Form Billing

<div class="one-half"><div class="billing-information"> <label>Credit Card Type</label> <select name="cc_type" id="cc_type"> <option value="" selected="selected">Choose Type</option> <option value="Visa">Visa</option> <option value="Master Card">Master Card</option> <option value="Discover">Discover</option> <option value="Amex">Amex</option> </select> <label>Credit Card Number</label> <input name="cc_number" id="cc_number" type="text" size="30" /> <label>Expiration Date</label> <select name="cc_month" id="cc_month"> <option value="" selected="selected">Month</option> <option value="01">01 - January</option> <option value="02">02 - February</option> <option value="03">03 - March</option> <option value="04">04 - April</option> <option value="05">05 - May</option> <option value="06">06 - June</option> <option value="07">07 - July</option> <option value="08">08 - August</option> <option value="09">09 - September</option> <option value="10">10 - October</option> <option value="11">11 - November</option> <option value="12">12 - December</option> </select> <select name="cc_year" id="cc_year"> <option value="" selected="selected">Year</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> <label>Credit Card Authentication</label> <input name="cc_code" id="cc_code" type="text" size="3" placeholder="201" /> <img src="https://framework.sabali.co/icons/store/credit-card-ccv-blue.png" alt="Checkout - Verification Number" width="150" /></div>