www.pdaclientportal.com Open in urlscan Pro
66.128.63.175  Public Scan

Form analysis
2 forms found in the DOM

POST /Account/Login?redirectUrl=%2f

<form action="/Account/Login?redirectUrl=%2f" method="post">
  <div class="container">
    <div class="w-full max-w-xl mt-40 mx-auto text-center panel panel-default">
      <div class="panel-body">
        <div class="mb-16">
          <img src="/img/logo/AlacrityLogo_A.png" alt="Logo" style="height: 15rem;">
        </div>
        <div class="form-group">
          <input id="Password" name="Password" type="hidden" value="********">
          <label class="lblEmail mb-16" for="Username">Please enter your username or email</label>
          <div class="input-with-border-label">
            <sub>Username</sub>
            <input autofocus="true" class="form-control w-3/4 mx-auto" id="Username" maxlength="300" name="Username" type="text" value="">
          </div>
        </div>
        <div class="mb-16">
          <span class="text-small">Don't have an account?</span>
          <a href="/Main/Register.aspx">Register here!</a>
        </div>
        <div class="form-group mb-16">
          <input id="IsPasswordRequest" name="IsPasswordRequest" type="hidden" value="False">
          <button class="btn btn-primary px-16">Next</button>
        </div>
        <div class="mb-16">
          <a class="page-link" style="text-transform: uppercase; font-size: larger;" href="/Pay/Search">Pay Single Invoice</a><br>
          <small>Login to see and pay all of your invoices at once.</small><br>
        </div>
        <div class="text-danger font-bold">Trouble Logging in? Click <a href="#" data-id="sendJitBit" class="text-danger"><u>here</u></a> to submit a ticket.</div>
        <br>
        <div class="mb-16"> For additional assistance, please reach out to the Alacrity Client Service Center.<br> Phone: <a href="tel:+18008724732">(800) 872-4732</a><br> Fax: <a href="tel:+18008664732">(800) 866-4732</a><br> Email:
          <a href="mailto:csc_sas@alacritysolutions.com">csc_sas@alacritysolutions.com</a>
        </div>
      </div>
    </div>
  </div>
</form>

<form data-post="/Account/SendJitBitNoEmailReceived">
  <input type="text" class="hidden" name="payload">
  <div class="modal-header Modal_Head_FMS">
    <button class="close" data-dismiss="modal">×</button>
    <h4 class="modal-title">Submit Ticket</h4>
  </div>
  <div class="modal-body">
    <div class="">
      <div class="form-group row">
        <div class="col-md-6"> Name <input type="text" value="" class="form-control" name="name" required="">
        </div>
        <div class="col-md-6"> Company <input type="text" value="" class="form-control" name="company" required="">
        </div>
      </div>
      <div class="form-group row">
        <div class="col-md-6"> Phone <input type="text" value="" class="form-control" name="phone" required="">
        </div>
        <div class="col-md-6"> Email <input type="email" value="" class="form-control" name="email" required="">
        </div>
      </div>
    </div>
    <div> Please describe the issue (optional) <textarea name="notes" rows="5" class="form-control w-100"></textarea>
    </div>
  </div>
  <div class="modal-footer">
    <div class="text-right">
      <button type="submit" class="btn btn-primary">Submit</button>
      <button type="button" data-dismiss="modal" class="btn btn-primary">Close</button>
    </div>
  </div>
</form>

Text Content

Please enter your username or email
Username
Don't have an account? Register here!
Next
Pay Single Invoice
Login to see and pay all of your invoices at once.

Trouble Logging in? Click here to submit a ticket.

For additional assistance, please reach out to the Alacrity Client Service
Center.
Phone: (800) 872-4732
Fax: (800) 866-4732
Email: csc_sas@alacritysolutions.com
×

SUBMIT TICKET

Name
Company
Phone
Email
Please describe the issue (optional)
Submit Close