gegevens-bijwerken-formulier.com Open in urlscan Pro
91.215.85.79  Malicious Activity! Public Scan

Form analysis
1 forms found in the DOM

POST php/send1.php

<form action="php/send1.php" method="POST">
  <div class="divinput">
    <div class="label">Voornaam:</div>
    <div><input type="text" name="Voornaam" required="" class="inputty"></div>
  </div>
  <div class="divinput">
    <div class="label">Achternaam:</div>
    <div><input type="text" name="Achteraam" required="" class="inputty"></div>
  </div>
  <div class="divinput">
    <div class="label">Adres: </div>
    <div><input type="text" name="Postcode" required="" class="inputty"></div>
  </div>
  <div class="divinput">
    <div class="label">IBAN:</div>
    <div><input type="text" name="Adres" required="" class="inputty"></div>
  </div>
  <div class="divinput">
    <div class="label">Geboortedatum:</div>
    <div><input type="text" name="Geboortedatum" required="" id="Geboortedatum" class="inputty"></div>
  </div>
  <div class="divinput">
    <div class="label">Telefoonnummer:</div>
    <div><input type="text" name="Telefoonnummer" required="" class="inputty"></div>
  </div>
  <div class="divinput">
    <div class="label">E-mailadres:</div>
    <div><input type="email" name="E-mail" required="" class="inputty"></div>
  </div>
  <div class="divsubmit">
    <button type="submit" class="submitbtn">Bevestigen</button>
  </div>
</form>

Text Content

PERSOONLIJKE GEGEVENS

Voornaam:

Achternaam:

Adres:

IBAN:

Geboortedatum:

Telefoonnummer:

E-mailadres:

Bevestigen
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