>
<option value="MV">Maldives, Republic of</option>
<option value="ML">Mali, Republic of</option>
<option value="MT">Malta, Republic of</option>
<option value="MH">Marshall Islands</option>
<option value="MQ">Martinique</option>
<option value="MR">Mauritania, Islamic Republic of</option>
<option value="MU">Mauritius</option>
<option value="YT">Mayotte</option>
<option value="FM">Micronesia, Federated States of</option>
<option value="MD">Moldova, Republic of</option>
<option value="MC">Monaco, Principality of</option>
<option value="MN">Mongolia, Mongolian People's Republic</option>
<option value="MS">Montserrat</option>
<option value="MA">Morocco, Kingdom of</option>
<option value="MZ">Mozambique, People's Republic of</option>
<option value="MM">Myanmar</option>
<option value="NA">Namibia</option>
<option value="NR">Nauru, Republic of</option>
<option value="NP">Nepal, Kingdom of</option>
<option value="AN">Netherlands Antilles</option>
<option value="NL">Netherlands, Kingdom of the</option>
<option value="NC">New Caledonia</option>
<option value="NZ">New Zealand</option>
<option value="NI">Nicaragua, Republic of</option>
<option value="NE">Niger, Republic of the</option>
<option value="NG">Nigeria, Federal Republic of</option>
<option value="NU">Niue, Republic of</option>
<option value="NF">Norfolk Island</option>
<option value="MP">Northern Mariana Islands</option>
<option value="NO">Norway, Kingdom of</option>
<option value="OM">Oman, Sultanate of</option>
<option value="PK">Pakistan, Islamic Republic of</option>
<option value="PW">Palau</option>
<option value="PS">Palestinian Territory, Occupied</option>
<option value="PA">Panama, Republic of</option>
<option value="PG">Papua New Guinea</option>
<option value="PY">Paraguay, Republic of</option>
<option value="PE">Peru, Republic of</option>
<option value="PH">Philippines, Republic of the</option>
<option value="PN">Pitcairn Island</option>
<option value="PL">Poland, Polish People's Republic</option>
<option value="PT">Portugal, Portuguese Republic</option>
<option value="PR">Puerto Rico</option>
<option value="QA">Qatar, State of</option>
<option value="RE">Reunion</option>
<option value="RO">Romania, Socialist Republic of</option>
<option value="RU">Russian Federation</option>
<option value="RW">Rwanda, Rwandese Republic</option>
<option value="WS">Samoa, Independent State of</option>
<option value="SM">San Marino, Republic of</option>
<option value="ST">Sao Tome and Principe, Democratic Republic of</option>
<option value="SA">Saudi Arabia, Kingdom of</option>
<option value="SN">Senegal, Republic of</option>
<option value="CS">Serbia and Montenegro</option>
<option value="SC">Seychelles, Republic of</option>
<option value="SL">Sierra Leone, Republic of</option>
<option value="SG">Singapore, Republic of</option>
<option value="SK">Slovakia (Slovak Republic)</option>
<option value="SI">Slovenia</option>
<option value="SB">Solomon Islands</option>
<option value="SO">Somalia, Somali Republic</option>
<option value="ZA">South Africa, Republic of</option>
<option value="GS">South Georgia and the South Sandwich Islands</option>
<option value="ES">Spain, Spanish State</option>
<option value="LK">Sri Lanka, Democratic Socialist Republic of</option>
<option value="SH">St. Helena</option>
<option value="KN">St. Kitts and Nevis</option>
<option value="LC">St. Lucia</option>
<option value="PM">St. Pierre and Miquelon</option>
<option value="VC">St. Vincent and the Grenadines</option>
<option value="SD">Sudan, Democratic Republic of the</option>
<option value="SR">Suriname, Republic of</option>
<option value="SJ">Svalbard & Jan Mayen Islands</option>
<option value="SZ">Swaziland, Kingdom of</option>
<option value="SE">Sweden, Kingdom of</option>
<option value="CH">Switzerland, Swiss Confederation</option>
<option value="SY">Syrian Arab Republic</option>
<option value="TW">Taiwan, Province of China</option>
<option value="TJ">Tajikistan</option>
<option value="TZ">Tanzania, United Republic of</option>
<option value="TH">Thailand, Kingdom of</option>
<option value="TL">Timor-Leste, Democratic Republic of</option>
<option value="TG">Togo, Togolese Republic</option>
<option value="TK">Tokelau (Tokelau Islands)</option>
<option value="TO">Tonga, Kingdom of</option>
<option value="TT">Trinidad and Tobago, Republic of</option>
<option value="TN">Tunisia, Republic of</option>
<option value="TR">Turkey, Republic of</option>
<option value="TM">Turkmenistan</option>
<option value="TC">Turks and Caicos Islands</option>
<option value="TV">Tuvalu</option>
<option value="UG">Uganda, Republic of</option>
<option value="UA">Ukraine</option>
<option value="AE">United Arab Emirates</option>
<option value="GB">United Kingdom of Great Britain & N. Ireland</option>
<option value="UY">Uruguay, Eastern Republic of</option>
<option value="UZ">Uzbekistan</option>
<option value="VU">Vanuatu</option>
<option value="VE">Venezuela, Bolivarian Republic of</option>
<option value="VN">Viet Nam, Socialist Republic of</option>
<option value="WF">Wallis and Futuna Islands</option>
<option value="EH">Western Sahara</option>
<option value="YE">Yemen</option>
<option value="ZM">Zambia, Republic of</option>
<option value="ZW">Zimbabwe</option>
</select>
</div>
</div>
<div class="col-xs-5">
<label for="phone-super-purchase" class="control-label sr-only">Phone</label>
<input id="phone-super-purchase" type="tel" name="phone" class="form-control" placeholder="Phone number">
</div>
</div>
</div>
</fieldset>
<fieldset id="form-payment-tax-detail" class="tnt-tax-detail col-xs-12">
<div class="form-group-flex tax-result">
<div id="tax-subtotal-container"> Subtotal: <span class="tax-subtotal"></span>
</div>
<div id="tax-total-container"> Total: <span class="tax-total"></span>
</div>
</div>
</fieldset>
<fieldset id="form-payment-super-purchase" class="col-xs-12">
<legend>How would you like to pay?</legend>
<div id="tn-pay-method-select-super-purchase" class="form-group" hidden="">
<template id="tn-pay-method-card-template-super-purchase">
<a class="btn btn-lg btn-block btn-default wallet-btn wallet-show-card" title="">
<span class="tn-cc-lg" data-cc=""></span>
<span class="tn-cc-text">
<span class="tn-cc-heading"><span class="tn-cc-ending-in">Ending in <span class="tn-cc-last-four"></span></span>
<span class="tn-cc-label text-muted"></span> <small class="tn-cc-exp"></small>
</span>
</span></a>
</template>
<div id="tn-pay-method-card-data-super-purchase" hidden="">
<template class="visa" data-card="VISA"><svg enable-background="new 0 0 780 500" height="22" viewBox="0 0 780 500" width="34" xmlns="http://www.w3.org/2000/svg">
<path d="m40 0h700c22.092 0 40 17.909 40 40v420c0 22.092-17.908 40-40 40h-700c-22.091 0-40-17.908-40-40v-420c0-22.091 17.909-40 40-40z" fill="#0e4595"></path>
<path
d="m293.2 348.73 33.361-195.76h53.36l-33.385 195.76zm246.11-191.54c-10.57-3.966-27.137-8.222-47.822-8.222-52.725 0-89.865 26.55-90.18 64.603-.299 28.13 26.514 43.822 46.752 53.186 20.771 9.595 27.752 15.714 27.654 24.283-.131 13.121-16.586 19.116-31.922 19.116-21.357 0-32.703-2.967-50.227-10.276l-6.876-3.11-7.489 43.823c12.463 5.464 35.51 10.198 59.438 10.443 56.09 0 92.5-26.246 92.916-66.882.199-22.269-14.016-39.216-44.801-53.188-18.65-9.055-30.072-15.099-29.951-24.268 0-8.137 9.668-16.839 30.557-16.839 17.449-.27 30.09 3.535 39.938 7.5l4.781 2.26zm137.31-4.223h-41.232c-12.773 0-22.332 3.487-27.941 16.234l-79.244 179.4h56.031s9.16-24.123 11.232-29.418c6.125 0 60.555.084 68.338.084 1.596 6.853 6.49 29.334 6.49 29.334h49.514l-43.188-195.64zm-65.418 126.41c4.412-11.279 21.26-54.723 21.26-54.723-.316.522 4.379-11.334 7.074-18.684l3.605 16.879s10.219 46.729 12.354 56.528zm-363.3-126.41-52.24 133.5-5.567-27.13c-9.725-31.273-40.025-65.155-73.898-82.118l47.766 171.2 56.456-.064 84.004-195.39h-56.521"
fill="#fff"></path>
<path d="m146.92 152.96h-86.041l-.681 4.073c66.938 16.204 111.23 55.363 129.62 102.41l-18.71-89.96c-3.23-12.395-12.597-16.094-24.186-16.527" fill="#f2ae14"></path>
</svg></template>
<template class="master" data-card="MasterCard"><svg enable-background="new 0 0 780 500" height="22" viewBox="0 0 780 500" width="34" xmlns="http://www.w3.org/2000/svg">
<path d="m40 0h700c22.092 0 40 17.909 40 40v420c0 22.092-17.908 40-40 40h-700c-22.091 0-40-17.908-40-40v-420c0-22.091 17.909-40 40-40z" fill="#16366f"></path>
<path d="m449.01 250c0 99.143-80.37 179.5-179.51 179.5s-179.5-80.361-179.5-179.5c0-99.133 80.362-179.5 179.5-179.5 99.137 0 179.51 80.37 179.51 179.5" fill="#d9222a"></path>
<path
d="m510.49 70.496c-46.38 0-88.643 17.596-120.5 46.466-6.49 5.889-12.548 12.237-18.125 18.996h36.266c4.966 6.037 9.536 12.388 13.685 19.013h-63.635c-3.827 6.121-7.28 12.469-10.341 19.008h84.312c2.893 6.185 5.431 12.53 7.6 19.004h-99.512c-2.091 6.235-3.832 12.581-5.217 19.009h109.94c2.689 12.49 4.044 25.231 4.041 38.008 0 19.934-3.254 39.113-9.254 57.02h-99.512c2.164 6.479 4.7 12.825 7.595 19.01h84.317c-3.064 6.54-6.52 12.889-10.347 19.013h-63.625c4.154 6.629 8.73 12.979 13.685 18.996h36.258c-5.57 6.772-11.63 13.126-18.13 19.012 31.86 28.867 74.118 46.454 120.5 46.454 99.138-.001 179.51-80.362 179.51-179.5 0-99.13-80.37-179.5-179.51-179.5"
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<span data-cc="american_express" title="American Express" class="allow_announce"><svg enable-background="new 0 0 780 500" height="22" viewBox="0 0 780 500" width="34" xmlns="http://www.w3.org/2000/svg"><path d="m40 .001h700c22.092 0 40 17.909 40 40v420c0 22.092-17.908 40-40 40h-700c-22.091 0-40-17.908-40-40v-420c0-22.091 17.909-40 40-40z" fill="#2557d6"></path><path d="m.253 235.69h37.441l8.442-19.51h18.9l8.42 19.51h73.668v-14.915l6.576 14.98h38.243l6.576-15.202v15.138h183.08l-.085-32.026h3.542c2.479.083 3.204.302 3.204 4.226v27.8h94.689v-7.455c7.639 3.92 19.518 7.455 35.148 7.455h39.836l8.525-19.51h18.9l8.337 19.51h76.765v-18.532l11.626 18.532h61.515v-122.51h-60.88v14.468l-8.522-14.468h-62.471v14.468l-7.828-14.468h-84.38c-14.123 0-26.539 1.889-36.569 7.153v-7.153h-58.229v7.153c-6.383-5.426-15.079-7.153-24.75-7.153h-212.74l-14.274 31.641-14.659-31.641h-67.005v14.468l-7.362-14.468h-57.145l-26.539 58.246v64.261h.003zm236.34-17.67h-22.464l-.083-68.794-31.775 68.793h-19.24l-31.858-68.854v68.854h-44.57l-8.42-19.592h-45.627l-8.505 19.592h-23.801l39.241-87.837h32.559l37.269 83.164v-83.164h35.766l28.678 59.587 26.344-59.587h36.485zm-165.9-37.823-14.998-35.017-14.915 35.017zm255.3 37.821h-73.203v-87.837h73.203v18.291h-51.289v15.833h50.06v18.005h-50.061v17.542h51.289zm103.16-64.18c0 14.004-9.755 21.24-15.439 23.412 4.794 1.748 8.891 4.838 10.84 7.397 3.094 4.369 3.628 8.271 3.628 16.116v17.255h-22.104l-.083-11.077c0-5.285.528-12.886-3.458-17.112-3.202-3.09-8.083-3.76-15.973-3.76h-23.523v31.95h-21.914v-87.838h50.401c11.199 0 19.451.283 26.535 4.207 6.933 3.924 11.09 9.652 11.09 19.45zm-27.699 13.042c-3.013 1.752-6.573 1.81-10.841 1.81h-26.62v-19.51h26.982c3.818 0 7.804.164 10.393 1.584 2.842 1.28 4.601 4.003 4.601 7.765 0 3.84-1.674 6.929-4.515 8.351zm62.844 51.138h-22.358v-87.837h22.358zm259.56 0h-31.053l-41.535-65.927v65.927h-44.628l-8.527-19.592h-45.521l-8.271 19.592h-25.648c-10.649 0-24.138-2.257-31.773-9.715-7.701-7.458-11.708-17.56-11.708-33.533 0-13.027 2.395-24.936 11.812-34.347 7.085-7.01 18.18-10.242 33.28-10.242h21.215v18.821h-20.771c-7.997 0-12.514 1.14-16.862 5.203-3.735 3.699-6.298 10.69-6.298 19.897 0 9.41 1.951 16.196 6.023 20.628 3.373 3.476 9.506 4.53 15.272 4.53h9.842l30.884-69.076h32.835l37.102 83.081v-83.08h33.366l38.519 61.174v-61.174h22.445zm-133.2-37.82-15.165-35.017-15.081 35.017zm189.04 178.08c-5.322 7.457-15.694 11.238-29.736 11.238h-42.319v-18.84h42.147c4.181 0 7.106-.527 8.868-2.175 1.665-1.474 2.605-3.554 2.591-5.729 0-2.561-1.064-4.593-2.677-5.811-1.59-1.342-3.904-1.95-7.722-1.95-20.574-.67-46.244.608-46.244-27.194 0-12.742 8.443-26.156 31.439-26.156h43.649v-17.479h-40.557c-12.237 0-21.129 2.81-27.425 7.174v-7.175h-59.985c-9.595 0-20.854 2.279-26.179 7.175v-7.175h-107.12v7.175c-8.524-5.892-22.908-7.175-29.549-7.175h-70.656v7.175c-6.745-6.258-21.742-7.175-30.886-7.175h-79.077l-18.094 18.764-16.949-18.764h-118.13v122.59h115.9l18.646-19.062 17.565 19.062 71.442.061v-28.838h7.021c9.479.14 20.66-.228 30.523-4.312v33.085h58.928v-31.952h2.842c3.628 0 3.985.144 3.985 3.615v28.333h179.01c11.364 0 23.244-2.786 29.824-7.845v7.845h56.78c11.815 0 23.354-1.587 32.134-5.649l.002-22.84zm-354.94-47.155c0 24.406-19.005 29.445-38.159 29.445h-27.343v29.469h-42.591l-26.984-29.086-28.042 29.086h-86.802v-87.859h88.135l26.961 28.799 27.875-28.799h70.021c17.389 0 36.929 4.613 36.929 28.945zm-174.22 40.434h-53.878v-17.48h48.11v-17.926h-48.11v-15.974h54.939l23.969 25.604zm86.81 10.06-33.644-35.789 33.644-34.65zm49.757-39.066h-28.318v-22.374h28.572c7.912 0 13.404 3.09 13.404 10.772 0 7.599-5.238 11.602-13.658 11.602zm148.36-40.373h73.138v18.17h-51.315v15.973h50.062v17.926h-50.062v17.48l51.314.08v18.23h-73.139zm-28.119 47.029c4.878 1.725 8.865 4.816 10.734 7.375 3.095 4.291 3.542 8.294 3.631 16.037v17.418h-22.002v-10.992c0-5.286.531-13.112-3.542-17.198-3.201-3.147-8.083-3.899-16.076-3.899h-23.42v32.09h-22.02v-87.859h50.594c11.093 0 19.173.47 26.366 4.146 6.915 4.004 11.266 9.487 11.266 19.511-.001 14.022-9.764 21.178-15.531 23.371zm-12.385-11.107c-2.932 1.667-6.556 1.811-10.818 1.811h-26.622v-19.732h26.982c3.902 0 7.807.08 10.458 1.587 2.84 1.423 4.538 4.146 4.538 7.903 0 3.758-1.699 6.786-4.538 8.431zm197.82 5.597c4.27 4.229 6.554 9.571 6.554 18.613 0 18.9-12.322 27.723-34.425 27.723h-42.68v-18.84h42.51c4.157 0 7.104-.525 8.95-2.175 1.508-1.358 2.589-3.333 2.589-5.729 0-2.561-1.17-4.592-2.675-5.811-1.675-1.34-3.986-1.949-7.803-1.949-20.493-.67-46.157.609-46.157-27.192 0-12.744 8.355-26.158 31.33-26.158h43.932v18.7h-40.198c-3.984 0-6.575.145-8.779 1.587-2.4 1.422-3.29 3.534-3.29 6.319 0 3.314 2.037 5.57 4.795 6.546 2.311.77 4.795.995 8.526.995l11.797.306c11.895.276 20.061 2.248 25.024 7.065zm86.955-23.52h-39.938c-3.986 0-6.638.144-8.867 1.587-2.312 1.423-3.202 3.534-3.202 6.322 0 3.314 1.951 5.568 4.791 6.544 2.312.771 4.795.996 8.444.996l11.878.304c11.983.284 19.982 2.258 24.86 7.072.891.67 1.422 1.422 2.033 2.175v-25z" fill="#fff"></path></svg></span>
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<span data-cc="master" title="MasterCard" class="allow_announce"><svg enable-background="new 0 0 780 500" height="22" viewBox="0 0 780 500" width="34" xmlns="http://www.w3.org/2000/svg"><path d="m40 0h700c22.092 0 40 17.909 40 40v420c0 22.092-17.908 40-40 40h-700c-22.091 0-40-17.908-40-40v-420c0-22.091 17.909-40 40-40z" fill="#16366f"></path><path d="m449.01 250c0 99.143-80.37 179.5-179.51 179.5s-179.5-80.361-179.5-179.5c0-99.133 80.362-179.5 179.5-179.5 99.137 0 179.51 80.37 179.51 179.5" fill="#d9222a"></path><path d="m510.49 70.496c-46.38 0-88.643 17.596-120.5 46.466-6.49 5.889-12.548 12.237-18.125 18.996h36.266c4.966 6.037 9.536 12.388 13.685 19.013h-63.635c-3.827 6.121-7.28 12.469-10.341 19.008h84.312c2.893 6.185 5.431 12.53 7.6 19.004h-99.512c-2.091 6.235-3.832 12.581-5.217 19.009h109.94c2.689 12.49 4.044 25.231 4.041 38.008 0 19.934-3.254 39.113-9.254 57.02h-99.512c2.164 6.479 4.7 12.825 7.595 19.01h84.317c-3.064 6.54-6.52 12.889-10.347 19.013h-63.625c4.154 6.629 8.73 12.979 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<div id="tn-pay-manual-entry-super-purchase">
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<label for="spreedly-number-super-purchase" class="sr-only">Credit card</label>
<div id="spreedly-number-super-purchase" class="form-control"></div>
<div id="tn-pay-cards-super-purchase" class="tn-pay-cards pull-right">
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</svg></span>
</div>
</div>
<div class="form-group-flex">
<div id="billing-cvv">
<label for="spreedly-cvv-super-purchase">CVV</label>
<div id="spreedly-cvv-super-purchase" class="form-control"></div>
</div>
<div id="billing-month">
<label for="tnpay-month-super-purchase" class="control-label">Expiration <span class="sr-only">Month</span>
</label>
<select id="tnpay-month-super-purchase" class="form-control" name="tnpay-month">
<option value="1"> Jan </option>
<option value="2"> Feb </option>
<option value="3"> Mar </option>
<option value="4"> Apr </option>
<option value="5"> May </option>
<option value="6"> Jun </option>
<option value="7"> Jul </option>
<option value="8"> Aug </option>
<option value="9"> Sep </option>
<option value="10"> Oct </option>
<option value="11"> Nov </option>
<option value="12"> Dec </option>
</select>
</div>
<div id="billing-year">
<label for="tnpay-year-super-purchase" class="sr-only"> Expiration year </label>
<select id="tnpay-year-super-purchase" class="form-control" name="tnpay-year">
<option value="2024" selected=""> 2024 </option>
<option value="2025"> 2025 </option>
<option value="2026"> 2026 </option>
<option value="2027"> 2027 </option>
<option value="2028"> 2028 </option>
<option value="2029"> 2029 </option>
<option value="2030"> 2030 </option>
<option value="2031"> 2031 </option>
<option value="2032"> 2032 </option>
<option value="2033"> 2033 </option>
<option value="2034"> 2034 </option>
</select>
</div>
</div>
</div><!-- tn-pay-manual-entry -->
</fieldset>
<fieldset class="col-xs-12">
<div class="form-group tn-tos-group">
<label>
<input id="tn-tos-super-purchase" type="checkbox" name="tos_confirm">
<span class="tn-tos-agree">I Agree to the Subscription <a class="tos-link" href="https://www.elpasoinc.com/site/terms.html">Terms of Use.</a>
</span>
<br>
<small class="service-renews purchase-standard" hidden="">This service will be automatically renewed and your credit card billed once it nears expiration.</small>
</label>
</div>
</fieldset>
<div class="form-group text-center"><input type="submit" class="btn btn-primary tn-pay-button" id="form-submit-super-purchase" value="Pay Now" disabled="">
</div>
<p class="secure-notice text-center">
<span class="purchase-gift">Secure transaction.</span>
<span class="purchase-standard">Secure transaction. Cancel anytime.</span>
</p>
</form>Text Content
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