kracie-twittercp-2022.shuttlerock-form.com Open in urlscan Pro
63.32.161.232  Public Scan

URL: https://kracie-twittercp-2022.shuttlerock-form.com/
Submission Tags: @phishunt_io
Submission: On February 13 via api from DE — Scanned from DE

Form analysis 1 forms found in the DOM

POST /confirm

<form id="form" class="h-adr" novalidate="novalidate" action="/confirm" accept-charset="UTF-8" method="post"><input type="hidden" name="authenticity_token"
    value="3AEr70ZWcd6qaPZO/ZF5qQ0Lfhs68n5cwhKBQHibfpyvwEMdrbIJelbXg8fyKgCQ4hppzx2c6HnjzXAm3cYKbA==">
  <div class="row py-3 border-bottom">
    <div class="col-sm-3 text-start"><span class="fw-bold" id="label_field_458a6c43-8c76-4133-a7a4-289381429790">お名前</span><span class="text-danger">*</span></div>
    <div class="col-sm-9 position-relative"><input value="458a6c43-8c76-4133-a7a4-289381429790" type="hidden" name="response[responses_fields_attributes[][field_id]]" id="response_responses_fields_attributes[][field_id]"><input
        id="field_458a6c43-8c76-4133-a7a4-289381429790" class="form-control" placeholder="" required="required" maxlength="1024" size="1024" type="text" name="response[responses_fields_attributes[][value]]"></div>
  </div>
  <div class="row py-3 border-bottom">
    <div class="col-sm-3 text-start"><span class="fw-bold" id="label_field_48f1d058-2fa9-4406-bcd4-c1d5d67cca67">お電話番号</span><span class="text-danger">*</span><br><small>(ハイフンなしでご記入ください)</small></div>
    <div class="col-sm-9 position-relative"><input value="48f1d058-2fa9-4406-bcd4-c1d5d67cca67" type="hidden" name="response[responses_fields_attributes[][field_id]]" id="response_responses_fields_attributes[][field_id]"><input
        id="field_48f1d058-2fa9-4406-bcd4-c1d5d67cca67" class="form-control" placeholder="" required="required" maxlength="11" size="11" type="text" name="response[responses_fields_attributes[][value]]"></div>
  </div>
  <div class="row py-3 border-bottom">
    <div class="col-sm-3 text-start"><span class="fw-bold" id="label_field_4e0be31d-75c9-49c4-984b-6e06dbddf59d">郵便番号</span><span class="text-danger">*</span><br><small>(ハイフンなしでご記入ください)</small></div>
    <div class="col-sm-9 position-relative"><input value="4e0be31d-75c9-49c4-984b-6e06dbddf59d" type="hidden" name="response[responses_fields_attributes[][field_id]]" id="response_responses_fields_attributes[][field_id]"><input
        id="field_4e0be31d-75c9-49c4-984b-6e06dbddf59d" class="form-control" placeholder="" required="required" maxlength="8" size="8" type="text" name="response[responses_fields_attributes[][value]]"></div>
  </div>
  <div class="row py-3 border-bottom">
    <div class="col-sm-3 text-start"><span class="fw-bold" id="label_field_a6ea9e7c-3f67-4458-b7e2-084961dc75d9">都道府県</span><span class="text-danger">*</span></div>
    <div class="col-sm-9 position-relative"><input value="a6ea9e7c-3f67-4458-b7e2-084961dc75d9" type="hidden" name="response[responses_fields_attributes[][field_id]]" id="response_responses_fields_attributes[][field_id]"><input
        id="field_a6ea9e7c-3f67-4458-b7e2-084961dc75d9" class="form-control" placeholder="" required="required" maxlength="1024" size="1024" type="text" name="response[responses_fields_attributes[][value]]"></div>
  </div>
  <div class="row py-3 border-bottom">
    <div class="col-sm-3 text-start"><span class="fw-bold" id="label_field_769f9c41-fb9c-4f40-8dc7-6b884e891315">市区町村</span><span class="text-danger">*</span></div>
    <div class="col-sm-9 position-relative"><input value="769f9c41-fb9c-4f40-8dc7-6b884e891315" type="hidden" name="response[responses_fields_attributes[][field_id]]" id="response_responses_fields_attributes[][field_id]"><input
        id="field_769f9c41-fb9c-4f40-8dc7-6b884e891315" class="form-control" placeholder="" required="required" maxlength="1024" size="1024" type="text" name="response[responses_fields_attributes[][value]]"></div>
  </div>
  <div class="row py-3 border-bottom">
    <div class="col-sm-3 text-start"><span class="fw-bold" id="label_field_4c803bb4-635b-496e-9bc9-2e6917712a4d">番地</span><span class="text-danger">*</span></div>
    <div class="col-sm-9 position-relative"><input value="4c803bb4-635b-496e-9bc9-2e6917712a4d" type="hidden" name="response[responses_fields_attributes[][field_id]]" id="response_responses_fields_attributes[][field_id]"><input
        id="field_4c803bb4-635b-496e-9bc9-2e6917712a4d" class="form-control" placeholder="" required="required" maxlength="1024" size="1024" type="text" name="response[responses_fields_attributes[][value]]"></div>
  </div>
  <div class="row py-3 border-bottom">
    <div class="col-sm-3 text-start"><span class="fw-bold" id="label_field_51cda6c7-c8e9-45b9-8fe3-bd98c8aba725">建物名・部屋番号</span></div>
    <div class="col-sm-9 position-relative"><input value="51cda6c7-c8e9-45b9-8fe3-bd98c8aba725" type="hidden" name="response[responses_fields_attributes[][field_id]]" id="response_responses_fields_attributes[][field_id]"><input
        id="field_51cda6c7-c8e9-45b9-8fe3-bd98c8aba725" class="form-control" placeholder="" maxlength="1024" size="1024" type="text" name="response[responses_fields_attributes[][value]]"></div>
  </div>
  <div class="row py-3 border-bottom">
    <div class="col-sm-3 text-start"><span class="fw-bold" id="label_field_c538e0ab-d89b-408b-a9dd-6af3e8c2701f">Twitterユーザー名</span><span class="text-danger">*</span><br><small>(@は含まずご記入ください)</small></div>
    <div class="col-sm-9 position-relative"><input value="c538e0ab-d89b-408b-a9dd-6af3e8c2701f" type="hidden" name="response[responses_fields_attributes[][field_id]]" id="response_responses_fields_attributes[][field_id]"><input
        id="field_c538e0ab-d89b-408b-a9dd-6af3e8c2701f" class="form-control" placeholder="" required="required" maxlength="1024" size="1024" type="text" name="response[responses_fields_attributes[][value]]"></div>
  </div>
  <div class="terms ql-editor card mt-4 p-3 overflow-auto">
    <p><strong>個人情報の取り扱いについて</strong></p>
    <p>お客様からいただいた個人情報は、当企画の運営業務にのみ利用させていただきます。</p>
    <p>また、当該業務の委託に必要な範囲内で委託先に提供する場合を除き、</p>
    <p>個人情報をお客様の承認無く、第三者に提供することはありません。</p>
  </div>
  <div class="my-5 form-check d-flex justify-content-center">
    <div class="terms-checkbox"><label class="form-check"><input name="response[confirmation_term]" type="hidden" value="0"><input class="form-check-input" type="checkbox" value="1" name="response[confirmation_term]"
          id="response_confirmation_term">個人情報の取り扱いについて同意する</label>
      <div class="invalid-tooltip"></div>
    </div>
  </div>
  <div class="text-center"><input type="submit" name="commit" value="確認する" class="btn btn-dark px-5 py-3 rounded-pill" data-disable-with="確認する"></div>
</form>

Text Content

ご当選おめでとうございます !!

賞品発送のための必要情報を

ご入力いただくようお願い申し上げます。

お名前*

お電話番号*
(ハイフンなしでご記入ください)

郵便番号*
(ハイフンなしでご記入ください)

都道府県*

市区町村*

番地*

建物名・部屋番号

Twitterユーザー名*
(@は含まずご記入ください)


個人情報の取り扱いについて

お客様からいただいた個人情報は、当企画の運営業務にのみ利用させていただきます。

また、当該業務の委託に必要な範囲内で委託先に提供する場合を除き、

個人情報をお客様の承認無く、第三者に提供することはありません。

個人情報の取り扱いについて同意する