secure.coplogic.com
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Submitted URL: https://secure.coplogic.com/rar/accessrequest/200001774/b10afb27-5fd6-49d3-af87-845a3212124e
Effective URL: https://secure.coplogic.com/rar/en/editpayment;jsessionid=DB8D727A256F8261AAA4AF23D125CEB0?dynparam=1681475926738
Submission: On April 14 via manual from US — Scanned from DE
Effective URL: https://secure.coplogic.com/rar/en/editpayment;jsessionid=DB8D727A256F8261AAA4AF23D125CEB0?dynparam=1681475926738
Submission: On April 14 via manual from US — Scanned from DE
Form analysis 1 forms found in the DOM
POST /rar/en/editpayment.myform
<form class="form-inline" data-generator="tapestry/core/form" action="/rar/en/editpayment.myform" method="post" id="myForm"><input value="ea17cf33-ad6c-4fe9-a8d0-e8c0afe67361" name="_csrf" type="hidden"><input value="1681475926882" name="dynparam"
type="hidden"><input
value="SsgfyOvZJNkKKe8/g+HAhDxrI0c=: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"
name="t:formdata" type="hidden"><input value="200329297" name="hidden" type="hidden">
<table class="dayTable">
<tbody>
<tr bgcolor="#335A8E">
<td colspan="2" class="title1">Pay for Requested Information</td>
</tr>
<tr bgcolor="#FFFFCC">
<td colspan="2">There will be a charge from LexisNexis® Request a Report that shows up from this payment on your credit card bill. Please enter all the information.</td>
</tr>
<tr bgcolor="#ffffff">
<td align="right">Request Number</td>
<td>22-0100306</td>
</tr>
<tr bgcolor="#ffffff">
<td align="right">Report Number</td>
<td>22-75842 </td>
</tr>
<tr bgcolor="#ffffff">
<td width="30%" align="right"><b>Amount to Be Charged</b></td>
<td align="left"><b><font color="red">$23.00</font></b></td>
</tr>
<tr bgcolor="#ffffff">
<td align="right">
<font color="red">*</font><b><label for="nameOnCardField" id="nameOnCardField-label" class="control-label">Name on Card</label></b>
</td>
<td><input aria-labelledby="nameOnCardField-label" size="20" maxlength="100" required="required" aria-required="true" id="nameOnCardField" class="form-control" name="nameOnCardField" type="text"></td>
</tr>
<tr bgcolor="#ffffff">
<td valign="middle" align="right">
<font color="red">*</font><b><label for="billAddrField" id="billAddrField-label" class="control-label">Billing Address</label></b>
</td>
<td align="left">
<div>
<fieldset class="border rounded p-1"><select data-update-url="/rar/en/editpayment.billaddrfield.countryfield:change?_csrf=ea17cf33-ad6c-4fe9-a8d0-e8c0afe67361&dynparam=1681475926887" data-update-zone="address3Zone"
placeholder="Country" class="form-control" id="countryField" name="countryField">
<option selected="selected" value="US">United States of America</option>
<option value="CA">Canada</option>
<option value="AF">Afghanistan</option>
<option value="AX">Aland Islands</option>
<option value="AL">Albania</option>
<option value="DZ">Algeria</option>
<option value="AS">American Samoa</option>
<option value="AD">Andorra</option>
<option value="AO">Angola</option>
<option value="AI">Anguilla</option>
<option value="AQ">Antarctica</option>
<option value="AG">Antigua and Barbuda</option>
<option value="AR">Argentina</option>
<option value="AM">Armenia</option>
<option value="AW">Aruba</option>
<option value="AU">Australia</option>
<option value="AT">Austria</option>
<option value="AZ">Azerbaijan</option>
<option value="BS">Bahamas</option>
<option value="BH">Bahrain</option>
<option value="BD">Bangladesh</option>
<option value="BB">Barbados</option>
<option value="BY">Belarus</option>
<option value="BE">Belgium</option>
<option value="BZ">Belize</option>
<option value="BJ">Benin</option>
<option value="BM">Bermuda</option>
<option value="BT">Bhutan</option>
<option value="BO">Bolivia, Plurinational State of</option>
<option value="BQ">Bonaire, Sint Eustatius and Saba</option>
<option value="BA">Bosnia and Herzegovina</option>
<option value="BW">Botswana</option>
<option value="BV">Bouvet Island</option>
<option value="BR">Brazil</option>
<option value="IO">British Indian Ocean Territory</option>
<option value="BN">Brunei Darussalam</option>
<option value="BG">Bulgaria</option>
<option value="BF">Burkina Faso</option>
<option value="BI">Burundi</option>
<option value="KH">Cambodia</option>
<option value="CM">Cameroon</option>
<option value="CA">Canada</option>
<option value="CV">Cape Verde</option>
<option value="KY">Cayman Islands</option>
<option value="CF">Central African Republic</option>
<option value="TD">Chad</option>
<option value="CL">Chile</option>
<option value="CN">China</option>
<option value="CX">Christmas Island</option>
<option value="CC">Cocos (Keeling) Islands</option>
<option value="CO">Colombia</option>
<option value="KM">Comoros</option>
<option value="CG">Congo</option>
<option value="CD">Congo, the Democratic Republic of the</option>
<option value="CK">Cook Islands</option>
<option value="CR">Costa Rica</option>
<option value="CI">Cote d'Ivoire</option>
<option value="HR">Croatia</option>
<option value="CU">Cuba</option>
<option value="CW">Curacao</option>
<option value="CY">Cyprus</option>
<option value="CZ">Czech Republic</option>
<option value="DK">Denmark</option>
<option value="DJ">Djibouti</option>
<option value="DM">Dominica</option>
<option value="DO">Dominican Republic</option>
<option value="EC">Ecuador</option>
<option value="EG">Egypt</option>
<option value="SV">El Salvador</option>
<option value="GQ">Equatorial Guinea</option>
<option value="ER">Eritrea</option>
<option value="EE">Estonia</option>
<option value="ET">Ethiopia</option>
<option value="FK">Falkland Islands (Malvinas)</option>
<option value="FO">Faroe Islands</option>
<option value="FJ">Fiji</option>
<option value="FI">Finland</option>
<option value="FR">France</option>
<option value="GF">French Guiana</option>
<option value="PF">French Polynesia</option>
<option value="TF">French Southern Territories</option>
<option value="GA">Gabon</option>
<option value="GM">Gambia</option>
<option value="GE">Georgia</option>
<option value="DE">Germany</option>
<option value="GH">Ghana</option>
<option value="GI">Gibraltar</option>
<option value="GR">Greece</option>
<option value="GL">Greenland</option>
<option value="GD">Grenada</option>
<option value="GP">Guadeloupe</option>
<option value="GU">Guam</option>
<option value="GT">Guatemala</option>
<option value="GG">Guernsey</option>
<option value="GN">Guinea</option>
<option value="GW">Guinea-Bissau</option>
<option value="GY">Guyana</option>
<option value="HT">Haiti</option>
<option value="HM">Heard Island and McDonald Islands</option>
<option value="VA">Holy See (Vatican City State)</option>
<option value="HN">Honduras</option>
<option value="HK">Hong Kong</option>
<option value="HU">Hungary</option>
<option value="IS">Iceland</option>
<option value="IN">India</option>
<option value="ID">Indonesia</option>
<option value="IR">Iran</option>
<option value="IQ">Iraq</option>
<option value="IE">Ireland</option>
<option value="IM">Isle of Man</option>
<option value="IL">Israel</option>
<option value="IT">Italy</option>
<option value="JM">Jamaica</option>
<option value="JP">Japan</option>
<option value="JE">Jersey</option>
<option value="JO">Jordan</option>
<option value="KZ">Kazakhstan</option>
<option value="KE">Kenya</option>
<option value="KI">Kiribati</option>
<option value="KP">North Korea</option>
<option value="KR">South Korea</option>
<option value="KW">Kuwait</option>
<option value="KG">Kyrgyzstan</option>
<option value="LA">Lao People's Democratic Republic</option>
<option value="LV">Latvia</option>
<option value="LB">Lebanon</option>
<option value="LS">Lesotho</option>
<option value="LR">Liberia</option>
<option value="LY">Libya</option>
<option value="LI">Liechtenstein</option>
<option value="LT">Lithuania</option>
<option value="LU">Luxembourg</option>
<option value="MO">Macao</option>
<option value="MK">Macedonia</option>
<option value="MG">Madagascar</option>
<option value="MW">Malawi</option>
<option value="MY">Malaysia</option>
<option value="MV">Maldives</option>
<option value="ML">Mali</option>
<option value="MT">Malta</option>
<option value="MH">Marshall Islands</option>
<option value="MQ">Martinique</option>
<option value="MR">Mauritania</option>
<option value="MU">Mauritius</option>
<option value="YT">Mayotte</option>
<option value="MX">Mexico</option>
<option value="FM">Micronesia, Federated States of</option>
<option value="MD">Moldova, Republic of</option>
<option value="MC">Monaco</option>
<option value="MN">Mongolia</option>
<option value="ME">Montenegro</option>
<option value="MS">Montserrat</option>
<option value="MA">Morocco</option>
<option value="MZ">Mozambique</option>
<option value="MM">Myanmar</option>
<option value="NA">Namibia</option>
<option value="NR">Nauru</option>
<option value="NP">Nepal</option>
<option value="NL">Netherlands</option>
<option value="NC">New Caledonia</option>
<option value="NZ">New Zealand</option>
<option value="NI">Nicaragua</option>
<option value="NE">Niger</option>
<option value="NG">Nigeria</option>
<option value="NU">Niue</option>
<option value="NF">Norfolk Island</option>
<option value="MP">Northern Mariana Islands</option>
<option value="NO">Norway</option>
<option value="OM">Oman</option>
<option value="PK">Pakistan</option>
<option value="PW">Palau</option>
<option value="PS">Palestinian Territory, Occupied</option>
<option value="PA">Panama</option>
<option value="PG">Papua New Guinea</option>
<option value="PY">Paraguay</option>
<option value="PE">Peru</option>
<option value="PH">Philippines</option>
<option value="PN">Pitcairn</option>
<option value="PL">Poland</option>
<option value="PT">Portugal</option>
<option value="PR">Puerto Rico</option>
<option value="QA">Qatar</option>
<option value="RE">Reunion</option>
<option value="RO">Romania</option>
<option value="RU">Russian</option>
<option value="RW">Rwanda</option>
<option value="BL">Saint Barthelemy</option>
<option value="SH">Saint Helena, Ascension and Tristan da Cunha</option>
<option value="KN">Saint Kitts and Nevis</option>
<option value="LC">Saint Lucia</option>
<option value="MF">Saint Martin (French part)</option>
<option value="PM">Saint Pierre and Miquelon</option>
<option value="VC">Saint Vincent and the Grenadines</option>
<option value="WS">Samoa</option>
<option value="SM">San Marino</option>
<option value="ST">Sao Tome and Principe</option>
<option value="SA">Saudi Arabia</option>
<option value="SN">Senegal</option>
<option value="RS">Serbia</option>
<option value="SC">Seychelles</option>
<option value="SL">Sierra Leone</option>
<option value="SG">Singapore</option>
<option value="SX">Sint Maarten (Dutch part)</option>
<option value="SK">Slovakia</option>
<option value="SI">Slovenia</option>
<option value="SB">Solomon Islands</option>
<option value="SO">Somalia</option>
<option value="ZA">South Africa</option>
<option value="GS">South Georgia and the South Sandwich Islands</option>
<option value="SS">South Sudan</option>
<option value="ES">Spain</option>
<option value="LK">Sri Lanka</option>
<option value="SD">Sudan</option>
<option value="SR">Suriname</option>
<option value="SJ">Svalbard and Jan Mayen</option>
<option value="SZ">Swaziland</option>
<option value="SE">Sweden</option>
<option value="CH">Switzerland</option>
<option value="SY">Syrian Arab Republic</option>
<option value="TW">Taiwan</option>
<option value="TJ">Tajikistan</option>
<option value="TZ">Tanzania, United Republic of</option>
<option value="TH">Thailand</option>
<option value="TL">Timor-Leste</option>
<option value="TG">Togo</option>
<option value="TK">Tokelau</option>
<option value="TO">Tonga</option>
<option value="TT">Trinidad and Tobago</option>
<option value="TN">Tunisia</option>
<option value="TR">Turkey</option>
<option value="TM">Turkmenistan</option>
<option value="TC">Turks and Caicos Islands</option>
<option value="TV">Tuvalu</option>
<option value="UG">Uganda</option>
<option value="UA">Ukraine</option>
<option value="AE">United Arab Emirates</option>
<option value="GB">United Kingdom</option>
<option selected="selected" value="US">United States</option>
<option value="UM">United States Minor Outlying Islands</option>
<option value="UY">Uruguay</option>
<option value="UZ">Uzbekistan</option>
<option value="VU">Vanuatu</option>
<option value="VE">Venezuela, Bolivarian Republic of</option>
<option value="VN">Viet Nam</option>
<option value="VG">Virgin Islands, British</option>
<option value="VI">Virgin Islands, U.S.</option>
<option value="WF">Wallis and Futuna</option>
<option value="EH">Western Sahara</option>
<option value="YE">Yemen</option>
<option value="ZM">Zambia</option>
<option value="ZW">Zimbabwe</option>
</select>
<div style="height:2px"></div>
<div data-zone-parameters="{"t:formid":"myForm","t:formcomponentid":"EditPayment:myform"}" data-container-type="zone" id="address3Zone"><input size="60" maxlength="80" placeholder="Street Address"
required="required" aria-required="true" id="streetField" class="form-control w-auto border-top-0 border-left-0 border-right-0 rounded-0 pl-0" name="streetField" type="text"><input
value="dyf4u4wGRP4r7KhoNBlYcucepNI=:H4sIAAAAAAAAAJWRMU4DMRBFh0gUaKmQOAEkgsaREGmgSgFVhCKtOMDYnixG3rWxJyRLwVE4AeISKei4AwegpaIguxsJpYjYdNa337yv8esX7M5OoHulDY+xzKngC2msRa3DxJDVInIg4voMMcDAhUygR3VHgtHT8rocCOUCWSOFxEhiKJchKr6umOOUeOq7t4vk8/D9pwM7I0iUKzg4e4M5MRyM7vER+xaLrJ9yMEV2OfcMSeOtZ2xVcLhtwXFwimJMpzI3MRpXLN70+eT75aMDMPezHhxtdivD5cr8AM8ADHtV1LRuSVbgv3+ATGfroqQJWy3oj25kp9Db/PzJeOU0rdv2V2mja8/Xvl9AqNhWZQIAAA=="
name="t:formdata" type="hidden">
<div style="height:2px"></div>
<table class="blankTable">
<tbody>
<tr>
<td><input size="30" maxlength="30" placeholder="City" required="required" aria-required="true" id="cityField" class="form-control w-auto border-top-0 border-left-0 border-right-0 rounded-0 px-0" name="cityField" type="text">
</td>
<td> </td>
<td><select placeholder="State" class="form-control custom-select browser-default border-top-0 border-left-0 border-right-0 rounded-0 pl-0 pr-4" id="state2Field" name="state2Field">
<option value="">Please Select</option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="DC">District of Columbia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
</select></td>
<td> </td>
<td><input size="5" maxlength="5" placeholder="Zip Code" required="required" aria-required="true" id="zipcodeField" class="form-control w-auto border-top-0 border-left-0 border-right-0 rounded-0 pl-0" name="zipcodeField"
type="text"></td>
</tr>
</tbody>
</table>
</div>
</fieldset>
</div>
</td>
</tr>
<tr bgcolor="#ffffff">
<td align="right">
<font color="red">*</font><b><label for="phoneField" id="phoneField-label" class="control-label">Phone</label></b>
</td>
<td align="left"><input aria-labelledby="phoneField-label" size="20" maxlength="20" onkeyup="if (!isIntlCountry()) { formatPhoneUp(this, event, countryCode, 0); }" onkeydown="if (!isIntlCountry()) { formatPhoneDown(this, event); }"
required="required" aria-required="true" id="phoneField" class="form-control" name="phoneField" type="text"><br> (yyy-zzz-zzzz for US/Canada, +xxx-yyy-zzzzzzz for international) </td>
</tr>
<tr bgcolor="#ffffff">
<td align="right">
<font color="red">*</font><b><label for="ccTypeField" id="ccTypeField-label" class="control-label">Credit Card Type</label></b>
</td>
<td align="left"><select aria-labelledby="ccTypeField-label" required="required" aria-required="true" class="form-control" id="ccTypeField" name="ccTypeField">
<option value="">Please Select</option>
<option value="AE">American Express</option>
<option value="MC">MasterCard</option>
<option value="VC">Visa</option>
</select></td>
</tr>
<tr bgcolor="#ffffff">
<td align="right">
<font color="red">*</font><b><label for="acctNoField" id="acctNoField-label" class="control-label">Card or Account Number</label></b>
</td>
<td><input aria-labelledby="acctNoField-label" size="20" autocomplete="off" maxlength="16" required="required" aria-required="true" id="acctNoField" class="form-control" name="acctNoField" type="text"></td>
</tr>
<tr bgcolor="#ffffff">
<td align="right">
<font color="red">*</font><b>Expiration Date</b>
</td>
<td align="left"><select required="required" aria-required="true" class="form-control" id="expMonthField" name="expMonthField">
<option value="">Month</option>
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option selected="selected" value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select> <select required="required" aria-required="true" class="form-control" id="expYearField" name="expYearField">
<option value="">Year</option>
<option selected="selected" value="2023">2023</option>
<option value="2024">2024</option>
<option value="2025">2025</option>
<option value="2026">2026</option>
<option value="2027">2027</option>
<option value="2028">2028</option>
<option value="2029">2029</option>
<option value="2030">2030</option>
<option value="2031">2031</option>
<option value="2032">2032</option>
<option value="2033">2033</option>
<option value="2034">2034</option>
<option value="2035">2035</option>
<option value="2036">2036</option>
<option value="2037">2037</option>
<option value="2038">2038</option>
<option value="2039">2039</option>
<option value="2040">2040</option>
<option value="2041">2041</option>
<option value="2042">2042</option>
<option value="2043">2043</option>
</select></td>
</tr>
<tr bgcolor="#ffffff">
<td align="right">
<font color="red">*</font><b><label for="cvnField" id="cvnField-label" class="control-label">Card Verification Number</label></b>
</td>
<td><input aria-labelledby="cvnField-label" size="4" autocomplete="off" maxlength="4" required="required" aria-required="true" id="cvnField" class="form-control" name="cvnField" type="text"> <img id="any_2"
src="/rar/assets/ctx/ca1701db/images/question-icon-tiny.png" alt="info img"
title="Card Verification Number is used for additional security verification. If you are using a MasterCard or Visa, please provide the 3-digit verification number located on the back of your card. If you are using an American Express card, please provide the 4-digit verification number located on the front of your card."
height="12"></td>
</tr>
<tr bgcolor="#ffffff">
<td colspan="2">
<b>Your access and use of this report(s) and these services is subject to the <a target="_blank" href="https://secure.coplogic.com/rar/showuserterms/200001774">Terms and Conditions</a> that you agreed to when requesting the report.</b></td>
</tr>
</tbody>
</table>
<div style="height: 3px"></div>
<table cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td><a style="border: #002F6C 2px solid; background: #335A8E" class="linkButton" id="review" data-submit-mode="normal" href="#"><span id="any_3">Continue ></span></a></td>
<td class="box2px"></td>
<td><a id="eventlink" style="border: #002F6C 2px solid; background: #335A8E" class="linkButton" href="/rar/en/editpayment:cancelpay?_csrf=ea17cf33-ad6c-4fe9-a8d0-e8c0afe67361&dynparam=1681475926889">Cancel</a></td>
</tr>
</tbody>
</table>
<div style="height: 2px"></div>
</form>Text Content
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