<svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" width="393" height="852" viewBox="0 0 393 852"><g id="html1"><g data-tag="head" id="head1" data-z-index="auto" data-stacking-context="true" aria-owns="script1"><g data-tag="script" id="script1" data-z-index="auto" data-stacking-context="true"/></g><g data-tag="body" id="body1" data-z-index="auto" data-stacking-context="true" role="document" aria-owns="p1 style1"><g data-stacking-layer="rootBackgroundAndBorders"><rect width="393" height="842" x="0" y="0" fill="rgb(255, 255, 255)"/></g><g data-tag="p" id="p1" data-z-index="auto" data-stacking-context="true" aria-owns="Captcha"><g data-tag="input" id="Captcha" data-z-index="auto" data-stacking-context="true" aria-placeholder="Enter the numbers seen above" aria-labelledby="" mask="url(#mask-for-Captcha1)"><g data-stacking-layer="rootBackgroundAndBorders"><rect width="350" height="30" x="20" y="0" fill="rgb(255, 255, 255)" stroke="rgb(204, 204, 204)" stroke-width="1px" rx="4" ry="4"/></g><g data-stacking-layer="childStackingContextsWithNegativeStackLevels"/><g data-stacking-layer="inFlowNonInlineNonPositionedDescendants"/><g data-stacking-layer="nonPositionedFloats"/><g data-stacking-layer="inFlowInlineLevelNonPositionedDescendants"/><g data-stacking-layer="childStackingContextsWithStackLevelZeroAndPositionedDescendantsWithStackLevelZero"/><g data-stacking-layer="childStackingContextsWithPositiveStackLevels"/><mask id="mask-for-Captcha1"><rect width="350" height="30" x="20" y="0" fill="#ffffff"/></mask></g></g><g data-tag="style" id="style1" data-z-index="auto" data-stacking-context="true"/></g></g></svg>
<svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" width="834" height="1210" viewBox="0 0 834 1210"><g id="html1"><g data-tag="head" id="head1" data-z-index="auto" data-stacking-context="true" aria-owns="script1"><g data-tag="script" id="script1" data-z-index="auto" data-stacking-context="true"/></g><g data-tag="body" id="body1" data-z-index="auto" data-stacking-context="true" role="document" aria-owns="p1 style1"><g data-stacking-layer="rootBackgroundAndBorders"><rect width="834" height="1200" x="0" y="0" fill="rgb(255, 255, 255)"/></g><g data-tag="p" id="p1" data-z-index="auto" data-stacking-context="true" aria-owns="Captcha"><g data-tag="input" id="Captcha" data-z-index="auto" data-stacking-context="true" aria-placeholder="Enter the numbers seen above" aria-labelledby="" mask="url(#mask-for-Captcha1)"><g data-stacking-layer="rootBackgroundAndBorders"><rect width="350" height="30" x="0" y="0" fill="rgb(255, 255, 255)" stroke="rgb(204, 204, 204)" stroke-width="1px" rx="4" ry="4"/></g><g data-stacking-layer="childStackingContextsWithNegativeStackLevels"/><g data-stacking-layer="inFlowNonInlineNonPositionedDescendants"/><g data-stacking-layer="nonPositionedFloats"/><g data-stacking-layer="inFlowInlineLevelNonPositionedDescendants"/><g data-stacking-layer="childStackingContextsWithStackLevelZeroAndPositionedDescendantsWithStackLevelZero"/><g data-stacking-layer="childStackingContextsWithPositiveStackLevels"/><mask id="mask-for-Captcha1"><rect width="350" height="30" x="0" y="0" fill="#ffffff"/></mask></g></g><g data-tag="style" id="style1" data-z-index="auto" data-stacking-context="true"/></g></g></svg>
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<body><p><input id="Captcha" maxlength="7" name="Captcha" placeholder="Enter the numbers seen above" style="width:350px;height:30px;line-height:30px" type="text"></p></body>

<style>


input {
  margin: 0;
  font-size: 100%;
  vertical-align: middle;
}

input {
  *overflow: visible;
  line-height: normal;
}

input::-moz-focus-inner {
  padding: 0;
  border: 0;
}
@media print {
  * {
    text-shadow: none !important;
    color: #000 !important;
    background: transparent !important;
    box-shadow: none !important;
  }
  @page  {
    margin: 0.5cm;
  }
  p {
    orphans: 3;
    widows: 3;
  }
}
body {
  margin: 0;
  font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;
  font-size: 14px;
  line-height: 20px;
  color: #333333;
  background-color: #ffffff;
}
p {
  margin: 0 0 10px;
}

input {
  font-size: 14px;
  font-weight: normal;
  line-height: 20px;
}
input {
  font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;
}

input[type="text"] {
  display: inline-block;
  height: 20px;
  padding: 4px 6px;
  margin-bottom: 10px;
  font-size: 14px;
  line-height: 20px;
  color: #555555;
  -webkit-border-radius: 4px;
  -moz-border-radius: 4px;
  border-radius: 4px;
  vertical-align: middle;
}
input {
  width: 206px;
}

input[type="text"] {
  background-color: #ffffff;
  border: 1px solid #cccccc;
  -webkit-box-shadow: inset 0 1px 1px rgba(0, 0, 0, 0.075);
  -moz-box-shadow: inset 0 1px 1px rgba(0, 0, 0, 0.075);
  box-shadow: inset 0 1px 1px rgba(0, 0, 0, 0.075);
  -webkit-transition: border linear .2s, box-shadow linear .2s;
  -moz-transition: border linear .2s, box-shadow linear .2s;
  -o-transition: border linear .2s, box-shadow linear .2s;
  transition: border linear .2s, box-shadow linear .2s;
}

input[type="text"]:focus {
  border-color: rgba(82, 168, 236, 0.8);
  outline: 0;
  outline: thin dotted \9;
  

  -webkit-box-shadow: inset 0 1px 1px rgba(0,0,0,.075), 0 0 8px rgba(82,168,236,.6);
  -moz-box-shadow: inset 0 1px 1px rgba(0,0,0,.075), 0 0 8px rgba(82,168,236,.6);
  box-shadow: inset 0 1px 1px rgba(0,0,0,.075), 0 0 8px rgba(82,168,236,.6);
}
input:-moz-placeholder {
  color: #999999;
}
input:-ms-input-placeholder {
  color: #999999;
}
input::-webkit-input-placeholder {
  color: #999999;
}
input {
  margin-left: 0;
}
input:focus:invalid {
  color: #b94a48;
  border-color: #ee5f5b;
}
input:focus:invalid:focus {
  border-color: #e9322d;
  -webkit-box-shadow: 0 0 6px #f8b9b7;
  -moz-box-shadow: 0 0 6px #f8b9b7;
  box-shadow: 0 0 6px #f8b9b7;
}
@-webkit-keyframes progress-bar-stripes {
  from {
    background-position: 40px 0;
  }
  to {
    background-position: 0 0;
  }
}
@-moz-keyframes progress-bar-stripes {
  from {
    background-position: 40px 0;
  }
  to {
    background-position: 0 0;
  }
}
@-ms-keyframes progress-bar-stripes {
  from {
    background-position: 40px 0;
  }
  to {
    background-position: 0 0;
  }
}
@-o-keyframes progress-bar-stripes {
  from {
    background-position: 0 0;
  }
  to {
    background-position: 40px 0;
  }
}
@keyframes progress-bar-stripes {
  from {
    background-position: 40px 0;
  }
  to {
    background-position: 0 0;
  }
}
@-ms-viewport {
  width: device-width;
}
@media (max-width: 767px) {
  body {
    padding-left: 20px;
    padding-right: 20px;
  }
}
@media (min-width: 768px) and (max-width: 979px) {
  input {
    margin-left: 0;
  }
}
@media (min-width: 1200px) {
  input {
    margin-left: 0;
  }
}
@media (max-width: 979px) {
  body {
    padding-top: 0;
  }
}
    

</style>