<?php
	session_start();
	require_once($_SERVER['DOCUMENT_ROOT'].'/vx_/site_info.php');
	require_once($_SERVER['DOCUMENT_ROOT'].'/vx/lib/mysql.php');
	require_once($_SERVER['DOCUMENT_ROOT'].'/vx/lib/phpCrypto.class.php');
	require_once($_SERVER['DOCUMENT_ROOT'].'/vx/lib/FluidPayHelper.php');

	$crypto = new phpCrypto();

	function time_left($str) {
		$secs = strtotime($str) - time();
		$minutes = floor($secs / 60);
		$seconds = $secs % 60;
		return str_pad($minutes,2,'0',STR_PAD_LEFT).':'.str_pad($seconds,2,'0',STR_PAD_LEFT).' mins';
	}
	
	function pretty_phone($str) {
		$str = preg_replace('/[^0-9]/','',$str);
		return '('.substr($str,0,3).') '.substr($str,3,3).'-'.substr($str,6);
	}
	
	if(!empty($_POST['action'])) {
		if($_POST['action']=='save_cc_info') {
			$errors = '';
			$filled_out_id = 0;
			$cc = preg_replace('/[^0-9]/','',$_POST['cc_num']);
			$cc_passed = strtoupper($_POST['cc_type']).', '.strlen($cc);
			$res = $db->get_results("SELECT * FROM lc2admin.cc_info_request WHERE id='".$db->clean($_POST['cid'])."'");
			if(empty($res)) {
				die('There was an error processing your request. Please have your representative send you a new link.');
			} else {
				$db->query("INSERT INTO lc2admin.cc_info_request_filled_out
							(
								code
								,site_code
								,lead_id
								,allocator_id
								,ts
								,cc_passed
								,user_agent
							) VALUES (
								'".$db->clean($res[0]->code)."'
								,'".$db->clean($res[0]->site_code)."'
								,'".$db->clean($res[0]->lead_id)."'
								,'".$db->clean($res[0]->allocator_id)."'
								,NOW()
								,'".$db->clean($cc_passed)."'
								,'".$db->clean($_SERVER['HTTP_USER_AGENT'])."'
							)");
				$filled_out_id = $db->last_insert_id();
			}
			if(empty($_POST['cc_num'])) {
				$errors .= ($errors=='') ? 'You must enter a credit card number.' : "\n".'You must enter a credit card number.';
			} else {
				$_POST['cc_num'] = preg_replace('/[^0-9]/','',$_POST['cc_num']);
				if(empty($_POST['cc_num'])) {
					$errors .= ($errors=='') ? 'You must enter a credit card number.' : "\n".'You must enter a credit card number.';
				} else {
					if(substr($_POST['cc_num'],0,1)=='3') {
						if(strlen($_POST['cc_num'])!=15) {
							$errors .= ($errors=='') ? 'American Express cards should be 15 digits long. You have entered '.strlen($_POST['cc_num']).' digits.' : "\n".'American Express cards should be 15 digits long. You have entered '.strlen($_POST['cc_num']).' digits.';
						}
					} else {
						if(strlen($_POST['cc_num'])!=16) {
							$errors .= ($errors=='') ? 'Your credit card should be 16 digits long. You have entered '.strlen($_POST['cc_num']).' digits.' : "\n".'Your credit card should be 15 digits long. You have entered '.strlen($_POST['cc_num']).' digits.';
						}
					}
				}
			}
			if(empty($_POST['cc_exp_month'])) {
				$errors .= ($errors=='') ? 'You must enter an expiration month.' : "\n".'You must enter an expiration month.';
			}
			if(empty($_POST['cc_exp_year'])) {
				$errors .= ($errors=='') ? 'You must enter an expiration year.' : "\n".'You must enter an expiration year.';
			}
			if(($_POST['cc_exp_year'] < date('Y')) || ($_POST['cc_exp_year']==date('Y') && ($_POST['cc_exp_month']*1) < (date('m')*1))) {
				$errors .= ($errors=='') ? 'The credit card expiration has expired.' : "\n".'The credit card expiration has expired.';
			}
			if(empty($_POST['cc_cvv'])) {
				if(substr($_POST['cc_first_four'],0,1)!=3) {
					$errors .= ($errors=='') ? 'You must enter an CVV number (3 digits on back of card).' : "\n".'You must enter an CVV number (3 digits on back of card).';
				} else {
					$errors .= ($errors=='') ? 'You must enter an CVV number (4 digits on front of card near the top right).' : "\n".'You must enter an CVV number (4 digits on front of card near the top right).';
				}
			}
			if(empty($_POST['first'])) {
				$errors .= ($errors=='') ? 'You must enter your first name.' : "\n".'You must enter your first name.';
			}
			if(empty($_POST['last'])) {
				$errors .= ($errors=='') ? 'You must enter your last name.' : "\n".'You must enter your last name.';
			}
			if(empty($_POST['email'])) {
				$errors .= ($errors=='') ? 'You must enter your email.' : "\n".'You must enter your email.';
			}
			if(empty($_POST['phone_1'])) {
				$errors .= ($errors=='') ? 'You must enter your phone.' : "\n".'You must enter your phone.';
			} else {
				$_POST['phone_1'] = preg_replace('/[^0-9]/','',$_POST['phone_1']);
			}
			if(empty($_POST['street_address'])) {
				$errors .= ($errors=='') ? 'You must enter the street address.' : "\n".'You must enter the street address.';
			}
			if(empty($_POST['zip'])) {
				$errors .= ($errors=='') ? 'You must enter the zip code.' : "\n".'You must enter the zip code.';
			}
			if(!empty($errors)) {
				$db->query("UPDATE lc2admin.cc_info_request_filled_out
							SET
								result='error'
								,error_message='".$db->clean($errors)."'
							WHERE id='".$db->clean($filled_out_id)."'");
				die($errors);
			}
			
			$res = $db->get_results("SELECT * FROM lc2admin.cc_info_request WHERE id='".$db->clean($_POST['cid'])."'");
			if(empty($res)) {
				die('There was an error processing your request. Please have your representative send you a new link.');
			}
			
			//check if they updated the address
			$client_id = 0;
			$existing_customer_id = '';
			$cres = $db->get_results("SELECT customerID,address1 FROM lc2".$res[0]->site_code."_lc.lc_leads WHERE id='".$db->clean($res[0]->lead_id)."'");
			if(!empty($cres)) {
				if($cres[0]->address1 != $_POST['street_address']) {
					$db->query("UPDATE lc2".$res[0]->site_code."_lc.lc_leads
								SET address1='".$db->clean($_POST['street_address'])."'
								WHERE id='".$db->clean($res[0]->lead_id)."'");
				}
				if(!empty($cres[0]->customerID)) {
					//This lead already has a client account. If we have already vaulted a
					//card for them, add this one to the same FluidPay customer instead of
					//creating a second customer record for the same person.
					$client_id = $cres[0]->customerID;
					$cv_res = $db->get_results("SELECT customer_id FROM FluidPay.customer_vault
												WHERE site_code='".$db->clean($res[0]->site_code)."'
												AND client_id='".$db->clean($client_id)."'
												ORDER BY ts DESC LIMIT 1");
					if(!empty($cv_res)) {
						$existing_customer_id = $cv_res[0]->customer_id;
					}
				}
			}

			$fp = fluidpay_client();
			$billing = array(
				'first_name' => $_POST['first']
				,'last_name' => $_POST['last']
				,'address_line_1' => $_POST['street_address']
				,'city' => $_POST['city']
				,'state' => $_POST['state']
				,'postal_code' => fluidpay_postal_code($_POST['zip'])
				,'country' => 'US'
				,'phone' => $_POST['phone_1']
				,'email' => $_POST['email']
			);
			//Unlike the old NMI vault call, this does send the CVV - we collect it anyway
			//and it gives the eventual sale a better shot at approving.
			$card = FluidPay::card(
				$_POST['cc_num']
				,fluidpay_expiration($_POST['cc_exp_month'],$_POST['cc_exp_year'])
				,$_POST['cc_cvv']
			);
			$vaulted = fluidpay_enroll_card(
				$fp
				,trim($_POST['first'].' '.$_POST['last'])
				,$card
				,$billing
				,$existing_customer_id
			);

			if(!empty($vaulted['payment_id'])) {
				//Keyed on the allocator lead id - this is what lcapi/CreateUser.php reads
				//back when it is called with an allocatorid and no cc_num.
				fluidpay_save_vault_lead(
					$db
					,$_POST['aid']
					,$vaulted['customer_id']
					,$vaulted['payment_id']
					,$_POST['cc_num']
					,$_POST['cc_exp_month']
					,$_POST['cc_exp_year']
				);
				$db->query("UPDATE lc2admin.cc_info_request_filled_out
							SET
								result='success'
								,error_message='".$db->clean($vaulted['customer_id'])."'
							WHERE id='".$db->clean($filled_out_id)."'");
				if(!empty($client_id)) {
					//They are already a client, so the monthly rebiller needs to pick this
					//card up too. Newest row by ts wins, so this supersedes the old one.
					fluidpay_save_vault(
						$db
						,$res[0]->site_code
						,$client_id
						,$vaulted['customer_id']
						,$vaulted['payment_id']
						,$_POST['cc_num']
						,$_POST['cc_exp_month']
						,$_POST['cc_exp_year']
					);
					$db->query("UPDATE lc2".$res[0]->site_code."_lc.lc_reseller
								SET cc_num='".$db->clean($crypto->encrypt(substr($_POST['cc_num'],0,6).'******'.substr($_POST['cc_num'],-4)))."'
								,bin_number='".$db->clean(substr($_POST['cc_num'],0,6))."'
								,cc_last_four='".$db->clean(substr($_POST['cc_num'],-4))."'
								,cc_first_four='".$db->clean(substr($_POST['cc_num'],0,4))."'
								,cc_exp_month='".$db->clean($_POST['cc_exp_month'])."'
								,cc_exp_year='".$db->clean($_POST['cc_exp_year'])."'
								WHERE id='".$db->clean($client_id)."'");
				}
			} else {
				include_once($_SERVER['DOCUMENT_ROOT'].'/vx/lib/ua.php');
				$error_message = $vaulted['error'];
				$marketer_res = $db->get_results("SELECT marketer FROM lc2admin.cc_info_request WHERE id='".$db->clean($_POST['cid'])."'");
				$body = '<p>Client Name: '.$_POST['first'].' '.$_POST['last'].'</p>
						<p>Marketer: '.$marketer_res[0]->marketer.'</p>
						<p>CC Type: '.$_POST['cc_type'].'</p>
						<p>Card Length: '.strlen($_POST['cc_num']).'</p>
						<p>Device: '.$device.', OS: '.$os.', Browser: '.$browser.'</p>
						<pre>'.print_r($vaulted,true).'</pre>';

				//require_once($_SERVER['DOCUMENT_ROOT'].'/vx/lib/mailgun.php');
				//mailgun_send_message('jeremy@usbusinessfundingsolutions.com','NoReply@surfcrm.com','PCI Customer Vault Failed',$body,1,'PCI Customer Vault Failed','heinz57@gmail.com,golfjrk@gmail.com','','',0,array(),'',0);

				if(strpos($error_message,'REFID:')!==false) {
					$arr = explode('REFID:',$error_message);
					$error_message = trim($arr[0]);
				}
				$cc_passed = strtoupper($_POST['cc_type']).', '.strlen($_POST['cc_num']);

				$db->query("INSERT INTO lc2admin.cc_info_errors
							(
								request_type
								,request_id
								,error_message
								,cc_passed
								,ts
							) VALUES (
								'marketer'
								,'".$db->clean($_POST['cid'])."'
								,'".$db->clean($error_message)."'
								,'".$db->clean($cc_passed)."'
								,NOW()
							)");
				$db->query("UPDATE lc2admin.cc_info_request_filled_out
							SET
								result='error'
								,error_message='".$db->clean($error_message)."'
							WHERE id='".$db->clean($filled_out_id)."'");
				echo 'There was a problem saving your card: '.$error_message;
			}
		}
		die();
	} else {
		if(!empty($_POST['email'])) {
			//Check for update first
			$is_there = $db->get_results("SELECT id FROM lc2{$siteCode}_lc.lc_reseller WHERE email='".$db->clean($_POST['email'])."' ORDER BY id DESC LIMIT 1");
			if(!empty($is_there)) {
				$res = $db->get_results("SELECT code FROM lc2admin.cc_info_request_update WHERE site_code='".$db->clean($siteCode)."' AND client_id='".$db->clean($is_there[0]->id)."' ORDER BY id DESC LIMIT 1");
				if(!empty($res)) {
					header("Location: update.php?c=".$res[0]->code);
					exit(0);
				}
			}
			$res = $db->get_results("SELECT id FROM allocator.leads WHERE leaddb='".$db->clean($siteCode)."' AND email='".$db->clean($_POST['email'])."' AND leadtype='partials' ORDER BY id DESC LIMIT 1");
			if(!empty($res)) {
				$allocator_id = $res[0]->id;
				$res = $db->get_results("SELECT code FROM lc2admin.cc_info_request WHERE allocator_id='".$db->clean($allocator_id)."' ORDER BY id DESC LIMIT 1");
				if(!empty($res)) {
					header("Location: index.php?c=".$res[0]->code);
					exit(0);
				} else {
					header("Location: index.php?error=expired");
					exit(0);
				}
			} else {
				header("Location: index.php?error=expired");
				exit(0);
			}
		}
	}
	
	$res = $db->get_results("SELECT c.*,r.id as rid,r.first,r.last,r.address1,r.city,r.state,r.zip,r.phone,r.email
							FROM lc2admin.cc_info_request c
							LEFT JOIN lc2{$siteCode}_lc.lc_leads r ON r.id=c.lead_id
							WHERE c.code='".$db->clean($_GET['c'])."'
							AND c.site_code='".$db->clean($siteCode)."'
							AND c.expires >= NOW()");
?>
<!doctype html>
<html>
	<head>
		<title>PCI Compliant Secure Form</title>
		<meta name="viewport" content="width=device-width, initial-scale=1.0">
		<style type="text/css">
			.container {
				width:500px;
				max-width:100%;
				margin:0px auto;
				text-align:center;
				font-size:16px;
				background:white;
			}
			.header {
				text-align:center;
			}
			.header img {
				width:100%;
			}
			.main_area {
				text-align:left;
				padding:10px;
			}
			.big_line {
				margin:20px 0px;
			}
			.big_text {
				font-size:28px;
				color:#1e3891;
				padding-bottom:10px;
			}
			.pci_logo {
				float:right;
			}
			.real_client_address {
				display:none;
			}
			input[type=text],input[type=tel],select {
				padding:10px 20px;
				width:90%;
				margin:0px auto;
				font-size:20px;
			}
			#submit_button {
				background:#dfedd6;
				color:black;
				border:1px solid black;
				border-radius:5px;
				cursor:pointer;
				text-align:center;
				padding:20px 0px;
				font-size:20px;
				width:90%;
			}
		</style>
		<script type="text/javascript" src="/vx/js/jquery/jquery-1.9.1.js"></script>
		<script type="text/javascript" src="/vx/js/jquery/jquery.formatter.min.js"></script>
		<script type="text/javascript">
			$(document).ready(function(){
				$('input[name=cc_num]').formatter({
				  'pattern': '{{9999}}-{{9999}}-{{9999}}-{{9999}}',
				  'persistent': false
				});
				$('input[name=cc_num]').formatter({
				  'pattern': '{{9999}}-{{9999}}-{{9999}}-{{9999}}',
				  'persistent': false
				});
				$('input[name=phone_1]').formatter({
				  'pattern': '({{999}}) {{999}}-{{9999}}',
				  'persistent': false
				});
			});
			
			function change_cc_type() {
				if($('[name=cc_type]:checked').val()=='amex') {
					$('input[name=cc_num]').formatter().resetPattern('{{9999}}-{{999999}}-{{99999}}');
					$('input[name=cc_cvv]').formatter().resetPattern('{{9999}}');
					$('.cvv_info_not_amex').hide();
					$('.cvv_info_amex').show();
				} else {
					$('input[name=cc_num]').formatter().resetPattern('{{9999}}-{{9999}}-{{9999}}-{{9999}}');
					$('input[name=cc_cvv]').formatter().resetPattern('{{999}}');
					$('.cvv_info_not_amex').show();
					$('.cvv_info_amex').hide();
				}
			}
			
			function save_cc_info(frm) {
				var str="action=save_cc_info";
				$(frm).find('input,select,textarea').each(function() {
					if(this.type=='checkbox' || this.type=='radio') {
						if($(this).is(':checked')) {
							str += "&" + encodeURIComponent(this.name) + '=' + encodeURIComponent($(this).val());
						}
					} else {
						str += "&" + encodeURIComponent(this.name) + '=' + encodeURIComponent($(this).val());
					}
				});
				$.ajax({
					url:"/vx/usa/pci_form/index.php",
					cache: false,
					type: "POST",
					data: str,
					success: function(results) {
						if(results!='') {
							alert(results);
						} else {
							$(frm)[0].outerHTML = '<p>Thank you for submitting your payment information.</p>';
						}
					},
					error: function(jqXHR, textStatus, errorThrown) {
					}
				});
			}
		</script>
	</head>
	<body>
		<div class="container">
			<div class="main_area">
				<div class="big_line">
					<div class="pci_logo"><img src="pci_logo.png" /></div>
					<div class="big_text">PCI Compliant Secure Form</div>
					<div style="clear:both;"></div>
				</div>
				<?php if(empty($res)) {
					$site_info = $db->get_results("SELECT phone FROM lc2admin.site WHERE site_code='".$db->clean($siteCode)."'");
					?>
					<?php if(empty($_GET['c'])) { ?>
						<?php if(!empty($_GET['error'])) { ?>
						<p>This code has expired. Please contact an enrollment specialist at <?= substr($site_info[0]->phone,0,3).'-'.substr($site_info[0]->phone,3,3).'-'.substr($site_info[0]->phone,6,4);?> to send you a new one.</p>
						<?php } ?>
						<p>Please enter your email address you signed up with to access the PCI link.</p>
						<form method="POST" action="index.php">
							<div class="big_line">
								<input type="text" name="email" value="" placeholder="Email Address" />
							</div>
							<center>
								<input type="submit" name="submit" value="Submit" id="submit_button" />
							</center>
						</form>
					<?php } else { ?>
						<p>This code has expired. Please contact an enrollment specialist at <?= substr($site_info[0]->phone,0,3).'-'.substr($site_info[0]->phone,3,3).'-'.substr($site_info[0]->phone,6,4);?> to send you a new one.</p>
					<?php } ?>
				<?php } else {
					$seconds_left = strtotime($res[0]->expires) - time();
					$expires_time = '';
					$minutes = 0;
					$seconds = 0;
					if($seconds_left >= 60) {
						$minutes = round($seconds_left/60);
					}
					if($minutes>0) {
						$expires_time = $minutes.' minutes';
					} else {
						$expires_time = $seconds.' seconds';
					}
					if($res[0]->address1=='-') {
						$res[0]->address1 = '';
					}
				?>
				<div><i>Secure Payment Form Expires in <strong id="expire_timer"><?= $expires_time;?></strong></i></div>
				<form onsubmit="save_cc_info(this); return false;">
					<input type="hidden" name="cid" value="<?= $res[0]->id;?>" />
					<input type="hidden" name="aid" value="<?= $res[0]->allocator_id;?>" />
					<input type="hidden" name="action" value="save_cc_info" />
					<div class="big_line">
						<div class="big_text">
							Client Information
							<a href="#" class="display_client_address" onclick="$('.real_client_address').show(); $('.display_client_address').hide(); return false;" style="font-size:12px;">Edit</a>
							<a href="#" class="real_client_address" onclick="$('.real_client_address').hide(); $('.display_client_address').show(); return false;" style="font-size:12px;">Edit</a>
						</div>
						<div style="padding-left:30px;">
							<div class="display_client_address" <?= (empty($res[0]->first) || empty($res[0]->last)) ? 'style="display:none;"' : '';?>><?= $res[0]->first.' '.$res[0]->last;?></div>
							<div class="real_client_address" <?= (empty($res[0]->first) || empty($res[0]->last)) ? 'style="display:block;"' : '';?>>
								<label>First Name<br />
									<input type="text" name="first" placeholder="First Name" value="<?= $res[0]->first;?>" />
								</label>
							</div>
							<div class="real_client_address" <?= (empty($res[0]->first) || empty($res[0]->last)) ? 'style="display:block;"' : '';?>>
								<label>Last Name<br />
									<input type="text" name="last" placeholder="Last Name" value="<?= $res[0]->last;?>" />
								</label>
							</div>
							<div class="display_client_address" <?= (empty($res[0]->address1)) ? 'style="display:none;"' : '';?>><?= $res[0]->address1;?></div>
							<div class="real_client_address" <?= (empty($res[0]->address1)) ? 'style="display:block;"' : '';?>>
								<label>Street Address<br />
									<input type="text" name="street_address" placeholder="Street Address" value="<?= $res[0]->address1;?>" />
								</label>
							</div>
							<div class="display_client_address" <?= (empty($res[0]->city) || empty($res[0]->state) || empty($res[0]->zip)) ? 'style="display:none;"' : '';?>><?= $res[0]->city.', '.$res[0]->state.' '.$res[0]->zip;?></div>
							<div class="real_client_address" <?= (empty($res[0]->city) || empty($res[0]->state) || empty($res[0]->zip)) ? 'style="display:block;"' : '';?>>
								<label>City<br />
									<input type="text" name="city" placeholder="City" value="<?= $res[0]->city;?>" />
								</label>
							</div>
							<div class="real_client_address" <?= (empty($res[0]->city) || empty($res[0]->state) || empty($res[0]->zip)) ? 'style="display:block;"' : '';?>>
								<label>State<br />
									<input type="text" name="state" placeholder="State (CA, NY)" value="<?= $res[0]->state;?>" />
								</label>
							</div>
							<div class="real_client_address" <?= (empty($res[0]->city) || empty($res[0]->state) || empty($res[0]->zip)) ? 'style="display:block;"' : '';?>>
								<label>Zip<br />
									<input type="tel" name="zip" placeholder="Zip Code" value="<?= $res[0]->zip;?>" />
								</label>
							</div>
							<div class="display_client_address" <?= (empty($res[0]->phone)) ? 'style="display:none;"' : '';?>><?= pretty_phone($res[0]->phone);?></div>
							<div class="real_client_address" <?= (empty($res[0]->phone)) ? 'style="display:block;"' : '';?>>
								<label>Phone<br />
									<input type="tel" name="phone_1" placeholder="Phone Number" value="<?= pretty_phone($res[0]->phone);?>" />
								</label>
							</div>
							<div class="display_client_address" <?= (empty($res[0]->email)) ? 'style="display:none;"' : '';?>><?= $res[0]->email;?></div>
							<div class="real_client_address" <?= (empty($res[0]->email)) ? 'style="display:block;"' : '';?>>
								<label>Email<br />
									<input type="text" name="email" placeholder="Email" value="<?= $res[0]->email;?>" />
								</label>
							</div>
						</div>
					</div>
					<div class="big_line">
						<div class="big_text">Card Type</div>
						<div class="credit_cards">
							<label><input type="radio" name="cc_type" value="visa" onclick="change_cc_type();" required style="vertical-align:middle;width:20px;height:20px;" /> <img src="visa.png" style="vertical-align:middle;" /></label>
							<label><input type="radio" name="cc_type" value="mast" onclick="change_cc_type();" required style="vertical-align:middle;width:20px;height:20px;" /> <img src="mast.png" style="vertical-align:middle;" /></label>
							<label><input type="radio" name="cc_type" value="disc" onclick="change_cc_type();" required style="vertical-align:middle;width:20px;height:20px;" /> <img src="disc.png" style="vertical-align:middle;" /></label>
							<label><input type="radio" name="cc_type" value="amex" onclick="change_cc_type();" required style="vertical-align:middle;width:20px;height:20px;" /> <img src="amex.png" style="vertical-align:middle;" /></label>
						</div>
					</div>
					<div class="big_line">
						<input type="tel" id="cc_num" name="cc_num" placeholder="Credit Card Number" required />
					</div>
					<div class="big_line">
						<div style="display:inline-block;vertical-align:middle;">
							<div style="display:inline-block;width:70px;">Expires</div>
							<select name="cc_exp_month" style="width:100px;padding:10px 0px;" required>
								<option value="">MM</option>
								<?php for($i=1;$i<=12;$i++) {?>
									<option value="<?= str_pad($i,2,'0',STR_PAD_LEFT);?>"><?= str_pad($i,2,'0',STR_PAD_LEFT);?></option>
								<?php } ?>
							</select> /
							<select name="cc_exp_year" style="width:150px;padding:10px 0px;" required>
								<option value="">YYYY</option>
								<?php $this_year = date('Y');
								$end_year = $this_year*1 + 10;
								for($i=$this_year;$i<=$end_year;$i++) { ?>
									<option value="<?= $i;?>"><?= $i;?></option>
								<?php } ?>
							</select>
						</div>
						<div style="margin-top:10px;">
							<div style="display:inline-block;vertical-align:middle;">
								<div style="display:inline-block;width:70px;">CVV</div>
								<input type="tel" name="cc_cvv" style="width:100px;" required />
							</div>
						</div>
						<div class="cvv_info_not_amex" style="display:none;"><i style="font-size:14px;">* The CVV is a 3 digit number on the back of your card.</i></div>
						<div class="cvv_info_amex" style="display:none;"><i style="font-size:14px;">* The CVV is a 4 digit number on the front of your card.</i></div>
					</div>
					<div class="big_line">
						<center><input type="submit" value="Submit" id="submit_button" /></center>
					</div>
				</form>
				<div class="big_line">
					<center>
						<img src="/vx/usa/pci_form/ssl_logo.png" style="vertical-align:middle;" />
						<?php
						$cert = '1889703';
						if($siteCode=='agf') {
							$cert = '1889702';
						} elseif($siteCode=='agg') {
							$cert = '1889703';
						} elseif($siteCode=='fa') {
							$cert = '1889711';
						} elseif($siteCode=='ggus') {
							$cert = '1889708';
						} elseif($siteCode=='nusaf') {
							$cert = '1889704';
						} elseif($siteCode=='nusag') {
							$cert = '1889705';
						} elseif($siteCode=='usafa') {
							$cert = '1889707';
						} elseif($siteCode=='usaga') {
							$cert = '1889706';
						} elseif($siteCode=='usagaorg') {
							$cert = '1889709';
						}
						?>
						<a href="//www.securitymetrics.com/site_certificate?id=<?= $cert;?>&tk=b09e62c4cae0d777a4ffbb2d08faa4b0"
						   target="_blank" rel="noopener noreferrer" style="vertical-align:middle;">
							<img src="https://www.securitymetrics.com/portal/app/ngsm/assets/img/BlueContent_Credit_Card_Safe_White_Rec.png"
								 alt="SecurityMetrics Credit Card Safe" />
						</a>
					</center>
				</div>
				<?php } ?>
			</div>
		</div>
	</body>
</html>