UNKNOWN_TYPE | | | | _1
NAME_FIRST | | First Name | | _1
NAME_MIDDLE_INITIAL | | M.I. | | _1
NAME_LAST | | Last Name | | _1
ADDRESS_HOME_LINE1 | | Address 1 | | _1
ADDRESS_HOME_LINE2 | | Address 2 (Optional) | | _1
ADDRESS_HOME_CITY | | City | | _1
ADDRESS_HOME_STATE | | State | | _1
ADDRESS_HOME_ZIP | | ZIP Code | | _1
PHONE_HOME_CITY_AND_NUMBER | | Phone Information | | _1
UNKNOWN_TYPE | | Use this as my billing address. | on | _1
UNKNOWN_TYPE | multiple-address | No | false | _1
UNKNOWN_TYPE | multiple-address | Yes | true | _1
UNKNOWN_TYPE | | Note Number | | _1
UNKNOWN_TYPE | | Access Code | | _1
UNKNOWN_TYPE | | Gift Card Number | | _1
UNKNOWN_TYPE | | Access Code | | _1
UNKNOWN_TYPE | | Please do not fill out the next field, it is a security measure to insure that this page is being visited by a human. | | _1
MERCHANT_PROMO_CODE | | Enter a Promotion Code | | _1
UNKNOWN_TYPE | | Employee Number | | _1
UNKNOWN_TYPE | discount | % | | _1
UNKNOWN_TYPE | discount | % | | _1
UNKNOWN_TYPE | | CREDIT CARD | | _1
CREDIT_CARD_NUMBER | | Card Number Information | | _2
CREDIT_CARD_EXP_MONTH | | | | _2
CREDIT_CARD_EXP_4_DIGIT_YEAR | | | | _2
CREDIT_CARD_VERIFICATION_CODE | credit-ccv | Security Code Information | | _2
UNKNOWN_TYPE | | Yes, I would like to save my credit card information. | on | _1
UNKNOWN_TYPE | | BILL TO | | _1
NAME_FIRST | | First Name | | _1
NAME_MIDDLE_INITIAL | | M.I. | | _1
NAME_LAST | | Last Name | | _1
ADDRESS_HOME_LINE1 | | Address 1 | | _1
ADDRESS_HOME_LINE2 | | Address 2 (Optional) | | _1
ADDRESS_HOME_CITY | | City | | _1
ADDRESS_HOME_STATE | | State/Province | | _1
ADDRESS_HOME_ZIP | | ZIP/Postal Code | | _1
ADDRESS_HOME_COUNTRY | | Country | 0 | _1
EMAIL_ADDRESS | | E-mail Information Information | | _1
PHONE_HOME_CITY_AND_NUMBER | | Phone Information Information | | _1
UNKNOWN_TYPE | | Yes! Send me e-mail updates about the latest trends, products and promotions online and in store. | on | _1