restlesslegs-site.e-captain.nl Open in urlscan Pro
2001:4018:1000:52::ec:10  Public Scan

URL: https://restlesslegs-site.e-captain.nl/onlinebetalen/a881a9a938bddb0f0f6cbacc5e8c5c51
Submission: On August 25 via api from BE — Scanned from NL

Form analysis 1 forms found in the DOM

POST

<form action="" method="post">
  <div class="table-responsive">
    <table class="table table-striped table-hover">
      <thead>
        <tr>
          <th>Factuurnr.</th>
          <th>Fact. datum</th>
          <th style="text-align: right;">Totaal</th>
          <th style="text-align: right;">Openstaand</th>
        </tr>
      </thead>
      <tbody>
        <tr>
          <td style="text-align: left; ">202200541</td>
          <td style="text-align: left; ">25-08-2022</td>
          <td style="text-align: right; ">€ 25,00</td>
          <td style="text-align: right; "><span style="font-weight: bold;">€ 25,00</span></td>
          <td>
            <input type="checkbox" name="cb_3013" checked="">
          </td>
        </tr>
      </tbody>
    </table>
  </div>
  <div style="font-weight: bold;"> Totaal openstaand: € 25,00 </div>
  <br>
  <div style="float: left;"> Betaalwijze: </div>
  <div style="float: left;">
    <select name="psp_code" class="form-control" style="max-width: 300px;">
      <option value="0" selected="selected">iDeal</option>
    </select>
  </div> &nbsp;<button type="submit" id="btnafrekenen" name="btnafrekenen" class="btn btn-default " style="width: 100px">Betalen</button>
  <br><br>
  <img src="/inc/images/logo ideal25px.jpg" border="0" title="Via uw eigen bank met iDEAL">&nbsp;
</form>

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Factuurnr. Fact. datum Totaal Openstaand 202200541 25-08-2022 € 25,00 € 25,00

Totaal openstaand: € 25,00

Betaalwijze:
iDeal
 Betalen