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+<!DOCTYPE html>
+<html lang="en">
+ <head>
+ <meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
+ <meta feature="9.1.4">
+ <title>Costco - Payment</title>
+ <meta name="currentBuildNumber" content="3.0.29057.0">
+ <meta name="ServerName" content="www.costco.com ">
+ <meta name="LocalAddress" content="xxx.xxx.xxx.48">
+ <meta name="LocalName" content="TP26">
+ </head>
+ <body>
+ <form name="CheckoutPaymentForm" id="CheckoutPaymentForm" method="post" action="https://www.costco.com/CostcoBillingPayment">
+ <input type="hidden" name="selfAddressId" id="hiddenSelfAddressId" value="">
+ <input type="hidden" id="billHiddenInput0" name="billHideenInput" value="">
+ <input type="hidden" id="billAddrId" name="billAddrId" value="">
+ <input type="hidden" id="membershipNumber" name="membershipNum">
+ <input type="hidden" name="orderItemsCount" value="1">
+ <input type="hidden" value="" id="selectedAddressId" name="selectedAddressId">
+ <input type="hidden" name="orderId" value="644156669" id="WC_CheckoutPaymentsAndBillingAddressf_orderId">
+ <input type="hidden" name="storeId" value="10301" id="CheckoutPayment_inputs_1">
+ <input type="hidden" name="catalogId" value="10701" id="CheckoutPayment_inputs_2">
+ <input type="hidden" name="langId" value="-1" id="CheckoutPayment_inputs_3">
+ <input type="hidden" name="curr_year" value="2017" id="CheckoutPayment_inputs_5">
+ <input type="hidden" name="curr_month" value="3" id="CheckoutPayment_inputs_6">
+ <input type="hidden" name="curr_date" value="19" id="CheckoutPayment_inputs_7">
+ <input type="hidden" name="URL" value="OrderPrepare?URL=CheckoutReviewView">
+ <input type="hidden" name="xCreditCardId" value="">
+ <input type="hidden" name="ccLastFour" value="">
+ <input type="hidden" name="checkCCValue" value="false">
+ <input type="hidden" name="backURL" value="">
+ <input type="hidden" name="piAmount" value="84.99000">
+ <input type="hidden" name="cardNumberValueHolder" value="">
+ <input type="hidden" name="authToken" value="312">
+ <div>
+ <label for="billMeLater">
+ <input type="radio" checked="checked" id="billMeLater" name="billMeLater" value="no"
+title="overall type: UNKNOWN_TYPE
+ server type: NO_SERVER_DATA
+ heuristic type: UNKNOWN_TYPE
+ label: Payment Method
+ parseable name: billMeLater
+ field signature: 1700925171
+ form signature: 4979691664972472743"
+autofill-prediction="UNKNOWN_TYPE"
+>
+ </label>
+ <br>
+ <div>
+ <div>
+ <label for="payMethodId">Card Type</label>
+ <select name="payMethodId" id="payMethodId"
+title="overall type: CREDIT_CARD_TYPE
+ server type: CREDIT_CARD_TYPE
+ heuristic type: CREDIT_CARD_TYPE
+ label: Card Type
+ parseable name: payMethodId
+ field signature: 3668211827
+ form signature: 4979691664972472743"
+autofill-prediction="CREDIT_CARD_TYPE"
+>
+ <option value="Costco Credit Card">Costco Credit Card</option>
+ <option value="Discover">Discover</option>
+ <option value="Master Card">MasterCard</option>
+ <option value="VISA" selected="selected">VISA</option>
+ </select>
+ </div>
+ <div>
+ <label for="account">Card number</label>
+ <input
+title="overall type: CREDIT_CARD_NUMBER
+ server type: NO_SERVER_DATA
+ heuristic type: CREDIT_CARD_NUMBER
+ label: Card number
+ parseable name: account
+ field signature: 3715653537
+ form signature: 4979691664972472743" type="text" id="account" name="account" value="" autocomplete="off"
+autofill-prediction="CREDIT_CARD_NUMBER"
+>
+ </div>
+ </div>
+ <div>
+ <div>
+ <label for="expire_month">Expiration Date</label>
+ <select
+title="overall type: CREDIT_CARD_EXP_MONTH
+ server type: CREDIT_CARD_EXP_MONTH
+ heuristic type: CREDIT_CARD_EXP_MONTH
+ label: Expiration Date
+ parseable name: expire_month
+ field signature: 3078539387
+ form signature: 4979691664972472743" id="expire_month" name="expire_month"
+autofill-prediction="CREDIT_CARD_EXP_MONTH"
+>
+ <option value="Month">Month</option>
+ <option value="01">1</option>
+ <option value="02">2</option>
+ <option value="03">3</option>
+ <option value="04">4</option>
+ <option value="05">5</option>
+ <option value="06">6</option>
+ <option value="07">7</option>
+ <option value="08">8</option>
+ <option value="09">9</option>
+ <option value="10">10</option>
+ <option value="11">11</option>
+ <option value="12">12</option>
+ </select>
+ <select
+title="overall type: CREDIT_CARD_EXP_4_DIGIT_YEAR
+ server type: CREDIT_CARD_EXP_4_DIGIT_YEAR
+ heuristic type: CREDIT_CARD_EXP_4_DIGIT_YEAR
+ label: Expiration Date
+ parseable name: expire_year
+ field signature: 2521850425
+ form signature: 4979691664972472743" name="expire_year"
+autofill-prediction="CREDIT_CARD_EXP_4_DIGIT_YEAR"
+>
+ <option value="Year">Year</option>
+ <option value="2017">2017</option>
+ <option value="2018">2018</option>
+ <option value="2019">2019</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>
+ <option value="2027">2027</option>
+ </select>
+ </div>
+ <div>
+ <label for="cc_cvc">CVV Code</label>
+ <input
+title="overall type: CREDIT_CARD_VERIFICATION_CODE
+ server type: NO_SERVER_DATA
+ heuristic type: CREDIT_CARD_VERIFICATION_CODE
+ label: CVV Code
+ parseable name: cc_cvc
+ field signature: 1956128288
+ form signature: 4979691664972472743" type="text" id="cc_cvc" name="cc_cvc" value="" maxlength="4" autocomplete="off"
+autofill-prediction="CREDIT_CARD_VERIFICATION_CODE"
+>
+ <span>&nbsp;<span>?</span>
+</span>
+ </div>
+ </div>
+ <div>
+ <label for="cc_nameoncard">Cardholder Name</label>
+ <input
+title="overall type: CREDIT_CARD_NAME_FULL
+ server type: CREDIT_CARD_NAME_FULL
+ heuristic type: CREDIT_CARD_NAME_FULL
+ label: Cardholder Name
+ parseable name: cc_nameoncard
+ field signature: 1086986730
+ form signature: 4979691664972472743" type="text" id="cc_nameoncard" name="cc_nameoncard" value="" autocomplete="off"
+autofill-prediction="CREDIT_CARD_NAME_FULL"
+>
+ </div>
+ <div>
+ <input
+title="overall type: UNKNOWN_TYPE
+ server type: NO_SERVER_DATA
+ heuristic type: UNKNOWN_TYPE
+ label: Save this as my default payment card
+ parseable name: save_CC
+ field signature: 3060743727
+ form signature: 4979691664972472743" type="checkbox" name="save_CC" id="save_CC"
+autofill-prediction="UNKNOWN_TYPE"
+>
+ <label for="save_CC">Save this as my default payment card</label>
+ </div>
+ </div>
+ </form>
+ <form name="CashCardForm" method="post" action="https://www.costco.com/CostcoCashCardProcess" id="CashCardForm">
+ <input type="hidden" name="storeId" value="10301">
+ <input type="hidden" name="langId" value="-1">
+ <input type="hidden" name="orderId" value="644156669">
+ <input type="hidden" name="catalogId" value="10701">
+ <input type="hidden" name="addressId" value="">
+ <input type="hidden" name="cc_payMethodId" value="CostcoCashCard">
+ <input type="hidden" name="action" value="">
+ <input type="hidden" name="URL" value="CheckoutPaymentView">
+ <input type="hidden" name="account" value="">
+ <input type="hidden" name="expire_month" value="">
+ <input type="hidden" name="expire_year" value="">
+ <input type="hidden" name="cc_nameoncard" value="">
+ <input type="hidden" name="payMethodId" value="">
+ <input type="hidden" name="xCreditCardId" value="">
+ <input type="hidden" name="ccLastFour" value="">
+ <input type="hidden" name="authToken" value="312404731%2cKsqvty%2bpMJ%2bCAl3XeIkCxSEgLa4%3d">
+ <div>
+ <div>
+ <label for="cash_account">Costco Cash Card Number</label>
+ <input
+title="Costco Cash Card Number" type="text" id="cash_account" name="cash_account" value="" maxlength="19" autocomplete="off">
+ </div>
+ <div>
+ <label for="cash_pin">PIN</label>
+ <input
+title="PIN" type="password" id="cash_pin" name="cash_pin" value="" maxlength="8" autocomplete="off">
+ <span>&nbsp;<span>?</span>
+</span>
+ <div>
+ <span>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;More Info - Costco Cash Card</span>
+ <span>
+ <i>Costco Cash</i> Card Number</span>
+ <span>This image highlights the unique number</span>
+ <img src="./Costco - Payment_files/cashcard-us.gif" alt="cashcard-us.gif">
+ <span>used to identify your <i>Costco Cash</i> card.</span>
+ <span> Pin Number</span>
+ <span>This number is used to access your</span>
+ <span>
+ <i>Costco Cash</i> card. The image shows</span>
+ <span>where this number is located.</span>
+ <span>@ 1998-2016 Costco Wholesale Corporation. All rights reserved.</span>
+ </div>
+ </div>
+ </div>
+ </form>
+ <form name="RefreshBilling" method="post" action="https://www.costco.com/CostcoBillingPayment" id="RefreshBilling">
+ <input type="hidden" name="storeId" value="10301">
+ <input type="hidden" name="langId" value="-1">
+ <input type="hidden" name="orderId" value="644156669">
+ <input type="hidden" name="catalogId" value="10701">
+ <input type="hidden" name="actionType" value="refresh">
+ <input type="hidden" name="authToken" value="312404731%2cKsqvty%2bpMJ%2bCAl3XeIkCxSEgLa4%3d">
+ <input type="hidden" name="deviceId" value="">
+ </form>
+ <form name="PromotionCodeForm" method="post" action="https://www.costco.com/CostcoManagePromotionCmd" id="PromotionCodeForm">
+ <input type="hidden" name="storeId" value="10301">
+ <input type="hidden" name="langId" value="-1">
+ <input type="hidden" name="orderId" value="644156669">
+ <input type="hidden" name="catalogId" value="10701">
+ <input type="hidden" name="taskType" value="A">
+ <input type="hidden" name="URL" value="OrderCalculate?updatePrices=1&amp;calculationUsageId=-1&amp;URL=OrderPrepare?URL=CostcoPostPromotionCodeAddRemove&amp;orderId=.">
+ <input type="hidden" name="errorViewName" value="CheckoutPaymentView">
+ <input type="hidden" name="account" value="">
+ <input type="hidden" name="expire_month" value="">
+ <input type="hidden" name="expire_year" value="">
+ <input type="hidden" name="cc_nameoncard" value="">
+ <input type="hidden" name="payMethodId" value="">
+ <input type="hidden" name="xCreditCardId" value="">
+ <input type="hidden" name="ccLastFour" value="">
+ <input type="hidden" name="checkCCValue" value="false">
+ <input type="hidden" id="billHiddenInput0" name="billHideenInput" value="">
+ <input type="hidden" id="billAddrId" name="billAddrId" value="">
+ <input type="hidden" name="addressId" value="">
+ <input type="hidden" name="cc_cvc" value="">
+ <input type="hidden" name="piAmount" value="84.99000">
+ <div>
+ <label for="PromotionCodeForm_1">Promo Code</label>
+ <input
+title="Promo Code" type="text" size="10" name="promoCode" id="PromotionCodeForm_1" value="">
+ </div>
+ </form>
+ <form id="AddressFormModal-Form" name="AddressFormModal-Form" autocomplete="on" method="post">
+ <div>
+ <input type="hidden" name="addressType" value="B">
+ <p id="addressFormModalRequired" tabindex="-1">
+<span>*</span> Required fields</p>
+ <div id="personName">
+ <div>
+ <label for="addressFormModalFirstName">FIRST NAME<span>*</span>
+</label>
+ <input id="addressFormModalFirstName" name="addressFormModalFirstName"
+title="overall type: NAME_FIRST
+ server type: NAME_FIRST
+ heuristic type: NAME_FIRST
+ label: FIRST NAME*
+ parseable name: addressFormModalFirstName
+ field signature: 2222266781
+ form signature: 8397269939060577503" type="text" maxlength="40"
+autofill-prediction="NAME_FIRST"
+>
+ </div>
+ <div>
+ <label for="addressFormModalMiddleInitial">M.I.</label>
+ <input id="addressFormModalMiddleInitial" name="addressFormModalMiddleInitial"
+title="overall type: NAME_MIDDLE_INITIAL
+ server type: NAME_MIDDLE_INITIAL
+ heuristic type: NAME_MIDDLE_INITIAL
+ label: M.I.
+ parseable name: addressFormModalMiddleInitial
+ field signature: 3540652809
+ form signature: 8397269939060577503" type="text" maxlength="1"
+autofill-prediction="NAME_MIDDLE_INITIAL"
+>
+ </div>
+ <div>
+ <label for="addressFormModalLastName">LAST NAME<span>*</span>
+</label>
+ <input id="addressFormModalLastName" name="addressFormModalLastName"
+title="overall type: NAME_LAST
+ server type: NAME_LAST
+ heuristic type: NAME_LAST
+ label: LAST NAME*
+ parseable name: addressFormModalLastName
+ field signature: 4218996568
+ form signature: 8397269939060577503" type="text" maxlength="40"
+autofill-prediction="NAME_LAST"
+>
+ </div>
+ </div>
+ <div>
+ <label for="addressFormModalCompany">COMPANY NAME</label>
+ <input id="addressFormModalCompany" name="addressFormModalCompany" type="text" maxlength="40"
+title="overall type: COMPANY_NAME
+ server type: COMPANY_NAME
+ heuristic type: COMPANY_NAME
+ label: COMPANY NAME
+ parseable name: addressFormModalCompany
+ field signature: 1845178698
+ form signature: 8397269939060577503"
+autofill-prediction="COMPANY_NAME"
+>
+ </div>
+ <div>
+ <label for="addressFormModalCountry">COUNTRY<span>*</span>
+</label>
+ <select id="addressFormModalCountry" name="addressFormModalCountry"
+title="overall type: ADDRESS_HOME_COUNTRY
+ server type: ADDRESS_HOME_COUNTRY
+ heuristic type: ADDRESS_HOME_COUNTRY
+ label: COUNTRY*
+ parseable name: addressFormModalCountry
+ field signature: 4052501735
+ form signature: 8397269939060577503"
+autofill-prediction="ADDRESS_HOME_COUNTRY"
+>
+ <option value="CA">Canada</option>
+ <option value="US">United States</option>
+ </select>
+ </div>
+ <div id="streetAddress">
+ <legend>
+ <label for="addressFormModalAddressLine1">STREET ADDRESS<span>*</span>
+</label>
+ </legend>
+ <div>
+ <input id="addressFormModalAddressLine1" name="addressFormModalAddressLine1" placeholder="Address Line 1" type="text" maxlength="30"
+title="overall type: ADDRESS_HOME_LINE1
+ server type: ADDRESS_HOME_LINE1
+ heuristic type: ADDRESS_HOME_LINE1
+ label: STREET ADDRESS*
+ parseable name: addressFormModalAddressLine1
+ field signature: 1532865404
+ form signature: 8397269939060577503"
+autofill-prediction="ADDRESS_HOME_LINE1"
+>
+ </div>
+ <div>
+ <input id="addressFormModalAddressLine2" name="addressFormModalAddressLine2" placeholder="Address Line 2" type="text" maxlength="30"
+title="overall type: ADDRESS_HOME_LINE2
+ server type: ADDRESS_HOME_LINE2
+ heuristic type: ADDRESS_HOME_LINE2
+ label: Address Line 2
+ parseable name: addressFormModalAddressLine2
+ field signature: 2315514959
+ form signature: 8397269939060577503"
+autofill-prediction="ADDRESS_HOME_LINE2"
+>
+ </div>
+ </div>
+ <div id="city">
+ <label for="addressFormModalCity">CITY<span>*</span>
+</label>
+ <input id="addressFormModalCity" name="addressFormModalCity" type="text" maxlength="40"
+title="overall type: ADDRESS_HOME_CITY
+ server type: ADDRESS_HOME_CITY
+ heuristic type: ADDRESS_HOME_CITY
+ label: CITY*
+ parseable name: addressFormModalCity
+ field signature: 4130865920
+ form signature: 8397269939060577503"
+autofill-prediction="ADDRESS_HOME_CITY"
+>
+ </div>
+ <div id="stateAndZip">
+ <div>
+ <label for="addressFormModalState">STATE / PROVINCE<span>*</span>
+</label>
+ <select id="addressFormModalState" name="addressFormModalState"
+title="overall type: ADDRESS_HOME_STATE
+ server type: ADDRESS_HOME_STATE
+ heuristic type: ADDRESS_HOME_STATE
+ label: STATE / PROVINCE*
+ parseable name: addressFormModalState
+ field signature: 4026908515
+ form signature: 8397269939060577503"
+autofill-prediction="ADDRESS_HOME_STATE"
+>
+ <option value="NO_STATE_TYPE_SELECTED" selected="selected">* Select</option>
+ <option value="Aa">AA - Armed Forces America</option>
+ <option value="Ae">AE - Armed Forces Europe</option>
+ <option value="AL">Alabama</option>
+ <option value="AK">Alaska</option>
+ <option value="Ap">AP - Armed Forces Pacific</option>
+ <option value="AZ">Arizona</option>
+ <option value="AR">Arkansas</option>
+ <option value="CA">California</option>
+ <option value="CO">Colorado</option>
+ <option value="CT">Connecticut</option>
+ <option value="DE">Delaware</option>
+ <option value="DC">District of Columbia</option>
+ <option value="FL">Florida</option>
+ <option value="GA">Georgia</option>
+ <option value="HI">Hawaii</option>
+ <option value="ID">Idaho</option>
+ <option value="IL">Illinois</option>
+ <option value="IN">Indiana</option>
+ <option value="IA">Iowa</option>
+ <option value="KS">Kansas</option>
+ <option value="KY">Kentucky</option>
+ <option value="LA">Louisiana</option>
+ <option value="ME">Maine</option>
+ <option value="MD">Maryland</option>
+ <option value="MA">Massachusetts</option>
+ <option value="MI">Michigan</option>
+ <option value="MN">Minnesota</option>
+ <option value="MS">Mississippi</option>
+ <option value="MO">Missouri</option>
+ <option value="MT">Montana</option>
+ <option value="NE">Nebraska</option>
+ <option value="NV">Nevada</option>
+ <option value="NH">New Hampshire</option>
+ <option value="NJ">New Jersey</option>
+ <option value="NM">New Mexico</option>
+ <option value="NY">New York</option>
+ <option value="NC">North Carolina</option>
+ <option value="ND">North Dakota</option>
+ <option value="OH">Ohio</option>
+ <option value="OK">Oklahoma</option>
+ <option value="OR">Oregon</option>
+ <option value="PA">Pennsylvania</option>
+ <option value="PR">Puerto Rico</option>
+ <option value="RI">Rhode Island</option>
+ <option value="SC">South Carolina</option>
+ <option value="SD">South Dakota</option>
+ <option value="TN">Tennessee</option>
+ <option value="TX">Texas</option>
+ <option value="UT">Utah</option>
+ <option value="VT">Vermont</option>
+ <option value="VA">Virginia</option>
+ <option value="WA">Washington</option>
+ <option value="WV">West Virginia</option>
+ <option value="WI">Wisconsin</option>
+ <option value="WY">Wyoming</option>
+ </select>
+ </div>
+ <div>
+ <label for="addressFormModalZip">ZIP / POSTAL CODE<span>*</span>
+</label>
+ <input id="addressFormModalZip" name="addressFormModalZip" type="text" maxlength="10"
+title="overall type: ADDRESS_HOME_ZIP
+ server type: ADDRESS_HOME_ZIP
+ heuristic type: ADDRESS_HOME_ZIP
+ label: ZIP / POSTAL CODE*
+ parseable name: addressFormModalZip
+ field signature: 2383002781
+ form signature: 8397269939060577503"
+autofill-prediction="ADDRESS_HOME_ZIP"
+>
+ </div>
+ </div>
+ <div id="phoneNumber">
+ <label for="addressFormModalPhoneNumber">PHONE NUMBER<span>*</span>
+</label>
+ <input id="addressFormModalPhoneNumber" name="addressFormModalPhoneNumber" type="text" maxlength="32"
+title="overall type: PHONE_HOME_CITY_AND_NUMBER
+ server type: PHONE_HOME_CITY_AND_NUMBER
+ heuristic type: PHONE_HOME_WHOLE_NUMBER
+ label: PHONE NUMBER*
+ parseable name: addressFormModalPhoneNumber
+ field signature: 1884423068
+ form signature: 8397269939060577503"
+autofill-prediction="PHONE_HOME_CITY_AND_NUMBER"
+>
+ </div>
+ <div id="email">
+ <label for="addressFormModalEmail" id="addressFormModalEmailLabel">EMAIL<span>*</span>
+</label>
+ <input id="addressFormModalEmail" name="addressFormModalEmail" type="text" maxlength="40"
+title="overall type: EMAIL_ADDRESS
+ server type: EMAIL_ADDRESS
+ heuristic type: EMAIL_ADDRESS
+ label: EMAIL*
+ parseable name: addressFormModalEmail
+ field signature: 1977954575
+ form signature: 8397269939060577503"
+autofill-prediction="EMAIL_ADDRESS"
+>
+ </div>
+ <div id="addressNickname">
+ <label for="addressFormModalAddressNickName">ADDRESS NICKNAME<span>*</span>
+ <span>&nbsp;<span>?</span>
+</span>
+ <span>The Address Nickname is a short name you create to help you easily identify this address within your address book.</span>
+ </label>
+ <input id="addressFormModalAddressNickName" name="addressFormModalAddressNickName" type="text" maxlength="35" placeholder="Holly at school, Mom, etc."
+title="overall type: ADDRESS_HOME_STREET_ADDRESS
+ server type: ADDRESS_HOME_STREET_ADDRESS
+ heuristic type: UNKNOWN_TYPE
+ label: ADDRESS NICKNAME* The Address Nickname is a short name you create to help you easily identify this a
+ parseable name: addressFormModalAddressNickName
+ field signature: 605446661
+ form signature: 8397269939060577503"
+autofill-prediction="ADDRESS_HOME_STREET_ADDRESS"
+>
+ </div>
+ <div>
+ <input name="saveAddressCheckbox" id="saveAddressCheckbox" type="checkbox"
+title="overall type: UNKNOWN_TYPE
+ server type: NO_SERVER_DATA
+ heuristic type: UNKNOWN_TYPE
+ label: Add to address book.
+ parseable name: saveAddressCheckbox
+ field signature: 784127875
+ form signature: 8397269939060577503"
+autofill-prediction="UNKNOWN_TYPE"
+>
+ <label for="saveAddressCheckbox">Add to address book. </label>
+ </div>
+ <div>
+ <input name="setDefaultCheckbox" id="setDefaultCheckbox" type="checkbox" disabled="true"
+title="overall type: UNKNOWN_TYPE
+ server type: NO_SERVER_DATA
+ heuristic type: UNKNOWN_TYPE
+ label: Save as default shipping address in Address Book
+ parseable name: setDefaultCheckbox
+ field signature: 1479095059
+ form signature: 8397269939060577503"
+autofill-prediction="UNKNOWN_TYPE"
+>
+ <label for="setDefaultCheckbox" id="setDefaultCheckboxModalLabel">Save as default billing address in Address Book</label>
+ </div>
+ </div>
+ </form>
+ <form id="AddressFormInline-Form" name="AddressFormInline-Form" autocomplete="on" method="post">
+ <div>
+ <input type="hidden" name="addressType" value="B">
+ <p id="addressFormInlineRequired" tabindex="-1">
+<span>*</span> Required fields</p>
+ <div id="personName">
+ <div>
+ <label for="addressFormInlineFirstName">FIRST NAME<span>*</span>
+</label>
+ <div>
+ <input id="addressFormInlineFirstName" name="addressFormInlineFirstName"
+title="overall type: NAME_FIRST
+ server type: NAME_FIRST
+ heuristic type: NAME_FIRST
+ label: FIRST NAME*
+ parseable name: addressFormInlineFirstName
+ field signature: 3938958812
+ form signature: 16870043504464996221" type="text" maxlength="40"
+autofill-prediction="NAME_FIRST"
+>
+ </div>
+ </div>
+ <div>
+ <label for="addressFormInlineMiddleInitial">M.I.</label>
+ <div>
+ <input id="addressFormInlineMiddleInitial" name="addressFormInlineMiddleInitial"
+title="overall type: NAME_MIDDLE_INITIAL
+ server type: NAME_MIDDLE_INITIAL
+ heuristic type: NAME_MIDDLE_INITIAL
+ label: M.I.
+ parseable name: addressFormInlineMiddleInitial
+ field signature: 3429701181
+ form signature: 16870043504464996221" type="text" maxlength="1"
+autofill-prediction="NAME_MIDDLE_INITIAL"
+>
+ </div>
+ </div>
+ <div>
+ <label for="addressFormInlineLastName">LAST NAME<span>*</span>
+</label>
+ <div>
+ <input id="addressFormInlineLastName" name="addressFormInlineLastName"
+title="overall type: NAME_LAST
+ server type: NAME_LAST
+ heuristic type: NAME_LAST
+ label: LAST NAME*
+ parseable name: addressFormInlineLastName
+ field signature: 2108416564
+ form signature: 16870043504464996221" type="text" maxlength="40"
+autofill-prediction="NAME_LAST"
+>
+ </div>
+ </div>
+ </div>
+ <div id="city">
+ <label for="addressFormInlineCompany">COMPANY NAME</label>
+ <div>
+ <input id="addressFormInlineCompany" name="addressFormInlineCompany" type="text" maxlength="40"
+title="overall type: COMPANY_NAME
+ server type: COMPANY_NAME
+ heuristic type: COMPANY_NAME
+ label: COMPANY NAME
+ parseable name: addressFormInlineCompany
+ field signature: 4087238350
+ form signature: 16870043504464996221"
+autofill-prediction="COMPANY_NAME"
+>
+ </div>
+ </div>
+ <div>
+ <label for="addressFormInlineCountry">COUNTRY<span>*</span>
+</label>
+ <div>
+ <select id="addressFormInlineCountry" name="addressFormInlineCountry"
+title="overall type: ADDRESS_HOME_COUNTRY
+ server type: ADDRESS_HOME_COUNTRY
+ heuristic type: ADDRESS_HOME_COUNTRY
+ label: COUNTRY*
+ parseable name: addressFormInlineCountry
+ field signature: 695762362
+ form signature: 16870043504464996221"
+autofill-prediction="ADDRESS_HOME_COUNTRY"
+>
+ <option value="CA">Canada</option>
+ <option value="US">United States</option>
+ </select>
+ </div>
+ </div>
+ <div id="streetAddress">
+ <legend>
+ <label for="addressFormInlineAddressLine1">STREET ADDRESS<span>*</span>
+</label>
+ </legend>
+ <div>
+ <input id="addressFormInlineAddressLine1" name="addressFormInlineAddressLine1" placeholder="Address Line 1" type="text" maxlength="30"
+title="overall type: ADDRESS_HOME_LINE1
+ server type: ADDRESS_HOME_LINE1
+ heuristic type: ADDRESS_HOME_LINE1
+ label: STREET ADDRESS*
+ parseable name: addressFormInlineAddressLine1
+ field signature: 1040409778
+ form signature: 16870043504464996221"
+autofill-prediction="ADDRESS_HOME_LINE1"
+>
+ </div>
+ <input id="addressFormInlineAddressLine2" name="addressFormInlineAddressLine2" placeholder="Address Line 2" type="text" maxlength="30"
+title="overall type: ADDRESS_HOME_LINE2
+ server type: ADDRESS_HOME_LINE2
+ heuristic type: ADDRESS_HOME_LINE2
+ label: Address Line 2
+ parseable name: addressFormInlineAddressLine2
+ field signature: 1640842807
+ form signature: 16870043504464996221"
+autofill-prediction="ADDRESS_HOME_LINE2"
+>
+ </div>
+ <div id="city">
+ <label for="addressFormInlineCity">CITY<span>*</span>
+</label>
+ <div>
+ <input id="addressFormInlineCity" name="addressFormInlineCity" type="text" maxlength="40"
+title="overall type: ADDRESS_HOME_CITY
+ server type: ADDRESS_HOME_CITY
+ heuristic type: ADDRESS_HOME_CITY
+ label: CITY*
+ parseable name: addressFormInlineCity
+ field signature: 2829321141
+ form signature: 16870043504464996221"
+autofill-prediction="ADDRESS_HOME_CITY"
+>
+ </div>
+ </div>
+ <div id="state">
+ <div>
+ <label for="addressFormInlineState">STATE / PROVINCE<span>*</span>
+</label>
+ <div>
+ <select id="addressFormInlineState" name="addressFormInlineState"
+title="overall type: ADDRESS_HOME_STATE
+ server type: ADDRESS_HOME_STATE
+ heuristic type: ADDRESS_HOME_STATE
+ label: STATE / PROVINCE*
+ parseable name: addressFormInlineState
+ field signature: 3295167441
+ form signature: 16870043504464996221"
+autofill-prediction="ADDRESS_HOME_STATE"
+>
+ <option value="NO_STATE_TYPE_SELECTED" selected="selected">* Select</option>
+ <option value="Aa">AA - Armed Forces America</option>
+ <option value="Ae">AE - Armed Forces Europe</option>
+ <option value="AL">Alabama</option>
+ <option value="AK">Alaska</option>
+ <option value="Ap">AP - Armed Forces Pacific</option>
+ <option value="AZ">Arizona</option>
+ <option value="AR">Arkansas</option>
+ <option value="CA">California</option>
+ <option value="CO">Colorado</option>
+ <option value="CT">Connecticut</option>
+ <option value="DE">Delaware</option>
+ <option value="DC">District of Columbia</option>
+ <option value="FL">Florida</option>
+ <option value="GA">Georgia</option>
+ <option value="HI">Hawaii</option>
+ <option value="ID">Idaho</option>
+ <option value="IL">Illinois</option>
+ <option value="IN">Indiana</option>
+ <option value="IA">Iowa</option>
+ <option value="KS">Kansas</option>
+ <option value="KY">Kentucky</option>
+ <option value="LA">Louisiana</option>
+ <option value="ME">Maine</option>
+ <option value="MD">Maryland</option>
+ <option value="MA">Massachusetts</option>
+ <option value="MI">Michigan</option>
+ <option value="MN">Minnesota</option>
+ <option value="MS">Mississippi</option>
+ <option value="MO">Missouri</option>
+ <option value="MT">Montana</option>
+ <option value="NE">Nebraska</option>
+ <option value="NV">Nevada</option>
+ <option value="NH">New Hampshire</option>
+ <option value="NJ">New Jersey</option>
+ <option value="NM">New Mexico</option>
+ <option value="NY">New York</option>
+ <option value="NC">North Carolina</option>
+ <option value="ND">North Dakota</option>
+ <option value="OH">Ohio</option>
+ <option value="OK">Oklahoma</option>
+ <option value="OR">Oregon</option>
+ <option value="PA">Pennsylvania</option>
+ <option value="PR">Puerto Rico</option>
+ <option value="RI">Rhode Island</option>
+ <option value="SC">South Carolina</option>
+ <option value="SD">South Dakota</option>
+ <option value="TN">Tennessee</option>
+ <option value="TX">Texas</option>
+ <option value="UT">Utah</option>
+ <option value="VT">Vermont</option>
+ <option value="VA">Virginia</option>
+ <option value="WA">Washington</option>
+ <option value="WV">West Virginia</option>
+ <option value="WI">Wisconsin</option>
+ <option value="WY">Wyoming</option>
+ </select>
+ </div>
+ </div>
+ <div>
+ <label for="addressFormInlineZip">ZIP / POSTAL CODE<span>*</span>
+</label>
+ <div>
+ <input id="addressFormInlineZip" name="addressFormInlineZip" type="text" maxlength="10"
+title="overall type: ADDRESS_HOME_ZIP
+ server type: ADDRESS_HOME_ZIP
+ heuristic type: ADDRESS_HOME_ZIP
+ label: ZIP / POSTAL CODE*
+ parseable name: addressFormInlineZip
+ field signature: 3060672026
+ form signature: 16870043504464996221"
+autofill-prediction="ADDRESS_HOME_ZIP"
+>
+ </div>
+ </div>
+ </div>
+ <div id="phoneNumber">
+ <label for="addressFormInlinePhoneNumber">PHONE NUMBER<span>*</span>
+</label>
+ <div>
+ <input id="addressFormInlinePhoneNumber" name="addressFormInlinePhoneNumber" type="text" maxlength="32"
+title="overall type: PHONE_HOME_CITY_AND_NUMBER
+ server type: PHONE_HOME_CITY_AND_NUMBER
+ heuristic type: PHONE_HOME_WHOLE_NUMBER
+ label: PHONE NUMBER*
+ parseable name: addressFormInlinePhoneNumber
+ field signature: 1198968276
+ form signature: 16870043504464996221"
+autofill-prediction="PHONE_HOME_CITY_AND_NUMBER"
+>
+ </div>
+ </div>
+ <div id="email">
+ <label for="addressFormInlineEmail" id="addressFormInlineEmailLabel">EMAIL<span>*</span>
+</label>
+ <div>
+ <input id="addressFormInlineEmail" name="addressFormInlineEmail" type="text" maxlength="40" value=""
+title="overall type: EMAIL_ADDRESS
+ server type: EMAIL_ADDRESS
+ heuristic type: EMAIL_ADDRESS
+ label: EMAIL*
+ parseable name: addressFormInlineEmail
+ field signature: 2460631353
+ form signature: 16870043504464996221"
+autofill-prediction="EMAIL_ADDRESS"
+>
+ </div>
+ </div>
+ <div id="addressNickname">
+ <label for="addressFormInlineAddressNickName">ADDRESS NICKNAME<span>*</span>
+<span>&nbsp;<span>?</span>
+</span>
+<span>The Address Nickname is a short name you create to help you easily identify this address within your address book.</span>
+</label>
+ <div>
+ <input id="addressFormInlineAddressNickName" name="addressFormInlineAddressNickName" type="text" maxlength="35" placeholder="Holly at school, Mom, etc."
+title="overall type: UNKNOWN_TYPE
+ server type: NO_SERVER_DATA
+ heuristic type: UNKNOWN_TYPE
+ label: ADDRESS NICKNAME* The Address Nickname is a short name you create to help you easily identify this a
+ parseable name: addressFormInlineAddressNickName
+ field signature: 2948011243
+ form signature: 16870043504464996221"
+autofill-prediction="UNKNOWN_TYPE"
+>
+ </div>
+ </div>
+ <div>
+ <input name="saveAddressCheckboxInline" id="saveAddressCheckboxInline" type="checkbox"
+title="overall type: UNKNOWN_TYPE
+ server type: NO_SERVER_DATA
+ heuristic type: UNKNOWN_TYPE
+ label: Add to address book.
+ parseable name: saveAddressCheckboxInline
+ field signature: 3323717546
+ form signature: 16870043504464996221"
+autofill-prediction="UNKNOWN_TYPE" checked="checked"
+>
+ <label for="saveAddressCheckboxInline">Add to address book. </label>
+ </div>
+ <div>
+ <input name="setDefaultCheckboxInline" id="setDefaultCheckboxInline" type="checkbox"
+title="overall type: UNKNOWN_TYPE
+ server type: NO_SERVER_DATA
+ heuristic type: UNKNOWN_TYPE
+ label: Save as default shipping address in Address Book
+ parseable name: setDefaultCheckboxInline
+ field signature: 2923970107
+ form signature: 16870043504464996221"
+autofill-prediction="UNKNOWN_TYPE"
+>
+ <label for="setDefaultCheckboxInline" id="setDefaultCheckboxInlineLabel">Save as default billing address in Address Book</label>
+ </div>
+ <div id="defaultAddressChangeInline">
+ <div id="WC_ContentAreaESpot_div_1_rx-DefaultAddrConfirm">
+ <div id="WC_ContentAreaESpot_div_2_rx-DefaultAddrConfirm">[rx-DefaultAddrConfirm]</div>
+ <div>
+ <ul>
+ <li value="1">
+ You are changing your Costco Default Shipping Address. &nbsp;All future orders from Costco.com, including Pharmacy Prescription Orders, will be sent to this Address.
+ </li>
+ </ul>
+ </div>
+ </div>
+ </div>
+ <div id="button-container">
+ <div>
+ <div>
+ <button id="addressFormInlineButton" type="button">
+<span>
+<span>Save Address</span>
+</span>
+</button>
+ </div>
+ </div>
+ </div>
+ </div>
+ </form>
+ <div id="footer-find-warehouse-block">
+ <label for="footer-search-field">Find a Warehouse</label>
+ <form id="WarehouseSearchForm" action="https://www.costco.com/warehouse-locations" novalidate="novalidate">
+ <div>
+ <input id="footer-search-field" type="search" name="location" tabindex="1" placeholder="City, state or zip" value=""
+title="Search">
+ <input type="submit" id="searchClear" value="Clear">
+ <input type="hidden" id="fromWLocSubmit" name="fromWLocSubmit" value="true">
+ <input type="hidden" id="numOfWarehouses" name="numOfWarehouses" value="10">
+ </div>
+ </form>
+ </div>
+ <div id="footer-email-offers-block">
+ <label for="footer-email-offers">Get Email Offers</label>
+ <form
+title="" action="https://www.costco.com/EmailSubscription" id="EmailOffersForm">
+ <div>
+ <input type="text" name="emailSignUp" id="footer-email-offers" placeholder="Enter your email">
+ <span>
+ <button type="submit" alt="Go">Go</button>
+ </span>
+ </div>
+ </form>
+ </div>
+ <input type="hidden" name="typeAheadDisabled" id="typeAheadDisabled" value="false">
+ </body>
+</html>