app.hatchbuck.com
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54.205.245.145
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Submitted URL: http://bmark.sdppayroll.com/api/LinkHandler/getaction?redirectParam2=K09weU5vMDBKWXB0WFFNOUdpSlJ5NGVkNnRzU0MzVjVPMVhFY1JpZCt...
Effective URL: https://app.hatchbuck.com/OnlineForm/722843135
Submission: On July 07 via api from US — Scanned from DE
Effective URL: https://app.hatchbuck.com/OnlineForm/722843135
Submission: On July 07 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
Name: form_722843135 — POST https://app.hatchbuck.com/onlineForm/submit.php
<form class="jotform-form" action="https://app.hatchbuck.com/onlineForm/submit.php" method="post" name="form_722843135" id="722843135" accept-charset="utf-8" novalidate="true"><input type="hidden" name="formID" value="722843135"><input type="hidden"
id="topRedirect" name="topRedirect" value="true">
<script type="text/javascript">
var currentURL = window.location.href.match(/topRedirect=([^&]*)/);
document.getElementById("topRedirect").value = (currentURL !== null ? currentURL[1] : true);
</script><input type="hidden" name="enableServerValidation" value="1"><input type="hidden" name="enable303Redirect" value="0">
<div class="form-all">
<ul class="form-section">
<li class="form-line" id="id_5">
<div id="cid_5" class="form-input-wide"> <img alt="" class="form-image" border="0" src="https://s3.amazonaws.com/s3.systematicrevenue.com/OnlineForm/uploads/5c99ef12233934985f9e1aea56bb4cf548af432de20742f25984c7af167115422a70148b.png"
height="200" width="600"> </div>
</li>
<li id="cid_8" class="form-input-wide">
<div class="form-header-group">
<h2 id="header_8" class="form-header">Pay Cards</h2>
</div>
</li>
<li class="form-line" id="id_9">
<div id="cid_9" class="form-input-wide">
<div id="text_9" class="form-html">
<p style="text-align: left;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Interested in learning more about our Paycard solution? </span></p>
<p style="text-align: left;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">FEATURES & BENEFITS:</span></p>
<ul style="list-style-type: disc;">
<li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">No cost to employer.</span></li>
<li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">No cost to cardholders to shop online, pay bills online, MasterCard transactions, and more.</span></li>
<li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Free ATM network (Allpoint).</span></li>
<li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Free mobile app with budgeting tool, ATM locator, bill pay, transaction history, suspend card feature plus other great resources.</span></li>
<li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Approximately two to fours weeks for set up.</span></li>
</ul>
<p style="text-align: left;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Simply complete the form below and get started with adding Paycards as a free benefit for your employees today! </span></p>
<p style="text-align: left;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">A member of our Southland Data Processing team will follow-up with you shortly.</span></p>
</div>
</div>
</li>
<li class="form-line" id="id_1"><label class="form-label-top" id="label_1" for="input_1"> First Name </label>
<div id="cid_1" class="form-input-wide"> <input type="text" class="form-textbox" id="input_1" name="q1_firstName1" size="51"> </div>
</li>
<li class="form-line" id="id_3"><label class="form-label-top" id="label_3" for="input_3"> Last Name </label>
<div id="cid_3" class="form-input-wide"> <input type="text" class="form-textbox" id="input_3" name="q3_lastName3" size="51"> </div>
</li>
<li class="form-line" id="id_7"><label class="form-label-top" id="label_7" for="input_7"> Company ID and Company Name(s) </label>
<div id="cid_7" class="form-input-wide"> <input type="text" class="form-textbox" id="input_7" name="q7_companyId" size="51"> </div>
</li>
<li class="form-line" id="id_10"><label class="form-label-top" id="label_10" for="input_10"> Phone Number<span class="form-required">*</span> </label>
<div id="cid_10" class="form-input-wide"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="tel" name="q10_phoneNumber10[area]" id="input_10_area" size="4"> - <label class="form-sub-label"
for="input_10_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="tel" name="q10_phoneNumber10[phone]" id="input_10_phone" size="14"> <label
class="form-sub-label" for="input_10_phone" id="sublabel_phone">Phone Number</label></span> </div>
</li>
<li class="form-line" id="id_4"><label class="form-label-top" id="label_4" for="input_4"> E-mail<span class="form-required">*</span> </label>
<div id="cid_4" class="form-input-wide"> <input type="email" class="form-textbox validate[required, Email]" id="input_4" name="q4_email" size="51" placeholder="ex: myname@example.com"> </div>
</li>
<li class="form-line" id="id_11"><label class="form-label-top" id="label_11" for="input_11"> Number of Employees </label>
<div id="cid_11" class="form-input-wide"> <input type="text" class="form-textbox" id="input_11" name="q11_customTextbox11" size="51"> </div>
</li>
<li class="form-line" id="id_12"><label class="form-label-top" id="label_12" for="input_12"> City </label>
<div id="cid_12" class="form-input-wide"> <input type="text" class="form-textbox" id="input_12" name="q12_city" size="51"> </div>
</li>
<li class="form-line" id="id_13"><label class="form-label-top" id="label_13" for="input_13"> State </label>
<div id="cid_13" class="form-input-wide"> <input type="text" class="form-textbox" id="input_13" name="q13_state" size="51"> </div>
</li>
<li class="form-line" id="id_14"><label class="form-label-top" id="label_14" for="input_14"> Notes, Questions, Etc. </label>
<div id="cid_14" class="form-input-wide"> <textarea style="font-family: inherit; font-size: inherit;" id="input_14" class="form-textarea" name="q14_notesQuestions14" cols="41" rows="6"></textarea> </div>
</li>
<li class="form-line" id="id_2">
<div id="cid_2" class="form-input-wide">
<div style="margin-left:156px" class="form-buttons-wrapper"><button id="input_2" type="submit" class="form-submit-button click to select" disabled="disabled" style="white-space:nowrap;">Submit Form</button></div>
</div>
</li>
<li style="display:none">Should be Empty: <input type="hidden" name="website" value=""></li>
</ul>
</div><input type="hidden" id="simple_spc" name="simple_spc" value="722843135-722843135">
<script type="text/javascript">
document.getElementById("si" + "mple" + "_spc").value = "722843135-722843135";
</script>
</form>Text Content
Form
*
* PAY CARDS
* Interested in learning more about our Paycard solution?
FEATURES & BENEFITS:
* No cost to employer.
* No cost to cardholders to shop online, pay bills online, MasterCard
transactions, and more.
* Free ATM network (Allpoint).
* Free mobile app with budgeting tool, ATM locator, bill pay, transaction
history, suspend card feature plus other great resources.
* Approximately two to fours weeks for set up.
Simply complete the form below and get started with adding Paycards as a free
benefit for your employees today!
A member of our Southland Data Processing team will follow-up with you
shortly.
* First Name
* Last Name
* Company ID and Company Name(s)
* Phone Number*
- Area Code Phone Number
* E-mail*
* Number of Employees
* City
* State
* Notes, Questions, Etc.
* Submit Form
* Should be Empty: