invoicepay.billeriq.com Open in urlscan Pro
67.202.202.245  Public Scan

Form analysis
1 forms found in the DOM

POST /ebpp/FRANKWINNE/Login/PayAsGuest

<form id="guest-form" method="post" action="/ebpp/FRANKWINNE/Login/PayAsGuest" data-toggle="validator" autocomplete="off" novalidate="novalidate">
  <input name="__RequestVerificationToken" type="hidden" value="CDAbhTxfYRlgK-weMRM3rM2DMJsNFMXoRgyHQjUz6ynVp32QmxrLiWJFv2XOgM8MgB8Q_sykVcKZStEzzyXox_G3OyZ6s3__LibigZPeg4E1">
  <input name="BillerID" type="hidden" value="3416">
  <div class="popover-form-group">
    <label for="AccountNumber">Customer Number</label>
    <a class="popover-question-reference_number hidden-mobile" data-original-title="" title=""><i class="fa fa-lg fa-question-circle"></i></a>
    <a class="popover-question-reference_number hidden-desktop" data-original-title="" title=""><i class="fa fa-lg fa-question-circle"></i></a>
    <input autocomplete="off" class="form-control nopaste" data-fieldlabel="Customer Number" data-val="true" data-val-regex="Special characters are not allowed as input" data-val-regex-pattern="^[^\<]+$" id="AccountNumber" maxlength="18"
      minlength="4" name="AccountNumber" required="true" type="text" value="" aria-required="true">
    <span class="field-validation-valid" data-valmsg-for="AccountNumber" data-valmsg-replace="true"></span>
  </div>
  <div class="form-group">
    <label for="ConfirmAccountNumber">Confirm Customer Number</label>
    <input id="ConfirmAccountNumber" autocomplete="off" class="form-control nopaste" data-val="true" data-val-equalto="Both Customer Number entries must match." data-val-equalto-other="*.AccountNumber" name="ConfirmAccountNumber" required=""
      type="text" value="" data-fieldlabel="Customer" number="" aria-required="true">
    <span class="field-validation-valid" data-valmsg-for="ConfirmAccountNumber" data-valmsg-replace="true"></span>
  </div>
  <div class="row rl-desktop">
    <div class="col-md-12">
      <div class="actions form-inline">
        <button id="pay-now-button" class="btn btn-success m-mobile">Guest Payment</button>
      </div>
    </div>
  </div>
</form>

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Welcome to Frank Winne & Son, Inc.'s Online Payment Portal!
 * Guest Payment
 * Welcome to Frank Winne & Son, Inc.'s Online Payment Portal!


LOGIN SCREEN


Customer Number
Confirm Customer Number
Guest Payment

(USE ZEROS BEFORE CUSTOMER NUMBER WITH LESS THAN 4 DIGITS. EX. 0369)
Sample: please enter just the 5 digit zip code (not the full 9 digits).
Enter your password.
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