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www.vacationcrm.com Open in urlscan Pro
2606:4700:3035::6815:286d  Public Scan

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Submitted URL: https://alanapayment.ltwtraveldesign.com/
Effective URL: https://www.vacationcrm.com/IFramePayment?agent_lookup=0d9cd50f-ee0f-4f95-893d-53a321bac504
Submission: On March 30 via automatic, source certstream-suspicious — Scanned from DE

Form analysis 1 forms found in the DOM

Name: payment — POST #

<form id="payment" name="payment" method="post" action="#">
  <a name="topOfPmtForm"></a>
  <input type="hidden" id="apiKey" name="ApiKey" value="644db0a4-1167-422e-af7b-15c46364ca50">
  <input type="hidden" id="LookupID" name="LookupID" value="0d9cd50f-ee0f-4f95-893d-53a321bac504">
  <input type="hidden" id="LookupByUser" name="LookupByUser" value="True">
  <input type="hidden" id="user_id" name="user_id" value="alanaclason">
  <input type="hidden" id="AgentSelected" name="AgentSelected">
  <input type="hidden" id="pmtinsurance_all_pmt_types" name="pmtinsurance_all_pmt_types" value="Y">
  <input type="hidden" id="hideInsuranceInfoForPaymentTypes" name="hideInsuranceInfoForPaymentTypes" value="N">
  <input type="hidden" name="Payment[PaymentDescription]" id="PaymentDescription" value="">
  <div class="reservation">
    <div class="card">
      <div class="card-header text-center" style="background: #E551FF; color: #FFFFFF;">
        <div id="contactInfo">
          <strong class="card-header-text">Contact Information</strong>
        </div>
      </div>
      <div class="card-body">
        <input type="hidden" name="PrimaryAgent" id="agent" value="alanaclason">
        <div class="form-group row" data-type="text">
          <label class="col-sm-4 col-form-label text-md-right field-label" for="ConfirmationNumber">Your Confirmation Number:</label>
          <div class="col-sm-8">
            <input name="ConfirmationNumber" type="text" maxlength="50" id="ConfirmationNumber" class="form-control field-value">
          </div>
          <div class="col-md-4 d-none d-sm-inline-block"></div>
          <div class="col-md-8 col additional-info">
            <small style="font-size: 11px">Please use your confirmation number found on your invoice.</small>
          </div>
        </div>
        <div class="form-group row" data-type="text">
          <label class="col-sm-4 col-form-label text-md-right field-label" for="YourName">Your Name(s)<span class="required"> *</span>:</label>
          <div class="col-sm-8">
            <input name="YourName" type="text" maxlength="50" id="YourName" class="form-control field-value" data-validetta="required">
          </div>
        </div>
        <div class="form-group row" data-type="text">
          <label class="col-sm-4 col-form-label text-md-right field-label" for="Email">Your Email<span class="required"> *</span>:</label>
          <div class="col-sm-8">
            <input name="Email" type="email" maxlength="50" id="Email" class="form-control field-value" data-validetta="required, email">
          </div>
        </div>
        <div class="form-group row" data-type="radio">
          <label class="col-sm-4 col-form-label text-md-right field-label" for="registry_0"> Is this a Honeymoon Registry Gift? </label>
          <span class="col-sm-8" id="registry">
            <label class="col-form-label mr-md-1" for="registry_0">
              <input id="registry_0" type="radio" name="registry" value="Yes" class="field-value">Yes </label>
            <label class=" col-form-label field-value" for="registry_1">
              <input id="registry_1" type="radio" name="registry" value="No" class="field-value">No </label>
          </span>
        </div>
        <div class="form-group row" data-type="text">
          <label class="col-sm-4 col-form-label text-md-right field-label" for="couple">If so, please provide the couple's name(s):</label>
          <div class="col-sm-8">
            <input name="couple" type="text" maxlength="50" id="couple" class="form-control field-value">
          </div>
        </div>
        <div class="form-group row" data-type="dropdown">
          <label class="col-sm-4 col-form-label text-md-right field-label" for="PaymentType">
            <span id="Label18">Credit Card Type<span class="required"> *</span>:</span>
          </label>
          <div class="col-sm-8">
            <select name="Payment[PaymentType]" id="PaymentType" class="form-control field-value" data-validetta="required">
              <option selected="selected" value="">Credit Card Type</option>
              <option value="AMEX">American Express</option>
              <option value="MC">MasterCard</option>
              <option value="DISCOVER">Discover</option>
              <option value="VISA">Visa</option>
            </select>
          </div>
        </div>
        <div id="payment_info"></div>
        <div class="form-group row" data-type="dropdown">
          <label class="col-sm-4 col-form-label text-md-right field-label" for="DepositOrFinal" id="dep_final">Payment Type<span class="required"> *</span>:</label>
          <div class="col-sm-8">
            <select name="DepositOrFinal" id="DepositOrFinal" class="form-control field-value" data-validetta="required">
              <option selected="selected" value="">Payment Type</option>
              <option value="Deposit">Deposit</option>
              <option value="Other OR Final Payment">Other OR Final Payment</option>
              <option value="Honeymoon Registry Gift">Honeymoon Registry Gift</option>
            </select>
          </div>
        </div>
        <div id="insurance" class="form-group row" data-type="radio" style="display: none;">
          <label class="col-sm-4 col-form-label text-md-right field-label" for="TravelProtection_0">Travel Protection<span class="required"> *</span>:</label>
          <span id="TravelProtection" class="col-sm-8">
            <label class="checkbox-inline" for="TravelProtection_0"><input id="TravelProtection_0" type="radio" name="insurance" value="Yes" class="TravelProtection field-value" data-validetta="required"> ACCEPT Protection.</label>
            <label class="checkbox-inline" for="TravelProtection_1"><input id="TravelProtection_1" type="radio" name="insurance" value="No" class="TravelProtection field-value" data-validetta="required"> DECLINE Protection.</label>
          </span>
          <div class="col-md-4 d-none d-sm-inline-block"></div>
          <div class="col-md-8 col additional-info">
            <label class="form_disclaimer"><span style="color: red;">I understand that I CANNOT purchase the cancel for any reason insurance once my deposit is paid</span></label>
          </div>
        </div>
        <div id="udf">
        </div>
        <div class="form-group row" data-type="textarea">
          <label class="col-sm-4 col-form-label text-md-right field-label" for="comments"> Additional Comments : </label>
          <div class="col-sm-8">
            <textarea name="Comment" rows="5" cols="20" id="comments" class="form-control field-value"></textarea>
          </div>
        </div>
        <div id="udfB">
        </div>
        <label id="form-disclaimer" class="form_disclaimer">By submitting, you certify that you are the cardholder and are authorizing the travel agency or its chosen Tour Operator/Supplier/Cruise Line to charge the listed amount to the credit card.
          You certify that you have verified that all information contained in the confirmation you received is accurate. You also certify you have read the Terms &amp; Conditions and the appropriate Travel Protection Plan details. Cancellation
          penalties may apply. Insurance is not refundable.
          <b><font color="red">This charge will be manually applied by the agency to your reservation.  If there are any issues, an agent will get back to you.   Please note that you may not see a charge from the travel agency on your credit card statement; the charge will come from our supplier and/or the airline directly. Payment may take 3-5 business days to fully process and be reflected on your statement.</font></b>
          <b>I authorize the travel agency to use the above information to charge my credit card the stated amount. Completion of this form and the initialing of this box signifies acceptance in lieu of my signature.</b><strong>
            <font color="red">By checking the box below and adding your signature, you indicate that the above amount is correct, you authorize the travel agency to charge your credit card for the specified amount, and you agree to the terms and
              conditions.</font>
          </strong></label>
        <div class="row mt-3">
          <div class="col-12 col-md-6">
            <div class="form-group row ml-4" data-type="agreement-checkbox">
              <input type="checkbox" class="form-check-input field-value field-Agreement" id="FirstAgreementCheck" name="FirstAgreementCheck" data-validetta="required" value="false">
              <label class="field-label" for="FirstAgreementCheck">I Agree <span class="required">*</span></label>
            </div>
            <hr>
          </div>
          <div class="col-md-6">
            <input class="form-control" data-validetta="required" id="dateInput" name="SignatureDate" placeholder="Enter Current Date" type="text" value="">
          </div>
          <div class="col-md-12 mt-2">
            <input class="form-control" data-validetta="required" id="signatureInput" name="Signature" placeholder="Your signature" type="text" value="">
          </div>
        </div>
      </div>
    </div>
  </div>
  <div class="form-group">
    <a name="validationSummary"></a>
    <div id="ValidationSummary1" style="color: Red; display: none;">
    </div>
    <div align="center">
      <input type="submit" name="SubmitButton" value="Submit" id="SubmitButton" class="btn btn-info btn-block-mobile">
    </div>
  </div>
</form>

Text Content

Contact Information
Your Confirmation Number:


Please use your confirmation number found on your invoice.
Your Name(s) *:

Your Email *:

Is this a Honeymoon Registry Gift? Yes No
If so, please provide the couple's name(s):

Credit Card Type *:
Credit Card Type American Express MasterCard Discover Visa

Payment Type *:
Payment Type Deposit Other OR Final Payment Honeymoon Registry Gift
Travel Protection *: ACCEPT Protection. DECLINE Protection.

I understand that I CANNOT purchase the cancel for any reason insurance once my
deposit is paid

Additional Comments :


By submitting, you certify that you are the cardholder and are authorizing the
travel agency or its chosen Tour Operator/Supplier/Cruise Line to charge the
listed amount to the credit card. You certify that you have verified that all
information contained in the confirmation you received is accurate. You also
certify you have read the Terms & Conditions and the appropriate Travel
Protection Plan details. Cancellation penalties may apply. Insurance is not
refundable. This charge will be manually applied by the agency to your
reservation. If there are any issues, an agent will get back to you. Please note
that you may not see a charge from the travel agency on your credit card
statement; the charge will come from our supplier and/or the airline directly.
Payment may take 3-5 business days to fully process and be reflected on your
statement. I authorize the travel agency to use the above information to charge
my credit card the stated amount. Completion of this form and the initialing of
this box signifies acceptance in lieu of my signature.By checking the box below
and adding your signature, you indicate that the above amount is correct, you
authorize the travel agency to charge your credit card for the specified amount,
and you agree to the terms and conditions.
I Agree *

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Ok



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UH OH!

An unexpected error has occured. Please enter all data for your credit card!

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Retry