| NETQUOTEVAR:DATETEXT | NETQUOTEVAR:CURRENTDATE |
| NETQUOTEVAR:ORDERNUMBERTEXT | NETQUOTEVAR:THEORDERNUMBER |
NETQUOTEDEL:DELIVERYINSTRUCTION | NETQUOTEVAR:DELIVERYINSTRUCTION_LABEL | NETQUOTEVAR:DELIVERYINSTRUCTION_TEXT |
NETQUOTEDEL:DELIVERYINSTRUCTION NETQUOTEDEL:PAYMENTPANEL NETQUOTEDEL:PAYMENTSENTSEPARATE | NETQUOTEVAR:PAYMENTMETHODTITLE: | NETQUOTEVAR:PAYMENTMETHODNAME |
NETQUOTEVAR:PURCHASEORDERNUMBER | NETQUOTEVAR:CREDITCARDTYPETITLE: | NETQUOTEVAR:CREDITCARDOPTIONS | <<< NETQUOTEVAR:SELECTONE |
| NETQUOTEVAR:CREDITCARDNUMBERTITLE: | ______________________________________ |
| NETQUOTEVAR:CREDITCARDISSUENUMBERTITLE: | _________ |
| NETQUOTEVAR:CREDITCARDCCV2TITLE | _________ |
| NETQUOTEVAR:CREDITCARDSTARTDATETITLE: | ____________ |
| NETQUOTEVAR:CREDITCARDEXPDATETITLE: | ____________ |
| NETQUOTEVAR:SIGNATURETITLE: | X______________________________________ |
NETQUOTEDEL:PAYMENTSENTSEPARATE NETQUOTEDEL:PAYMENTOTHER | NETQUOTEVAR:PAYMENTMETHODTITLE: | NETQUOTEVAR:PAYMENTMETHODNAME |
NETQUOTEVAR:PURCHASEORDERNUMBER NETQUOTEDEL:PAYMENTCREDITCARD | NETQUOTEVAR:CREDITCARDTITLE: | NETQUOTEVAR:CREDITCARDTYPE |
NETQUOTEDEL:PAYMENTCREDITCARD NETQUOTEDEL:PAYMENTOTHER NETQUOTEDEL:PAYMENTPANEL | Terms and Conditions: | Accepted |