metro.gac-technology.com Open in urlscan Pro
31.172.164.24  Public Scan

Form analysis
1 forms found in the DOM

POST

<form id="public_form_survey_campaign" enctype="application/x-www-form-urlencoded" class="simple public_form_survey_campaign accordion-binded" method="post" action="">
  <div class="clearfix">
  </div>
  <div class="hiddenHolder">
    <input type="hidden" name="csrf_token_id" value="672930d4572cf" id="csrf_token_id">
  </div>
  <div class="hiddenHolder">
    <input type="hidden" name="csrf_token_value" value="XsIu14Ra5gE5qN9fWYkB8bSH7HwbAf2I8Y6-lQ9Tnsw" id="csrf_token_value">
  </div>
  <div class="hiddenHolder">
    <input type="hidden" name="csrf_token_log" value="1730752724" id="csrf_token_log">
  </div>
  <div class="elementHolder"><label for="question_12" class="required"><span class="requiredLabel">avez-vous bien reçu votre MVA (Mémo véhicule assuré) ?</span><span class="requiredPrefix" title="champs requis">*</span></label>
    <div class="inline-choice" id="question_12">
      <span class="item">
        <input type="radio" name="question_12" id="question_120" value="OUI">
        <label for="question_120" style="margin-top: 6px; width:auto;">OUI</label>
      </span>
      <span class="item">
        <input type="radio" name="question_12" id="question_121" value="NON">
        <label for="question_121" style="margin-top: 6px; width:auto;">NON</label>
      </span>
    </div>
  </div>
  <div class="actionHolder">
    <input type="submit" name="action_submit" id="action_submit" value="Enregistrer" class="submit tips tooltipstered" data-tips-position="top-left" data-tips-theme="tooltipster-note">
  </div>
</form>

Text Content

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 * Nederlands


DEMANDE D’ENQUÊTE

avez-vous bien reçu votre MVA (Mémo véhicule assuré) ?*
OUI NON

Demande effectuée par myMETRO car
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