<form id="form1" action="https://sandbox.plimus.com/jsp/buynow.jsp" method="post"> <div> <input type="hidden" name="contractId" value="2114108" /> <input type="hidden" name="quantity" value="1" /> <input type="hidden" name="overridePrice" value="20" /> <input type="hidden" name="custom1" value="1001" /> <input type="hidden" name="enableCustom" value="Y" /> <input type="hidden" name="firstName" value="Lakhan" /> <input type="hidden" name="lastName" value="Pal" /> <input type="hidden" name="email" value="lakhangarg@gmail.com" /> <input type="hidden" name="address1" value="6252 NW 65 Terrace" /> <input type="hidden" name="address2" value="Test Course" /> <input type="hidden" name="city" value="Parkland" /> <input type="hidden" name="zipCode" value="33067" /> <input type="hidden" name="country" value="us" /> <input type="hidden" name="state" value="FL" /> <input type="hidden" name="workPhone" value="1-858-350-7473" /> <input type="hidden" name="cardNumber" value="4111111111111111" /> <input type="hidden" name="verifyCardCode" value="411" /> <input type="hidden" name="bCur" value="USD" /> <input type="hidden" name="currency" value="USD" /> <input type="submit" id="btnSubmit" name="btnSubmit" value="Plimus - Pay Now"/> </div> </form>