170363 single web page / cc gateway

I need a small page and integrate it to Epoch/Paycomm Find the PDF attached for Epoch The page will be shown in an iframe 494wx389h I have 6 images of US bills, each will have a radio button next to it and the value will be that of the bill (One dollar bill = $1) There will be a field much like sales tax that will show the amount of the "radio item" x 1.177 and rounded UP to 2 decimal places. The 3rd item is the total of the radio item + the "tax" I want the 2 items above to update as the radio button is clicked via javascript "onclick" or however ... The submit button will then "post" to the gateway as per the PDF using only the "minimum" items they require (memberID, ProductID,TotalPrice) If you wanted to include a simple [login to view URL] that would be great but I can code that myself, if you do, just a simple echo of the vars received is good enough. Just to show it works.