{"_id":"5632a5ec49e16d0d001224c3","category":{"_id":"5632a5e749e16d0d00122444","pages":["5632a5ec49e16d0d001224bd","5632a5ec49e16d0d001224be","5632a5ec49e16d0d001224bf","5632a5ec49e16d0d001224c0","5632a5ec49e16d0d001224c1","5632a5ec49e16d0d001224c2","5632a5ec49e16d0d001224c3","5632a5ec49e16d0d001224c4","5632a5ec49e16d0d001224c5","5632a5ec49e16d0d001224c6","5632a5ec49e16d0d001224c7","5632a5ec49e16d0d001224c8","5632a5ec49e16d0d001224c9","5632a5ec49e16d0d001224ca","5632a5ec49e16d0d001224cb","5633bab59c607719001b86a1","5633bcbac49a7c19001fd0a6","5633befcc49a7c19001fd0a9","5633c585b904a10d0032f864","5633d7547b56ae0d0025a062","5633d7e87b56ae0d0025a066","5633d85435355017003ca3c8","5633da507e9e880d00af1a28","5633daa3fa71f30d00ba74ab","5633e1f87e9e880d00af1a3f","5633e323fa71f30d00ba74b9","5633e3aa7b56ae0d0025a072","5633e4c6737ea01700ea3276"],"project":"55b933b3146ef121002158d3","version":"5632a5e549e16d0d00122443","__v":14,"sync":{"url":"","isSync":false},"reference":false,"createdAt":"2015-07-31T23:12:47.262Z","from_sync":false,"order":0,"slug":"epayment-form","title":"ePayment Form"},"githubsync":"","project":"55b933b3146ef121002158d3","__v":0,"user":"55b932ba8fd1a02b00f496c8","version":{"_id":"5632a5e549e16d0d00122443","__v":6,"project":"55b933b3146ef121002158d3","createdAt":"2015-10-29T23:04:05.701Z","releaseDate":"2015-10-29T23:04:05.701Z","categories":["5632a5e749e16d0d00122444","5632a5e749e16d0d00122445","5632a5e749e16d0d00122446","5632a5e749e16d0d00122447","5632a5e749e16d0d00122448","5632a5e749e16d0d00122449","5632a5e749e16d0d0012244a","5632a5e749e16d0d0012244b","5632a5e749e16d0d0012244c","5632a5e749e16d0d0012244d","5632a5e749e16d0d0012244e","5632a5e749e16d0d0012244f","5632a5e749e16d0d00122450","5632b179df556c0d00cd095b","564e13053b2b4a19000cd69b","59caa9df65accc001a489c95","59cab50965accc001a489d28","59cadd464ab7b70024378e74"],"is_deprecated":false,"is_hidden":false,"is_beta":false,"is_stable":true,"codename":"","version_clean":"1.1.0","version":"1.1"},"parentDoc":null,"updates":[],"next":{"pages":[],"description":""},"createdAt":"2015-08-03T18:34:34.024Z","link_external":false,"link_url":"","sync_unique":"","hidden":false,"api":{"settings":"","results":{"codes":[]},"auth":"required","params":[],"url":""},"isReference":false,"order":6,"body":"## Case Study: Recurring Subscription Form \n\nThe following is a case study for creating a simple recurring or subscription page hosted on eBizCharge's side and linked from your website that connects to eBizCharge for secure processing. This is a great starting off point for service fee merchants that want to accept a fixed dollar amount from the client through a payment form. Below you can download the necessary source code files. Edit the HTML source code with your favorite editor (Notepad, TextEdit, Dreamweaver) to input your source key and edit any of the templated text already there for you. Save the files in the original format. These files will need to be uploaded via a service such as FTP, or something similar, to your website. Once you've uploaded the files you can access them through the browser. Clicking on the button submits the form to eBizCharge and brings the customer to the secure payment area on eBizCharge's servers. The customer completes the payment process by entering their payment information. For information on editing eBizCharge's hosted paymet form click [here](/docs/sourcespaymentformtemplate).\n\n## ePayment Form fields used\n\nThe form uses the following fields to post to eBizCharge:\n**-UMkey **- This is the source key that connects you as a valid merchant on our gateway (Required)\n**-UMcommand** - This indicates the type of a transaction, sale. (Required)\n**-UMcustreceipt** - This flags eBizCharge to send a customer receipt via email through a value of 'yes'.\n**-UMaddcustomer** UMrecurring is deprecated - This flags eBizCharge to add this transaction as a customer record in Customers & Billing area of the Merchant Console.\n**-UMinvoice** - This allows you to pass a numerical invoice number for record keeping. (Required)\n**-UMamount** - A text box displayed for customer to enter a decimal (0.00) amount. (Required)\n**-UMbillamount** - Sets the monetary amount to charge on each cycle. If this field is left blank the UMamount will be used instead. This is NOT the “initial” charge or “setup” charge, this is only the “recurring” charge. UMamount determines the initial charge.\n**-UMschedule** - Determines the recurring billing schedule. Possible values are daily, weekly, biweekly, monthly, bimonthly, quarterly, biannually, or annually. (defaults to monthly)\n**-UMnumleft** - Number of transactions remaining in recurring billing cycle. If the recurring billing should go on indefinitely, set this to *. (defaults to *)\n**-UMstart** - Start date. Default is tomorrow. Must be entered in YYYYMMDD format. If set to UMstart=next the date of the next billing cycle will be used. For example if today is 1/10/2009 and UMschedule=monthly then UMstart will be set to 2/10/2009.\n**-UMdescription** - A text box for any comments left by the donor\n**-UMcomments** - Optional transaction comments field. Comments are displayed on the transaction details page.\n**-UMemail** - A place for the donor to enter their email address for a confirmation receipt.\n**-Billing Fields** - All the billing fields that will be transferred over to the secure payment form.\n \nThe form is not limited to only these fields. Others may be used. Please customize based on your preferences.\n[block:api-header]\n{\n  \"type\": \"basic\",\n  \"title\": \"HTML Source for Recurring form\"\n}\n[/block]\n\n[block:code]\n{\n  \"codes\": [\n    {\n      \"code\": \"<!DOCTYPE html PUBLIC \\\"-//W3C//DTD XHTML 1.0 Transitional//EN\\\" \\\"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd\\\">  \\n<html xmlns=\\\"http://www.w3.org/1999/xhtml\\\">  \\n<head>  \\n<meta http-equiv=\\\"Content-Type\\\" content=\\\"text/html; charset=UTF-8\\\" />  \\n<title>Recurring Payment Form</title>  \\n</head>     \\n<body>     \\n<style type=\\\"text/css\\\">  /*<![CDATA[*/   \\ndiv.c6 {text-align: center}   \\np.c5 {text-align: center}   \\nspan.c4 {font-family: Verdana; font-size: 80%}   \\nspan.c3 {font-family: Verdana}   \\nspan.c2 {color: #FFFFFF; \\nfont-family: Verdana, Arial; font-size: 120%}   \\nspan.c1 {color: #FFFFFF; font-family: Verdana, Arial; font-size: 200%}  /*]]>*/  \\n</style>  \\n</head>  \\n<body>  \\n<form action=\\\"https://www.ebizcharge.com/interface/epayform/\\\">  \\n<input type=\\\"hidden\\\" name=\\\"UMkey\\\" value=\\\"HBDy1XU40KsourceKeyHere7a5iOh2HP\\\" />   \\n<input type=\\\"hidden\\\" name=\\\"UMcommand\\\" value=\\\"sale\\\" />  \\n<input type=\\\"hidden\\\" name=\\\"UMcustreceipt\\\" value=\\\"yes\\\" />  \\n<input type=\\\"hidden\\\" name=\\\"UMaddcustomer\\\" value=\\\"yes\\\"/>  \\n<div class=\\\"c6\\\"> \\n<table border=\\\"0\\\" width=\\\"700\\\" cellpadding=\\\"4\\\" cellspacing=\\\"0\\\">  \\n<tr>  \\n<td bgcolor=\\\"#9999FF\\\" width=\\\"692\\\" colspan=\\\"2\\\">\\n<strong><span class=\\\"c1\\\">Subscribe to a recurring service fee</span></strong>\\n</td>  \\n</tr>  \\n<tr>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"692\\\" colspan=\\\"2\\\"> \\n</td>  \\n</tr>  \\n<tr>  \\n<td bgcolor=\\\"#C4C7D4\\\" width=\\\"692\\\" colspan=\\\"2\\\">\\n<span class=\\\"c3\\\"><strong>Recurring Payment Details:</strong></span>\\n</td>  \\n</tr>  \\n<tr>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\">         \\n</td>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\"> </td>  \\n</tr>  \\n<tr>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\">\\n<span class=\\\"c4\\\">Order Number:</span>\\n</td>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">\\n<input type=\\\"text\\\" name=\\\"UMinvoice\\\" value=\\\"12345678\\\" />\\n</td>  \\n</tr>  \\n<tr>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\">\\n<span class=\\\"c4\\\">Initial / Down Payment Amount:</span>\\n</td>  <td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">\\n<input type=\\\"text\\\" name=\\\"UMamount\\\" value=\\\"0.00\\\" />\\n</td>  \\n</tr>  \\n<tr>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\">\\n<span class=\\\"c4\\\">Subscription / Recurring Payment Amount (if different from Initial):</span>\\n</td>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">\\n<input type=\\\"text\\\" name=\\\"UMbillamount\\\" value=\\\"\\\" width=\\\"250\\\" />\\n</td>  \\n</tr>  \\n<tr>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\">\\n<span class=\\\"c4\\\">Choose your schedule:</span>\\n</td>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">\\n<select name=\\\"UMschedule\\\"> \\n<option value=\\\"daily\\\">daily</option>  \\n<option value=\\\"weekly\\\">weekly</option>  \\n<option value=\\\"biweekly\\\">biweekly</option>  \\n<option value=\\\"monthly\\\">monthly</option>  \\n<option value=\\\"bimonthly\\\">bimonthly</option>  \\n<option value=\\\"quarterly\\\">quarterly</option>  \\n<option value=\\\"biannually\\\">biannually</option>  \\n<option value=\\\"annually\\\">annually</option>  \\n</select>\\n</td>  \\n</tr>  \\n<tr>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\">\\n<span class=\\\"c4\\\">Number of Payments, \\\"*\\\" means indefinite:</span>\\n</td>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">\\n<input type=\\\"text\\\" name=\\\"UMnumleft\\\" value=\\\"*\\\" size=\\\"10\\\" />\\n</td>  \\n</tr>  \\n<tr>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\">\\n<span class=\\\"c4\\\">Start Date of Payments (YYYYMMDD format);   \\nIf set to next, date of the next billing cycle will be used. \\nIf today is 1/10/2009 and schedule is monthly then start date = 2/10/2009:\\n</span>\\n</td>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">\\n<input type=\\\"text\\\" name=\\\"UMstart\\\" value=\\\"next\\\" />\\n</td>  \\n</tr>  \\n<tr>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\"> \\n</td>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\"> \\n</td>  \\n</tr>  \\n<tr>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\">\\n<span class=\\\"c4\\\">Description of Service:</span>\\n</td>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">  \\n<input type=\\\"text\\\" name=\\\"UMdescription\\\" value=\\\"Service Fee\\\">  \\n</td>  \\n</tr>  \\n<tr>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\">\\n<span class=\\\"c4\\\">Comments:</span>\\n</td>  <td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">  \\n<textarea name=\\\"UMcomments\\\" cols=\\\"40\\\" rows=\\\"5\\\">  Enter your comments here...  </textarea>  <br />\\n</td>  \\n</tr>  \\n<tr>  \\t\\t\\t\\n<td bgcolor=\\\"#C4C7D4\\\" width=\\\"692\\\" colspan=\\\"2\\\">\\n<font face=\\\"Verdana\\\"><b>Billing Information:</b></font>\\n</td>  \\t\\t\\n</tr>  \\t\\t\\n<tr>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\"><font face=\\\"Verdana\\\" size=\\\"2\\\">Company Name:</font></td>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">  \\t\\t\\t\\n<input type=\\\"text\\\" name=\\\"UMbillcompany\\\" size=\\\"28\\\" value=\\\"\\\"></td>  \\t\\t\\n</tr>  \\t\\t\\n<tr>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\"><font face=\\\"Verdana\\\" size=\\\"2\\\">First Name:</font></td>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">  \\t\\t\\t\\n<input type=\\\"text\\\" name=\\\"UMbillfname\\\" size=\\\"28\\\" value=\\\"\\\"></td>  \\t\\t\\n</tr>  \\t\\t\\n<tr>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\"><font face=\\\"Verdana\\\" size=\\\"2\\\">Last Name:</font></td>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">  \\t\\t\\t\\n<input type=\\\"text\\\" name=\\\"UMbilllname\\\" size=\\\"28\\\" value=\\\"\\\"></td>  \\t\\t\\n</tr>  \\t\\t\\n<tr>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\"><font face=\\\"Verdana\\\" size=\\\"2\\\">Address:</font></td>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">  \\t\\t\\t\\n<input type=\\\"text\\\" name=\\\"UMbillstreet\\\" size=\\\"28\\\" value=\\\"\\\"></td>  \\t\\t\\n</tr>  \\t\\t\\n<tr>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\"><font face=\\\"Verdana\\\" size=\\\"2\\\">Address Line 2:</font></td>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">  \\t\\t\\t\\n<input type=\\\"text\\\" name=\\\"UMbillstreet2\\\" size=\\\"28\\\" value=\\\"\\\"></td>  \\t\\t\\n</tr>  \\t\\t\\n<tr>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\"><font face=\\\"Verdana\\\" size=\\\"2\\\">City:</font></td>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">     \\t\\t\\t\\n<input type=\\\"text\\\" name=\\\"UMbillcity\\\" size=\\\"28\\\" value=\\\"\\\"></td>  \\t\\t\\n</tr>  \\t\\t\\n<tr>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\"><font face=\\\"Verdana\\\" size=\\\"2\\\">State:</font></td>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">  \\t\\t\\t\\n<input type=\\\"text\\\" name=\\\"UMbillstate\\\" size=\\\"28\\\" value=\\\"\\\"></td>  \\t\\t\\n</tr>  \\t\\t\\n<tr>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\"><font face=\\\"Verdana\\\" size=\\\"2\\\">Zip:</font></td>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">  \\t\\t\\t\\n<input type=\\\"text\\\" name=\\\"UMbillzip\\\" size=\\\"11\\\" value=\\\"\\\"></td>  \\t\\t\\n</tr>  \\t\\t\\n<tr>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\"><font face=\\\"Verdana\\\" size=\\\"2\\\">Country:</font></td>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">  \\t\\t\\t\\n<input type=\\\"text\\\" name=\\\"UMbillcountry\\\" size=\\\"28\\\" value=\\\"\\\"></td>  \\t\\t\\n</tr>  \\t\\t\\n<tr>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\"><font face=\\\"Verdana\\\" size=\\\"2\\\">Phone Number:</font></td>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">  \\t\\t\\t\\n<input type=\\\"text\\\" name=\\\"UMbillphone\\\" size=\\\"28\\\" value=\\\"\\\"></td>  \\t\\t\\n</tr>  \\t\\t\\n<tr>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"234\\\" align=\\\"right\\\"><font face=\\\"Verdana\\\" size=\\\"2\\\">Email Address:</font></td>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"450\\\">  \\t\\t\\t\\n<input type=\\\"text\\\" name=\\\"UMemail\\\" size=\\\"28\\\" value=\\\"\\\"></td>  \\t\\t\\n</tr>  \\t\\t\\n<tr>  \\t\\t\\t\\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"692\\\" colspan=\\\"2\\\"><font face=\\\"Verdana\\\" size=\\\"2\\\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;  \\t\\t\\t\\n</font></td>  \\t\\t\\n</tr>  \\n<tr>  \\n<td bgcolor=\\\"#F0F0F0\\\" width=\\\"692\\\" colspan=\\\"2\\\">  \\n<p class=\\\"c5\\\">\\n<input type=\\\"image\\\" src=\\\"ebizchargesecurebuttongray3.gif\\\" value=\\\"Continue to Payment Form\\\" />\\n</p>  \\n<hr />\\n</td>  \\n</tr>  \\n</table>  \\n</div>  \\n</form>  \\n</body>  \\n</html>\",\n      \"language\": \"html\"\n    }\n  ]\n}\n[/block]","excerpt":"","slug":"recurring","type":"basic","title":"Recurring"}
## Case Study: Recurring Subscription Form The following is a case study for creating a simple recurring or subscription page hosted on eBizCharge's side and linked from your website that connects to eBizCharge for secure processing. This is a great starting off point for service fee merchants that want to accept a fixed dollar amount from the client through a payment form. Below you can download the necessary source code files. Edit the HTML source code with your favorite editor (Notepad, TextEdit, Dreamweaver) to input your source key and edit any of the templated text already there for you. Save the files in the original format. These files will need to be uploaded via a service such as FTP, or something similar, to your website. Once you've uploaded the files you can access them through the browser. Clicking on the button submits the form to eBizCharge and brings the customer to the secure payment area on eBizCharge's servers. The customer completes the payment process by entering their payment information. For information on editing eBizCharge's hosted paymet form click [here](/docs/sourcespaymentformtemplate). ## ePayment Form fields used The form uses the following fields to post to eBizCharge: **-UMkey **- This is the source key that connects you as a valid merchant on our gateway (Required) **-UMcommand** - This indicates the type of a transaction, sale. (Required) **-UMcustreceipt** - This flags eBizCharge to send a customer receipt via email through a value of 'yes'. **-UMaddcustomer** UMrecurring is deprecated - This flags eBizCharge to add this transaction as a customer record in Customers & Billing area of the Merchant Console. **-UMinvoice** - This allows you to pass a numerical invoice number for record keeping. (Required) **-UMamount** - A text box displayed for customer to enter a decimal (0.00) amount. (Required) **-UMbillamount** - Sets the monetary amount to charge on each cycle. If this field is left blank the UMamount will be used instead. This is NOT the “initial” charge or “setup” charge, this is only the “recurring” charge. UMamount determines the initial charge. **-UMschedule** - Determines the recurring billing schedule. Possible values are daily, weekly, biweekly, monthly, bimonthly, quarterly, biannually, or annually. (defaults to monthly) **-UMnumleft** - Number of transactions remaining in recurring billing cycle. If the recurring billing should go on indefinitely, set this to *. (defaults to *) **-UMstart** - Start date. Default is tomorrow. Must be entered in YYYYMMDD format. If set to UMstart=next the date of the next billing cycle will be used. For example if today is 1/10/2009 and UMschedule=monthly then UMstart will be set to 2/10/2009. **-UMdescription** - A text box for any comments left by the donor **-UMcomments** - Optional transaction comments field. Comments are displayed on the transaction details page. **-UMemail** - A place for the donor to enter their email address for a confirmation receipt. **-Billing Fields** - All the billing fields that will be transferred over to the secure payment form. The form is not limited to only these fields. Others may be used. Please customize based on your preferences. [block:api-header] { "type": "basic", "title": "HTML Source for Recurring form" } [/block] [block:code] { "codes": [ { "code": "<!DOCTYPE html PUBLIC \"-//W3C//DTD XHTML 1.0 Transitional//EN\" \"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd\"> \n<html xmlns=\"http://www.w3.org/1999/xhtml\"> \n<head> \n<meta http-equiv=\"Content-Type\" content=\"text/html; charset=UTF-8\" /> \n<title>Recurring Payment Form</title> \n</head> \n<body> \n<style type=\"text/css\"> /*<![CDATA[*/ \ndiv.c6 {text-align: center} \np.c5 {text-align: center} \nspan.c4 {font-family: Verdana; font-size: 80%} \nspan.c3 {font-family: Verdana} \nspan.c2 {color: #FFFFFF; \nfont-family: Verdana, Arial; font-size: 120%} \nspan.c1 {color: #FFFFFF; font-family: Verdana, Arial; font-size: 200%} /*]]>*/ \n</style> \n</head> \n<body> \n<form action=\"https://www.ebizcharge.com/interface/epayform/\"> \n<input type=\"hidden\" name=\"UMkey\" value=\"HBDy1XU40KsourceKeyHere7a5iOh2HP\" /> \n<input type=\"hidden\" name=\"UMcommand\" value=\"sale\" /> \n<input type=\"hidden\" name=\"UMcustreceipt\" value=\"yes\" /> \n<input type=\"hidden\" name=\"UMaddcustomer\" value=\"yes\"/> \n<div class=\"c6\"> \n<table border=\"0\" width=\"700\" cellpadding=\"4\" cellspacing=\"0\"> \n<tr> \n<td bgcolor=\"#9999FF\" width=\"692\" colspan=\"2\">\n<strong><span class=\"c1\">Subscribe to a recurring service fee</span></strong>\n</td> \n</tr> \n<tr> \n<td bgcolor=\"#F0F0F0\" width=\"692\" colspan=\"2\"> \n</td> \n</tr> \n<tr> \n<td bgcolor=\"#C4C7D4\" width=\"692\" colspan=\"2\">\n<span class=\"c3\"><strong>Recurring Payment Details:</strong></span>\n</td> \n</tr> \n<tr> \n<td bgcolor=\"#F0F0F0\" width=\"234\"> \n</td> \n<td bgcolor=\"#F0F0F0\" width=\"450\"> </td> \n</tr> \n<tr> \n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\">\n<span class=\"c4\">Order Number:</span>\n</td> \n<td bgcolor=\"#F0F0F0\" width=\"450\">\n<input type=\"text\" name=\"UMinvoice\" value=\"12345678\" />\n</td> \n</tr> \n<tr> \n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\">\n<span class=\"c4\">Initial / Down Payment Amount:</span>\n</td> <td bgcolor=\"#F0F0F0\" width=\"450\">\n<input type=\"text\" name=\"UMamount\" value=\"0.00\" />\n</td> \n</tr> \n<tr> \n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\">\n<span class=\"c4\">Subscription / Recurring Payment Amount (if different from Initial):</span>\n</td> \n<td bgcolor=\"#F0F0F0\" width=\"450\">\n<input type=\"text\" name=\"UMbillamount\" value=\"\" width=\"250\" />\n</td> \n</tr> \n<tr> \n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\">\n<span class=\"c4\">Choose your schedule:</span>\n</td> \n<td bgcolor=\"#F0F0F0\" width=\"450\">\n<select name=\"UMschedule\"> \n<option value=\"daily\">daily</option> \n<option value=\"weekly\">weekly</option> \n<option value=\"biweekly\">biweekly</option> \n<option value=\"monthly\">monthly</option> \n<option value=\"bimonthly\">bimonthly</option> \n<option value=\"quarterly\">quarterly</option> \n<option value=\"biannually\">biannually</option> \n<option value=\"annually\">annually</option> \n</select>\n</td> \n</tr> \n<tr> \n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\">\n<span class=\"c4\">Number of Payments, \"*\" means indefinite:</span>\n</td> \n<td bgcolor=\"#F0F0F0\" width=\"450\">\n<input type=\"text\" name=\"UMnumleft\" value=\"*\" size=\"10\" />\n</td> \n</tr> \n<tr> \n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\">\n<span class=\"c4\">Start Date of Payments (YYYYMMDD format); \nIf set to next, date of the next billing cycle will be used. \nIf today is 1/10/2009 and schedule is monthly then start date = 2/10/2009:\n</span>\n</td> \n<td bgcolor=\"#F0F0F0\" width=\"450\">\n<input type=\"text\" name=\"UMstart\" value=\"next\" />\n</td> \n</tr> \n<tr> \n<td bgcolor=\"#F0F0F0\" width=\"234\"> \n</td> \n<td bgcolor=\"#F0F0F0\" width=\"450\"> \n</td> \n</tr> \n<tr> \n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\">\n<span class=\"c4\">Description of Service:</span>\n</td> \n<td bgcolor=\"#F0F0F0\" width=\"450\"> \n<input type=\"text\" name=\"UMdescription\" value=\"Service Fee\"> \n</td> \n</tr> \n<tr> \n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\">\n<span class=\"c4\">Comments:</span>\n</td> <td bgcolor=\"#F0F0F0\" width=\"450\"> \n<textarea name=\"UMcomments\" cols=\"40\" rows=\"5\"> Enter your comments here... </textarea> <br />\n</td> \n</tr> \n<tr> \t\t\t\n<td bgcolor=\"#C4C7D4\" width=\"692\" colspan=\"2\">\n<font face=\"Verdana\"><b>Billing Information:</b></font>\n</td> \t\t\n</tr> \t\t\n<tr> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\"><font face=\"Verdana\" size=\"2\">Company Name:</font></td> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"450\"> \t\t\t\n<input type=\"text\" name=\"UMbillcompany\" size=\"28\" value=\"\"></td> \t\t\n</tr> \t\t\n<tr> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\"><font face=\"Verdana\" size=\"2\">First Name:</font></td> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"450\"> \t\t\t\n<input type=\"text\" name=\"UMbillfname\" size=\"28\" value=\"\"></td> \t\t\n</tr> \t\t\n<tr> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\"><font face=\"Verdana\" size=\"2\">Last Name:</font></td> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"450\"> \t\t\t\n<input type=\"text\" name=\"UMbilllname\" size=\"28\" value=\"\"></td> \t\t\n</tr> \t\t\n<tr> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\"><font face=\"Verdana\" size=\"2\">Address:</font></td> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"450\"> \t\t\t\n<input type=\"text\" name=\"UMbillstreet\" size=\"28\" value=\"\"></td> \t\t\n</tr> \t\t\n<tr> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\"><font face=\"Verdana\" size=\"2\">Address Line 2:</font></td> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"450\"> \t\t\t\n<input type=\"text\" name=\"UMbillstreet2\" size=\"28\" value=\"\"></td> \t\t\n</tr> \t\t\n<tr> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\"><font face=\"Verdana\" size=\"2\">City:</font></td> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"450\"> \t\t\t\n<input type=\"text\" name=\"UMbillcity\" size=\"28\" value=\"\"></td> \t\t\n</tr> \t\t\n<tr> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\"><font face=\"Verdana\" size=\"2\">State:</font></td> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"450\"> \t\t\t\n<input type=\"text\" name=\"UMbillstate\" size=\"28\" value=\"\"></td> \t\t\n</tr> \t\t\n<tr> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\"><font face=\"Verdana\" size=\"2\">Zip:</font></td> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"450\"> \t\t\t\n<input type=\"text\" name=\"UMbillzip\" size=\"11\" value=\"\"></td> \t\t\n</tr> \t\t\n<tr> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\"><font face=\"Verdana\" size=\"2\">Country:</font></td> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"450\"> \t\t\t\n<input type=\"text\" name=\"UMbillcountry\" size=\"28\" value=\"\"></td> \t\t\n</tr> \t\t\n<tr> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\"><font face=\"Verdana\" size=\"2\">Phone Number:</font></td> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"450\"> \t\t\t\n<input type=\"text\" name=\"UMbillphone\" size=\"28\" value=\"\"></td> \t\t\n</tr> \t\t\n<tr> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"234\" align=\"right\"><font face=\"Verdana\" size=\"2\">Email Address:</font></td> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"450\"> \t\t\t\n<input type=\"text\" name=\"UMemail\" size=\"28\" value=\"\"></td> \t\t\n</tr> \t\t\n<tr> \t\t\t\n<td bgcolor=\"#F0F0F0\" width=\"692\" colspan=\"2\"><font face=\"Verdana\" size=\"2\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; \t\t\t\n</font></td> \t\t\n</tr> \n<tr> \n<td bgcolor=\"#F0F0F0\" width=\"692\" colspan=\"2\"> \n<p class=\"c5\">\n<input type=\"image\" src=\"ebizchargesecurebuttongray3.gif\" value=\"Continue to Payment Form\" />\n</p> \n<hr />\n</td> \n</tr> \n</table> \n</div> \n</form> \n</body> \n</html>", "language": "html" } ] } [/block]