<form method="post" action="https://payeer.com/merchant/">
<input type="hidden" name="m_shop" value="12345">
<input type="hidden" name="m_orderid" value="1">
<select name="m_amount">
<option value="5.00">5$</option>
<option value="10.00">10$</option>
<option value="15.00">15$</option>
<option value="20.00">20$</option>
<option value="25.00">25$</option>
<option value="50.00">50$</option>
<option value="100.00">100$</option>
</select>
<input type="hidden" name="m_curr" value="USD">
<input type="hidden" name="m_desc" value="RG9uYXRl">
<input type="hidden" name="m_sign" value="9F75D081884C7D659A2FEAA0C55AD015A3BF4F1B2B0B822CD15D6C15B0F00A08">
<input type="submit" name="m_process" value="send" />
</form>