@@Enter your billing information exactly as it appears on your credit card statement@@.

{ERRORMSG}
@@Name@@:
@@Address@@:
@@City@@:
@@State@@:
@@Zip@@:
@@Country@@:
@@Card@@ @@Type@@:
@@Card@@ @@Number@@:
@@CID@@*:
@@Expires@@:
@@Amount@@ @@$@@:   @@Minimum@@ @@$@@{MINIMUM}@@
@@Please click the Submit button once. The charge process could take a minute or more@@

* @@The CID (card identification) number is the last 3 digits in the signature block on the back of your credit card. On American Express cards, it's the 4-digit, non-embossed number on the front of the card above your credit card number. We are requesting it as an added security precaution.@@