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<FORM ACTION="https://<SERVER-NAME>/charge/charge.cfm" METHOD="POST">
<INPUT TYPE="HIDDEN" NAME="BillNumber" VALUE="545000000000001">
<INPUT TYPE="HIDDEN" NAME="Merchant_ID" VALUE="Your Merchant_ID">
<INPUT TYPE="HIDDEN" NAME="Login" VALUE="Your login">
<INPUT TYPE="HIDDEN" NAME="Password" VALUE="Your password">
<INPUT TYPE="HIDDEN" NAME="Amount" VALUE="100">
<INPUT TYPE="HIDDEN" NAME="Currency" VALUE="BYN">
<INPUT TYPE="HIDDEN" NAME="Language" VALUE="0">
<INPUT TYPE="HIDDEN" NAME="Format" VALUE="3">
<INPUT TYPE="SUBMIT" NAME="Submit" VALUE="Execute">
</FORM>