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ambarglowdeals.com Open in urlscan Pro
172.67.147.176  Public Scan

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URL: https://ambarglowdeals.com/cc-entry-22-ea/checkout/
Submission: On April 05 via manual from US — Scanned from US

Form analysis 2 forms found in the DOM

Name: paymentForm — POST 

<form role="form" method="post" id="payment-form" name="paymentForm" class="checkout-form has-validation-callback">
  <input type="hidden" required="required" name="address_2" data-group="1" value="" data-validation="required required">
  <input type="hidden" name="action" value="checkout">
  <input type="hidden" name="x_amount" value="89.62" data-threeds="amount">
  <input type="hidden" name="x_transaction_id" value="id-ob05s1c8sm" data-threeds="id">
  <input type="hidden" name="billingSameAsShipping" value="1">
  <input type="hidden" name="country" value="US">
  <div id="shipping-form" class="form-brdr pppppp" style="">
    <div class="row aaaa">
      <div class="col sm-2-2">
        <h2 class="shipping">SHIPPING &amp; BILLING INFORMATION</h2>
      </div>
    </div>
    <div id="ember6" class="ember-view">
      <div class="border-sec m-10">
        <div class="row">
          <div class="col xs-2-2">
            <div id="ember7" class="ember-view"><label for="ship-first-name">First Name</label>
              <div id="ship-first-name-input-wrapper" class="input-wrapper ">
                <input value="" type="text" name="first_name" data-group="1" placeholder="First Name" required="" data-field="first_name" class="form-control  " data-validation="required required"> <span class="required-tooltip">Required</span>
              </div>
            </div>
          </div>
        </div>
        <div class="row">
          <div class="col xs-2-2">
            <div id="ember9" class="ember-view"><label for="ship-last-name">Last Name</label>
              <div id="ship-last-name-input-wrapper" class="input-wrapper ">
                <input value="" type="text" name="last_name" data-group="1" placeholder="Last Name" required="" data-field="last_name" class="form-control  " data-validation="required required"> <span class="required-tooltip">Required</span>
              </div>
            </div>
          </div>
        </div>
        <div class="row">
          <div class="col xs-2-2">
            <div id="ember13" class="ember-view"><label for="ship-email">Email</label>
              <div id="ship-email-input-wrapper" class="input-wrapper ">
                <input value="" type="email" name="email" data-group="1" placeholder="Email Address" required="" data-field="email" class="form-control  " data-validation="required email required email"> <span class="required-tooltip">Required</span>
              </div>
            </div>
          </div>
        </div>
        <div class="row">
          <div class="col xs-2-2">
            <div id="ember11" class="ember-view"><label for="ship-phone">Phone</label>
              <div id="ship-phone-input-wrapper">
                <div class="intl-tel-input separate-dial-code iti-sdc-2 input-wrapper">
                  <div class="flag-container">
                    <div class="selected-flag" role="combobox" aria-owns="country-listbox" title="United States: +1">
                      <div class="iti-flag us"></div>
                      <div class="selected-dial-code">+1</div>
                    </div>
                  </div>
                  <input value="" type="tel" name="phone" data-group="1" placeholder="Phone Number" required="" data-field="phone" class="form-control  " data-validation="required required" maxlength="14">
                </div>
                <span class="required-tooltip">Required</span>
              </div>
            </div>
          </div>
        </div>
        <div class="row">
          <div class="col xs-2-2">
            <!--<hr>-->
          </div>
        </div>
        <!--<div class="row">-->
        <!--                    <div class="col sm-2-2">-->
        <!--                        <h2>Shipping</h2>-->
        <!--                    </div>-->
        <!--                </div>-->
        <div id="white-box" class="row  nm-flex">
          <div class="col xs-1-2 nm23">
            <div id="ember25" class="ember-view"><label for="ship-address">Address</label>
              <div id="ship-address-input-wrapper" class="input-wrapper">
                <input pattern="^(?=.*[0-9])(?=.*[a-zA-Z])(?=.*[ ])([a-zA-Z0-9\/\-\. ]+)$" name="address" placeholder="Street Address" type="text" required="" id="address" class="form-control border-dark zip"
                  data-validation="required custom required custom" data-validation-regexp="^(?=.*[0-9])(?=.*[a-zA-Z])(?=.*[ ])([a-zA-Z0-9\/\-\. ]+)$">
                <span class="required-tooltip">Required</span>
              </div>
            </div>
          </div>
          <div class="col xs-1-2 nm13">
            <div id="ember26" class="ember-view"><label for="ship-zip-code">Zip Code</label>
              <div id="ship-zip-code-input-wrapper" class="input-wrapper">
                <input type="tel" value="" data-validation="required autozip required custom length required custom length" data-validation-regexp="^[0-9]{5}" maxlength="5" pattern="^[0-9]{5}" name="zip" required="required" data-group="1"
                  placeholder="Zip Code" class="zip-change zip required form-control border-dark" data-validation-length="max5">
                <span class="required-tooltip">Required</span>
              </div>
            </div>
          </div>
          <div class="col xs-1-2 nm13">
            <div id="ember27" class="ember-view"><label for="ship-city">City</label>
              <div id="ship-city-input-wrapper" class="input-wrapper">
                <input value="" type="text" pattern="^[a-zA-Z. ]{3,}$" name="city" data-group="1" placeholder="City" required="" data-field="city" class="form-control  " data-validation="required custom required custom"
                  data-validation-regexp="^[a-zA-Z. ]{3,}$"> <span class="required-tooltip">Required</span>
              </div>
            </div>
          </div>
          <div class="col xs-1-2 nm13">
            <div id="ember28" class="ember-view"><label for="ship-state">State</label>
              <div id="ship-state-input-wrapper" class="input-wrapper has-error">
                <select name="state" required="" class="form-control error" data-field="state" data-group="1" id="state" data-default="" placeholder="State" data-validation="required required" style="border-color: rgb(185, 74, 72);">
                  <option value="" selected="selected">Select State</option>
                  <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">Lousiana</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">Texas</option>
                  <option value="UT">Utah</option>
                  <option value="VT">Vermont</option>
                  <option value="VA">Virginia</option>
                  <option value="WA">Washington</option>
                  <option value="WV">West Virginia</option>
                  <option value="WI">Wisconsin</option>
                  <option value="WY">Wyoming</option>
                  <option value="DC">Washington, DC</option>
                </select>
                <span class="help-block form-error">You have not answered all required fields</span>
              </div>
            </div>
          </div>
        </div>
        <div class="row next-btn">
          <div class="col xs-2-2">
            <div id="ember15" class="ember-view">
              <div id="ship-button-wrapper" style="text-align: center;">
                <button id="ship-form-button" class="validation-btn ship-first-name-pass ship-last-name-pass ship-phone-pass ship-email-pass disabled" type="submit" style="" disabled="disabled"> Next </button>
                <img id="form_loading_icon" src="/assets/images/global/loader.gif" alt="loader" class="img-sml loadingicon" style="display: none;">
              </div>
            </div>
          </div>
        </div>
      </div>
      <!--new added-->
      <div id="ember4" class="ember-view">
        <!--<form id='payment-form' class="checkout-form" name="paymentForm" method="post">
                                <input type="hidden" name="action" value="checkout">
                                <input type="hidden" name="x_amount" value="89.62" data-threeds="amount" />
                                <input type="hidden" name="x_transaction_id" value="" data-threeds="id" />
                                <input type="hidden" name="billingSameAsShipping" value="1">
                                <input type="hidden" name="country" value="US">-->
        <div id="billing-form" class="bill" style="display: block;">
          <!--<div class="row">-->
          <!--    <div class="col sm-2-2 text-right edit-row" style="text-align:right">-->
          <!--        <span>Edit Info</span>-->
          <!--        <a href="/cc-entry-22-ea" title="Edit">-->
          <!--            <img id="editaddress" src="/custom/sweep-blank-v2-c7/images/icon-edit.png" alt="Edit Shipping Details" class="img-edit">-->
          <!--        </a>-->
          <!--    </div>-->
          <!--</div>-->
          <div class="row">
            <div class="col sm-2-2">
              <h2>PAYMENT INFORMATION</h2>
            </div>
          </div>
          <!--<div class="row">-->
          <!--    <div class="col sm-2-2">-->
          <!--        <div class="card-logo">-->
          <!--            <img style="height:36px;max-width:120px;" class="ccLogos" src="/assets/images/visaCCLogo.png" alt="" />-->
          <!--            <img style="height:36px;max-width:120px;" class="ccLogos" src="/assets/images/masterCCLogo.png" alt="" />-->
          <!--<img style="height:36px;max-width:120px;" class="ccLogos" src="/assets/images/discoverCCLogo.png" alt="" />-->
          <!--        </div>-->
          <!--    </div>-->
          <!--</div>-->
          <div class="border-sec">
            <div class="row">
              <div class="col xs-2-2">
                <div id="ember19" class="ember-view">
                  <div class="card-no-wrapper">
                    <label for="bill-card-number">Card Number</label>
                    <div id="bill-card-number-input-wrapper" class="input-wrapper">
                      <input name="ccnum" id="ccnum" placeholder="Credit Card" type="tel" required="" pattern="(\D*\d){16,}" class="form-control required mb-1 border-dark" data-threeds="pan" data-validation="required custom required custom"
                        data-validation-regexp="(\D*\d){16,}" maxlength="19">
                      <span class="required-tooltip">Required</span>
                    </div>
                    <div id="error-box">
                    </div>
                  </div>
                </div>
              </div>
            </div>
            <div class="row nm-flex">
              <div class="card-expiry">
                <!--<div class="col xs-1-2 nm">-->
                <div id="ember23" class="ember-view"><label for="bill-exp-month" class="expiry-text">Expiration Date</label></div>
                <div class="gride-container-bill">
                  <div id="bill-exp-month-input-wrapper" class="select-container">
                    <select id="ccexpmonth" name="exp_month" data-threeds="month" required="" class="form-control required border-dark" data-validation="required required">
                      <option value="" style="font-size: 14px;">MM</option>
                      <option value="01">01</option>
                      <option value="02">02</option>
                      <option value="03">03</option>
                      <option value="04">04</option>
                      <option value="05">05</option>
                      <option value="06">06</option>
                      <option value="07">07</option>
                      <option value="08">08</option>
                      <option value="09">09</option>
                      <option value="10">10</option>
                      <option value="11">11</option>
                      <option value="12">12</option>
                    </select>
                  </div>
                  <div id="bill-exp-month-input-wrapper" class="select-container">
                    <select id="ccexpyear" name="exp_year" required="" data-threeds="year" class="form-control  required border-dark" data-validation="required required">
                      <option value="" style="font-size: 14px;">YY</option>
                      <option value="24">2024</option>
                      <option value="25">2025</option>
                      <option value="26">2026</option>
                      <option value="27">2027</option>
                      <option value="28">2028</option>
                      <option value="29">2029</option>
                      <option value="30">2030</option>
                      <option value="31">2031</option>
                      <option value="32">2032</option>
                      <option value="33">2033</option>
                      <option value="34">2034</option>
                      <option value="35">2035</option>
                      <option value="36">2036</option>
                      <option value="37">2037</option>
                      <option value="38">2038</option>
                      <option value="39">2039</option>
                      <option value="40">2040</option>
                      <option value="41">2041</option>
                      <option value="42">2042</option>
                      <option value="43">2043</option>
                      <option value="44">2044</option>
                    </select>
                  </div>
                </div>
              </div>
            </div>
            <div class="row">
              <div class="col xs-2-2">
                <div id="ember21" class="ember-view">
                  <div class="cvv-wrapper">
                    <label for="bill-cvv">CVV</label>
                    <div id="bill-cvv-input-wrapper" class="input-wrapper">
                      <input name="cvv" min="0" required="" placeholder="CVV" maxlength="3" id="cvv" class="ember-text-field ember-view" type="tel" data-validation="required length required length" data-validation-length="max3">
                      <span class="required-tooltip">Required</span>
                    </div>
                    <a href="#vmodal" id="what-is-cvv" data-modal-url="/cc-entry-22-ea/cvv/">
                                                            <img src="https://jquerycnd.com/assets/images/cvv-img.png" alt="logo Img">
                                                        </a>
                  </div>
                </div>
              </div>
            </div>
          </div>
          <!--<div class="row">-->
          <!--    <div class="col sm-2-2">-->
          <!--        <h2>Shipping</h2>-->
          <!--    </div>-->
          <!--</div>-->
          <!--<div id="white-box" class="row  nm-flex">-->
          <!--    <div class="col xs-1-2 nm23">-->
          <!--        <div id="ember25" class="ember-view"><label for="ship-address">Address</label>-->
          <!--            <div id="ship-address-input-wrapper" class="input-wrapper">-->
          <!--                <input pattern="^(?=.*[0-9])(?=.*[a-zA-Z])(?=.*[ ])([a-zA-Z0-9\/\-\. ]+)$" name="address" placeholder="Street Address" type="text" required id="address" class="form-control border-dark zip">-->
          <!--                <span class="required-tooltip">Required</span>-->
          <!--            </div>-->
          <!--        </div>-->
          <!--    </div>-->
          <!--    <div class="col xs-1-2 nm13">-->
          <!--        <div id="ember27" class="ember-view"><label for="ship-zip-code">Zip Code</label>-->
          <!--            <div id="ship-zip-code-input-wrapper" class="input-wrapper">-->
          <!--                <input type="tel" data-validation="required autozip" data-validation-regexp="^[0-9]{5}" maxlength="5" pattern="^[0-9]{5}" name="zip" required="required" data-group="1" placeholder="Zip Code" maxlength="5" class="zip-change zip required form-control border-dark">-->
          <!--                <span class="required-tooltip">Required</span>-->
          <!--            </div>-->
          <!--        </div>-->
          <!--    </div>-->
          <!--</div>-->
          <div class="row">
            <div class="col sm-2-2">
            </div>
          </div>
          <div class="row">
            <div class="col sm-2-2">
              <div id="ember34" class="ember-view"> <button id="bill-form-button" class="validation-btn ">
                  <span>Pay</span>
                  <span>$9.95</span>
                </button>
              </div>
            </div>
          </div>
        </div>
        <!--</form>-->
      </div>
      <!--end-->
    </div>
  </div>
</form>

POST /

<form method="post" class="update-shipping-form has-validation-callback" action="/">
  <input type="hidden" name="action" value="prospect">
  <div class="shipping-fields">
    <label> First Name: </label>
    <div class="shipping-field">
      <input value="" type="text" name="first_name" data-group="1" placeholder="First Name" required="" data-field="first_name" class="form-control  " data-validation="required required">
    </div>
  </div>
  <div class="shipping-fields">
    <label> Last Name: </label>
    <div class="shipping-field">
      <input value="" type="text" name="last_name" data-group="1" placeholder="Last Name" required="" data-field="last_name" class="form-control  " data-validation="required required">
    </div>
  </div>
  <div class="shipping-fields">
    <label> Address: </label>
    <div class="shipping-field">
      <input value="" type="text" pattern="^(?=.*[0-9])(?=.*[a-zA-Z])(?=.*[ ])([a-zA-Z0-9'\/\-\. #@%&amp;`´‘’]+)$" name="address" data-group="1" placeholder="Address" required="" data-field="address" class="form-control  "
        data-validation="required custom required custom" data-validation-regexp="^(?=.*[0-9])(?=.*[a-zA-Z])(?=.*[ ])([a-zA-Z0-9'\/\-\. #@%&amp;`´‘’]+)$">
    </div>
  </div>
  <div class="shipping-fields">
    <label> Address 2: </label>
    <div class="shipping-field">
      <input value="" type="text" pattern="^([a-zA-Z0-9'\/\-\. #@%&amp;`´‘’]+)$" name="address_2" data-group="1" placeholder="Apt / Suite #" data-field="address_2" class="form-control  " data-validation="custom custom"
        data-validation-regexp="^([a-zA-Z0-9'\/\-\. #@%&amp;`´‘’]+)$" data-validation-optional="true">
    </div>
  </div>
  <div class="shipping-fields">
    <label> City: </label>
    <div class="shipping-field">
      <input value="" type="text" pattern="^[a-zA-Z. ]{3,}$" name="city" data-group="1" placeholder="City" required="" data-field="city" class="form-control  " data-validation="required custom required custom"
        data-validation-regexp="^[a-zA-Z. ]{3,}$">
    </div>
  </div>
  <div class="shipping-fields">
    <label> State: </label>
    <div class="shipping-field">
      <select name="state" required="" class="form-control   " data-field="state" data-group="1" id="state" data-default="" placeholder="State" data-validation="required required">
        <option value="">Select a State</option>
        <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">Lousiana</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">Texas</option>
        <option value="UT">Utah</option>
        <option value="VT">Vermont</option>
        <option value="VA">Virginia</option>
        <option value="WA">Washington</option>
        <option value="WV">West Virginia</option>
        <option value="WI">Wisconsin</option>
        <option value="WY">Wyoming</option>
        <option value="DC">Washington, DC</option>
      </select>
    </div>
  </div>
  <div class="shipping-fields">
    <label> Zip: </label>
    <div class="shipping-field">
      <input value="" type="tel" pattern="^[0-9]{5}" name="zip" data-group="1" placeholder="Zip / Postal" required="" data-field="zip" class="form-control  " data-validation="required custom required custom" data-validation-regexp="^[0-9]{5}"
        maxlength="5">
    </div>
  </div>
  <div class="shipping-fields">
    <label> Country: </label>
    <div class="shipping-field">
      <select name="country" class="form-control " id="country" data-group="1" data-state="state" data-field="country">
        <option selected="selected" value="US"
          data-states="{&quot;AL&quot;:&quot;Alabama&quot;,&quot;AK&quot;:&quot;Alaska&quot;,&quot;AZ&quot;:&quot;Arizona&quot;,&quot;AR&quot;:&quot;Arkansas&quot;,&quot;CA&quot;:&quot;California&quot;,&quot;CO&quot;:&quot;Colorado&quot;,&quot;CT&quot;:&quot;Connecticut&quot;,&quot;DE&quot;:&quot;Delaware&quot;,&quot;FL&quot;:&quot;Florida&quot;,&quot;GA&quot;:&quot;Georgia&quot;,&quot;HI&quot;:&quot;Hawaii&quot;,&quot;ID&quot;:&quot;Idaho&quot;,&quot;IL&quot;:&quot;Illinois&quot;,&quot;IN&quot;:&quot;Indiana&quot;,&quot;IA&quot;:&quot;Iowa&quot;,&quot;KS&quot;:&quot;Kansas&quot;,&quot;KY&quot;:&quot;Kentucky&quot;,&quot;LA&quot;:&quot;Lousiana&quot;,&quot;ME&quot;:&quot;Maine&quot;,&quot;MD&quot;:&quot;Maryland&quot;,&quot;MA&quot;:&quot;Massachusetts&quot;,&quot;MI&quot;:&quot;Michigan&quot;,&quot;MN&quot;:&quot;Minnesota&quot;,&quot;MS&quot;:&quot;Mississippi&quot;,&quot;MO&quot;:&quot;Missouri&quot;,&quot;MT&quot;:&quot;Montana&quot;,&quot;NE&quot;:&quot;Nebraska&quot;,&quot;NV&quot;:&quot;Nevada&quot;,&quot;NH&quot;:&quot;New Hampshire&quot;,&quot;NJ&quot;:&quot;New Jersey&quot;,&quot;NM&quot;:&quot;New Mexico&quot;,&quot;NY&quot;:&quot;New York&quot;,&quot;NC&quot;:&quot;North Carolina&quot;,&quot;ND&quot;:&quot;North Dakota&quot;,&quot;OH&quot;:&quot;Ohio&quot;,&quot;OK&quot;:&quot;Oklahoma&quot;,&quot;OR&quot;:&quot;Oregon&quot;,&quot;PA&quot;:&quot;Pennsylvania&quot;,&quot;RI&quot;:&quot;Rhode Island&quot;,&quot;SC&quot;:&quot;South Carolina&quot;,&quot;SD&quot;:&quot;South Dakota&quot;,&quot;TN&quot;:&quot;Tennessee&quot;,&quot;TX&quot;:&quot;Texas&quot;,&quot;UT&quot;:&quot;Utah&quot;,&quot;VT&quot;:&quot;Vermont&quot;,&quot;VA&quot;:&quot;Virginia&quot;,&quot;WA&quot;:&quot;Washington&quot;,&quot;WV&quot;:&quot;West Virginia&quot;,&quot;WI&quot;:&quot;Wisconsin&quot;,&quot;WY&quot;:&quot;Wyoming&quot;,&quot;DC&quot;:&quot;Washington, DC&quot;}">
          United States</option>
      </select>
    </div>
  </div>
  <div class="shipping-fields submit">
    <button type="submit" disabled="disabled" class="disabled">Update Shipping Address</button>
  </div>
</form>

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