Payment.html (8360B)
1 <!DOCTYPE html> 2 <html lang="en"> 3 <head> 4 <meta name="generator" content="HTML Tidy for HTML5 for Mac OS X version 5.4.0"> 5 <meta http-equiv="content-type" content="text/html; charset=utf-8"> 6 <meta charset="utf-8"> 7 <meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1"> 8 <meta name="viewport" content="width=device-width, minimum-scale=1.0, maximum-scale=1.0, user-scalable=no"> 9 <title>Checkout</title> 10 <meta property="og:type" content="Website"> 11 <meta property="og:image" content="http://sphotos-b.xx.fbcdn.net/hphotos-ash4/229244_10150189115584236_162217_n.jpg"> 12 <meta property="og:site_name" content="Walmart.com"> 13 <meta property="fb:app_id" content="105223049547814"> 14 <meta property="twitter:card" content="summary"> 15 <meta property="twitter:image" content="https://pbs.twimg.com/profile_images/616833885/walmart_logo_youtube_bigger.jpg"> 16 <meta property="twitter:site" content="@walmart"> 17 <meta property="og:title" content="Checkout"> 18 <meta property="twitter:title" content="Checkout"> 19 </head> 20 <body> 21 <form> 22 <label> 23 <span> 24 <span>Promo code 25 (optional)</span> 26 </span> 27 </label> 28 <div> 29 <input name="promoCode"> 30 </div> 31 <button type="submit"> 32 <span>Apply</span> 33 </button> 34 </form> 35 <form> 36 <div> 37 <div> 38 <div> 39 <div>* required field</div> 40 <div> 41 <label for="firstName"> 42 <span>First name on 43 card*</span> 44 </label> 45 </div> 46 <div> 47 <div> 48 <label for="firstName"> 49 <input id="firstName" value="" 50 name="firstName" 51 title="First name" autocomplete="section-payment given-name" maxlength="25"> 52 </label> 53 </div> 54 </div> 55 <div> 56 <label for="lastName"> 57 <span>Last name on 58 card*</span> 59 </label> 60 </div> 61 <div> 62 <div> 63 <label for="lastName"> 64 <input id="lastName" value="" 65 name="lastName" 66 title="Last name" autocomplete="section-payment family-name" maxlength="25"> 67 </label> 68 </div> 69 </div> 70 <div> 71 <label for="creditCard"> 72 <span>Card 73 number*</span> 74 </label> 75 </div> 76 <div> 77 <div> 78 <label for="creditCard"> 79 <input id="creditCard" pattern="[0-9]*" inputmode="numeric" name="creditCard" autocomplete="section-payment cc-number" maxlength="16"> 80 </label> 81 </div> 82 </div> 83 <div> 84 <div> 85 <div> 86 <label> 87 <span>Expiration date*</span> 88 </label> 89 <div> 90 <span> 91 <label for="month-chooser"> 92 <svg width="11" height="6"> 93 <polygon fill="#027DC3" points="5.5,6 0,0 11,0"> 94 </polygon> 95 </svg> 96 <select id="month-chooser" name="month-chooser" autocomplete="section-payment cc-exp-month"> 97 <option selected="selected" value="" disabled="disabled"> 98 MM 99 </option> 100 <option value="01">01</option> 101 <option value="02">02</option> 102 <option value="03">03</option> 103 <option value="04">04</option> 104 <option value="05">05</option> 105 <option value="06">06</option> 106 <option value="07">07</option> 107 <option value="08">08</option> 108 <option value="09">09</option> 109 <option value="10">10</option> 110 <option value="11">11</option> 111 <option value="12">12</option> 112 </select> 113 </label> 114 </span> 115 </div> 116 <span> / </span> 117 <div> 118 <span> 119 <label for="year-chooser"> 120 <svg width="11" height="6"> 121 <polygon fill="#027DC3" points="5.5,6 0,0 11,0"> 122 </polygon> 123 </svg> 124 <select id="year-chooser" name="year-chooser" autocomplete="section-payment cc-exp-year"> 125 <option selected="selected" value="" disabled="disabled"> 126 YY 127 </option> 128 <option value="2017">17</option> 129 <option value="2018">18</option> 130 <option value="2019">19</option> 131 <option value="2020">20</option> 132 <option value="2021">21</option> 133 <option value="2022">22</option> 134 <option value="2023">23</option> 135 <option value="2024">24</option> 136 <option value="2025">25</option> 137 <option value="2026">26</option> 138 <option value="2027">27</option> 139 </select> 140 </label> 141 </span> 142 </div> 143 </div> 144 </div> 145 <div> 146 <input 147 title=" " name="brwsrAutofillText" type="text"> 148 <input 149 title=" " name="brwsrAutofillPassword" type="password"> 150 <div> 151 <div> 152 <label for="cvv"> 153 <span> 154 <span> 155 <span>Security code*</span> 156 </span> 157 </span> 158 </label> 159 <div> 160 <label for="cvv"> 161 <button type="button"> 162 <label for="cvv"> 163 <span name="help" size="1" alt="Icon for help"> 164 </span> 165 </label> 166 </button> 167 </label> 168 </div> 169 </div> 170 <div> 171 <div> 172 <input id="cvv" name="cvv" 173 title="cvv" value="" autocomplete="section-payment cc-csc" maxlength="3" pattern="[0-9]*" inputmode="numeric" type="password"> 174 </div> 175 </div> 176 </div> 177 </div> 178 </div> 179 <div> 180 <label for="phone"> 181 <span>Phone number*</span> 182 <span>Ex: (415) 183 444 - 5555</span> 184 </label> 185 </div> 186 <div> 187 <div> 188 <label for="phone"> 189 <input id="phone" value="" name="phone" 190 title="Phone" autocomplete="section-payment tel" maxlength="14" type="tel"> 191 </label> 192 </div> 193 </div> 194 </div> 195 </div> 196 <div> 197 <div> 198 <div> 199 <label> 200 <input checked="checked" type="checkbox"> 201 </label> 202 <div> 203 <label> 204 <span>Same as shipping</span> 205 </label> 206 </div> 207 <div> 208 <p> 209 <span>22F., No.55, Haiiu 1st Rd., Bafu Dist.,</span> 210 <br> 211 <span> 212 <span>San Bruno</span> 213 <span>,</span> 214 </span> 215 <span> 216 <span>CA</span> 217 </span> 218 <span>94066</span> 219 </p> 220 </div> 221 </div> 222 </div> 223 </div> 224 </div> 225 <div> 226 <div> 227 <button type="button"> 228 <span>Review Your 229 Order</span> 230 </button> 231 </div> 232 </div> 233 </form> 234 </body> 235 </html>