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Form analysis
2 forms found in the DOM

Name: checkout — POST /secure/?sessid2=sessid20230329204513786&aff_id=106&sid=1218&sid2=7119_sessid20230329204514405&account_id=6963&product_codename=prod8&redirect=aHR0cHM6Ly93d3cudHJpY2hvZm9sLmNvbS91cGdyYWRlLTE%3D&lang=en

<form action="/secure/?sessid2=sessid20230329204513786&amp;aff_id=106&amp;sid=1218&amp;sid2=7119_sessid20230329204514405&amp;account_id=6963&amp;product_codename=prod8&amp;redirect=aHR0cHM6Ly93d3cudHJpY2hvZm9sLmNvbS91cGdyYWRlLTE%3D&amp;lang=en"
  id="checkout" method="post" name="checkout">
  <input name="action" type="hidden" value="checkout">
  <input name="payment_method" id="payment_method" type="hidden" value="creditcard">
  <input type="hidden" name="salespage_url" value="" id="salespage_url">
  <input type="hidden" name="product_codename" value="prod8" id="product_codename">
  <input type="hidden" id="salestax_amount" name="salestax_amount" value="0.00">
  <h2>Secure checkout</h2>
  <div class="field">
    <label>Payment method</label>
    <div class="payment-type">
      <div class="payment-type-item payment-type-card selected" data-payment-type="card">
        <img src="https://cdn.buygoods.com/assets/6272/images/visa.svg" alt="Visa">
        <img src="https://cdn.buygoods.com/assets/6272/images/mastercard.svg" alt="Mastercard">
        <img src="https://cdn.buygoods.com/assets/6272/images/amex.svg" alt="Amex">
        <img src="https://cdn.buygoods.com/assets/6272/images/discover.svg" alt="Discover">
        <img src="https://cdn.buygoods.com/assets/6272/images/jcb.svg" alt="JCB">
      </div>
      <div class="payment-type-separator"> or </div>
      <div class="payment-type-item payment-type-paypal" data-payment-type="paypal">
        <img src="https://cdn.buygoods.com/assets/6272/images/paypal.png" alt="PayPal">
      </div>
    </div>
  </div>
  <div data-payment-form="card" style="display: block;">
    <div class="field">
      <label for="emailaddress">Email address</label>
      <input id="emailaddress" name="emailaddress" onblur="addLead(this.value)" type="text" class="input" placeholder="you@email.com">
    </div>
    <div class="field hide-paypal-flex">
      <label for="phone">Phone</label>
      <input id="phone" placeholder="Your phone number" name="phone" onblur="addLead()" type="text" class="input">
    </div>
    <div class="field hide-paypal-flex">
      <label for="creditcards_address">Billing address</label>
      <input id="creditcards_address" name="creditcards_address" type="text" class="input" placeholder="Your billing address">
    </div>
    <div class="field-group">
      <div class="field hide-paypal-flex">
        <label for="creditcards_city">Billing city</label>
        <input id="creditcards_city" name="creditcards_city" type="text" class="input" placeholder="City">
      </div>
      <div class="field" style="width: 50px; flex: none; flex-grow: 1;">
        <label for="creditcards_zip">Zip Code</label>
        <input id="creditcards_zip" placeholder="Zip" onblur="calculateSalesTax()" name="creditcards_zip" type="text" class="input">
      </div>
    </div>
    <div class="field-group">
      <div class="field">
        <label for="creditcards_country">Billing country</label>
        <select id="creditcards_country" style="width: 100%;" onchange="onCountryChange(this.value,this.id);calculateSalesTax();" name="creditcards_country" class="input">
          <option value="">Please Select</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="Åland Islands">Åland Islands</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="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">Bolivia</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="Cambodia">Cambodia</option>
          <option value="Cameroon">Cameroon</option>
          <option value="Canada">Canada</option>
          <option value="Cape Verde">Cape Verde</option>
          <option value="Cayman Islands">Cayman Islands</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="Cook Islands">Cook Islands</option>
          <option value="Costa Rica">Costa Rica</option>
          <option value="Croatia">Croatia</option>
          <option value="Curacao">Curaçao</option>
          <option value="Cyprus">Cyprus</option>
          <option value="Czech Republic">Czech Republic</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="Falkland Islands">Falkland Islands</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 and McDonald Islands">Heard and McDonald Islands</option>
          <option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
          <option value="Honduras">Honduras</option>
          <option value="Hungary">Hungary</option>
          <option value="Iceland">Iceland</option>
          <option value="India">India</option>
          <option value="Indonesia">Indonesia</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="Japan">Japan</option>
          <option value="Jamaica">Jamaica</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="South Korea">South Korea</option>
          <option value="Kuwait">Kuwait</option>
          <option value="Kyrgyzstan">Kyrgyzstan</option>
          <option value="Laos">Laos</option>
          <option value="Latvija">Latvija</option>
          <option value="Lesotho">Lesotho</option>
          <option value="Liberia">Liberia</option>
          <option value="Liechtenstein">Liechtenstein</option>
          <option value="Lithuania">Lithuania</option>
          <option value="Luxembourg">Luxembourg</option>
          <option value="Macao">Macao</option>
          <option value="Republic of Macedonia">Republic of Macedonia</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="Federated States of Micronesia">Federated States of Micronesia</option>
          <option value="Moldova">Moldova</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="Netherlands Antilles">Netherlands Antilles</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">Palestine</option>
          <option value="Panama">Panama</option>
          <option value="Papua New Guinea">Papua New Guinea</option>
          <option value="Paraguay">Paraguay</option>
          <option value="Perú">Perú</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="Rwanda">Rwanda</option>
          <option value="Reunion">Réunion</option>
          <option value="St. Barthelemy">St. Barthélemy</option>
          <option value="St. Helena, Ascension and Tristan Da Cunha">St. Helena, Ascension and Tristan Da Cunha</option>
          <option value="St. Kitts And Nevis">St. Kitts And Nevis</option>
          <option value="Saint Lucia">Saint Lucia</option>
          <option value="St. Martin">St. Martin</option>
          <option value="St. Pierre And Miquelon">St. Pierre And Miquelon</option>
          <option value="St. Vincent And The Grenedines">St. Vincent And The Grenedines</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="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="Spain">Spain</option>
          <option value="St. Kitts and Nevis">St. Kitts and Nevis</option>
          <option value="Sri Lanka">Sri Lanka</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="Taiwan">Taiwan</option>
          <option value="Tajikistan">Tajikistan</option>
          <option value="Tanzania">Tanzania</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="Türkiye">Türkiye</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="US Minor Outlying Islands">US Minor Outlying Islands</option>
          <option value="Uruguay">Uruguay</option>
          <option value="Uzbekistan">Uzbekistan</option>
          <option value="Vanuatu">Vanuatu</option>
          <option value="Vietnam">Vietnam</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="Zambia">Zambia</option>
        </select>
      </div>
      <div class="field">
        <label for="creditcards_state">Billing state</label>
        <div id="statewrapper"><select onchange="calculateSalesTax()" style="width:100%;" name="creditcards_state" class="input" id="creditcards_state">
            <option value="">Select State</option>
            <option value="Baden-Württemberg">Baden-Württemberg</option>
            <option value="Bayern">Bayern</option>
            <option value="Berlin">Berlin</option>
            <option value="Brandenburg">Brandenburg</option>
            <option value="Bremen">Bremen</option>
            <option value="Hamburg">Hamburg</option>
            <option value="Hessen">Hessen</option>
            <option value="Mecklenburg-Vorpommern">Mecklenburg-Vorpommern</option>
            <option value="Niedersachsen">Niedersachsen</option>
            <option value="Nordrhein-Westfalen">Nordrhein-Westfalen</option>
            <option value="Rheinland-Pfalz">Rheinland-Pfalz</option>
            <option value="Saarland">Saarland</option>
            <option value="Sachsen">Sachsen</option>
            <option value="Sachsen-Anhalt">Sachsen-Anhalt</option>
            <option value="Schleswig-Holstein">Schleswig-Holstein</option>
            <option value="Thüringen">Thüringen</option>
          </select></div>
      </div>
    </div>
    <div class="field hide-paypal">
      <input type="checkbox" id="toggleShipping" class="checkbox" checked="">
      <label for="toggleShipping">I have the same shipping address</label>
    </div>
    <div data-form="shipping" class="hide-paypal-shipping" style="display: none;">
      <div class="field">
        <label for="addresses_address">Shipping address</label>
        <input id="addresses_address" name="addresses_address" type="text" class="input" placeholder="Your shipping address">
      </div>
      <div class="field-group">
        <div class="field">
          <label for="addresses_city">Shipping city</label>
          <input id="addresses_city" name="addresses_city" type="text" class="input" placeholder="City">
        </div>
        <div class="field" style="width: 50px;">
          <label for="addresses_zip">Zip Code</label>
          <input id="addresses_zip" placeholder="Zip" onblur="calculateSalesTax()" name="addresses_zip" type="text" class="input">
        </div>
      </div>
      <div class="field-group">
        <div class="field">
          <label for="addresses_country">Shipping country</label>
          <select style="width: 100%;" id="addresses_country" onchange="onCountryChange(this.value,this.id);calculateSalesTax();" name="addresses_country" class="input">
            <option value="">Please Select</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="Åland Islands">Åland Islands</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="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">Bolivia</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="Cambodia">Cambodia</option>
            <option value="Cameroon">Cameroon</option>
            <option value="Canada">Canada</option>
            <option value="Cape Verde">Cape Verde</option>
            <option value="Cayman Islands">Cayman Islands</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="Cook Islands">Cook Islands</option>
            <option value="Costa Rica">Costa Rica</option>
            <option value="Croatia">Croatia</option>
            <option value="Curacao">Curaçao</option>
            <option value="Cyprus">Cyprus</option>
            <option value="Czech Republic">Czech Republic</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="Falkland Islands">Falkland Islands</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 and McDonald Islands">Heard and McDonald Islands</option>
            <option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
            <option value="Honduras">Honduras</option>
            <option value="Hungary">Hungary</option>
            <option value="Iceland">Iceland</option>
            <option value="India">India</option>
            <option value="Indonesia">Indonesia</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="Japan">Japan</option>
            <option value="Jamaica">Jamaica</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="South Korea">South Korea</option>
            <option value="Kuwait">Kuwait</option>
            <option value="Kyrgyzstan">Kyrgyzstan</option>
            <option value="Laos">Laos</option>
            <option value="Latvija">Latvija</option>
            <option value="Lesotho">Lesotho</option>
            <option value="Liberia">Liberia</option>
            <option value="Liechtenstein">Liechtenstein</option>
            <option value="Lithuania">Lithuania</option>
            <option value="Luxembourg">Luxembourg</option>
            <option value="Macao">Macao</option>
            <option value="Republic of Macedonia">Republic of Macedonia</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="Federated States of Micronesia">Federated States of Micronesia</option>
            <option value="Moldova">Moldova</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="Netherlands Antilles">Netherlands Antilles</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>
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            <option value="Palau">Palau</option>
            <option value="Palestine">Palestine</option>
            <option value="Panama">Panama</option>
            <option value="Papua New Guinea">Papua New Guinea</option>
            <option value="Paraguay">Paraguay</option>
            <option value="Perú">Perú</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="Rwanda">Rwanda</option>
            <option value="Reunion">Réunion</option>
            <option value="St. Barthelemy">St. Barthélemy</option>
            <option value="St. Helena, Ascension and Tristan Da Cunha">St. Helena, Ascension and Tristan Da Cunha</option>
            <option value="St. Kitts And Nevis">St. Kitts And Nevis</option>
            <option value="Saint Lucia">Saint Lucia</option>
            <option value="St. Martin">St. Martin</option>
            <option value="St. Pierre And Miquelon">St. Pierre And Miquelon</option>
            <option value="St. Vincent And The Grenedines">St. Vincent And The Grenedines</option>
            <option value="Samoa">Samoa</option>
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            <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="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="Spain">Spain</option>
            <option value="St. Kitts and Nevis">St. Kitts and Nevis</option>
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            <option value="Virgin Islands, U.S.">Virgin Islands, U.S.</option>
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        <div class="field">
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          <div id="statewrapper_shipping">
            <select style="width: 100%;" id="addresses_state" name="addresses_state" class="input">
              <option value="">Select State</option>
            </select>
          </div>
        </div>
      </div>
    </div>
    <div class="card hide-paypal">
      <div class="field">
        <label for="creditcards_cardnumber">Card number</label>
        <div class="creditcards">
          <img src="https://cdn.buygoods.com/assets/6272/images/visa.svg" alt="Visa">
          <img src="https://cdn.buygoods.com/assets/6272/images/mastercard.svg" alt="Mastercard">
          <img src="https://cdn.buygoods.com/assets/6272/images/amex.svg" alt="Amex">
          <img src="https://cdn.buygoods.com/assets/6272/images/discover.svg" alt="Discover">
          <img src="https://cdn.buygoods.com/assets/6272/images/jcb.svg" alt="JCB">
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        <input id="creditcards_cardnumber" name="creditcards_cardnumber" type="text" class="input" placeholder="xxxx xxxx xxxx xxxx" data-cardinal-field="AccountNumber">
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      <div class="field">
        <label for="creditcards_name">Your name</label>
        <input id="creditcards_name" onblur="addLead()" name="creditcards_name" type="text" class="input" placeholder="Name as it appears on your card">
      </div>
      <div class="field-group relative">
        <div class="field expiration mb-0">
          <label for="creditcards_month">Expiration date</label>
          <div class="field-group">
            <div class="field">
              <select class="input" name="creditcards_month" id="creditcards_month" style="width: 110px;">
                <option value="">Month</option>
                <option value="1">1</option>
                <option value="2">2</option>
                <option value="3">3</option>
                <option value="4">4</option>
                <option value="5">5</option>
                <option value="6">6</option>
                <option value="7">7</option>
                <option value="8">8</option>
                <option value="9">9</option>
                <option value="10">10</option>
                <option value="11">11</option>
                <option value="12">12</option>
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            <div class="field">
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                <option value="">Year</option>
                <option value="2022">2022</option>
                <option value="2023">2023</option>
                <option value="2024">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>
                <option value="2035">2035</option>
                <option value="2036">2036</option>
                <option value="2037">2037</option>
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            </div>
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        <div class="cvv">
          <div class="field mb-0">
            <label for="creditcards_ccv" style="display: flex;" data-cvv-info=""> CVV <svg data-cvv="mobile" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 20 20" fill="currentColor"
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            <input id="creditcards_ccv" name="creditcards_ccv" type="text" class="input" placeholder="xxx">
          </div>
          <div class="field mb-0" data-cvv="desktop">
            <label>&nbsp;</label>
            <a href="https://offer.local/merchant-checkout#" data-cvv-info="">
What's a CVV?
</a>
          </div>
        </div>
        <div class="tooltip" data-tooltip="cvv">
          <div class="tooltip-section visa">
            <div class="tooltip-heading"> Visa, MasterCard, <br>Discover &amp; JCB </div>
            <div class="tooltip-body">
              <div class="tooltip-content"> The 3 digits on the card's <strong>back</strong>. </div>
              <img src="https://cdn.buygoods.com/assets/6272/images/visa-cvv.jpg">
            </div>
          </div>
          <div class="tooltip-section amex">
            <div class="tooltip-heading"> American Express <br>
            </div>
            <div class="tooltip-body">
              <div class="tooltip-content"> The 4 digits on the card's <strong>front</strong>. </div>
              <img src="https://cdn.buygoods.com/assets/6272/images/amex-cvv.jpg">
            </div>
          </div>
          <div class="tooltip-close" data-tooltip-close="">
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        </div>
      </div>
    </div>
  </div>
  <div id="payment_terms" style="display:none;">
    <p><strong>Payment terms:</strong></p>
    <span id="payment_terms_tax">$177.00</span>
  </div>
  <div class="field mb-0">
    <button id="submitButton" onclick="CardinalCheckout()" class="button loading" type="button">
      <span class="default-state"> Place Order </span>
      <span class="loading-state">
        <span class="loader"></span>
        <span>Processing</span>
      </span>
    </button>
  </div>
</form>

<form>
  <input type="hidden" name="JWTContainer" id="JWTContainer"
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  <input type="hidden" name="cardinal_order_number" id="cardinal_order_number" value="ORDER-6963-20230329204636681">
  <input type="hidden" name="cardinal_response" id="cardinal_response" value="">
  <input type="hidden" name="skip_kount_validation" id="skip_kount_validation" value="0">
</form>

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CVV
  What's a CVV?
Visa, MasterCard,
Discover & JCB
The 3 digits on the card's back.
American Express

The 4 digits on the card's front.


Payment terms:

$177.00
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ORDER DETAILS

Trichofol - 3 Bottles
3 Bottles at $59.00 per bottle
Subtotal $177.00
Taxes $0.00
Shipping $15.95
Grand total $192.95
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BuyGoods contact details
1000 North West st. Suite #1200, Wilmington, DE, 19801, USA
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   retailer.
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