HTML

form-sample.html

<!--HTML-->
<form class="form-horizontal2 boxed" method="post" action="https://
<tenantid>.SANDBOX.verygoodproxy.com/post">
  <!--CREDIT CART PAYMENT-->
  <div class="panel panel-info">
    <div class="form-group">
      <div class="col-md-12">
        <label for="pan_number" id="pan_number_label">Credit Card Number</label>
        <input class="form-control" placeholder="Card Number" type="text" name="cc_number" id="pan_number" value="">
      </div>
    </div>
    <div class="form-group">
      <label for="pan_exp" id="pan_exp_label">CC Expiration</label>
      <input class="form-control" placeholder="Card Expiration" type="text" name="cc_exp" id="pan_exp">
    </div>
  </div>
  <div class="form-group">
    <label for="pan_cvv" id="pan_cvv_label">CC CVV</label>
    <input class="form-control" placeholder="CVV" type="text" name="cc_cvv" id="pan_cvv" value="">
  </div>
  <div class="form-group">
    <span>Pay securely using your credit card</span>
  </div>
  <button type="submit">Place Order</button>
</form>