primeunionltd.live Open in urlscan Pro
2a02:4780:a:1403:0:c09:19c0:5  Public Scan

Form analysis
2 forms found in the DOM

POST

<form action="" method="post" role="form" enctype="multipart/form-data" siq_id="autopick_2043">
  <div class="form-wizard-header">
    <a href="../index.php"> <img src="../assets/settings/batch-18---simple-shapes-2-high-resolution-logo-removebg-preview.png" class="navbar-logo" alt="logo" width="200"></a><br>
    <div id="google_translate_element">
      <div class="skiptranslate goog-te-gadget" dir="ltr" style="display: none;">
        <div id=":0.targetLanguage"><select class="goog-te-combo" aria-label="Language Translate Widget"></select></div>Powered by <span
          style="white-space:nowrap"><a class="VIpgJd-ZVi9od-l4eHX-hSRGPd" href="https://translate.google.com" target="_blank"><img src="https://www.gstatic.com/images/branding/googlelogo/1x/googlelogo_color_42x16dp.png" width="37px" height="14px" style="padding-right: 3px" alt="Google Translate">Translate</a></span>
      </div>
    </div>
    <script type="text/javascript">
      function googleTranslateElementInit() {
        new google.translate.TranslateElement({
          pageLanguage: 'en'
        }, 'google_translate_element');
      }
    </script>
    <script type="text/javascript" src="//translate.google.com/translate_a/element.js?cb=googleTranslateElementInit"></script>
    <p>Fill all form field to go next step</p>
    <ul class="list-unstyled form-wizard-steps clearfix">
      <li class="active"><span>1</span></li>
      <li><span>2</span></li>
      <li><span>3</span></li>
      <li><span><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="feather feather-check">
            <polyline points="20 6 9 17 4 12"></polyline>
          </svg></span></li>
    </ul>
  </div>
  <fieldset class="wizard-fieldset show">
    <h5>Personal Info</h5>
    <div class="row">
      <div class="col-md-6">
        <div class="form-group">
          <input type="text" class="form-control wizard-required" id="fname" name="firstname">
          <label for="fname" class="wizard-form-text-label">First Name*</label>
          <div class="wizard-form-error"></div>
        </div>
      </div>
      <div class="col-md-6">
        <div class="form-group">
          <input type="text" class="form-control wizard-required" id="lname" name="lastname">
          <label for="lname" class="wizard-form-text-label">Last Name*</label>
          <div class="wizard-form-error"></div>
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-md-6">
        <div class="form-group">
          <input type="text" class="form-control wizard-required" id="occupation" name="occupation">
          <label for="occupation" class="wizard-form-text-label">Occupation</label>
          <div class="wizard-form-error"></div>
        </div>
      </div>
      <div class="col-md-6">
        <div class="form-group">
          <select class="form-control" name="acct_currency" required="">
            <option selected="selected">Select Main Currency</option>
            <option value="USD">USD</option>
            <option value="EUR">EUROS</option>
            <option value="EUR">POUNDS</option>
          </select>
        </div>
      </div>
    </div>
    <div class="form-group"> Gender <div class="wizard-form-radio">
        <input name="radio-name" id="radio1" type="radio" value="male">
        <label for="radio1">Male</label>
      </div>
      <div class="wizard-form-radio">
        <input name="radio-name" id="radio2" type="radio" value="female">
        <label for="radio2">Female</label>
      </div>
    </div>
    <h5>Residential Address</h5>
    <div class="form-group">
      <input type="text" class="form-control wizard-required" id="address" name="address">
      <label for="address" class="wizard-form-text-label">Street Address*</label>
      <div class="wizard-form-error"></div>
    </div>
    <div class="row">
      <div class="col-md-6">
        <div class="form-group">
          <input type="text" class="form-control wizard-required" id="Suite" name="suite">
          <label for="Suite" class="wizard-form-text-label">Apt/Suite/Unit*</label>
          <div class="wizard-form-error"></div>
        </div>
      </div>
      <div class="col-md-6">
        <div class="form-group">
          <input type="text" class="form-control wizard-required" id="city" name="city">
          <label for="city" class="wizard-form-text-label">City*</label>
          <div class="wizard-form-error"></div>
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-md-6">
        <div class="form-group">
          <input type="text" class="form-control wizard-required" id="state" name="state">
          <label for="state" class="wizard-form-text-label">State*</label>
          <div class="wizard-form-error"></div>
        </div>
      </div>
      <div class="col-md-6">
        <div class="form-group">
          <input type="text" class="form-control wizard-required" id="zipcode" name="zipcode">
          <label for="zipcode" class="wizard-form-text-label">Zip Code*</label>
          <div class="wizard-form-error"></div>
        </div>
      </div>
      <div class="col-md-6">
        <div class="form-group">
          <select class="form-control" name="country" required="">
            <option selected="selected">Select Country</option>
            <option value="Afganistan">Afghanistan</option>
            <option value="Albania">Albania</option>
            <option value="Algeria">Algeria</option>
            <option value="American Samoa">American Samoa</option>
            <option value="Andorra">Andorra</option>
            <option value="Angola">Angola</option>
            <option value="Anguilla">Anguilla</option>
            <option value="Antigua &amp; Barbuda">Antigua &amp; Barbuda</option>
            <option value="Argentina">Argentina</option>
            <option value="Armenia">Armenia</option>
            <option value="Aruba">Aruba</option>
            <option value="Australia">Australia</option>
            <option value="Austria">Austria</option>
            <option value="Azerbaijan">Azerbaijan</option>
            <option value="Bahamas">Bahamas</option>
            <option value="Bahrain">Bahrain</option>
            <option value="Bangladesh">Bangladesh</option>
            <option value="Barbados">Barbados</option>
            <option value="Belarus">Belarus</option>
            <option value="Belgium">Belgium</option>
            <option value="Belize">Belize</option>
            <option value="Benin">Benin</option>
            <option value="Bermuda">Bermuda</option>
            <option value="Bhutan">Bhutan</option>
            <option value="Bolivia">Bolivia</option>
            <option value="Bonaire">Bonaire</option>
            <option value="Bosnia &amp; Herzegovina">Bosnia &amp; Herzegovina</option>
            <option value="Botswana">Botswana</option>
            <option value="Brazil">Brazil</option>
            <option value="British Indian Ocean Ter">British Indian Ocean Ter</option>
            <option value="Brunei">Brunei</option>
            <option value="Bulgaria">Bulgaria</option>
            <option value="Burkina Faso">Burkina Faso</option>
            <option value="Burundi">Burundi</option>
            <option value="Cambodia">Cambodia</option>
            <option value="Cameroon">Cameroon</option>
            <option value="Canada">Canada</option>
            <option value="Canary Islands">Canary Islands</option>
            <option value="Cape Verde">Cape Verde</option>
            <option value="Cayman Islands">Cayman Islands</option>
            <option value="Central African Republic">Central African Republic</option>
            <option value="Chad">Chad</option>
            <option value="Channel Islands">Channel Islands</option>
            <option value="Chile">Chile</option>
            <option value="China">China</option>
            <option value="Christmas Island">Christmas Island</option>
            <option value="Cocos Island">Cocos Island</option>
            <option value="Colombia">Colombia</option>
            <option value="Comoros">Comoros</option>
            <option value="Congo">Congo</option>
            <option value="Cook Islands">Cook Islands</option>
            <option value="Costa Rica">Costa Rica</option>
            <option value="Cote DIvoire">Cote DIvoire</option>
            <option value="Croatia">Croatia</option>
            <option value="Cuba">Cuba</option>
            <option value="Curaco">Curacao</option>
            <option value="Cyprus">Cyprus</option>
            <option value="Czech Republic">Czech Republic</option>
            <option value="Denmark">Denmark</option>
            <option value="Djibouti">Djibouti</option>
            <option value="Dominica">Dominica</option>
            <option value="Dominican Republic">Dominican Republic</option>
            <option value="East Timor">East Timor</option>
            <option value="Ecuador">Ecuador</option>
            <option value="Egypt">Egypt</option>
            <option value="El Salvador">El Salvador</option>
            <option value="Equatorial Guinea">Equatorial Guinea</option>
            <option value="Eritrea">Eritrea</option>
            <option value="Estonia">Estonia</option>
            <option value="Ethiopia">Ethiopia</option>
            <option value="Falkland Islands">Falkland Islands</option>
            <option value="Faroe Islands">Faroe Islands</option>
            <option value="Fiji">Fiji</option>
            <option value="Finland">Finland</option>
            <option value="France">France</option>
            <option value="French Guiana">French Guiana</option>
            <option value="French Polynesia">French Polynesia</option>
            <option value="French Southern Ter">French Southern Ter</option>
            <option value="Gabon">Gabon</option>
            <option value="Gambia">Gambia</option>
            <option value="Georgia">Georgia</option>
            <option value="Germany">Germany</option>
            <option value="Ghana">Ghana</option>
            <option value="Gibraltar">Gibraltar</option>
            <option value="Great Britain">Great Britain</option>
            <option value="Greece">Greece</option>
            <option value="Greenland">Greenland</option>
            <option value="Grenada">Grenada</option>
            <option value="Guadeloupe">Guadeloupe</option>
            <option value="Guam">Guam</option>
            <option value="Guatemala">Guatemala</option>
            <option value="Guinea">Guinea</option>
            <option value="Guyana">Guyana</option>
            <option value="Haiti">Haiti</option>
            <option value="Hawaii">Hawaii</option>
            <option value="Honduras">Honduras</option>
            <option value="Hong Kong">Hong Kong</option>
            <option value="Hungary">Hungary</option>
            <option value="Iceland">Iceland</option>
            <option value="Indonesia">Indonesia</option>
            <option value="India">India</option>
            <option value="Iran">Iran</option>
            <option value="Iraq">Iraq</option>
            <option value="Ireland">Ireland</option>
            <option value="Isle of Man">Isle of Man</option>
            <option value="Israel">Israel</option>
            <option value="Italy">Italy</option>
            <option value="Jamaica">Jamaica</option>
            <option value="Japan">Japan</option>
            <option value="Jordan">Jordan</option>
            <option value="Kazakhstan">Kazakhstan</option>
            <option value="Kenya">Kenya</option>
            <option value="Kiribati">Kiribati</option>
            <option value="Korea North">Korea North</option>
            <option value="Korea Sout">Korea South</option>
            <option value="Kuwait">Kuwait</option>
            <option value="Kyrgyzstan">Kyrgyzstan</option>
            <option value="Laos">Laos</option>
            <option value="Latvia">Latvia</option>
            <option value="Lebanon">Lebanon</option>
            <option value="Lesotho">Lesotho</option>
            <option value="Liberia">Liberia</option>
            <option value="Libya">Libya</option>
            <option value="Liechtenstein">Liechtenstein</option>
            <option value="Lithuania">Lithuania</option>
            <option value="Luxembourg">Luxembourg</option>
            <option value="Macau">Macau</option>
            <option value="Macedonia">Macedonia</option>
            <option value="Madagascar">Madagascar</option>
            <option value="Malaysia">Malaysia</option>
            <option value="Malawi">Malawi</option>
            <option value="Maldives">Maldives</option>
            <option value="Mali">Mali</option>
            <option value="Malta">Malta</option>
            <option value="Marshall Islands">Marshall Islands</option>
            <option value="Martinique">Martinique</option>
            <option value="Mauritania">Mauritania</option>
            <option value="Mauritius">Mauritius</option>
            <option value="Mayotte">Mayotte</option>
            <option value="Mexico">Mexico</option>
            <option value="Midway Islands">Midway Islands</option>
            <option value="Moldova">Moldova</option>
            <option value="Monaco">Monaco</option>
            <option value="Mongolia">Mongolia</option>
            <option value="Montserrat">Montserrat</option>
            <option value="Morocco">Morocco</option>
            <option value="Mozambique">Mozambique</option>
            <option value="Myanmar">Myanmar</option>
            <option value="Nambia">Nambia</option>
            <option value="Nauru">Nauru</option>
            <option value="Nepal">Nepal</option>
            <option value="Netherland Antilles">Netherland Antilles</option>
            <option value="Netherlands">Netherlands (Holland, Europe)</option>
            <option value="Nevis">Nevis</option>
            <option value="New Caledonia">New Caledonia</option>
            <option value="New Zealand">New Zealand</option>
            <option value="Nicaragua">Nicaragua</option>
            <option value="Niger">Niger</option>
            <option value="Nigeria">Nigeria</option>
            <option value="Niue">Niue</option>
            <option value="Norfolk Island">Norfolk Island</option>
            <option value="Norway">Norway</option>
            <option value="Oman">Oman</option>
            <option value="Pakistan">Pakistan</option>
            <option value="Palau Island">Palau Island</option>
            <option value="Palestine">Palestine</option>
            <option value="Panama">Panama</option>
            <option value="Papua New Guinea">Papua New Guinea</option>
            <option value="Paraguay">Paraguay</option>
            <option value="Peru">Peru</option>
            <option value="Phillipines">Philippines</option>
            <option value="Pitcairn Island">Pitcairn Island</option>
            <option value="Poland">Poland</option>
            <option value="Portugal">Portugal</option>
            <option value="Puerto Rico">Puerto Rico</option>
            <option value="Qatar">Qatar</option>
            <option value="Republic of Montenegro">Republic of Montenegro</option>
            <option value="Republic of Serbia">Republic of Serbia</option>
            <option value="Reunion">Reunion</option>
            <option value="Romania">Romania</option>
            <option value="Russia">Russia</option>
            <option value="Rwanda">Rwanda</option>
            <option value="St Barthelemy">St Barthelemy</option>
            <option value="St Eustatius">St Eustatius</option>
            <option value="St Helena">St Helena</option>
            <option value="St Kitts-Nevis">St Kitts-Nevis</option>
            <option value="St Lucia">St Lucia</option>
            <option value="St Maarten">St Maarten</option>
            <option value="St Pierre &amp; Miquelon">St Pierre &amp; Miquelon</option>
            <option value="St Vincent &amp; Grenadines">St Vincent &amp; Grenadines</option>
            <option value="Saipan">Saipan</option>
            <option value="Samoa">Samoa</option>
            <option value="Samoa American">Samoa American</option>
            <option value="San Marino">San Marino</option>
            <option value="Sao Tome &amp; Principe">Sao Tome &amp; Principe</option>
            <option value="Saudi Arabia">Saudi Arabia</option>
            <option value="Senegal">Senegal</option>
            <option value="Seychelles">Seychelles</option>
            <option value="Sierra Leone">Sierra Leone</option>
            <option value="Singapore">Singapore</option>
            <option value="Slovakia">Slovakia</option>
            <option value="Slovenia">Slovenia</option>
            <option value="Solomon Islands">Solomon Islands</option>
            <option value="Somalia">Somalia</option>
            <option value="South Africa">South Africa</option>
            <option value="Spain">Spain</option>
            <option value="Sri Lanka">Sri Lanka</option>
            <option value="Sudan">Sudan</option>
            <option value="Suriname">Suriname</option>
            <option value="Swaziland">Swaziland</option>
            <option value="Sweden">Sweden</option>
            <option value="Switzerland">Switzerland</option>
            <option value="Syria">Syria</option>
            <option value="Tahiti">Tahiti</option>
            <option value="Taiwan">Taiwan</option>
            <option value="Tajikistan">Tajikistan</option>
            <option value="Tanzania">Tanzania</option>
            <option value="Thailand">Thailand</option>
            <option value="Togo">Togo</option>
            <option value="Tokelau">Tokelau</option>
            <option value="Tonga">Tonga</option>
            <option value="Trinidad &amp; Tobago">Trinidad &amp; Tobago</option>
            <option value="Tunisia">Tunisia</option>
            <option value="Turkey">Turkey</option>
            <option value="Turkmenistan">Turkmenistan</option>
            <option value="Turks &amp; Caicos Is">Turks &amp; Caicos Is</option>
            <option value="Tuvalu">Tuvalu</option>
            <option value="Uganda">Uganda</option>
            <option value="United Kingdom">United Kingdom</option>
            <option value="Ukraine">Ukraine</option>
            <option value="United Arab Erimates">United Arab Emirates</option>
            <option value="United States of America">United States of America</option>
            <option value="Uraguay">Uruguay</option>
            <option value="Uzbekistan">Uzbekistan</option>
            <option value="Vanuatu">Vanuatu</option>
            <option value="Vatican City State">Vatican City State</option>
            <option value="Venezuela">Venezuela</option>
            <option value="Vietnam">Vietnam</option>
            <option value="Virgin Islands (Brit)">Virgin Islands (Brit)</option>
            <option value="Virgin Islands (USA)">Virgin Islands (USA)</option>
            <option value="Wake Island">Wake Island</option>
            <option value="Wallis &amp; Futana Is">Wallis &amp; Futana Is</option>
            <option value="Yemen">Yemen</option>
            <option value="Zaire">Zaire</option>
            <option value="Zambia">Zambia</option>
            <option value="Zimbabwe">Zimbabwe</option>
          </select>
        </div>
      </div>
    </div>
    <div class="form-group clearfix">
      <a href="javascript:;" class="form-wizard-next-btn float-right">Next</a>
    </div>
    <br>
    <a href="../login.php" class="forgot-pass-link"><b><u>CLICK TO LOGIN YOUR ACCOUNT</u></b></a>
  </fieldset>
  <fieldset class="wizard-fieldset">
    <h5>Create your login</h5>
    <div class="form-group">
      <input type="text" class="form-control wizard-required" id="email" name="acct_email">
      <label for="email" class="wizard-form-text-label">Email Address*</label>
      <div class="wizard-form-error"></div>
    </div>
    <div class="row">
      <div class="col-md-6">
        <div class="form-group">
          <input type="number" class="form-control wizard-required" placeholder="1234567890" id="phoneNumber" name="phoneNumber">
          <label for="phoneNumber" class="wizard-form-text-label">Phone Number* (Please do not enter the + in your number )</label>
          <div class="wizard-form-error"></div>
        </div>
      </div>
      <div class="col-md-6">
        <div class="form-group">
          <input type="text" class="form-control wizard-required" id="username" name="username">
          <input type="text" name="acct_pin" id="acct_pin" value="1234" hidden="">
          <label for="city" class="wizard-form-text-label">Username*</label>
          <div class="wizard-form-error"></div>
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-md-6">
        <div class="form-group">
          <input type="password" class="form-control wizard-required" id="pwd" name="acct_password">
          <label for="pwd" class="wizard-form-text-label">Password*</label>
          <div class="wizard-form-error"></div>
          <span class="wizard-password-eye"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round"
              class="feather feather-lock">
              <rect x="3" y="11" width="18" height="11" rx="2" ry="2"></rect>
              <path d="M7 11V7a5 5 0 0 1 10 0v4"></path>
            </svg></span>
        </div>
      </div>
      <div class="col-md-6">
        <div class="form-group">
          <input type="password" class="form-control wizard-required" id="confirmPassword" name="confirmPassword">
          <label for="confirmPassword" class="wizard-form-text-label">Confirm Password*</label>
          <div class="wizard-form-error"></div>
          <span class="wizard-password-eye"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round"
              class="feather feather-lock">
              <rect x="3" y="11" width="18" height="11" rx="2" ry="2"></rect>
              <path d="M7 11V7a5 5 0 0 1 10 0v4"></path>
            </svg></span>
        </div>
      </div>
    </div>
    <div class="form-group clearfix">
      <a href="javascript:;" class="form-wizard-previous-btn float-left">Previous</a>
      <a href="javascript:;" class="form-wizard-next-btn float-right">Next</a>
    </div>
  </fieldset>
  <fieldset class="wizard-fieldset">
    <h5>Verify your identity</h5>
    <p>We'er required by law to collect your Social Security Number / TIN.</p>
    <div id="Div1">
      <div class="container">
        <div class="row mb-3">
          <div class="col-md-2 mb-2">
            <svg xmlns="http://www.w3.org/2000/svg" width="40" height="40" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="feather feather-lock text-primary">
              <rect x="3" y="11" width="18" height="11" rx="2" ry="2"></rect>
              <path d="M7 11V7a5 5 0 0 1 10 0v4"></path>
            </svg>
          </div>
          <div class="col-md-10">
            <h6>Security in mind</h6> We use your SSN or TIN to help keep your account safe and secure.
          </div>
        </div>
        <div class="row mb-3">
          <div class="col-md-2 mb-3">
            <svg xmlns="http://www.w3.org/2000/svg" width="40" height="40" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="feather feather-credit-card text-primary">
              <rect x="1" y="4" width="22" height="16" rx="2" ry="2"></rect>
              <line x1="1" y1="10" x2="23" y2="10"></line>
            </svg>
          </div>
          <div class="col-md-10">
            <h6>Only for what you need</h6> Occasionally we'll need to provide you with tax documents, which require your SSN.
          </div>
        </div>
        <div class="row mb-3">
          <div class="col-md-2 mb-3">
            <svg xmlns="http://www.w3.org/2000/svg" width="40" height="40" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="feather feather-edit text-primary">
              <path d="M11 4H4a2 2 0 0 0-2 2v14a2 2 0 0 0 2 2h14a2 2 0 0 0 2-2v-7"></path>
              <path d="M18.5 2.5a2.121 2.121 0 0 1 3 3L12 15l-4 1 1-4 9.5-9.5z"></path>
            </svg>
          </div>
          <div class="col-md-10">
            <h6>No credit score impact</h6> Applying for Prime Union Account will never impact your credit score
          </div>
        </div>
      </div>
    </div>
    <div id="Div2">
      <div class="form-group">
        <input type="password" class="form-control wizard-required" id="ssn" name="ssn">
        <label for="ssn" class="wizard-form-text-label">Social Security Number / TIN*</label>
        <div class="wizard-form-error"></div>
        <span class="wizard-password-eye"><i class="far fa-eye"></i></span>
      </div>
      <div class="form-group">
        <input type="password" class="form-control wizard-required" id="confirm-ssn" name="confirm-ssn">
        <label for="confirm-ssn" class="wizard-form-text-label">Confirm SSN / TIN*</label>
        <div class="wizard-form-error"></div>
        <span class="wizard-password-eye"><i class="far fa-eye"></i></span>
      </div>
      <div class="form-group">
        <input type="date" class="form-control wizard-required" id="dob" name="dob">
        <label for="dob" class="wizard-form-text-label">Date of Birth*</label>
        <div class="wizard-form-error"></div>
        <span class="wizard-password-eye"><i class="far fa-eye"></i></span>
      </div>
    </div>
    <div class="form-group clearfix">
      <a href="javascript:;" class="form-wizard-previous-btn float-left">Previous</a>
      <a class="form-wizard-next-btn float-right" id="Button1" value="Click" onclick="switchVisible();">Next post</a>
      <a href="javascript:;" class="form-wizard-next-btn float-right" id="nextShow">Next time</a>
    </div>
  </fieldset>
  <fieldset class="wizard-fieldset text-white">
    <div class="mt-3">
      <div class="form-group">
        <label for="frontDoc">Upload Profile Image</label>
        <input class="form-control" type="file" name="profile_pic" id="frontDoc" required="">
      </div>
    </div>
    <div class="mt-3">
      <div class="form-group">
        <label for="frontDoc">ID CARD FRONT</label>
        <input class="form-control" type="file" name="frontID" id="frontDoc" required="">
      </div>
      <div class="form-group">
        <label for="">ID CARD BACK</label>
        <input class="form-control" type="file" name="backID" id="" required="">
      </div>
    </div>
    <div class="form-group clearfix">
      <a href="javascript:;" class="form-wizard-previous-btn float-left">Previous</a>
      <!--                            <a href="javascript:;" class="form-wizard-submit float-right">Submit</a>-->
      <button class="form-wizard-submit float-right btn btn-primary" type="submit" name="regSubmit">Submit</button>
    </div>
  </fieldset>
</form>

POST //translate.googleapis.com/translate_voting?client=te

<form id="goog-gt-votingForm" action="//translate.googleapis.com/translate_voting?client=te" method="post" target="votingFrame" class="VIpgJd-yAWNEb-hvhgNd-aXYTce" siq_id="autopick_4418"><input type="text" name="sl"
    id="goog-gt-votingInputSrcLang"><input type="text" name="tl" id="goog-gt-votingInputTrgLang"><input type="text" name="query" id="goog-gt-votingInputSrcText"><input type="text" name="gtrans" id="goog-gt-votingInputTrgText"><input type="text"
    name="vote" id="goog-gt-votingInputVote"></form>

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