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buy.php
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buy.php
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<meta name="description" content="">
<meta name="author" content="">
<title>LAND ASSET ADMINISTRATION</title>
<!-- css -->
<link href="css/bootstrap.min.css" rel="stylesheet" type="text/css">
<link href="font-awesome/css/font-awesome.min.css" rel="stylesheet" type="text/css" />
<link href="css/nivo-lightbox.css" rel="stylesheet" />
<link href="css/nivo-lightbox-theme/default/default.css" rel="stylesheet" type="text/css" />
<link href="css/owl.carousel.css" rel="stylesheet" media="screen" />
<link href="css/owl.theme.css" rel="stylesheet" media="screen" />
<link href="css/flexslider.css" rel="stylesheet" />
<link href="css/animate.css" rel="stylesheet" />
<link href="css1/style.css" rel="stylesheet">
<link href="color/default.css" rel="stylesheet">
<section class="sign-in">
<form class="well form-horizontal" action=" " method="post" id="contact_form">
<div class="form-group">
<div class="container">
<div class="row">
<h3 style="text-align: center">Make your Payment</h3><br>
<label class="col-md-4 control-label">First Name</label>
<div class="col-md-4 inputGroupContainer">
<div class="input-group">
<span class="input-group-addon"><i class="glyphicon glyphicon-user"></i></span>
<input name="first_name" placeholder="First Name" class="form-control" type="text">
</div>
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label">Last Name</label>
<div class="col-md-4 inputGroupContainer">
<div class="input-group">
<span class="input-group-addon"><i class="glyphicon glyphicon-user"></i></span>
<input name="last_name" placeholder="Last Name" class="form-control" type="text">
</div>
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label">E-Mail</label>
<div class="col-md-4 inputGroupContainer">
<div class="input-group">
<span class="input-group-addon"><i class="glyphicon glyphicon-envelope"></i></span>
<input name="email" placeholder="E-Mail Address" class="form-control" type="text">
</div>
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label">Phone #</label>
<div class="col-md-4 inputGroupContainer">
<div class="input-group">
<span class="input-group-addon"><i class="glyphicon glyphicon-earphone"></i></span>
<input name="phone" placeholder="(845)555-1212" class="form-control" type="text">
</div>
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label">Address</label>
<div class="col-md-4 inputGroupContainer">
<div class="input-group">
<span class="input-group-addon"><i class="glyphicon glyphicon-home"></i></span>
<input name="address" placeholder="Address" class="form-control" type="text">
</div>
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label">City</label>
<div class="col-md-4 inputGroupContainer">
<div class="input-group">
<span class="input-group-addon"><i class="glyphicon glyphicon-home"></i></span>
<input name="city" placeholder="city" class="form-control" type="text">
</div>
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label">State</label>
<div class="col-md-4 selectContainer">
<div class="input-group">
<span class="input-group-addon"><i class="glyphicon glyphicon-list"></i></span>
<select name="state" class="form-control selectpicker">
<option value=" ">Please select your state</option>
<option>Alabama</option>
<option>Alaska</option>
<option>Arizona</option>
<option>Arkansas</option>
<option>California</option>
<option>Colorado</option>
<option>Connecticut</option>
<option>Delaware</option>
<option>District of Columbia</option>
<option> Florida</option>
<option>Georgia</option>
<option>Hawaii</option>
<option>daho</option>
<option>Illinois</option>
<option>Indiana</option>
<option>Iowa</option>
<option> Kansas</option>
<option>Kentucky</option>
<option>Louisiana</option>
<option>Maine</option>
<option>Maryland</option>
<option> Mass</option>
<option>Michigan</option>
<option>Minnesota</option>
<option>Mississippi</option>
<option>Missouri</option>
<option>Montana</option>
<option>Nebraska</option>
<option>Nevada</option>
<option>New Hampshire</option>
<option>New Jersey</option>
<option>New Mexico</option>
<option>New York</option>
<option>North Carolina</option>
<option>North Dakota</option>
<option>Ohio</option>
<option>Oklahoma</option>
<option>Oregon</option>
<option>Pennsylvania</option>
<option>Rhode Island</option>
<option>South Carolina</option>
<option>South Dakota</option>
<option>Tennessee</option>
<option>Texas</option>
<option> Uttah</option>
<option>Vermont</option>
<option>Virginia</option>
<option>Washington</option>
<option>West Virginia</option>
<option>Wisconsin</option>
<option>Wyoming</option>
</select>
</div>
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label">Zip Code</label>
<div class="col-md-4 inputGroupContainer">
<div class="input-group">
<span class="input-group-addon"><i class="glyphicon glyphicon-home"></i></span>
<input name="zip" placeholder="Zip Code" class="form-control" type="text">
</div>
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label"></label>
<div class="col-md-4">
<a href="finpay.php" class="btn btn-skin" id="btn-scroll">BUY</a>
</div>
</div>
</div>
</div>
</fieldset>
</form>
</div>
</div>
<script src="js/jquery.min.js"></script>
<script src="js/bootstrap.min.js"></script>
<script src="js/jquery.sticky.js"></script>
<script src="js/slippry.min.js"></script>
<script src="js/jquery.flexslider-min.js"></script>
<script src="js/morphext.min.js"></script>
<script src="js/jquery.mb.YTPlayer.js"></script>
<script src="js/jquery.easing.min.js"></script>
<script src="js/jquery.scrollTo.js"></script>
<script src="js/jquery.appear.js"></script>
<script src="js/stellar.js"></script>
<script src="js/wow.min.js"></script>
<script src="js/owl.carousel.min.js"></script>
<script src="js/nivo-lightbox.min.js"></script>
<script src="js/jquery.nicescroll.min.js"></script>
<script src="js/custom.js"></script>
<script src="contactform/contactform.js"></script>
</body>
</html>