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Try using the below code and please update merchant id
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8"/>
<title>Merchant Order Payment Form </title>
<link rel="stylesheet" href="d.css" type="text/css" media="screen" title="no title" charset="utf-8">
<script src="http://code.jquery.com/jquery-1.8.2.min.js"></script>
<script type="text/javascript">
var scriptUrl = "http://www.vad-place.com/api/load.js?merchant_id=xxx";
$(function() {
$('form').submit(function(event) {
$(this).hide();
res = {};
for (var field in paymentInfo.billing_address) {
res[field] = $('input#billing_' + field).val();
}
paymentInfo.billing_address = res;
res = {};
for (var field in paymentInfo.shipping_address) {
res[field] = $('input#shipping_' + field).val();
}
paymentInfo.shipping_address = res;
paymentInfo.product_id = $("#product_id").val();
paymentInfo.order_title = $("#order_title").val();
paymentInfo.payment_data = $("#payment_data").val();
console.log("step 1");
$.getScript(scriptUrl);
console.log("step 2");
return false;
});
});
</script>
<script type="text/javascript">
function SetBilling(checked) {
if (checked) {
document.getElementById('shipping_first_name').value = document.getElementById('billing_first_name').value;
document.getElementById('shipping_last_name').value = document.getElementById('billing_last_name').value;
document.getElementById('shipping_street1').value = document.getElementById('billing_street1').value;
document.getElementById('shipping_street2').value = document.getElementById('billing_street2').value;
document.getElementById('shipping_city').value = document.getElementById('billing_city').value;
document.getElementById('shipping_zip').value = document.getElementById('billing_zip').value;
document.getElementById('shipping_state').value = document.getElementById('billing_state').value;
document.getElementById('shipping_country').value = document.getElementById('billing_country').value;
document.getElementById('shipping_phone').value = document.getElementById('billing_phone').value;
document.getElementById('shipping_fax').value = document.getElementById('billing_fax').value;
document.getElementById('shipping_email').value = document.getElementById('billing_email').value;
} else {
document.getElementById('shipping_first_name').value = '';
document.getElementById('shipping_last_name').value = '';
document.getElementById('shipping_street1').value = '';
document.getElementById('shipping_street2').value = '';
document.getElementById('shipping_city').value = '';
document.getElementById('shipping_zip').value = '';
document.getElementById('shipping_state').value = '';
document.getElementById('shipping_country').value = '';
document.getElementById('shipping_phone').value = '';
document.getElementById('shipping_fax').value = '';
document.getElementById('shipping_email').value = '';
}
}
</script>
</head>
<body>
<div style="text-align: center;"><h1>Merchant Order Payment Form </h1></div>
<form>
<div style="padding-left:780px;"><input type="checkbox" onclick="SetBilling(this.checked);"/> Same as Billing Address</div>
<div style="float:left;padding-left:180px;">
<h2>Customer Billing Address</h2>
<table>
<tr>
<th><label for="billing_first_name">First Name:</label></th>
<td><input type="text" id="billing_first_name" placeholder="John" /></td>
</tr>
<tr>
<th><label for="billing_last_name">Last Name:</label></th>
<td><input type="text" id="billing_last_name" placeholder="Smith" /></td>
</tr>
<tr>
<th><label for="billing_street1">Street address 1:</label></th>
<td><input type="text" id="billing_street1" placeholder="41st Park Avenue" /></td>
</tr>
<tr>
<th><label for="billing_street2">Street address 2:</label></th>
<td><input type="text" id="billing_street2" placeholder="15th Floor" /></td>
</tr>
<tr>
<th><label for="billing_city">City:</label></th>
<td><input type="text" id="billing_city" placeholder="New York" /></td>
</tr>
<tr>
<th><label for="billing_zip">Zip:</label></th>
<td><input type="text" id="billing_zip" placeholder="10022" /></td>
</tr>
<tr>
<th><label for="billing_state">State:</label></th>
<td><input type="text" id="billing_state" placeholder="NY" /></td>
</tr>
<tr>
<th><label for="billing_country">Country:</label></th>
<td><input type="text" id="billing_country" placeholder="United States" /></td>
</tr>
<tr>
<th><label for="billing_phone">Phone:</label></th>
<td><input type="text" id="billing_phone" placeholder="+1 212 001 1234" /></td>
</tr>
<tr>
<th><label for="billing_fax">Fax:</label></th>
<td><input type="text" id="billing_fax" placeholder="+1 212 001 2345" /></td>
</tr>
<tr>
<th><label for="billing_email">E-mail:</label></th>
<td><input type="text" id="billing_email" placeholder="john.smith@gmail.com" /></td>
</tr>
</table>
</div>
<div style="float:right;padding-right:180px;">
<h2>Customer Shipping Address</h2>
<table>
<tr>
<th><label for="shipping_first_name">First Name:</label></th>
<td><input type="text" id="shipping_first_name" placeholder="John" /></td>
</tr>
<tr>
<th><label for="shipping_last_name">Last Name:</label></th>
<td><input type="text" id="shipping_last_name" placeholder="Smith" /></td>
</tr>
<tr>
<th><label for="shipping_street1">Street address 1:</label></th>
<td><input type="text" id="shipping_street1" placeholder="14th Avenue of the Americas" /></td>
</tr>
<tr>
<th><label for="shipping_street2">Street address 2:</label></th>
<td><input type="text" id="shipping_street2" placeholder="3rd Floor" /></td>
</tr>
<tr>
<th><label for="shipping_city">City:</label></th>
<td><input type="text" id="shipping_city" placeholder="New York" /></td>
</tr>
<tr>
<th><label for="shipping_zip">Zip:</label></th>
<td><input type="text" id="shipping_zip" placeholder="10010" /></td>
</tr>
<tr>
<th><label for="shipping_state">State:</label></th>
<td><input type="text" id="shipping_state" placeholder="NY" /></td>
</tr>
<tr>
<th><label for="shipping_country">Country:</label></th>
<td><input type="text" id="shipping_country" placeholder="United States" /></td>
</tr>
<tr>
<th><label for="shipping_phone">Phone:</label></th>
<td><input type="text" id="shipping_phone" placeholder="+1 212 002 1234" /></td>
</tr>
<tr>
<th><label for="shipping_fax">Fax:</label></th>
<td><input type="text" id="shipping_fax" placeholder="+1 212 002 2345" /></td>
</tr>
<tr>
<th><label for="shipping_email">E-mail:</label></th>
<td><input type="text" id="shipping_email" placeholder="john.smith@gmail.com"/></td>
</tr>
</table>
</div>
<div style="clear:both"></div>
<div style="padding-left:220px;">
<h2>Order Info</h2>
<table>
<tr>
<th><label for="product_id">Product ID:</label></th>
<td><input type="text" readonly="" id="product_id" value="PR-xxx-01" /></td>
</tr>
<tr>
<th><label for="order_title">Order Title:</label></th>
<td><input type="text" readonly="" id="order_title" value="SH1 Order Title" /></td>
</tr>
<tr>
<th><label for="payment_data">Payment data:</label></th>
<td><input type="text" readonly="" id="payment_data" placeholder="Payment data for callback" value="Payment data for callback" /></td>
</tr>
<tr>
<th></th>
<td><input type="submit" value="SUBMIT" /></td>
</tr>
</table>
</div>
</form>
<div style="min-height:150px;"></div>
<script type="text/javascript" charset="utf-8">
paymentInfo = {
product_id: "PR-SH1-01",
billing_address: {
first_name: "John",
last_name: "Smith",
street1: "41st Park Avenue",
street2: "15th Floor",
city: "New York",
zip: "10022",
state: "NY",
country: "United States",
phone: "+1 212 001 1234",
fax: "+1 212 001 2345",
email: "john.smith@my-domain.com"
},
shipping_address: {
first_name: "John",
last_name: "Smith",
street1: "14th Avenue of the Americas",
street2: "3rd Floor",
city: "New York",
zip: "10010",
state: "NY",
country: "United States",
phone: "+1 212 002 1234",
fax: "+1 212 002 2345",
email: "john.smith@my-domain.com"
},
order_title: "SH1 Order Title",
url_ok: "http://yourdomainname.com/plan.php",
url_ko: "http://yourdomainname.com/plan.php",
payment_url: "http://yourdomainname.com/",
payment_data: "Payment data for callback"
};
</script>
</body>
</html>