Paysafe Secure Data Services Demo1

Please enter your invoice number and total amount of charge authorized

Invoice Number  
Charge Amount   

Here is a simple example where Merchant passes final charge amount and invoice number to the paysafe system. Our server then presents a form requesting payment information. The collected information is place in the merchant's database, and notification sent that an order has been accepted.

Below is the HTML for this page. Press the submit button to see the demo.

<FORM METHOD="POST" ACTION="https://www.paysafe.com/cgi-bin/paysafe.cgi">
<PRE>
Invoice Number  <INPUT TYPE="TEXT"   NAME="PAYSAFE_MERCHANT_ORDER_ID" VALUE="950310AA12">
Charge Amount   <INPUT TYPE="TEXT"   NAME="PAYSAFE_CHARGE_AMOUNT" SIZE="8" VALUE="35.00">
</PRE>
<INPUT TYPE="HIDDEN" NAME="PAYSAFE_MERCHANT_ID"     VALUE="1010">
<INPUT TYPE="HIDDEN" NAME="PAYSAFE_ACTION"          VALUE="GET_CC_FORM">
<INPUT TYPE="HIDDEN" NAME="PAYSAFE_DESCRIPTION"     VALUE="Demo Product 1">
<INPUT TYPE="HIDDEN" NAME="PAYSAFE_MERCHANT_CARDS"  VALUE="MS,VS,AE">

<INPUT TYPE="HIDDEN" NAME="PAYSAFE_FORM_TITLE"      VALUE="Paysafe Secure Data Services Payment Form">
<INPUT TYPE="HIDDEN" NAME="PAYSAFE_CARD_NAME"       VALUE="Bill Clinton">
<INPUT TYPE="HIDDEN" NAME="PAYSAFE_CARD_ADDR"       VALUE="1600 Pennsylvania Avenue">
<INPUT TYPE="HIDDEN" NAME="PAYSAFE_CARD_CITY"       VALUE="Washington">
<INPUT TYPE="HIDDEN" NAME="PAYSAFE_CARD_STATE"      VALUE="DC">
<INPUT TYPE="HIDDEN" NAME="PAYSAFE_CARD_ZIP"        VALUE="20500">
<INPUT TYPE="HIDDEN" NAME="PAYSAFE_CARD_COUNTRY"    VALUE="USA">
<INPUT TYPE="HIDDEN" NAME="PAYSAFE_CARD_TEL"        VALUE="(202) 456-1414">
<INPUT TYPE="HIDDEN" NAME="PAYSAFE_CARD_FAX"        VALUE="(202) 456-2883">
<INPUT TYPE="HIDDEN" NAME="PAYSAFE_CARD_EMAIL"      VALUE="president@whitehouse.gov">

<INPUT TYPE="SUBMIT" NAME="Submit"                      VALUE="Submit Request">
<INPUT TYPE="RESET" NAME="Reset Form"                   VALUE="reset form">
</FORM>