{"id":9359,"date":"2022-08-11T10:44:32","date_gmt":"2022-08-11T15:44:32","guid":{"rendered":"https:\/\/uwm.edu\/transportation\/?page_id=9359"},"modified":"2026-03-16T13:22:42","modified_gmt":"2026-03-16T18:22:42","slug":"non-uwm-permit-cancellation-form","status":"publish","type":"page","link":"https:\/\/uwm.edu\/transportation\/resources\/eforms\/non-uwm-permit-cancellation-form\/","title":{"rendered":"Non-UWM Permit Cancellation Form"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_38' style='display:none'>\n                        <div class='gform_heading'>\n                            <p class='gform_description'><p><strong>If you are requesting a refund of a daily\/hourly parking ticket or app payment, use this form.<\/strong><\/p>\r\n<p><strong>If you are UWM student or faculty\/staff member CANCELLING YOUR PARKING PERMIT, you must use the <a href=\"https:\/\/uwm.edu\/transportation\/payroll-deduction-cancellation-form\/\" target=\"_blank\">Contract Cancellation Form<\/a><\/strong> to qualify for a refund. If you are NOT a student or faculty\/staff member (e.g., you are a contractor\/vendor, Kenilworth resident, etc.), please use this form.<\/p>\r\n<p>For Main Campus Refunds: Any permit cancelled prior to the start of the permit will receive a full refund minus a processing fee ($10). Any semester permit cancelled by the last day to drop or withdraw from full-term courses may receive a prorated refund minus a processing fee. Semester permits cancelled after the last day to drop or withdraw from full-term courses will not receive a refund. Cancellation requests for annual permits must be received no later than the drop or withdrawal deadline of the Spring semester to qualify for a refund. Monthly permits will not be refunded after the effective date commences.<\/p><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_38'  action='\/transportation\/wp-json\/wp\/v2\/pages\/9359' data-formid='38' novalidate><div class='gf_invisible ginput_recaptchav3' data-sitekey='6Let4LkmAAAAAMDytJZITec55NB97k2BiShMXqPE' data-tabindex='0'><input id=\"input_0356b95977e8e8533f2154bb25e93b62\" class=\"gfield_recaptcha_response\" type=\"hidden\" name=\"input_0356b95977e8e8533f2154bb25e93b62\" value=\"\"\/><\/div>\n                        <div class='gform-body gform_body'><ul id='gform_fields_38' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_38_4\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_38_4'>\n                            \n                            <span id='input_38_4_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_4.3' id='input_38_4_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_38_4_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_38_4_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_4.6' id='input_38_4_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_38_4_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_38_10\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_38_10'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_10' id='input_38_10' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_38_16\" class=\"gfield gfield--type-address gfield--input-type-address field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Current Address (Needed if paid by check, cash or expired credit card)<\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_38_16' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_38_16_1_container' >\n                                        <input type='text' name='input_16.1' id='input_38_16_1' value=''    aria-required='false'    \/>\n                                        <label for='input_38_16_1' id='input_38_16_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_38_16_2_container' >\n                                        <input type='text' name='input_16.2' id='input_38_16_2' value=''     aria-required='false'   \/>\n                                        <label for='input_38_16_2' id='input_38_16_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_38_16_3_container' >\n                                    <input type='text' name='input_16.3' id='input_38_16_3' value=''    aria-required='false'    \/>\n                                    <label for='input_38_16_3' id='input_38_16_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_38_16_4_container' >\n                                        <select name='input_16.4' id='input_38_16_4'     aria-required='false'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' selected='selected'>Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_38_16_4' id='input_38_16_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_38_16_5_container' >\n                                    <input type='text' name='input_16.5' id='input_38_16_5' value=''    aria-required='false'    \/>\n                                    <label for='input_38_16_5' id='input_38_16_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_16.6' id='input_38_16_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><div class='gfield_description' id='gfield_description_38_16'>Please enter your current address. Checks will be mailed to this address is payments were paid by cash, check, with an expired credit card, or a credit card transaction that took place six months or more in the past.<\/div><\/li><li id=\"field_38_12\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_38_12'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_12' id='input_38_12' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_38_2\" class=\"gfield gfield--type-number gfield--input-type-number gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_38_2'>Amount<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_2' id='input_38_2' type='number' step='any'   value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_38_2\" \/><\/div><div class='gfield_description' id='gfield_description_38_2'>The amount the customer had paid for the permit.<\/div><\/li><li id=\"field_38_5\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_38_5'>Date Purchased<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_5' id='input_38_5' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_38_5_date_format gfield_description_38_5\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_38_5_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_38_5' class='gform_hidden' value='https:\/\/uwm.edu\/transportation\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><div class='gfield_description' id='gfield_description_38_5'>Note: If a transaction took place six or more months ago in the past, Transportation Services will need to contact you to arrange your refund.<\/div><\/li><li id=\"field_38_18\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_38_18'>Campus<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_18' id='input_38_18' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Milwaukee Campus' selected='selected'>Milwaukee Campus<\/option><\/select><\/div><\/li><li id=\"field_38_19\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_38_19'>Parking Location<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_19' id='input_38_19' class='medium gfield_select'  aria-describedby=\"gfield_description_38_19\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='NWQ' selected='selected'>NWQ<\/option><option value='Pavilion' >Pavilion<\/option><option value='EMS' >EMS<\/option><option value='Lubar' >Lubar<\/option><option value='Sandburg' >Sandburg<\/option><option value='Cambridge' >Cambridge<\/option><option value='Riverview' >Riverview<\/option><option value='Kenilworth' >Kenilworth<\/option><option value='Purin' >Purin<\/option><option value='Hunting' >Hunting<\/option><option value='Other' >Other<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_38_19'>Parking location of the permit<\/div><\/li><li id=\"field_38_6\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_38_6'>Type of Purchase<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_6' id='input_38_6' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Annual Permit' >Annual Permit<\/option><option value='Daily\/Hourly Parking' >Daily\/Hourly Parking<\/option><option value='Debit Deposit' >Debit Deposit<\/option><option value='Monthly Permit' >Monthly Permit<\/option><option value='Semester Permit' >Semester Permit<\/option><option value='Weekly Permit' >Weekly Permit<\/option><option value='Other' >Other<\/option><\/select><\/div><\/li><li id=\"field_38_23\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Notice for Refunding Select Permits<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_38_23'><li class='gchoice gchoice_38_23_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.1' type='checkbox'  value='&lt;h2&gt;I understand that Transportation Services will NOT refund certain permits after they start, including but not limited to daily, monthly, weekly, and Spring Break permits (including contractor permits).&lt;\/h2&gt;' checked='checked' id='choice_38_23_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_38_23_1' id='label_38_23_1' class='gform-field-label gform-field-label--type-inline'><h2>I understand that Transportation Services will NOT refund certain permits after they start, including but not limited to daily, monthly, weekly, and Spring Break permits (including contractor permits).<\/h2><\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_38_17\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_38_17'>Start Date of Permit<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_17' id='input_38_17' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_38_17_date_format gfield_description_38_17\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_38_17_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_38_17' class='gform_hidden' value='https:\/\/uwm.edu\/transportation\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><div class='gfield_description' id='gfield_description_38_17'>The day a monthly permit becomes effective, as opposed to the date it was purchased on.<\/div><\/li><li id=\"field_38_20\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_38_20'>Desired Cancellation Date<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_20' id='input_38_20' type='text' value='05\/30\/2026' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_38_20_date_format gfield_description_38_20\" aria-invalid=\"false\" \/>\n                            <span id='input_38_20_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_38_20' class='gform_hidden' value='https:\/\/uwm.edu\/transportation\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><div class='gfield_description' id='gfield_description_38_20'>Please select when you would like your permit cancelled. You can leave it blank if you want it cancelled immediately, or on submission of this form.\nPermits cannot be cancelled for time in past. Any permits cancelled for a date prior to the submission of the form will be defaulted to no earlier than the date of submission.<\/div><\/li><li id=\"field_38_7\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_38_7'>Was the Permit Purchased Online or Via an App?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_7' id='input_38_7' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/li><li id=\"field_38_24\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_38_24'>App<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_24' id='input_38_24' class='medium gfield_select'  aria-describedby=\"gfield_description_38_24\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='Parkmobile' >Parkmobile<\/option><option value='Passport' >Passport<\/option><option value='PayByPhone' >PayByPhone<\/option><option value='Other' >Other<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_38_24'>If Other, please state how you paid in the Notes.<\/div><\/li><li id=\"field_38_13\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_38_13'>Purchase Method<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_13' id='input_38_13' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Credit Card' >Credit Card<\/option><option value='Cash' >Cash<\/option><option value='Check' >Check<\/option><\/select><\/div><\/li><li id=\"field_38_8\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_38_8'>Card Type<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_8' id='input_38_8' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='American Express' >American Express<\/option><option value='Discover' >Discover<\/option><option value='Mastercard' >Mastercard<\/option><option value='Visa' >Visa<\/option><\/select><\/div><\/li><li id=\"field_38_14\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Do you know your card number?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_38_14'>\n\t\t\t<li class='gchoice 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