<script language="JavaScript" type="text/javascript">
 /* Mscaras ER */
function mascara(o,f){
    v_obj=o
    v_fun=f
    setTimeout("execmascara()",1)
}

function execmascara(){
    v_obj.value=v_fun(v_obj.value)
}

function mnum(v){
    v=v.replace(/\D/g,"")                    
    return v
}

function mcep(v){
    v=v.replace(/\D/g,"")                    
    v=v.replace(/^(\d{5})(\d)/,"$1$2")         
    return v
}
function mcpf(v){
    v=v.replace(/\D/g,"")                    
    v=v.replace(/^(\d{5})(\d)/,"$1$2")         
    return v
}

function mdata(v){
    v=v.replace(/\D/g,"");                    
    v=v.replace(/(\d{2})(\d)/,"$1-$2");       
    v=v.replace(/(\d{2})(\d)/,"$1-$2");       
                                             
    v=v.replace(/(\d{2})(\d{2})$/,"$1$2");
    return v;
}

function mvalor(v){
    v=v.replace(/\D/g,"");
    v=v.replace(/(\d)(\d{8})$/,"$1.$2");
    v=v.replace(/(\d)(\d{5})$/,"$1.$2");
        
    v=v.replace(/(\d)(\d{2})$/,"$1,$2");
    return v;
}
function mtel(v){
    v=v.replace(/\D/g,"");             //Remove tudo o que não é dígito
    v=v.replace(/^(\d{2})(\d)/g,"($1) $2"); //Coloca parênteses em volta dos dois primeiros dígitos
    v=v.replace(/(\d)(\d{4})$/,"$1-$2");    //Coloca hífen entre o quarto e o quinto dígitos
    return v;
}

//-->
</script><p>
<img src="https://socepel.com.br/wp-content/plugins/boleto-pag-seguro-direto/images/icon-128x128.png" width="128" height="128">
</p>
<form name="form1" action="https://socepel.com.br/?page_id=5294" method="post" >
<input type="hidden" id="nonce_boleto_pag_seguro_direto_form" name="nonce_boleto_pag_seguro_direto_form" value="152219d201" /><input type="hidden" name="_wp_http_referer" value="/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F5293" />
  <p>Valor</p>
  <p>
    <input name="valor"  onkeypress="mascara(this, mvalor);" type="text" id="valor" required>
  </p>
  
    
   <p>Vencimento: 1 a 30 dias. Ex.: 20-12-2018</p>
  <p>
    <input name="vencimento"  onkeypress="mascara(this, mdata);" type="text" id="vencimento" value="19-04-2026" maxlength="10" required>
  </p>
  
  
  <p>Nome</p>
  <p>
    <input name="nome" type="text" id="nome" required>
  </p>
  <p>E-mail</p>
  <p>
    <input name="email" type="text" id="email" required>
  </p>
  <p>CEP</p>
  <p> 
    <input name="cep" type="text" id="cep"  onkeypress="mascara(this, mcep);" maxlength="8" required>
  </p>
  <p>Telefone Celular</p>
  <p> 
    <input name="telefone" type="text" id="telefone" onkeypress="mascara(this, mtel);" maxlength="15" required>
  </p>
  <p>CPF</p>
  <p>
    <input name="cpf" type="text" id="cpf"  onkeypress="mascara(this, mcpf);" maxlength="11" required>
  </p>
  <p>Para gerar um carnê com vencimentos mensais sequenciais, informe o número de parcelas; ou deixe apenas 1</p>
 <p>Até 12</p>
    
  <p>
    <input name="parcelas" type="text"  onkeypress="mascara(this, mnum);" id="parcelas" value="1" maxlength="2" required>
  </p>
  <p><br>
   
    <input name="value1" type="text" id="value1" value="4" size="5" maxlength="1" readonly="true" >
    + 
    <input name="value2" type="text" id="value2" value="2" size="5" maxlength="1" readonly="true" > =
	
	<input name="value3" type="text" id="value3" value="" size="5" maxlength="2" required >
  </p>
  <p>
    <input type="submit" name="Submit" value="Continuar">
  </p>
</form>{"id":5293,"date":"2019-06-06T20:25:33","date_gmt":"2019-06-06T20:25:33","guid":{"rendered":"https:\/\/socepel.com.br\/?page_id=5293"},"modified":"2019-06-06T20:25:33","modified_gmt":"2019-06-06T20:25:33","slug":"form-dados-do-boleto","status":"publish","type":"page","link":"https:\/\/socepel.com.br\/?page_id=5293","title":{"rendered":"Boleto PagSeguro Direto"},"content":{"rendered":"\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":5,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-5293","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/socepel.com.br\/index.php?rest_route=\/wp\/v2\/pages\/5293","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/socepel.com.br\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/socepel.com.br\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/socepel.com.br\/index.php?rest_route=\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/socepel.com.br\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=5293"}],"version-history":[{"count":1,"href":"https:\/\/socepel.com.br\/index.php?rest_route=\/wp\/v2\/pages\/5293\/revisions"}],"predecessor-version":[{"id":5297,"href":"https:\/\/socepel.com.br\/index.php?rest_route=\/wp\/v2\/pages\/5293\/revisions\/5297"}],"wp:attachment":[{"href":"https:\/\/socepel.com.br\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=5293"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}