<div class="text-notification alert alert-danger" style="display:none;"></div>
<div id="orderServiceAddress"> <form id="orderServiceAddressForm"> <h3>Where Do You Need Service?</h3> <div class="text-tier text-tier clearfix"> <div class="column-order column-order2"> <div class="column-order-in"> <input type="text" id="service_address" name="service_address" placeholder="Street" maxlength="50"> </div> </div> <div class="column-order"> <div class="column-order-in"> <input type="text" id="service_city" name="service_city" placeholder="City" maxlength="20"> </div> </div> <div class="column-order"> <div class="column-order-in"> <input type="text" name="service_zip" placeholder="Zip" onkeypress='return event.charCode >= 48 && event.charCode <= 57' maxlength="5" readonly="true"> </div> </div> </div> <div><p></p><p>- or -</p> ESI-ID<br>(This 17- or 22- digit number can be found on your current electric bill)<br></div> <div class="text-tier text-tier clearfix"> <div class="column-order column-order2"> <div class="column-order-in"> <input type="text" id="service_esiid" name="service_esiid" placeholder="ESI ID"> </div> </div> </div> <div id="creditIdSeparator" style="display:none"><p></p><p>- And provide Nueces Account Number -</p></div><div id="creditIdInput" class="text-tier text-tier clearfix" style="display:none"><div class="column-order column-order2"><div class="column-order-in"><input type="text" id="credit_id" name="credit_id" placeholder="Nueces Member ID"></div></div></div> <div class="text-tier text-tier clearfix"> <div class="column-order-in"> <input type="submit" class="button-search" value="Search"/> </div> </div> <div class="alert alert-warning"> <i class="fa fa-exclamation-triangle"></i> <span>Note</span>: <span>If you are unable to locate your address or have a special request contact us at</span> 1.855.888.9888 <span>and we will be happy to assist you!</span> </div> <div id="orderServiceAddressSearchResult" class="text-result" style="display:none;"></div> </form> </div>
<div id="orderServiceType" class="panel panel-default" style="display:none;margin:15px;"> <div class="panel-heading" style="padding:15px 8px 8px 8px;"> <h3> <span class="lbl_movein_switch">Are you moving or switching providers at the selected service location?</span> </h3> </div> <div class="panel-body"> <table class="table table-striped" cellspacing="0" cellpadding="0" border="0"> <tbody> <tr> <td style="vertical-align:top;"><span class="lbl_service_type">Service Type</span> *</th> <td> <input id="sigma_ENROL_TYPE" ed="R" name="sigma_ENROL_TYPE" type="radio" value="M" onclick="fnCheckEnrollmentType('M')" checked=""> <span class="lbl_move_in" data-i18n="opts.move_in">Move-in (New Service)</span><br> <input id="sigma_ENROL_TYPE" ed="R" name="sigma_ENROL_TYPE" type="radio" value="S" onclick="fnCheckEnrollmentType('S')"> <span class="lbl_switch" data-i18n="opts.switch">Switch to V247 Power as soon as possible</span><br> <input id="sigma_ENROL_TYPE" ed="R" name="sigma_ENROL_TYPE" type="radio" value="SS" onclick="fnCheckEnrollmentType('SS')"> <span class="lbl_self_switch" data-i18n="opts.s_switch">Switch to V247 Power on a specific date</span> </td> </tr> <tr> <td style="vertical-align:top;"><span class="lbl_date_req">Date Requested</span> *</th> <td> <input id="sigma_REQUEST_DATE" name="sigma_REQUEST_DATE" type="text" size="20" ed="R" sigmatype="datepicker" readonly="readonly" class="datepicker"> </td> </tr> <tr> <td colspan="2"> <div> <div class="alert alert-info" style="padding:0px;margin-top:5px;"> <table style="margin:0px;border-style:none;"> <tr> <td><i class="fa fa-info-circle"></i></td> <td><span>A standard switch will be completed in 0-7 business days. Move-in and self-selected switch fees may be applicable and passed through to you from your TDSP. Please refer to your TOS for full list of TDSP fees.</span></td> </tr> </table> </div> <div class="alert alert-info" style="padding:0px"> <table style="margin:0px;border-style:none;"> <tr> <td><i class="fa fa-info-circle"></i></td> <td><span>In the case of a switch request, you have the right to review and rescind the Terms of Service within three federal business days, after receiving the Terms Of Service, without penalty.</span></td> </tr> </table> </div> <div class="alert alert-info" style="padding:0px;margin-bottom:5px;"> <table style="margin:0px;border-style:none;"> <tr> <td><i class="fa fa-info-circle"></i></td> <td><span>If you terminates your service with us, prior to the end of the initial term specified in your contract, you may be responsible to pay an early termination fee (ETF) specified in your TOS/EFL.</span></td> </tr> </table> </div> <div style="clear:both"></div> </div> </td> </tr> </tbody> </table> </div> </div>
<div id="orderCustomerInfo" class="order-page-left" style="display:none;padding:0px 8px 8px 25px;"> <form id="orderForm" action="" method="post"> <div class="panel panel-default"> <div class="panel-heading"><h3>YOUR CONTACT INFORMATION</h3></div> <div class="panel-body"> <div class="text-tier1 text-tier clearfix"> <div class="column-order column-order3"> <div class="column-order-in"> <div class="text-description">First Name *</div> <input type="text" name="customer_first_name" placeholder="First Name"/> </div> </div> <div class="column-order column-order3"> <div class="column-order-in"> <div class="text-description">Middle Initial</div> <input type="text" name="customer_middle_name" placeholder="Middle Initial"/> </div> </div> <div class="column-order column-order3"> <div class="column-order-in"> <div class="text-description">Last Name *</div> <input type="text" name="customer_last_name" placeholder="Last Name"/> </div> </div> </div> <div class="text-tier text-tier clearfix"> <div class="column-order column-order3"> <div class="column-order-in"> <div class="text-description">Date of Birth *</div> <input id="customer_dob" name="customer_dob" type="text" size="20" readonly="readonly" class="datepicker" placeholder="Date of Birth" /> </div> </div> <div class="column-order" style="width:66.66%"> <div class="column-order-in"> <div class="text-description">Authorized Representative</div> <input type="text" name="authorized_representative" placeholder="Authorized Representative"/> </div> </div> </div> </div> </div> <div class="panel panel-default"> <div class="panel-heading"><h3>BILLING ADDRESS</h3></div> <div class="panel-body"> <div class="text-tier text-tier clearfix"> <label><input type="checkbox" name="copy_service_address" checked="checked" onclick="fnCopyServiceAddress()"/> Same as Service Address</label> </div> <div class="text-tier1 text-tier clearfix"> <div class="column-order column-order2"> <div class="column-order-in"> <div class="text-description">Street Address *</div> <input type="text" id="customer_billing_address" name="customer_billing_address" placeholder="Street Address"/> </div> </div> <div class="column-order column-order2"> <div class="column-order-in"> <div class="text-description">Apartment Name</div> <input type="text" id="customer_billing_apt" name="customer_billing_apt" placeholder="Apartment Name"/> </div> </div> </div> <div class="text-tier1 text-tier clearfix"> <div class="column-order column-order3"> <div class="column-order-in"> <div class="text-description">City *</div> <input type="text" id="customer_billing_city" name="customer_billing_city" placeholder="City"/> </div> </div> <div class="column-order column-order3"> <div class="column-order-in"> <div class="text-description">State *</div> <input type="text" id="customer_billing_state" name="customer_billing_state" placeholder="State"/> </div> </div> <div class="column-order column-order3"> <div class="column-order-in"> <div class="text-description">Zip *</div> <input type="text" id="customer_billing_zipcode" name="customer_billing_zipcode" placeholder="Zip" onkeypress='return event.charCode >= 48 && event.charCode <= 57' maxlength="9"/> </div> </div> </div> </div> </div> <div class="panel panel-default"> <div class="panel-heading"><h3>COMMUNICATION</h3></div> <div class="panel-body"> <div class="text-tier2 text-tier clearfix"> <div class="column-order column-order2"> <div class="column-order-in"> <div class="text-description">Primary Phone *</div> <input type="tel" name="customer_phone" placeholder="Phone Number 1"/> <div class="text-description"></div> </div> </div> <div class="column-order column-order2"> <div class="column-order-in"> <div class="text-description">Email *</div> <input type="email" name="customer_email" placeholder="Email Address"/> <div class="text-description"></div> </div> </div> </div> <div class="text-tier2 text-tier clearfix"> <div class="column-order column-order2"> <div class="column-order-in"> <div class="text-description">Secondary Phone</div> <input type="tel" name="customer_phone2" placeholder="Phone Number 2"/> <div class="text-description"></div> </div> </div> <div class="column-order column-order2"> <div class="column-order-in"> <div class="text-description"></div> <div class="text-description"></div> </div> </div> </div> <div class="text-tier text-tier clearfix"> <div class="column-order-in"> <div class="label-title">What language would you like us to use for future communication?</div> <p> <label><input type="radio" name="customer_language" value="Default" checked="checked"/> English</label> </p> <p> <label><input type="radio" name="customer_language" value="es.Default"/> Spanish</label> </p> <p> <label><input type="radio" name="customer_language" value="vi.Default"/> Vietnamese</label> </p> </div> </div> <div class="text-tier text-tier clearfix"> <div class="column-order column-order3"> <div class="column-order-in"> <div class="label-title">How would you like to receive your bill?</div> <select class="form-control" id="sigma_BILL_MODE" placeholder="Bill Mode" style="width:240px;"><option value="" selected="">-Select-</option> <option value="Email">Email</option> <option value="Paper">Paper Bill</option> </select> </div> </div> </div><div id="pnl_EmailConfirm" class="column-order column-order3" style="display:none;"> <div class="column-order-in"> <div class="label-title"> Please confirm your Email</div>
<input type="text" name="SecondEmail" placeholder="Re-type your Email" /> </div> </div> <div class="text-tier text-tier clearfix"> <div class="column-order column-order3"> <div class="column-order-in"> <div class="label-title">How did your hear about us?</div> <select class="form-control" id="sigma_REFERRED_BY" placeholder="Referred By" style="width:240px;"> <option value="" selected="">-Select-</option> <option value="00">Referral</option> <option value="01">Web</option> <option value="02">Radio</option> <option value="03">Store Front Referral</option> <option value="04">Mail</option> <option value="05">Chron</option> </select> </div> </div> <div id="pnl_referralOption" class="column-order column-order3" style="display:none;"> <div class="column-order-in"> <div class="label-title">Referred By CUSTOMER ID</div> <input type="text" name="sigma_REFERRED_CUST_ID" placeholder="10-digit Customer ID" onkeypress='return event.charCode >= 48 && event.charCode <= 57' maxlength="10" /> </div> </div> </div> </div> </div> <div class="panel panel-default"> <div class="panel-heading"><h3>YOUR IDENTITY / SECURITY INFORMATION</h3></div> <div class="panel-body"> <div class="text-tier text-tier clearfix"> <div class="column-order column-order"> <div class="column-order-in"> <div class="text-description">SSN</div> <input type="text" name="customer_social_security_number" placeholder="Social Security Number"/> </div> </div> </div> <div class="text-tier text-tier clearfix"> <p> <div class="text-description"><i>(You must enter your Social Security Number if you would like to use a credit check to assess whether a deposit is required)</i></div> <div class="text-description">-or-</div> </p> </div> <div class="text-tier1 text-tier clearfix"> <div class="column-order column-order3"> <div class="column-order-in"> <div class="text-description">ID (Driver's License# or Any other)</div> <input type="text" name="customer_security_id" placeholder="ID"/> </div> </div> <div class="column-order column-order3"> <div class="column-order-in"> <div class="text-description">ID State</div> <input type="text" name="customer_security_state" placeholder="State"/> </div> </div> <div class="column-order column-order3"> <div class="column-order-in"> <div class="text-description">ID Expiry Date</div> <input type="text" id="customer_security_expiry" name="customer_security_expiry" size="20" readonly="readonly" class="datepicker" placeholder="Expiry Date"/> </div> </div> </div> </div> </div> <div class="panel panel-default"> <div class="panel-heading"><h3>CREDIT VERIFICATIONS</h3></div> <div class="panel-body"> <table border="0" class="table" style="width:100%;"> <tr> <td style="width:250px;vertical-align:middle;"> <label><input type="radio" id="sigma_FLOW_STATUS" name="sigma_FLOW_STATUS" value="-102" onclick="fnShowAdditionalFees()" /> <span>Check My Credit</span></label> </td> <td rowspan="3" id="pnl_feeOptions" class="panel-body alert" style="height:200px;vertical-align:top;"> <div> <div id="ENR_FEE_CC_MSGS" style="display: none;"> <span class="lbl_credit_verify">Credit Verification</span> </div> <div id="ENR_FEE_NOCC_MSGS" style="display: none;"> <span>I would like to pay the maximum deposit of</span> $150.00 <span>and not run the credit check.</span> </div> <div id="ENR_FEE_WAIVECC_MSGS" style="display: none;"> <p> <label><input class="xform-control" type="radio" id="sigma_SUB_FLOW_STATUS" name="sigma_SUB_FLOW_STATUS" value="-229" /> <span>I will submit a letter from my current provider showing timely payments for the last 12 months with no more than 1 late payment</span></label> <hr> <label><input class="xform-control" type="radio" id="sigma_SUB_FLOW_STATUS" name="sigma_SUB_FLOW_STATUS" value="-228" /> <span>I am 65+ and can provide proof of timely payments to my current electric provider.</span></label> <hr><label><input class="xform-control" type="radio" id="sigma_SUB_FLOW_STATUS" name="sigma_SUB_FLOW_STATUS" value="-227"> <span>I am a victim of family violence and will complete and return the required forms(<a href="http://www.puc.state.tx.us/industry/electric/forms/violence/DepWaivFrm.pdf" style="color:blue" target="_blank" title="Waiver Form">click here</a>).</span></label><hr> <span>Please fax all your waiver documents to us at</span> 1.855.215.9090 <span>or email us at</span> waiverdocuments@v247power.com </p> </div> </div> </td> </tr> <tr> <td style="width:250px;vertical-align:middle;"><label><input type="radio" id="sigma_FLOW_STATUS" name="sigma_FLOW_STATUS" value="-104" onclick="fnShowAdditionalFees()" /> <span>Don't Check Credit</span></label></td> </tr> <tr> <td style="width:250px;vertical-align:middle;"><label><input type="radio" id="sigma_FLOW_STATUS" name="sigma_FLOW_STATUS" value="-106" onclick="fnShowAdditionalFees()" /> <span>Waive Deposit</span></label></td> </tr> </table> </div> </div> <div class="panel panel-default" style="display:none;"> <div class="panel-heading"><h3>YOUR ACCOUNT INFORMATION</h3></div> <div class="panel-body"> <div class="text-tier text-tier clearfix"> <div class="column-order"> <div class="column-order-in"> <div class="label-title">Give a username and password to access your account online</div> <div class="text-description"> Username and password must be 8-18 characters in length</div> </div> </div> </div> <div class="text-tier text-tier clearfix"> <div class="column-order column-order3"> <div class="column-order-in"> <input type="text" name="customer_username" placeholder="Username"/> </div> </div> <div class="column-order column-order3"> <div class="column-order-in"> <input type="password" name="customer_password" placeholder="Password"/> </div> </div> <div class="column-order column-order3"> <div class="column-order-in"> <input type="password" name="customer_password_2" placeholder="Confirm Password"/> </div> </div> </div> </div> </div> <div class="panel panel-default"> <div class="panel-heading"><h3>Please read carefully and provide authorization</h3></div> <div class="panel-body"> <div class="text-tier text-tier clearfix button-submit"> <div> <p style="text-align:left;"> <input type="checkbox" name="customer_agree_terms_1" value="1"/> <span>I am choosing V247 Power Corporation. TX PUCT # 10210 to provide energy services for the selected location.</span> </p> <p style="text-align:left;"> <input type="checkbox" name="customer_agree_terms_2" value="1"/> <span>I am an authorized person to request service for the selected location. Any Enrollment request including move-in or a switch can only be made by the service applicant or the applicant's authorized agent. If you are not an authorized individual, please do not submit your request using this portal.</span> </p> <p style="text-align:left;"> <input type="checkbox" name="customer_agree_terms_3" value="1"/> <span>I have read and understand all the authorization disclosures and terms of service for the product I have chosen. You can view, print or save your Terms of Service document <a href="https://v247power.com/customerportal/InfoFiles/tos/en_TOS.pdf" target="_blank">here</a>.</span> </p> <p> <div> <div class="alert alert-info" style="padding:0px;margin-top:5px;"> <table style="margin:0px;border-style:none;"> <tr> <td><i class="fa fa-info-circle"></i></td> <td><span>You will receive a copy of the terms of service document via email or, upon request, via regular US mail, that will explain all the terms of the agreement and how to exercise the right of rescission.</span></td> </tr> </table> </div></div> </p> </div> <p> <input id="enrollSubmitEn" type="submit" value="Submit"/> </p> </div> </div> </div> <input type="text" hidden="hidden" name="product_id" value="0"/> <input type="text" hidden="hidden" name="product_name" value=""/><input type="text" hidden="hidden" name="product_price" value="0"/>
<input type="text" hidden="hidden" name="iSigmaCustId" value="1234567891"/>
<input type="text" hidden="hidden" name="customer_moving_switching" value=""/>
<input type="text" hidden="hidden" name="customer_start_service_date" value=""/>
<input type="text" hidden="hidden" name="customer_ESI" value=""/>
<input type="text" hidden="hidden" name="customer_EFL" value=""/>
<input type="text" hidden="hidden" name="customer_service_address" value=""/>
<input type="text" hidden="hidden" name="customer_service_apt" value=""/>
<input type="text" hidden="hidden" name="customer_service_city" value=""/>
<input type="text" hidden="hidden" name="customer_service_state" value=""/>
<input type="text" hidden="hidden" name="customer_service_zipcode" value=""/>
<input type="text" hidden="hidden" name="customer_agree_terms" value="0"/> </form> </div>
<input type="text" name="SecondEmail" placeholder="Re-type your Email" /> </div> </div> <div class="text-tier text-tier clearfix"> <div class="column-order column-order3"> <div class="column-order-in"> <div class="label-title">How did your hear about us?</div> <select class="form-control" id="sigma_REFERRED_BY" placeholder="Referred By" style="width:240px;"> <option value="" selected="">-Select-</option> <option value="00">Referral</option> <option value="01">Web</option> <option value="02">Radio</option> <option value="03">Store Front Referral</option> <option value="04">Mail</option> <option value="05">Chron</option> </select> </div> </div> <div id="pnl_referralOption" class="column-order column-order3" style="display:none;"> <div class="column-order-in"> <div class="label-title">Referred By CUSTOMER ID</div> <input type="text" name="sigma_REFERRED_CUST_ID" placeholder="10-digit Customer ID" onkeypress='return event.charCode >= 48 && event.charCode <= 57' maxlength="10" /> </div> </div> </div> </div> </div> <div class="panel panel-default"> <div class="panel-heading"><h3>YOUR IDENTITY / SECURITY INFORMATION</h3></div> <div class="panel-body"> <div class="text-tier text-tier clearfix"> <div class="column-order column-order"> <div class="column-order-in"> <div class="text-description">SSN</div> <input type="text" name="customer_social_security_number" placeholder="Social Security Number"/> </div> </div> </div> <div class="text-tier text-tier clearfix"> <p> <div class="text-description"><i>(You must enter your Social Security Number if you would like to use a credit check to assess whether a deposit is required)</i></div> <div class="text-description">-or-</div> </p> </div> <div class="text-tier1 text-tier clearfix"> <div class="column-order column-order3"> <div class="column-order-in"> <div class="text-description">ID (Driver's License# or Any other)</div> <input type="text" name="customer_security_id" placeholder="ID"/> </div> </div> <div class="column-order column-order3"> <div class="column-order-in"> <div class="text-description">ID State</div> <input type="text" name="customer_security_state" placeholder="State"/> </div> </div> <div class="column-order column-order3"> <div class="column-order-in"> <div class="text-description">ID Expiry Date</div> <input type="text" id="customer_security_expiry" name="customer_security_expiry" size="20" readonly="readonly" class="datepicker" placeholder="Expiry Date"/> </div> </div> </div> </div> </div> <div class="panel panel-default"> <div class="panel-heading"><h3>CREDIT VERIFICATIONS</h3></div> <div class="panel-body"> <table border="0" class="table" style="width:100%;"> <tr> <td style="width:250px;vertical-align:middle;"> <label><input type="radio" id="sigma_FLOW_STATUS" name="sigma_FLOW_STATUS" value="-102" onclick="fnShowAdditionalFees()" /> <span>Check My Credit</span></label> </td> <td rowspan="3" id="pnl_feeOptions" class="panel-body alert" style="height:200px;vertical-align:top;"> <div> <div id="ENR_FEE_CC_MSGS" style="display: none;"> <span class="lbl_credit_verify">Credit Verification</span> </div> <div id="ENR_FEE_NOCC_MSGS" style="display: none;"> <span>I would like to pay the maximum deposit of</span> $150.00 <span>and not run the credit check.</span> </div> <div id="ENR_FEE_WAIVECC_MSGS" style="display: none;"> <p> <label><input class="xform-control" type="radio" id="sigma_SUB_FLOW_STATUS" name="sigma_SUB_FLOW_STATUS" value="-229" /> <span>I will submit a letter from my current provider showing timely payments for the last 12 months with no more than 1 late payment</span></label> <hr> <label><input class="xform-control" type="radio" id="sigma_SUB_FLOW_STATUS" name="sigma_SUB_FLOW_STATUS" value="-228" /> <span>I am 65+ and can provide proof of timely payments to my current electric provider.</span></label> <hr><label><input class="xform-control" type="radio" id="sigma_SUB_FLOW_STATUS" name="sigma_SUB_FLOW_STATUS" value="-227"> <span>I am a victim of family violence and will complete and return the required forms(<a href="http://www.puc.state.tx.us/industry/electric/forms/violence/DepWaivFrm.pdf" style="color:blue" target="_blank" title="Waiver Form">click here</a>).</span></label><hr> <span>Please fax all your waiver documents to us at</span> 1.855.215.9090 <span>or email us at</span> waiverdocuments@v247power.com </p> </div> </div> </td> </tr> <tr> <td style="width:250px;vertical-align:middle;"><label><input type="radio" id="sigma_FLOW_STATUS" name="sigma_FLOW_STATUS" value="-104" onclick="fnShowAdditionalFees()" /> <span>Don't Check Credit</span></label></td> </tr> <tr> <td style="width:250px;vertical-align:middle;"><label><input type="radio" id="sigma_FLOW_STATUS" name="sigma_FLOW_STATUS" value="-106" onclick="fnShowAdditionalFees()" /> <span>Waive Deposit</span></label></td> </tr> </table> </div> </div> <div class="panel panel-default" style="display:none;"> <div class="panel-heading"><h3>YOUR ACCOUNT INFORMATION</h3></div> <div class="panel-body"> <div class="text-tier text-tier clearfix"> <div class="column-order"> <div class="column-order-in"> <div class="label-title">Give a username and password to access your account online</div> <div class="text-description"> Username and password must be 8-18 characters in length</div> </div> </div> </div> <div class="text-tier text-tier clearfix"> <div class="column-order column-order3"> <div class="column-order-in"> <input type="text" name="customer_username" placeholder="Username"/> </div> </div> <div class="column-order column-order3"> <div class="column-order-in"> <input type="password" name="customer_password" placeholder="Password"/> </div> </div> <div class="column-order column-order3"> <div class="column-order-in"> <input type="password" name="customer_password_2" placeholder="Confirm Password"/> </div> </div> </div> </div> </div> <div class="panel panel-default"> <div class="panel-heading"><h3>Please read carefully and provide authorization</h3></div> <div class="panel-body"> <div class="text-tier text-tier clearfix button-submit"> <div> <p style="text-align:left;"> <input type="checkbox" name="customer_agree_terms_1" value="1"/> <span>I am choosing V247 Power Corporation. TX PUCT # 10210 to provide energy services for the selected location.</span> </p> <p style="text-align:left;"> <input type="checkbox" name="customer_agree_terms_2" value="1"/> <span>I am an authorized person to request service for the selected location. Any Enrollment request including move-in or a switch can only be made by the service applicant or the applicant's authorized agent. If you are not an authorized individual, please do not submit your request using this portal.</span> </p> <p style="text-align:left;"> <input type="checkbox" name="customer_agree_terms_3" value="1"/> <span>I have read and understand all the authorization disclosures and terms of service for the product I have chosen. You can view, print or save your Terms of Service document <a href="https://v247power.com/customerportal/InfoFiles/tos/en_TOS.pdf" target="_blank">here</a>.</span> </p> <p> <div> <div class="alert alert-info" style="padding:0px;margin-top:5px;"> <table style="margin:0px;border-style:none;"> <tr> <td><i class="fa fa-info-circle"></i></td> <td><span>You will receive a copy of the terms of service document via email or, upon request, via regular US mail, that will explain all the terms of the agreement and how to exercise the right of rescission.</span></td> </tr> </table> </div></div> </p> </div> <p> <input id="enrollSubmitEn" type="submit" value="Submit"/> </p> </div> </div> </div> <input type="text" hidden="hidden" name="product_id" value="0"/> <input type="text" hidden="hidden" name="product_name" value=""/><input type="text" hidden="hidden" name="product_price" value="0"/>
<input type="text" hidden="hidden" name="iSigmaCustId" value="1234567891"/>
<input type="text" hidden="hidden" name="customer_moving_switching" value=""/>
<input type="text" hidden="hidden" name="customer_start_service_date" value=""/>
<input type="text" hidden="hidden" name="customer_ESI" value=""/>
<input type="text" hidden="hidden" name="customer_EFL" value=""/>
<input type="text" hidden="hidden" name="customer_service_address" value=""/>
<input type="text" hidden="hidden" name="customer_service_apt" value=""/>
<input type="text" hidden="hidden" name="customer_service_city" value=""/>
<input type="text" hidden="hidden" name="customer_service_state" value=""/>
<input type="text" hidden="hidden" name="customer_service_zipcode" value=""/>
<input type="text" hidden="hidden" name="customer_agree_terms" value="0"/> </form> </div>
<div id="orderPlanInfo" class="order-page-right" style="display:none;"> <h2>YOU ARE SIGNING UP FOR <span id="productName">SMART & BRIGHT PLAN 24</span></h2>
<div class="order-page-right-content"> <p>Your Service Address</p><p><span id="serviceAddressFull">13126 ABC STREET, HOUSTON CITY TEXAS STATE, 77478</span></p><div><h4>V247 Power Charges:</h4>
Energy Charge: <span id="productPrice" style="font-size:14pt;">5</span><small style="font-size: 10pt;">¢ /kWh</small>
Minimum Usage Fee: <span id="productBaseCharge"></span></div> <br><h4><span id="utilityProviderName"></span> Charges:</h4>
Delivery Charge: $<span id="displayTDUfee"> </span>/kWh
Monthly Delivery Charge: $<span id="displayTDUmonthly"> </span>
<div><br>Early Termination Fee: <span id="productETF"></span></div> </div> </div>
<div class="order-page-right-content"> <p>Your Service Address</p><p><span id="serviceAddressFull">13126 ABC STREET, HOUSTON CITY TEXAS STATE, 77478</span></p><div><h4>V247 Power Charges:</h4>
Energy Charge: <span id="productPrice" style="font-size:14pt;">5</span><small style="font-size: 10pt;">¢ /kWh</small>
Minimum Usage Fee: <span id="productBaseCharge"></span></div> <br><h4><span id="utilityProviderName"></span> Charges:</h4>
Delivery Charge: $<span id="displayTDUfee"> </span>/kWh
Monthly Delivery Charge: $<span id="displayTDUmonthly"> </span>
<div><br>Early Termination Fee: <span id="productETF"></span></div> </div> </div>
<div id="enrollmentConfirmation" style="display:none;">
[printfriendly]
<div>
<span>
<div id="enrollmentWelcomeSection" style="display:none;">
<p>Please print a copy of this page for your records.</p>
</div>
<div id="paymentSuccessfulSection" style="display:none;">
<p><strong><span>Dear </span><span id="customerFullname"></span></strong></p>
Thank you for choosing V247 Power! You have made an excellent choice! Your deposit payment of $150 was successful. The confirmation number for this credit card transaction is <strong><span id="depositReferenceId" ></span></strong>. This notice serves as an acknowledgment that we have received your enrollment request with the following details:
</div> <div id="enrollmentWelcomeSectionExt1" style="display:none;">
<p><strong><span>Dear </span><span id="customerFullname2"></span></strong></p>
Thank you for choosing V247 Power! You have made an excellent choice! This notice serves as an acknowledgment that we have received your Enrollment Request with the following details:
</div> <div id="WaiveDepositSection" style="display:none;">
<p><strong><span>Dear </span><span id="customerFullname3"></span></strong></p>
Thank you for choosing V247 Power! You have made an excellent choice! Due to your selected plan, you are not required to pay Deposit. This notice serves as an acknowledgment that we have received your enrollment request with the following details:
</div> <div id="enrollmentWelcomeSectionExt2" style="display:none;">
<div id = "enrollDetailTable">
<table style="border:none;" style="width:100%;" >
<tr><td style="width:25%;padding:0;border-bottom:none;">Customer ID:</td style="padding:0;border-bottom:none;"><td><span id="enrollmentCustomerId"></span></td></tr>
<tr><td style="width:25%;">Your Name:</td><td><span id="customerFullname1"></span></td> </tr>
<tr><td style="width:25%;">Service Address:</td><td><span id="customerServiceAddress"></span></td> </tr>
<tr><td style="width:25%;">Billing Address:</td><td><span id="customerBillingAddress"></span></td></tr>
<tr><td style="width:25%;">Your Meter ID (ESI-ID):</td><td><span id="premiseId"></span></td></tr>
<tr><td style="width:25%;">Your Selected Plan:</td><td><span id="planName"></span></td></tr>
<tr><td style="width:25%;">Requested Start Date:</td><td><span id="requestStartDate"></span> </td></tr>
<tr><td style="width:25%;">Type of Order:</td><td><span id="typeOfOrder"></span></td> </tr>
</table>
</div>
<p><strong><u>What’s Next?</u> </strong>
<ul style="list-style-type:disc">
<li>A V247 Power Customer Care Agent will contact you within one business day if there is an issue with your on-line enrollment request.</li>
<li>You will receive an Enrollment Acceptance email (if provided during the enrollment) to confirm your Requested Start Date when the TDU in your area completes the order.</li>
<li>Your Requested Start Date may change based on when the TDU in your area completes the order.</li>
<li><b>Standard Switch and Self Selected Switch: </b>You have the right to rescind your service request with V247 Power without any Early Termination Fee or penalty of any kind within three (3) federal business days of receiving the Terms of Service (Welcome Packet). To rescind this request, call 1.855.888.9888 or email to <a href="mailto:customercare@v247power.com"> customercare@v247power.com </a>.</li>
<li>Rescission requests received after three (3) federal business days are not guaranteed, however, you have the right to select another REP. Regardless of the method or reason for rescission, termination or cancellation you are responsible for the payment of all services provided and billed by V247 Power until your switch to another REP is complete.</li>
<li><b>New Service / Move-in: </b>The right to rescind is not applicable for New Service / Move-In orders.</li>
</ul>
Again, thank you for choosing V247 Power! We look forward to serving your electricity needs soon!</p>
<p></p>
<p>Sincerely,<span></span>
<strong>V247 Power Customer Care Team</strong>
<p></p>
Toll Free 1.855.888.9888<span></span>
Email: <a href="mailto:customercare@v247power.com"> customercare@v247power.com </a><span></span>
Website: <a href="http://www.v247power.com" style="color:blue" target="_blank" title="Website"> http://www.v247power.com</a><span></span>
Mailing Address: 9999 Bellaire Blvd., Suite 1133, Houston, TX 77036 <span></span>
Monday - Friday 8AM to 6PM (CST)<span></span>
PUCT#: 10210</p>
<p></p>
<hr>
<p><strong>Refer your Friends & Family</strong><br>
After your family member or friend signs up with us, you will receive a $25 bill credit. Visit <a href="https://v247power.com/refer-a-friend/" style="color:blue" target="_blank" title="Website"> this page</a> for more details and conditions.</p>
<hr>
</div>
<div id="creditNeedDepositSection" style="display:none;">
<p>Thank you for choosing V247 Power and submitting your enrollment application! </p>
<p>We're sorry that your credit was not approved.</p>
<p><strong><u>What’s Next?</u></strong>
<ul style="list-style-type:disc">
<li>You can still continue with your Enrollment Request by making a deposit payment below. </li>
<li>The maximum deposit required to complete your Enrollment Request is $150.00.</li>
<li>Please contact us at 1.855.888.9888 Monday through Friday 8 am CST – 6 pm CST or <a href="mailto:customercare@v247power.com"> customercare@v247power.com </a> with this reference ID <strong><span id="enrollmentCustomerId1"></span></strong> if you have any questions or issues with your payment.</li>
</ul></p>
</div> <div id="skipCreditCheckSection" style="display:none;">
<p>Thank you for choosing V247 Power and submitting your enrollment application!</p>
<p><strong><u>What’s Next?</u></strong>
<ul style="list-style-type:disc">
<li>Please make a deposit payment below to complete the Enrollment Request.</li>
<li>The maximum deposit required to complete your Enrollment Request is $150.00 based on your request to not run a Credit Check.</li>
<li>Please contact us at 1.855.888.9888 Monday through Friday 8 am CST – 6 pm CST or <a href="mailto:customercare@v247power.com"> customercare@v247power.com </a> with this reference ID <strong><span id="enrollmentCustomerId2"></span></strong> if you have any questions or issues with your payment.</li>
</ul></p>
</div> <div id="paymentNotSuccessfulSection" style="display:none;">
<p><span>We're sorry, your deposit payment was unsuccessful, please try again or contact us at 1.855.888.9888 to finish the deposit payment. Please provide your enrollment reference ID <strong><span id="enrollmentCustomerId3"></strong></span> when contacting v247power.</p> </div> <div id="waiverSection" style="display:none;">
<p>Please print a copy of this page for your records.<br>
Your Enrollment Reference ID is <strong><span id="enrollmentCustomerId4"></span></strong></p> <p><strong><u>Next Step:</u> </strong>
Please submit all the waiver documents via Email <a href="mailto:waiverdocuments@v247power.com"> waiverdocuments@v247power.com</a> or via Fax 1.855.215.9090 that meet ONE (1) of these following criteria:<br>
<li>Demonstrate satisfactory credit by providing a letter of credit that illustrates you were not late on an electricity bill payment more than once over the last 12 consecutive months. This standardized letter can be obtained from your current provider. <a href="https://v247power.com/Docs/FORM/V247Power_LoC.pdf" target="_blank" >Click here</a> for example letter
</li>
<li>You are over the age of 65 and not delinquent in payment of any electric service account</li>
<li>You are a victim of family violence, please fill out this form <a href="http://www.puc.state.tx.us/industry/electric/forms/violence/DepWaivFrm.pdf" style="color:blue" target="_blank" title="Waiver Form"><span>click here</span></a></li>
Our Customer Care Agents will promptly review your submitted documents and contact you the same business day. Please note that your enrollment will be pending until all these items are submitted and approved.</p> <p><strong><u>Once Approved:</u> </strong> After your Enrollment has been processed successfully, you will receive an Enrollment Acceptance email with your account number, service and billing address, ESI-ID, and start date. When your account is Active, V247 Power will mail a Welcome Package to your billing address. These documents include the Terms of Service (TOS), Your Rights As A Customer (YRAC), and the Electricity Facts Label (EFL).</p> <p><strong><u>Last Step:</u> </strong> : Don't forget to check your email for the Enrollment Approval confirmation. Please contact our Customer Care Team if you have any questions at 1.855.888.9888 or email<a href="mailto:customercare@v247power.com"> customercare@v247power.com</a>.</p> <p>Thank You for choosing V247 Power! We look forward to serving your electricity needs soon!</p>
</div> </span>
</div>
<div style="clear:both"></div>
</div>
Enrollment Notice
[printfriendly]
<div>
<span>
<div id="enrollmentWelcomeSection" style="display:none;">
<p>Please print a copy of this page for your records.</p>
</div>
<div id="paymentSuccessfulSection" style="display:none;">
<p><strong><span>Dear </span><span id="customerFullname"></span></strong></p>
Thank you for choosing V247 Power! You have made an excellent choice! Your deposit payment of $150 was successful. The confirmation number for this credit card transaction is <strong><span id="depositReferenceId" ></span></strong>. This notice serves as an acknowledgment that we have received your enrollment request with the following details:
</div> <div id="enrollmentWelcomeSectionExt1" style="display:none;">
<p><strong><span>Dear </span><span id="customerFullname2"></span></strong></p>
Thank you for choosing V247 Power! You have made an excellent choice! This notice serves as an acknowledgment that we have received your Enrollment Request with the following details:
</div> <div id="WaiveDepositSection" style="display:none;">
<p><strong><span>Dear </span><span id="customerFullname3"></span></strong></p>
Thank you for choosing V247 Power! You have made an excellent choice! Due to your selected plan, you are not required to pay Deposit. This notice serves as an acknowledgment that we have received your enrollment request with the following details:
</div> <div id="enrollmentWelcomeSectionExt2" style="display:none;">
<div id = "enrollDetailTable">
<table style="border:none;" style="width:100%;" >
<tr><td style="width:25%;padding:0;border-bottom:none;">Customer ID:</td style="padding:0;border-bottom:none;"><td><span id="enrollmentCustomerId"></span></td></tr>
<tr><td style="width:25%;">Your Name:</td><td><span id="customerFullname1"></span></td> </tr>
<tr><td style="width:25%;">Service Address:</td><td><span id="customerServiceAddress"></span></td> </tr>
<tr><td style="width:25%;">Billing Address:</td><td><span id="customerBillingAddress"></span></td></tr>
<tr><td style="width:25%;">Your Meter ID (ESI-ID):</td><td><span id="premiseId"></span></td></tr>
<tr><td style="width:25%;">Your Selected Plan:</td><td><span id="planName"></span></td></tr>
<tr><td style="width:25%;">Requested Start Date:</td><td><span id="requestStartDate"></span> </td></tr>
<tr><td style="width:25%;">Type of Order:</td><td><span id="typeOfOrder"></span></td> </tr>
</table>
</div>
<p><strong><u>What’s Next?</u> </strong>
<ul style="list-style-type:disc">
<li>A V247 Power Customer Care Agent will contact you within one business day if there is an issue with your on-line enrollment request.</li>
<li>You will receive an Enrollment Acceptance email (if provided during the enrollment) to confirm your Requested Start Date when the TDU in your area completes the order.</li>
<li>Your Requested Start Date may change based on when the TDU in your area completes the order.</li>
<li><b>Standard Switch and Self Selected Switch: </b>You have the right to rescind your service request with V247 Power without any Early Termination Fee or penalty of any kind within three (3) federal business days of receiving the Terms of Service (Welcome Packet). To rescind this request, call 1.855.888.9888 or email to <a href="mailto:customercare@v247power.com"> customercare@v247power.com </a>.</li>
<li>Rescission requests received after three (3) federal business days are not guaranteed, however, you have the right to select another REP. Regardless of the method or reason for rescission, termination or cancellation you are responsible for the payment of all services provided and billed by V247 Power until your switch to another REP is complete.</li>
<li><b>New Service / Move-in: </b>The right to rescind is not applicable for New Service / Move-In orders.</li>
</ul>
Again, thank you for choosing V247 Power! We look forward to serving your electricity needs soon!</p>
<p></p>
<p>Sincerely,<span></span>
<strong>V247 Power Customer Care Team</strong>
<p></p>
Toll Free 1.855.888.9888<span></span>
Email: <a href="mailto:customercare@v247power.com"> customercare@v247power.com </a><span></span>
Website: <a href="http://www.v247power.com" style="color:blue" target="_blank" title="Website"> http://www.v247power.com</a><span></span>
Mailing Address: 9999 Bellaire Blvd., Suite 1133, Houston, TX 77036 <span></span>
Monday - Friday 8AM to 6PM (CST)<span></span>
PUCT#: 10210</p>
<p></p>
<hr>
<p><strong>Refer your Friends & Family</strong><br>
After your family member or friend signs up with us, you will receive a $25 bill credit. Visit <a href="https://v247power.com/refer-a-friend/" style="color:blue" target="_blank" title="Website"> this page</a> for more details and conditions.</p>
<hr>
</div>
<div id="creditNeedDepositSection" style="display:none;">
<p>Thank you for choosing V247 Power and submitting your enrollment application! </p>
<p>We're sorry that your credit was not approved.</p>
<p><strong><u>What’s Next?</u></strong>
<ul style="list-style-type:disc">
<li>You can still continue with your Enrollment Request by making a deposit payment below. </li>
<li>The maximum deposit required to complete your Enrollment Request is $150.00.</li>
<li>Please contact us at 1.855.888.9888 Monday through Friday 8 am CST – 6 pm CST or <a href="mailto:customercare@v247power.com"> customercare@v247power.com </a> with this reference ID <strong><span id="enrollmentCustomerId1"></span></strong> if you have any questions or issues with your payment.</li>
</ul></p>
</div> <div id="skipCreditCheckSection" style="display:none;">
<p>Thank you for choosing V247 Power and submitting your enrollment application!</p>
<p><strong><u>What’s Next?</u></strong>
<ul style="list-style-type:disc">
<li>Please make a deposit payment below to complete the Enrollment Request.</li>
<li>The maximum deposit required to complete your Enrollment Request is $150.00 based on your request to not run a Credit Check.</li>
<li>Please contact us at 1.855.888.9888 Monday through Friday 8 am CST – 6 pm CST or <a href="mailto:customercare@v247power.com"> customercare@v247power.com </a> with this reference ID <strong><span id="enrollmentCustomerId2"></span></strong> if you have any questions or issues with your payment.</li>
</ul></p>
</div> <div id="paymentNotSuccessfulSection" style="display:none;">
<p><span>We're sorry, your deposit payment was unsuccessful, please try again or contact us at 1.855.888.9888 to finish the deposit payment. Please provide your enrollment reference ID <strong><span id="enrollmentCustomerId3"></strong></span> when contacting v247power.</p> </div> <div id="waiverSection" style="display:none;">
<p>Please print a copy of this page for your records.<br>
Your Enrollment Reference ID is <strong><span id="enrollmentCustomerId4"></span></strong></p> <p><strong><u>Next Step:</u> </strong>
Please submit all the waiver documents via Email <a href="mailto:waiverdocuments@v247power.com"> waiverdocuments@v247power.com</a> or via Fax 1.855.215.9090 that meet ONE (1) of these following criteria:<br>
<li>Demonstrate satisfactory credit by providing a letter of credit that illustrates you were not late on an electricity bill payment more than once over the last 12 consecutive months. This standardized letter can be obtained from your current provider. <a href="https://v247power.com/Docs/FORM/V247Power_LoC.pdf" target="_blank" >Click here</a> for example letter
</li>
<li>You are over the age of 65 and not delinquent in payment of any electric service account</li>
<li>You are a victim of family violence, please fill out this form <a href="http://www.puc.state.tx.us/industry/electric/forms/violence/DepWaivFrm.pdf" style="color:blue" target="_blank" title="Waiver Form"><span>click here</span></a></li>
Our Customer Care Agents will promptly review your submitted documents and contact you the same business day. Please note that your enrollment will be pending until all these items are submitted and approved.</p> <p><strong><u>Once Approved:</u> </strong> After your Enrollment has been processed successfully, you will receive an Enrollment Acceptance email with your account number, service and billing address, ESI-ID, and start date. When your account is Active, V247 Power will mail a Welcome Package to your billing address. These documents include the Terms of Service (TOS), Your Rights As A Customer (YRAC), and the Electricity Facts Label (EFL).</p> <p><strong><u>Last Step:</u> </strong> : Don't forget to check your email for the Enrollment Approval confirmation. Please contact our Customer Care Team if you have any questions at 1.855.888.9888 or email<a href="mailto:customercare@v247power.com"> customercare@v247power.com</a>.</p> <p>Thank You for choosing V247 Power! We look forward to serving your electricity needs soon!</p>
</div> </span>
</div>
<div style="clear:both"></div>
</div>
<div id="MAKE_PAYMENT_DIV" style="display:none;"> <div> <div class="panel panel-default"> <div class="panel-heading"><span class="ui-float-left ui-mma-icon-balinfo"></span> <span class="lbl_make_pay">Make a Payment Online Now</span></div> <div class="panel-body"> <div id="DIV_PAYNOW_MSG" class="ui-mma-div-messages"></div> <div> <div class="row col-md-12"> <div class="row col-md-8"> <div class="form-group col-sm-12"> <label class="control-label col-xs-6"><span class="lbl_pn_payamt">Payment Amount</span></label> <div class="col-xs-6"> <input class="form-control" type="text" id="txtPaySchedAmount" maxlength="10" size="20" value="150.00" disabled="disabled"> </div> </div> <div class="form-group col-sm-12" style="display:none"> <label class="control-label col-xs-6"><span class="lbl_pn_paydt">Payment Date</span>:</label> <div class="col-xs-6"> <input class="form-control hasDatepicker" type="text" id="txtPaySchedDate" maxlength="10" size="15" value=""> </div> </div> </div> </div> </div> <div> <div> <div id="CC" class="active"> <h3><span class="lbl_cc_pay">Pay by Credit Card</span></h3> <div id="CC_ENTRY_TAB" class="row col-md-12"> <div class="row col-md-8"> <div class="form-group col-sm-12"> <label class="control-label col-xs-6" for="selCCType"><span class="lbl_cc_type">Credit Card Type</span></label> <div class="col-xs-6"> <select class="form-control" id="selCCType" name="selCCType"> <option value=""></option> <option value="Amex">American Express</option> <option value="Discover">Discover</option> <option value="Master">Master</option> <option value="Visa">Visa</option> </select> </div> </div> <div class="form-group col-sm-12"> <label class="control-label col-xs-6"><span class="lbl_cc">Card</span></label> <div class="col-xs-6"> <div class="input-group"> <div class="input-group-addon"><i class="fa fa-credit-card"></i></div> <input class="form-control" type="text" name="txtCCNum" id="txtCCNum" size="20" maxlength="16" /> </div> </div> </div> <div class="form-group col-sm-12"> <label class="control-label col-xs-6"><span class="lbl_cc_sc">Security Code</span></label> <div class="col-xs-4"> <div class="input-group"> <div class="input-group-addon"><i id="ccToolTip" class="fa fa-question"></i></div> <input class="form-control" type="text" name="txtCCPin" id="txtCCPin" size="4" maxlength="4" /> </div> </div> </div> <div class="form-group col-sm-12"> <label class="control-label col-xs-6"><span class="lbl_cc_expmonyr">Expiration Month/Year</span></label> <div class="col-xs-3"> <select class="form-control" id="selExpMM" name="selExpMM"> <option value=""></option> <option value="01">01</option> <option value="02">02</option> <option value="03">03</option> <option 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> </div> <div class="col-xs-3"> <select class="form-control" id="selExpYYYY" name="selExpYYYY"> <option value=""></option> <option value="2016">2016</option> <option value="2017">2017</option> <option value="2018">2018</option> <option value="2019">2019</option> <option value="2020">2020</option> <option value="2021">2021</option> <option value="2022">2022</option> <option value="2023">2023</option> <option value="2024">2024</option> <option value="2025">2025</option> <option value="2026">2026</option> </select> </div> </div> </div> <div class="col-md-3"> <div class="ccardsecimg"></div> </div> </div> <!-- main row --> </div> </div> </div> <div> <div> <h3>Billing Address</h3> <div> <div> <div class="col-xs-12"> <input type="checkbox" name="cbxPayBillAddr" id="cbxPayBillAddr" value="B" onclick="javascript:loadCurrentAddress()" style="display: none;"> <span>Use Current Mailing Address</span> </div> </div> <div class="row col-md-8"> <div class="form-group col-sm-12"> <label class="control-label col-xs-6" for="txtPayCustName"><span>Name</span>*</label> <div class="col-xs-6"> <input class="form-control" type="text" id="txtPayCustName" maxlength="50"> </div> </div> <div class="form-group col-sm-12"> <label class="control-label col-xs-6" for="txtPayCustAddress1"><span>Address</span>*</label> <div class="col-xs-6"> <input class="form-control" type="text" id="txtPayCustAddress1" maxlength="50"> </div> </div> <div class="form-group col-sm-12"> <label class="control-label col-xs-6" for="txtPayCustCity"><span>City</span>*</label> <div class="col-xs-6"> <input class="form-control" type="text" id="txtPayCustCity" maxlength="50"> </div> </div> <div class="form-group col-sm-12"> <label class="control-label col-xs-6" for="txtPayCustState"><span>State</span>*</label> <div class="col-xs-6"> <input class="form-control" type="text" id="txtPayCustState" maxlength="2"> </div> </div> <div class="form-group col-sm-12"> <label class="control-label col-xs-6" for="txtPayCustZip"><span>Zip</span>*</label> <div class="col-xs-6"> <input class="form-control" type="text" id="txtPayCustZip" maxlength="9"> </div> </div> </div> </div> </div> </div> <div> <div id="DIV_PAY_NOW_AUTHORIZE" class="row col-md-12"> <h3><span class="lbl_authorize">Authorize</span></h3> <div class="form-group col-sm-12"> <div class="col-xs-12"> <input type="checkbox" id="cbxPayAuth" name="cbxPayAuth" value="Y"> <span class="lbl_auth_payment">Authorize Payment</span> </div> </div> </div> <div class="form-actions1"> <h3></h3> <div id="DIV_PAY_BILL" class="row col-md-12"> <button class="btn btn-primary" name="cmdPayNow" id="cmdPayNow"><i class="icon-money"></i> <span class="lbl_submit_payment">Submit Payment</span></button> <button class="btn" name="cmdPayNowCancel" id="cmdPayNowCancel"><span class="lbl_cancel">Cancel</span></button> </div> </div> </div> </div> </div> </div> </div>
<img src="/newv247/wp-content/themes/Divi/images/ajax-loader2.gif" id="imgLoader" style="display: none;">