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mutual-service-test.vtl-lab.com Open in urlscan Pro
47.241.192.149  Public Scan

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URL: https://mutual-service-test.vtl-lab.com/
Submission: On September 13 via automatic, source certstream-suspicious — Scanned from SG

Form analysis 1 forms found in the DOM

<form class="container-sm mt-4">
  <h3 class="h3 my-3">Mutual Service PDF Download</h3>
  <div class="row mb-3 mw-">
    <div class="col"><input class="form-control" type="text" name="certHolder" placeholder="Certificate Holder" value=""></div>
  </div>
  <div class="row mb-3">
    <div class="col"><input class="form-control" type="text" name="insurePerson" placeholder="Insured Person" value=""></div>
  </div>
  <div class="row mb-3">
    <div class="col"><input class="form-control" type="text" name="sex" placeholder="Sex" value=""></div>
  </div>
  <div class="row mb-3">
    <div class="col"><input class="form-control" type="text" name="nationality" placeholder="Nationality" value=""></div>
  </div>
  <div class="row mb-3">
    <div class="col"><input class="form-control" type="text" name="period" placeholder="Period" value=""></div>
  </div>
  <div class="row mb-3">
    <div class="col"><input class="form-control" type="text" name="compensationAmount" placeholder="Compensation Amount" value=""></div>
  </div>
  <div class="row mb-3">
    <div class="col"><input class="form-control" type="text" name="premium" placeholder="Premium" value=""></div>
  </div>
  <div class="row">
    <div class="col"><button type="submit" class="btn btn-primary">Submit</button></div>
  </div>
</form>

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MUTUAL SERVICE PDF DOWNLOAD








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