{"id":1927,"date":"2022-10-27T14:38:08","date_gmt":"2022-10-27T21:38:08","guid":{"rendered":"https:\/\/sgwflorida.com\/orlando\/?page_id=1927"},"modified":"2024-02-26T15:31:53","modified_gmt":"2024-02-26T23:31:53","slug":"credit-card-authorization","status":"publish","type":"page","link":"https:\/\/sgwflorida.com\/orlando\/contact\/credit-card-authorization\/","title":{"rendered":"Credit Card Authorization"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1497.6px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>                  <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework credit-card-form_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_4' style='display:none'><div id='gf_4' class='gform_anchor' tabindex='-1'><\/div>                         <div class='gform_heading'> \t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>                         <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_4' id='gform_4' class='credit-card-form' action='\/orlando\/wp-json\/wp\/v2\/pages\/1927#gf_4' data-formid='4' novalidate>                         <div class='gform-body gform_body'><div id='gform_fields_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_4_32\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_32'><span class='gform-field-label__text'>Phone<\/span><\/label><div class='ginput_container'><input name='input_32' id='input_4_32' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_4_32'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_4_1\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Credit Card Authorization<\/h3><div class='gsection_description' id='gfield_description_4_1'><b>The following information must be completed in full before any sales transaction can be made. Please read and fill in all information carefully.<\/b> <br \/>Instructions:<br> 1. Complete all fields below.<br> 2. Initial and Enter Name at end of form (will represent your signature) .<br> 3. Click Submit<\/div><\/div><div id=\"field_4_2\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_2'><span class='gform-field-label__text'>Cardholder&#039;s Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_4_2' type='text' value='' class='large'    placeholder='Cardholder&#039;s Name (Full Name Required)' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_3\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_3'><span class='gform-field-label__text'>Are You a Homeowner or Contractor\/Company?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_3' id='input_4_3' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Are You a Homeowner or Contractor\/Company? (Required)<\/option><option value='Company' >Company<\/option><option value='Homeowner' >Homeowner<\/option><\/select><\/div><\/div><div id=\"field_4_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_4'><span class='gform-field-label__text'>Company Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_4_4' type='text' value='' class='large'    placeholder='Company Name (Required)' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_5\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_5'><span class='gform-field-label__text'>Please Select Your SGW Sales Representative<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_5' id='input_4_5' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please Select Your SGW Sales Representative (Required)<\/option><option value='Wendy Carolina Mechan' >Wendy Carolina Mechan<\/option><option value='Jennifer Rodriguez' >Jennifer Rodriguez<\/option><option value='Juan Sebastian Velasquez' >Juan Sebastian Velasquez<\/option><option value='Vanessa Gutierrez' >Vanessa Gutierrez<\/option><option value='Gustavo Palma' >Gustavo Palma<\/option><option value='Estefania Varela' >Estefania Varela<\/option><option value='Carla Terceros' >Carla Terceros<\/option><option value='Cristina Adriana Yepes' >Cristina Adriana Yepes<\/option><\/select><\/div><\/div><div id=\"field_4_30\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><label class='gfield_label gform-field-label' for='input_4_30'><span class='gform-field-label__text'>Rep Email<\/span><\/label><div class='ginput_container ginput_container_email'>                             <input name='input_30' id='input_4_30' type='email' value='' class='large'     aria-invalid=\"false\"  \/>                         <\/div><\/div><div id=\"field_4_6\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_6'><span class='gform-field-label__text'>Purchase Reference<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_6' id='input_4_6' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Purchase Reference (Required)<\/option><option value='I Have a Sales Order Number' >I Have a Sales Order Number<\/option><option value='I Have an Estimate Number' >I Have an Estimate Number<\/option><option value='I Don&#039;t Have a Purchase Reference' >I Don&#039;t Have a Purchase Reference<\/option><\/select><\/div><\/div><div id=\"field_4_7\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_7'><span class='gform-field-label__text'>Estimate Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_4_7' type='text' value='' class='large'    placeholder='Estimate Number (Required)' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_8\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_8'><span class='gform-field-label__text'>Sales Order Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_4_8' type='text' value='' class='large'    placeholder='Sales Order Number (Required)' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_4_9\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Billing Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>                         <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_4_9' >                          <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_4_9_1_container' >                                         <input type='text' name='input_9.1' id='input_4_9_1' value=''   placeholder='Street Address (Required)' aria-required='true'    \/>                                         <label for='input_4_9_1' id='input_4_9_1_label' class='gform-field-label gform-field-label--type-sub'>Street Address<\/label>                                     <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_4_9_3_container' >                                     <input type='text' name='input_9.3' id='input_4_9_3' value=''   placeholder='City (Required)' aria-required='true'    \/>                                     <label for='input_4_9_3' id='input_4_9_3_label' class='gform-field-label gform-field-label--type-sub'>City<\/label>                                  <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_4_9_4_container' >                                         <select name='input_9.4' id='input_4_9_4'     aria-required='true'    ><option value='' selected='selected'>State\/Province\/Region (Required)<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/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='Guam' >Guam<\/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='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/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='U.S. Virgin Islands' >U.S. Virgin Islands<\/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_4_9_4' id='input_4_9_4_label' class='gform-field-label gform-field-label--type-sub'>State<\/label>                                       <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_4_9_5_container' >                                     <input type='text' name='input_9.5' id='input_4_9_5' value=''   placeholder='ZIP\/Postal Code (Required)' aria-required='true'    \/>                                     <label for='input_4_9_5' id='input_4_9_5_label' class='gform-field-label gform-field-label--type-sub'>ZIP Code<\/label>                                 <\/span><input type='hidden' class='gform_hidden' name='input_9.6' id='input_4_9_6' value='US' \/>                     <div class='gf_clear gf_clear_complex'><\/div>                 <\/div><\/fieldset><div id=\"field_4_10\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield--width-half gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_10'><span class='gform-field-label__text'>Daytime Phone Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_10' id='input_4_10' type='tel' value='' class='large'  placeholder='Daytime Phone Number (Required)' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><div id=\"field_4_11\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_11'><span class='gform-field-label__text'>Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>                             <input name='input_11' id='input_4_11' type='email' value='' class='large'   placeholder='Email (Required)' aria-required=\"true\" aria-invalid=\"false\"  \/>                         <\/div><\/div><div id=\"field_4_12\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_12'><span class='gform-field-label__text'>Amount Authorized<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_12'>I authorize Synthetic Grass Warehouse to charge the following amount:<\/div><div class='ginput_container ginput_container_number'><input name='input_12' id='input_4_12' type='text' step='any' min='1'  value='' class='medium'    placeholder='Example: $100' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_4_12 gfield_description_4_12\" \/><div class='gfield_description instruction' id='gfield_instruction_4_12'>Please enter a number greater than or equal to <strong>1<\/strong>.<\/div><\/div><\/div><div id=\"field_4_28\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_28'><span class='gform-field-label__text'>Credit Card Type<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_28' id='input_4_28' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>-- Select Credit Card Type<\/option><option value='Visa' >Visa<\/option><option value='Master Card' >Master Card<\/option><option value='American Express' >American Express<\/option><option value='Discover' >Discover<\/option><\/select><\/div><\/div><div id=\"field_4_25\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_25'><span class='gform-field-label__text'>Credit Card Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_4_25' type='text' value='' class='large'    placeholder='Credit Card Number' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"9999-9999-9999-9999\"\/><\/div><\/div><div id=\"field_4_29\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_29'><span class='gform-field-label__text'>Credit Card Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_29' id='input_4_29' type='text' value='' class='large'    placeholder='Credit Card Number' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"9999-999999-99999\"\/><\/div><\/div><div id=\"field_4_26\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_26'><span class='gform-field-label__text'>CVV Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text' data-text-counter-max='4' data-text-counter-template='{current} of {max} max characters'><input name='input_26' id='input_4_26' type='text' value='' class='large' maxlength='4'   placeholder='CVV Number' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_27\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_27'><span class='gform-field-label__text'>Expiration<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_27' id='input_4_27' type='text' value='' class='large'  aria-describedby=\"gfield_description_4_27\"  placeholder='Expiration' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"*9\/9999\"\/><\/div><div class='gfield_description' id='gfield_description_4_27'>2 digit month, 4 digit year.  Ex: 12\/2019<\/div><\/div><div id=\"field_4_19\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >BY SIGNING THIS DOCUMENT, YOU ARE AUTHORIZING SYNTHETIC GRASS WAREHOUSE, INC. PERMISSION TO CHARGE YOUR CREDIT CARD.<\/div><fieldset id=\"field_4_20\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Accept<\/span><\/legend><div class='gfield_description' id='gfield_description_4_20'>I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_4_20'><div class='gchoice gchoice_4_20_1'> \t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.1' type='checkbox'  value='By checking this box and typing my name below, I am electronically signing my application.'  id='choice_4_20_1'   aria-describedby=\"gfield_description_4_20\"\/> \t\t\t\t\t\t\t\t<label for='choice_4_20_1' id='label_4_20_1' class='gform-field-label gform-field-label--type-inline'>By checking this box and typing my name below, I am electronically signing my application.<\/label> \t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_21\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_21'><span class='gform-field-label__text'>Cardholder&#039;s Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_4_21' type='text' value='' class='large'    placeholder='Cardholder&#039;s Name (Full Name Required)' 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field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_23'><span class='gform-field-label__text'>Date<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'> \t\t\t\t\t<input \t\t\t\t\tplaceholder='Date (Required)' \t\t\t\t\tid='input_4_23' \t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon' \t\t\t\t\ttype='text' \t\t\t\t\tname='input_23' \t\t\t\t\tvalue='' \t\t\t\t\t  \t\t\t\t\taria-invalid=\"false\"  \t\t\t\t\taria-required=\"true\" \t\t\t\t\t  \t\t\t\t\t \t\t\t\t\tdata-mask=\"99\/99\/9999\" \t\t\t\t\t\/> \t\t\t\t<kbd id='keyboardHint_input_4_23' hidden class='down'><\/kbd> \t\t\t\t<button type='button' id='datepicker_toggle_input_4_23' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button 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