Invest In Phoenix

In this section

https://www.investinphoenix.com/Lists/DynamicPageSections/DispForm.aspx?ID=459

Payment Form

<h2>A secure credit card payment form should appear on your screen after you submit your information:</h2> <div class="separate-section__component phoenix-form__container"> <form action="https://payments.phoenix.gov/Transfer" method="post" class="phoenix-form" name="frmMain" id="frmMain"> <div class="form-field"> <em> <span>First Name*</span> <input type="text" name="BillingAddress.FirstName" value="" class="required triple-width" placeholder="First"> </em> </div> <div class="form-field"> <em> <span>Last Name*</span> <input type="text" name="BillingAddress.LastName" value="" class="required triple-width" placeholder="Last"> </em> </div> <div class="form-field"> <em> <span>Phone Number*</span> <input type="hidden" name="BillingAddress.PhoneNumbers[0].Key" value="home" /> <input type="text" name="BillingAddress.PhoneNumbers[0].Value" value="" class="required triple-width phone" placeholder="Phone Number"> </em> </div> <div class="form-field"> <em> <span>Email Address*</span> <input type="hidden" name="BillingAddress.EmailAddresses[0].Key" value="primary" /> <input type="text" name="BillingAddress.EmailAddresses[0].Value" value="" class="required triple-width email" placeholder="Email Address"> </em> </div> <input type="hidden" name="Cart[0].CartItemNumber" value="1" /> <input type="hidden" name="Cart[0].ServiceID" value="87000002" /> <input type="hidden" name="Cart[0].ProductSKU" value="87000002" /> <input type="hidden" name="Cart[0].Quantity" value="1" /> <input type="hidden" name="Cart[0].Name" value="Phoenix Film and Digital Media Permit" /> <input type="hidden" name="Cart[0].UnitPrice" value="100.00" /> <input type="hidden" name="Cart[0].TaxAmount" value="0" /> <div class="form-field"> <em> <span>Production Company Name On Permit*</span> <input type="hidden" name="Cart[0].ItemData[0].Key" value="Production_Company" /> <input type="text" name="Cart[0].ItemData[0].Value" value="" class="required triple-width" placeholder="Production Company Name That Will Appear On Permit*"> </em> </div> <div class="form-field"> <em> <span>Production Company Representative</span> <input type="hidden" name="Cart[0].ItemData[1].Key" value="Representative" /> <input type="text" name="Cart[0].ItemData[1].Value" value="" class="triple-width" placeholder="Production Company Representative"> </em> </div> <div class="form-field"> <em> <span>Additional Information</span> <textarea name="Cart[0].ItemData[2].Value" rows="5" cols="80" class="triple-width" placeholder="Additional Information (max 255 characters)"></textarea> </em> </div> <div style="text-align:center;"> <input type="submit" class="submit pay-now-button" value="Pay Now" /> </div> </form> </div> <script type="text/javascript"> var sVal = queryString('MODE'); $.extend($.validator.messages, { required: "**" }); $(function () { $("#frmMain").validate(); }); function doSubmit() { if (sVal == 'TEST') { $('#frmMain').attr('action', 'https://payments-test.phoenix.gov/Transfer'); } $("#frmMain").submit(); } </script>

CED-Form