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payments.html
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<!DOCTYPE html>
<!--[if lt IE 7]> <html class="no-js lt-ie9 lt-ie8 lt-ie7" lang="en"> <![endif]-->
<!--[if IE 7]> <html class="no-js lt-ie9 lt-ie8" lang="en"> <![endif]-->
<!--[if IE 8]> <html class="no-js lt-ie9" lang="en"> <![endif]-->
<!--[if gt IE 8]><!--> <html class="no-js" lang="en"> <!--<![endif]-->
<head>
<meta charset="utf-8">
<!-- Use the .htaccess and remove these lines to avoid edge case issues.
More info: h5bp.com/i/378 -->
<meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1">
<title></title>
<meta name="description" content="">
<meta name="author" content="">
<meta name="viewport" content="width=device-width, minimum-scale=1, maximum-scale=1">
<link rel="stylesheet" href="css/application.css">
<link rel="stylesheet" href="css/brand.css">
<link rel="sitemap" type="application/xml" title="Sitemap" href="/sitemap.xml" />
<!-- All JavaScript at the bottom, except this Modernizr build. -->
<script src="js/vendor/modernizr.custom.82447.js"></script>
<script src="js/WEX.js"></script>
</head>
<body>
<!-- Prompt IE 6 users to install Chrome Frame. Remove this if you support IE 6.
chromium.org/developers/how-tos/chrome-frame-getting-started -->
<!--[if lt IE 7]><p class="chromeframe">Your browser is <em>ancient!</em> <a href="http://browsehappy.com/">Upgrade to a different browser</a> or <a href="http://www.google.com/chromeframe/?redirect=true">install Google Chrome Frame</a> to experience this site.</p><![endif]-->
<header class="navbar">
<nav class="ui-session navbar-inner hidden-phone">
<div class="container">
<ul class="nav pull-right">
<li class="divider-vertical"></li>
<li class="dropdown">
<a href="#" class="dropdown-toggle" data-toggle="dropdown">
<i class="icon-briefcase icon-white"></i>ACME Corp | 000000000<b class="caret"></b>
</a>
<ul class="dropdown-menu">
<li><a href="#">Action</a></li>
<li><a href="#">Change Account</a></li>
</ul>
</li>
<li class="divider-vertical"></li>
<li class="dropdown">
<a href="#" class="dropdown-toggle" data-toggle="dropdown">
<i class="icon-user icon-white"></i>User12345<b class="caret"></b>
</a>
<ul class="dropdown-menu">
<li><a href="#">Profile</a></li>
<li><a href="#">Preferences</a></li>
<li class="divider"></li>
<li><a href="/">Signout</a></li>
</ul>
</li>
</ul>
</div>
</nav>
<nav class="ui-navigation">
<div class="container">
<div class="drop-shadow curved curved-hz-1">
<a href="dashboard.html" class="brand">
<img src="brand/acme/ui-logo.jpg" title="Acme Co.">
</a>
<a class="visible-phone pull-right btn" data-toggle="collapse" data-target="#session-collapse">
<i class="icon-cog"></i>
</a>
<a class="pull-right btn btn-navbar" data-toggle="collapse" data-target="#nav-collapse">
<span class="icon-bar"></span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
</a>
<div id="nav-collapse" class="nav-collapse">
<ul class="nav nav-pills pull-right">
<li>
<a href="dashboard.html">Home</a>
</li>
<li class="dropdown">
<a href="#" class="dropdown-toggle" data-toggle="dropdown">Account Activity<b class="caret"></b></a>
<ul class="dropdown-menu">
<li><a href="users.html">Manage Users</a></li>
</ul>
</li>
<li class="dropdown active">
<a href="#" class="dropdown-toggle" data-toggle="dropdown">Payments<b class="caret"></b></a>
<ul class="dropdown-menu">
<li><a href="payments.html">Make Payment</a></li>
<li><a href="accounts.html">Manage Bank Accounts</a></li>
</ul>
</li>
<li class="dropdown">
<a href="#" class="dropdown-toggle" data-toggle="dropdown">Rewards<b class="caret"></b></a>
<ul class="dropdown-menu">
<li><a href="#">Action</a></li>
</ul>
</li>
<li class="dropdown">
<a href="#" class="dropdown-toggle" data-toggle="dropdown">Account Services<b class="caret"></b></a>
<ul class="dropdown-menu">
<li><a href="#">Action</a></li>
</ul>
</li>
</ul>
</div>
<div id="session-collapse" class="nav-collapse visible-phone">
<ul class="nav nav-pills">
<li class="dropdown">
<a href="#" class="dropdown-toggle" data-toggle="dropdown">
<i class="icon-briefcase"></i>ACME Corp | 000000000<b class="caret"></b>
</a>
<ul class="dropdown-menu">
<li><a href="#">Action</a></li>
<li><a href="#">Change Account</a></li>
</ul>
</li>
<li class="dropdown">
<a href="#" class="dropdown-toggle" data-toggle="dropdown">
<i class="icon-user"></i>User12345<b class="caret"></b>
</a>
<ul class="dropdown-menu">
<li><a href="#">Profile</a></li>
<li><a href="#">Preferences</a></li>
<li class="divider"></li>
<li><a href="/">Signout</a></li>
</ul>
</li>
</ul>
</div>
</div>
</div>
</nav>
</header>
<div class="container" data-page="payments">
<div class="ui-panel">
<header class="clearfix">
<h2 class="pull-left">Make Payment</h2>
<!-- Breadcrumb :: Hidden Phone -->
<nav class="pull-right hidden-phone">
<ul class="breadcrumb">
<li><a href="#" class="brand-secondary">Payments</a> <span class="divider">/</span></li>
<li class="active">Make Payment</li>
</ul>
</nav>
</header>
<ul class="nav nav-tabs stacked-fallback margin-top margin-sides">
<li class="active"><a href="#user_information" data-toggle="tab">Step 1: Enter Payment</a></li>
<li><a href="#user_summary" data-toggle="tab">Step 2: Verify</a></li>
<li><a href="#user_confirmation" data-toggle="tab">Step 3: Confirmation</a></li>
</ul>
<div class="tab-content">
<div id="user_information" class="tab-pane active">
<form action="" class="form-horizontal padding-sides">
<div class="clearfix">
<div class="pull-right pull-fallback">
<div class="well text-left">
<p class="lead">Related Links</p>
<ul>
<li><a href="#">View Payment History</a></li>
<li><a href="#">View Activity</a></li>
</ul>
</div>
</div>
<div class="pull-left pull-fallback">
<div class="control-group margin-no-bottom">
<label class="control-label">Payment Schedule:</label>
<div class="controls">
<label class="radio clearfix">
<input type="radio" name="payment_schedule" value="payment_date" checked>
One-Time Payment
<div class="control-group stacked-fallback">
<label class="control-label" for="">Payment Date:</label>
<div class="controls">
<div class="input-append">
<input class="span2" id="appendedInputButton" size="16" type="text"><button class="btn" type="button"><i class="icon icon-calendar"></i></button>
</div>
</div>
</div>
</label>
<label class="radio clearfix">
<input type="radio" name="payment_schedule" value="payment_monthly">
Repeat Payment
<div class="control-group stacked-fallback">
<label class="control-label" for="">Monthly Payment Date:</label>
<div class="controls">
<select>
<option value="">SELECT (1-31)</option>
</select>
</div>
</div>
</label>
</div>
</div>
</div>
</div>
<div class="alert alert-info">
<button type="button" class="close" data-dismiss="alert">×</button>
<strong>Please Note:</strong> Payments received after X:XX pm ET may not be credited until the next day. Scheduled payments will be processed on the date selected.
</div>
<div class="padding-top">
<div class="control-group">
<label class="control-label" for="">Bank Account:</label>
<div class="controls">
<select class="span-auto">
<option value="">Default Bank Description - XXXX1234</option>
</select>
</div>
</div>
<div class="control-group">
<label class="control-label" for="">Payment Amount:</label>
<div class="controls">
<table class="table table-condensed table-borderless table-inline">
<tbody>
<tr>
<td><label class="radio text-gray_dark"><input type="radio" name="payment_amount" value="1" checked> Minimum Amount Due</label></td>
<td>$86.23</td>
<td><button class="btn btn-mini" type="button" title="title text" rel="tooltip"><i class="icon-info-sign"></i></button></td>
</tr>
<tr>
<td><label class="radio text-gray_dark"><input type="radio" name="payment_amount" value="2"> Full Statement Balance</label></td>
<td>$2,154.00</td>
<td><button class="btn btn-mini" type="button" title="title text" rel="tooltip"><i class="icon-info-sign"></i></button></td>
</tr>
<tr>
<td><label class="radio text-gray_dark"><input type="radio" name="payment_amount" value="3"> Current Outstanding Balance</label></td>
<td>$2,422.19</td>
<td><button class="btn btn-mini" type="button" title="title text" rel="tooltip"><i class="icon-info-sign"></i></button></td>
</tr>
<tr>
<td><label class="radio text-gray_dark"><input type="radio" name="payment_amount" value="4"> Other Amount</label></td>
<td>
<div class="input-prepend">
<span class="add-on">$</span><input type="text" class="input-small input-small-fallback">
</div>
</td>
<td><button class="btn btn-mini" type="button" title="title text" rel="tooltip"><i class="icon-info-sign"></i></button></td>
</tr>
</tbody>
</table>
</div>
</div>
</div>
</form>
<div class="form-actions padding-sides">
<button type="button" class="btn btn-primary btn-large pull-right">Continue</button>
</div>
</div>
</div>
</div>
</div>
</body>
</html>