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<form class="form-horizontal"><fieldset id="payment"><legend>{{ text_card_details }}</legend><div class="form-group required"><label class="col-sm-2 control-label" for="input-type">{{ entry_type }}</label><div class="col-sm-10"><select name="type" id="input-type" class="form-control">{% for key, title in cards %}<option value="{{ key }}">{{ title }}</option>{% endfor %}</select></div></div><div class="form-group required"><label class="col-sm-2 control-label" for="input-number">{{ entry_number }}</label><div class="col-sm-10"><input type="text" name="number" value="" placeholder="{{ entry_number }}" id="input-number" class="form-control" /></div></div><div class="form-group required"><label class="col-sm-2 control-label" for="input-expire-date">{{ entry_expire_date }}</label><div class="col-sm-3"><select name="expire_month" id="expire-date" class="form-control">{% for month in months %}<option value="{{ month.value }}">{{ month.text }}</option>{% endfor %}</select></div><div class="col-sm-3"><select name="expire_year" class="form-control">{% for year in year_expire %}<option value="{{ year.value }}">{{ year.text }}</option>{% endfor %}</select></div></div><div class="form-group required"><label class="col-sm-2 control-label" for="input-cvv2">{{ entry_cvv2 }}</label><div class="col-sm-10"><input type="text" name="cvv2" value="" placeholder="{{ entry_cvv2 }}" id="input-cvv2" class="form-control" /></div></div></fieldset></form><div class="buttons"><div class="pull-right"><input id="button-confirm" type="submit" value="{{ button_confirm }}" class="btn btn-primary" /></div></div><script type="text/javascript">$('#button-confirm').bind('click', function() {$.ajax({url: 'index.php?route=extension/payment/securetrading_ws/process',type: 'post',data: $('#payment :input'),dataType: 'json',beforeSend: function() {$('#button-confirm').attr('disabled', true);$('form.form-horizontal .alert').remove();$('#payment').before('<div class="alert alert-info"><i class="fa fa-info-circle"></i> {{ text_wait }}</div>');},complete: function() {$('#button-confirm').attr('disabled', false);},success: function(json) {$('form.form-horizontal .alert').remove();if (json['status']) {if (json['redirect']) {location = json['redirect'];} else {$('#payment').before('<form id="threed-form" action="' + json['acs_url'] + '" method="POST"><input type="hidden" name="PaReq" value="' + json['pareq'] + '" /><input type="hidden" name="MD" value="' + json['md'] + '" /><input type="hidden" name="TermUrl" value="' + json['term_url'] + '" /></form>');$('#threed-form').submit();}} else {$('#payment').before('<div class="alert alert-danger alert-dismissible"><i class="fa fa-info-circle"></i> ' + json['message'] + '</div>');}}});});</script>