securepayment.link
Open in
urlscan Pro
2a06:98c1:3121::7
Public Scan
URL:
https://securepayment.link/shendellpollock/shendell-pollock-lc/
Submission: On April 26 via manual from PH — Scanned from DE
Submission: On April 26 via manual from PH — Scanned from DE
Form analysis 1 forms found in the DOM
POST /shendellpollock/shendell-pollock-lc/
<form method="post" enctype="multipart/form-data" id="gform_1" action="/shendellpollock/shendell-pollock-lc/">
<div class="gform_body gform-body">
<ul id="gform_fields_1" class="gform_fields top_label form_sublabel_below description_below">
<li id="field_1_1" class="gfield gsection field_sublabel_below field_description_below gfield_visibility_visible">
<h2 class="gsection_title">Payment Details</h2>
<div class="gsection_description" id="gfield_description_1_1">*This information is required</div>
</li>
<li id="field_1_10" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label gfield_label_before_complex">Name<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name" id="input_1_10">
<span id="input_1_10_3_container" class="name_first">
<input type="text" name="input_10.3" id="input_1_10_3" value="" aria-required="true">
<label for="input_1_10_3">First</label>
</span>
<span id="input_1_10_6_container" class="name_last">
<input type="text" name="input_10.6" id="input_1_10_6" value="" aria-required="true">
<label for="input_1_10_6">Last</label>
</span>
</div>
</li>
<li id="field_1_9" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_9">Email<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_9" id="input_1_9" type="text" value="" class="medium" aria-required="true" aria-invalid="false">
</div>
</li>
<li id="field_1_11" class="gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_11">Phone<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_phone"><input name="input_11" id="input_1_11" type="text" value="" class="medium" aria-required="true" aria-invalid="false"></div>
</li>
<li id="field_1_14" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_14">Invoice #<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_14" id="input_1_14" type="text" value="" class="medium" aria-required="true" aria-invalid="false"> </div>
</li>
<li id="field_1_2" class="gfield gf_right_half gfield_price gfield_price_1_2 gfield_product_1_2 gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_2">Payment
Amount<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_product_price">
<input name="input_2" id="input_1_2" type="text" value="" class="small ginput_amount" placeholder="$0.00" aria-required="true" aria-invalid="false">
</div>
</li>
<li id="field_1_6" class="gfield gsection field_sublabel_below field_description_below gfield_visibility_visible">
<h2 class="gsection_title">Billing Details</h2>
<div class="gsection_description" id="gfield_description_1_6">*This information is required</div>
</li>
<li id="field_1_7" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label gfield_label_before_complex">Billing Address<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address" id="input_1_7">
<span class="ginput_full address_line_1 ginput_address_line_1" id="input_1_7_1_container">
<input type="text" name="input_7.1" id="input_1_7_1" value="" aria-required="true">
<label for="input_1_7_1" id="input_1_7_1_label">Street Address</label>
</span><span class="ginput_full address_line_2 ginput_address_line_2" id="input_1_7_2_container">
<input type="text" name="input_7.2" id="input_1_7_2" value="" aria-required="false">
<label for="input_1_7_2" id="input_1_7_2_label">Address Line 2</label>
</span><span class="ginput_left address_city ginput_address_city" id="input_1_7_3_container">
<input type="text" name="input_7.3" id="input_1_7_3" value="" aria-required="true">
<label for="input_1_7_3" id="input_1_7_3_label">City</label>
</span><span class="ginput_right address_state ginput_address_state" id="input_1_7_4_container">
<select name="input_7.4" id="input_1_7_4" aria-required="true">
<option value="" selected="selected"></option>
<option value="Alabama">Alabama</option>
<option value="Alaska">Alaska</option>
<option value="Arizona">Arizona</option>
<option value="Arkansas">Arkansas</option>
<option value="California">California</option>
<option value="Colorado">Colorado</option>
<option value="Connecticut">Connecticut</option>
<option value="Delaware">Delaware</option>
<option value="District of Columbia">District of Columbia</option>
<option value="Florida">Florida</option>
<option value="Georgia">Georgia</option>
<option value="Hawaii">Hawaii</option>
<option value="Idaho">Idaho</option>
<option value="Illinois">Illinois</option>
<option value="Indiana">Indiana</option>
<option value="Iowa">Iowa</option>
<option value="Kansas">Kansas</option>
<option value="Kentucky">Kentucky</option>
<option value="Louisiana">Louisiana</option>
<option value="Maine">Maine</option>
<option value="Maryland">Maryland</option>
<option value="Massachusetts">Massachusetts</option>
<option value="Michigan">Michigan</option>
<option value="Minnesota">Minnesota</option>
<option value="Mississippi">Mississippi</option>
<option value="Missouri">Missouri</option>
<option value="Montana">Montana</option>
<option value="Nebraska">Nebraska</option>
<option value="Nevada">Nevada</option>
<option value="New Hampshire">New Hampshire</option>
<option value="New Jersey">New Jersey</option>
<option value="New Mexico">New Mexico</option>
<option value="New York">New York</option>
<option value="North Carolina">North Carolina</option>
<option value="North Dakota">North Dakota</option>
<option value="Ohio">Ohio</option>
<option value="Oklahoma">Oklahoma</option>
<option value="Oregon">Oregon</option>
<option value="Pennsylvania">Pennsylvania</option>
<option value="Rhode Island">Rhode Island</option>
<option value="South Carolina">South Carolina</option>
<option value="South Dakota">South Dakota</option>
<option value="Tennessee">Tennessee</option>
<option value="Texas">Texas</option>
<option value="Utah">Utah</option>
<option value="Vermont">Vermont</option>
<option value="Virginia">Virginia</option>
<option value="Washington">Washington</option>
<option value="West Virginia">West Virginia</option>
<option value="Wisconsin">Wisconsin</option>
<option value="Wyoming">Wyoming</option>
<option value="Armed Forces Americas">Armed Forces Americas</option>
<option value="Armed Forces Europe">Armed Forces Europe</option>
<option value="Armed Forces Pacific">Armed Forces Pacific</option>
</select>
<label for="input_1_7_4" id="input_1_7_4_label">State</label>
</span><span class="ginput_left address_zip ginput_address_zip" id="input_1_7_5_container">
<input type="text" name="input_7.5" id="input_1_7_5" value="" aria-required="true">
<label for="input_1_7_5" id="input_1_7_5_label">ZIP Code</label>
</span><input type="hidden" class="gform_hidden" name="input_7.6" id="input_1_7_6" value="United States">
<div class="gf_clear gf_clear_complex"></div>
</div>
</li>
<li id="field_1_8" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_8">Secure Credit Card</label>
<div class="ginput_complex ginput_container ginput_container_creditcard hps_secure_cc" id="input_1_8">
<div id="HPS_secure_cc">
<div class="ss-shield"></div>
<div id="secure-submit-card" class="form-group">
<label for="iframesCardHolder">Card Holder<span class="red">*</span></label>
<input type="text" name="card_name" placeholder="John Doe"><br><br>
</div>
<div id="secure-submit-card" class="form-group">
<label for="iframesCardNumber">Card Number<span class="red">*</span></label>
<div class="iframeholder" id="iframesCardNumber"><iframe id="heartland-frame-cardNumber" name="cardNumber" frameborder="0" scrolling="no"
src="https://api.heartlandportico.com/SecureSubmit.v1/token/2.1/field.html#cardNumber:https%3A%2F%2Fsecurepayment.link%2Fshendellpollock%2Fshendell-pollock-lc%2F" style="border: 0px; height: 49px;"></iframe></div>
</div>
<div id="secure-submit-date" class="form-group">
<label for="iframesCardExpiration">Card Expiration<span class="red">*</span></label>
<div class="iframeholder" id="iframesCardExpiration"><iframe id="heartland-frame-cardExpiration" name="cardExpiration" frameborder="0" scrolling="no"
src="https://api.heartlandportico.com/SecureSubmit.v1/token/2.1/field.html#cardExpiration:https%3A%2F%2Fsecurepayment.link%2Fshendellpollock%2Fshendell-pollock-lc%2F" style="border: 0px; height: 49px;"></iframe></div>
</div>
<div id="secure-submit-cvv" class="form-group">
<label for="iframesCardCvv">Card CVV<span class="red">*</span></label>
<div class="iframeholder" id="iframesCardCvv"><iframe id="heartland-frame-cardCvv" name="cardCvv" frameborder="0" scrolling="no"
src="https://api.heartlandportico.com/SecureSubmit.v1/token/2.1/field.html#cardCvv:https%3A%2F%2Fsecurepayment.link%2Fshendellpollock%2Fshendell-pollock-lc%2F" style="border: 0px; height: 49px;"></iframe></div>
</div>
</div>
</div>
</li>
<li id="field_1_12" class="gfield gfield_price gfield_price_1_ gfield_total gfield_total_1_ field_sublabel_below field_description_below gfield_visibility_visible" aria-atomic="true" aria-live="polite"><label class="gfield_label"
for="input_1_12">Total</label>
<div class="ginput_container ginput_container_total">
<span class="ginput_total ginput_total_1">$0.00</span>
<input type="hidden" name="input_12" id="input_1_12" class="gform_hidden" value="0">
</div>
</li>
<li id="field_1_15" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_15">Signature</label>
<div>
<div id="input_1_15_Container" class="gfield_signature_container ginput_container" style="height: 180px; z-index: 99; width: 300px;"><input type="hidden" class="gform_hidden" name="input_1_15_valid" id="input_1_15_valid"><canvas
id="input_1_15" width="300" height="180"
style="border-width: 2px; border-style: dashed; border-color: rgb(221, 221, 221); background-color: rgb(255, 255, 255); cursor: url("https://securepayment.link/shendellpollock/wp-content/plugins/gravityformssignature/includes/super_signature/pen.cur"), pointer; height: 180px; width: 300px;"></canvas>
</div>
<div id="input_1_15_toolbar" style="margin: 5px; position: relative; height: 20px; background-color: transparent; width: 300px;"><img id="input_1_15_resetbutton"
src="https://securepayment.link/shendellpollock/wp-content/plugins/gravityformssignature/includes/super_signature/refresh.png" style="cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent" alt="Clear Signature">
<div id="input_1_15_status" style="color: blue; height: 20px; width: auto; padding: 2px; font-family: verdana; font-size: 12px; float: left; margin-right: 30px; display: none;"></div><input type="hidden" id="input_1_15_data"
name="input_1_15_data" value=""><input type="hidden" id="input_1_15_data_smooth" name="input_1_15_data_smooth" value=""><input type="hidden" id="input_1_15_data_canvas" name="input_1_15_data_canvas" value=""><button type="button"
id="input_1_15_lockedReset" class="gform_signature_locked_reset"
style="display:none;height:24px;cursor:pointer;padding: 0 0 0 1.8em;opacity:0.75;font-size:0.813em;border:0;background: transparent url(data:image/svg+xml;base64,PHN2ZyB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciIHZpZXdCb3g9IjAgMCA0NDggNTEyIiBjbGFzcz0idW5kZWZpbmVkIj48cGF0aCBkPSJNNDAwIDIyNGgtMjR2LTcyQzM3NiA2OC4yIDMwNy44IDAgMjI0IDBTNzIgNjguMiA3MiAxNTJ2NzJINDhjLTI2LjUgMC00OCAyMS41LTQ4IDQ4djE5MmMwIDI2LjUgMjEuNSA0OCA0OCA0OGgzNTJjMjYuNSAwIDQ4LTIxLjUgNDgtNDhWMjcyYzAtMjYuNS0yMS41LTQ4LTQ4LTQ4em0tMTA0IDBIMTUydi03MmMwLTM5LjcgMzIuMy03MiA3Mi03MnM3MiAzMi4zIDcyIDcydjcyeiIgY2xhc3M9InVuZGVmaW5lZCIvPjwvc3ZnPg==) no-repeat left center;background-size:16px;">Reset
to re-sign.</button>
</div>
</div>
</li>
<li id="field_1_13" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_13">CAPTCHA</label>
<div id="input_1_13" class="ginput_container ginput_recaptcha gform-initialized" data-sitekey="6Lc_k1kUAAAAAP1bkCjMSvnv10SJ-cgC5l90ZiZf" data-theme="light" data-tabindex="0" data-badge="">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6Lc_k1kUAAAAAP1bkCjMSvnv10SJ-cgC5l90ZiZf&co=aHR0cHM6Ly9zZWN1cmVwYXltZW50Lmxpbms6NDQz&hl=en&v=QENb_qRrX0-mQMyENQjD6Fuj&theme=light&size=normal&cb=atxqkp9d8iqq"
width="304" height="78" role="presentation" name="a-r2t2rajbi8zc" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox"></iframe></div><textarea id="g-recaptcha-response" name="g-recaptcha-response"
class="g-recaptcha-response" style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div>
</li>
</ul>
</div>
<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_1" class="gform_button button" value="Submit Payment" onclick="if(window["gf_submitting_1"]){return false;} window["gf_submitting_1"]=true; "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_1"]){return false;} window["gf_submitting_1"]=true; jQuery("#gform_1").trigger("submit",[true]); }">
<input type="hidden" class="gform_hidden" name="is_submit_1" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="1">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_1" value="WyJbXSIsIjRlZjNhYzJhNGIyNTI0ZjM5NjZhODFiNzg3MzQ5ZGZkIl0=">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_1" id="gform_target_page_number_1" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_1" id="gform_source_page_number_1" value="1">
<input type="hidden" name="gform_field_values" value="">
</div>
</form>Text Content
* Return To Site Select Page * Return To Site SHENDELL & POLLOCK, L.C. – ONE TIME PAYMENT * PAYMENT DETAILS *This information is required * Name* First Last * Email* * Phone* * Invoice #* * Payment Amount* * BILLING DETAILS *This information is required * Billing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code * Secure Credit Card Card Holder* Card Number* Card Expiration* Card CVV* * Total $0.00 * Signature Reset to re-sign. * CAPTCHA Copyright © 2021 Shendell & Pollock, P.L. | Privacy & Security Policy | Refund Policy Notifications