Example

<input name="apiKey" value="<?=$apiKey?>" type="text">
<input name="email" value="[email protected]" type="text">
<input name="birthday" value="1970-01-01" type="text">
<input name="amount" value="<?=$amount?>" type="text">
<input name="currency" value="<?=$currency?>" type="text">
<input name="returnUrl" value="http://merchantReturnUrl.com" type="text">
<input name="referenceNo" value="<?=$referenceNo?>" type="text">
<input name="billingTitle" value="Mr." type="text">
<input name="billingFirstName" value="John" type="text">
<input name="billingLastName" value="Doe" type="text">
<input name="billingAddress1" value="26 green street" type="text">
<input name="billingAddress2" value="" type="text">
<input name="billingCity" value="Paris" type="text">
<input name="billingPostcode" value="75001" type="text">
<input name="billingState" value="" type="text">
<input name="token" value=" " type="text">
<input name="timestamp" value="<?=$timestamp?>" type="text">
<select name="billingCountry">
    <option value="TR">TURKEY</option>
    <option value="IT">ITALY</option>
    <option value="FR" selected>FRANCE</option>
</select>
<input name="billingPhone" value="" type="text">
<input name="billingFax" value="" type="text">
<input value="SEND" type="submit">