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www.lifeinsurancesavings.com Open in urlscan Pro
2606:4700:20::681a:c85  Public Scan

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Submitted URL: http://track.durgonnews.com/go/vnKEztX3wgDIulA1mp2MIg2/
Effective URL: https://www.lifeinsurancesavings.com/final-expense/quote-form?sCode=VOMM&cid=t:emrg:c:0f79730923844f17b7faf3110a1ae552:ad::se:email:p...
Submission: On August 20 via manual from US — Scanned from US

Form analysis 1 forms found in the DOM

<form id="form1" tabindex="0" class="fields-container d-flex flex-column gap-3 my-5">
  <div class="fd-wrapper"><label>Month<select class="form-select " aria-label="Birth Month" name="month">
        <option value="" disabled="" selected="">Please select</option>
        <option value="1">January</option>
        <option value="2">February</option>
        <option value="3">March</option>
        <option value="4">April</option>
        <option value="5">May</option>
        <option value="6">June</option>
        <option value="7">July</option>
        <option value="8">August</option>
        <option value="9">September</option>
        <option value="10">October</option>
        <option value="11">November</option>
        <option value="12">December</option>
      </select>
      <div class="error-message"></div>
    </label><label>Day<select class="form-select " aria-label="Birth Day" name="day">
        <option value="" disabled="" selected="">Please select</option>
      </select>
      <div class="error-message"></div>
    </label><label>Year<input type="text" inputmode="numeric" class="form-control " placeholder="XXXX" aria-label="Birth Year" name="year" maxlength="4" value="">
      <div class="error-message"></div>
    </label></div><input type="submit" tabindex="-1">
</form>

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