campaigns.icicibank.com
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2600:9000:2204:6200:18:d223:eac0:93a1
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Submitted URL: https://mdeal.in/c_k6dA6
Effective URL: https://campaigns.icicibank.com/credit-card/platinumCreditCard/index.html?utm_source=affiliate&utm_medium=email&utm_content=iP-C...
Submission: On August 06 via api from IN — Scanned from DE
Effective URL: https://campaigns.icicibank.com/credit-card/platinumCreditCard/index.html?utm_source=affiliate&utm_medium=email&utm_content=iP-C...
Submission: On August 06 via api from IN — Scanned from DE
Form analysis
1 forms found in the DOMName: wf-form-eligibility-form — POST
<form id="wf-form-eligibility-form" name="wf-form-eligibility-form" data-name="eligibility-form" method="post" class="eligibility-form" aria-label="eligibility-form" novalidate="novalidate">
<input id="uniqueToken" name="uniqueToken" value="" type="hidden">
<input id="Referrer" name="Referrer" value="" type="hidden">
<input id="SearchEngine" name="SearchEngine" value="affiliate" type="hidden">
<input id="adtype" name="adtype" value="email" type="hidden">
<input id="Keyword" name="Keyword" value="" type="hidden">
<input id="adgroup" name="adgroup" value="iP-CC_60d2f6f20873fd0f9412da45" type="hidden">
<input id="Campaign" name="Campaign" value="all" type="hidden">
<input id="CampaignKey" name="CampaignKey" type="hidden" value="">
<input id="gclid" name="gclid" type="hidden">
<input id="utm_info" name="utm_info" value="" type="hidden">
<input id="utm_lms" name="utm_lms" type="hidden" value="intmntz">
<input id="GA_PARAM" name="GA_PARAM" type="hidden">
<input id="ITM" name="ITM" type="hidden">
<input id="NTB_ID" name="NTB_ID" type="hidden">
<input id="FED_ID" name="FED_ID" type="hidden">
<input id="getFbpValue" name="getFbpValue" type="hidden" value="">
<input id="getFbcValue" name="getFbcValue" type="hidden" value="">
<input id="txtproduct" name="txtproduct" type="hidden" value="platinum-chip">
<input id="card" name="card" type="hidden" value="platinum-chip">
<input id="Is_acknowledged_IT" name="Is_acknowledged_IT" type="hidden" value="">
<input id="Is_Salary_Mode" name="Is_Salary_Mode" type="hidden" value="">
<input id="sendOtp" name="sendOtp" type="hidden" value="yes">
<input id="hdnuseragent" name="hdnuseragent" type="hidden" value="">
<input id="hdnLeadId" name="hdnLeadId" type="hidden" value="">
<input id="companyType" name="companyType" type="hidden" value="">
<input id="companyCategory" name="companyCategory" type="hidden" value="">
<div class="slick">
<div>
<div class="eligibility-form-fieldset">
<h2 class="text-h4 text-orange-500"> How do we get in touch? </h2>
<label for="name" class="field-label">Full Name</label><input type="text" class="input-text-field w-input" autocomplete="off" maxlength="256" name="name" data-name="name" placeholder="Enter name here" id="name"><label for="email_address"
class="field-label">Email Address</label><input type="email" class="input-text-field w-input" autocomplete="off" maxlength="256" name="email_address" data-name="email_address" placeholder="yourname@example.com" id="email_address"
list="email-options"><datalist id="email-options"></datalist><label for="city" class="field-label">select city</label><select id="city" name="city" data-name="city" autocomplete="off" class="input-select-field w-select">
<option value="">Select city...</option>
<option value="Delhi">Delhi</option>
<option value="Mumbai">Mumbai</option>
<option value="Chennai">Chennai</option>
<option value="Kolkata">Kolkata</option>
<option value="Bengaluru">Bengaluru</option>
<option value="Hyderabad">Hyderabad</option>
<option value="Ahmedabad">Ahmedabad</option>
<option value="Pune">Pune</option>
<option value="Other City">Other City</option>
</select>
<div class="spacer-8"></div>
<input type="text" class="input-text-field input-text-field--other-city w-input" maxlength="256" name="other_city" data-name="other_city" placeholder="Enter City Name" id="other_city" required=""><label for="pan_number"
class="field-label">PAN Card Number</label><input style="text-transform: uppercase" type="text" class="input-text-field w-input" autocomplete="off" maxlength="10" name="pan_number" data-name="pan_number" pattern="[a-zA-Z0-9]+"
placeholder="Enter PAN" id="pan_number">
</div>
</div>
<div>
<div class="eligibility-form-fieldset" id="employment_type">
<h2 class="text-h4 text-orange-500"> What is your Employment Type? </h2>
<div class="spacer-16"></div>
<div class="w-layout-grid form-options-grid">
<div class="radio-button-field-container">
<div data-questionnaire="salary" class="radio-button-field salaried">
<div class="w-embed">
<input type="radio" data-name="employment_type" id="salaried" name="employment_type" value="salaried" class="w-form-formradioinput w-radio-input" tabindex="0">
</div>
<div class="faux-input-radio">
<div class="faux-input-radio__dot"></div>
</div>
<div class="text-base">Salaried</div>
</div>
</div>
<div class="radio-button-field-container">
<div data-questionnaire="self" class="radio-button-field self">
<div class="w-embed">
<input type="radio" data-name="employment_type" id="salaried" name="employment_type" value="self-employed" class="w-form-formradioinput w-radio-input" tabindex="0">
</div>
<div class="faux-input-radio">
<div class="faux-input-radio__dot"></div>
</div>
<div class="text-base">Self - employed</div>
</div>
</div>
</div>
<div class="salary-questions">
<label for="salary" class="field-label">Salary (per month)</label>
<div class="range-values">
<div>₹0</div>
<div>₹3,00,000+</div>
</div>
<div class="w-embed">
<input type="range" min="0" max="300000" value="0" class="range-slider" step="5000">
<div class="spacer-16"></div>
<input type="text" value="0" maxlength="256" name="salary" data-name="salary" id="salary" class="input-text-field w-input inc" tabindex="0" readonly="">
</div>
<label for="company" class="field-label">company</label><input type="text" class="input-text-field w-input ui-autocomplete-input" autocomplete="off" maxlength="256" name="company" data-name="company" placeholder="Enter Company"
id="company">
</div>
<div class="self-questions">
<label for="salary" class="field-label">gross turnover last year</label>
<div class="range-values">
<div>₹0</div>
<div>₹1Cr. +</div>
</div>
<div class="w-embed">
<input type="range" min="0" max="10000000" value="0" class="range-slider" step="5000">
<div class="spacer-16"></div>
<input type="text" value="0" maxlength="256" name="gross_annual_income" data-name="gross_annual_income" id="gross-annual-income" class="input-text-field w-input inc" tabindex="0" readonly="" required="1">
</div>
<label for="itr_status" class="field-label">has your ITR been acknowledged by income tax department?</label><select id="itr_status" name="itr_status" data-name="itr_status" required="" autocomplete="off" class="input-select-field w-select">
<option value="yes">Yes</option>
<option value="no">No</option>
</select>
</div>
</div>
</div>
<div>
<div class="eligibility-form-fieldset">
<h2 class="text-h4 text-orange-500 text-center-copy"> Almost there! Do you have any account with ICICI Bank? </h2>
<div class="spacer-16"></div>
<div class="w-layout-grid form-options-grid">
<div class="radio-button-field-container">
<div class="radio-button-field">
<div class="w-embed">
<input type="radio" data-name="relationship_type" name="relationship_type" value="No Relationship" class="w-form-formradioinput w-radio-input" tabindex="0">
</div>
<div class="faux-input-radio">
<div class="faux-input-radio__dot"></div>
</div>
<div class="text-base">No Account</div>
</div>
</div>
<div class="radio-button-field-container">
<div class="radio-button-field">
<div class="w-embed">
<input type="radio" data-name="relationship_type" name="relationship_type" value="Salary Account" class="w-form-formradioinput w-radio-input" tabindex="0">
</div>
<div class="faux-input-radio">
<div class="faux-input-radio__dot"></div>
</div>
<div class="text-base">Salary Account</div>
</div>
</div>
<div class="radio-button-field-container">
<div class="radio-button-field">
<div class="w-embed">
<input type="radio" data-name="relationship_type" name="relationship_type" value="Savings/Current Account" class="w-form-formradioinput w-radio-input" tabindex="0">
</div>
<div class="faux-input-radio">
<div class="faux-input-radio__dot"></div>
</div>
<div class="text-base">Savings / Current Account</div>
</div>
</div>
<div class="radio-button-field-container">
<div class="radio-button-field">
<div class="w-embed">
<input type="radio" data-name="relationship_type" name="relationship_type" value="Home/Car/Personal Loan/Credit Card" class="w-form-formradioinput w-radio-input" tabindex="0">
</div>
<div class="faux-input-radio">
<div class="faux-input-radio__dot"></div>
</div>
<div class="text-base"> Home / Car / Personal Loan or Credit Card </div>
</div>
</div>
</div>
</div>
</div>
<div>
<div class="eligibility-form-fieldset">
<h2 class="text-h4 text-orange-500">Almost done!</h2>
<div class="eligibility-form__submission-error-message"> You have entered an invalid OTP. Please resend and enter the new OTP before continuing. </div>
<label class="field-label">Phone Number</label>
<div class="otp-field">
<div class="w-embed">
<input type="text" value="+91" maxlength="3" name="dialing_code" data-name="dialing_code" id="dialing-code" class="input-text-field dialing-code w-input" tabindex="0" readonly="">
</div>
<div>
<input type="number" class="input-text-field w-input" autocomplete="off" maxlength="256" name="phone_number" data-name="phone_number" placeholder="10 digit phone number" id="phone_number" required="">
<div class="spacer-8"></div>
<input type="number" class="input-text-field hidden w-input" onchange="Javascript:VerifySMS();" autocomplete="one-time-code" maxlength="256" name="otp" data-name="otp" placeholder="Enter OTP received." id="otp" required="">
</div>
<a data-otp="fetch" onclick="SendSMS()" href="#" class="button-secondary mt-0 w-button" id="sendOTP">get otp</a>
</div>
<label for="dob" class="field-label">Date of Birth (dd/mm/yyyy)</label>
<div class="dob">
<input type="number" class="input-text-field w-input" maxlength="256" name="dob_day" data-name="dob_day" placeholder="DD" id="dob_day" required="">
<div class="input-hr-spacer"></div>
<input type="number" class="input-text-field w-input" maxlength="256" name="dob_month" data-name="dob_month" placeholder="MM" id="dob_month" required="">
<div class="input-hr-spacer"></div>
<input type="number" class="input-text-field w-input" maxlength="256" name="dob_year" data-name="dob_year" placeholder="YYYY" id="dob_year" required="">
</div>
<div class="form-group" id="captcha_div">
<div id="gogl_captcha" class="g-recaptcha" data-sitekey="6LeMtTceAAAAANlK0_mDmUJcqUNsHDCrV5ogVXmn" data-callback="verifyCaptcha">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LeMtTceAAAAANlK0_mDmUJcqUNsHDCrV5ogVXmn&co=aHR0cHM6Ly9jYW1wYWlnbnMuaWNpY2liYW5rLmNvbTo0NDM.&hl=de&v=pCoGBhjs9s8EhFOHJFe8cqis&size=normal&cb=2edrg8q16urh"
width="304" height="78" role="presentation" name="a-wcodzvntd38f" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox"></iframe></div><textarea id="g-recaptcha-response" name="g-recaptcha-response"
class="g-recaptcha-response" style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div>
<div id="g-recaptcha-error" class="error"></div>
</div>
<div class="spacer-24"></div>
<label class="w-checkbox checkbox-field">
<div class="w-checkbox-input w-checkbox-input--inputType-custom input-checkbox"></div>
<input type="checkbox" id="tos_agree" name="tos_agree" data-name="tos_agree" autocomplete="off" style="opacity: 0; position: absolute; z-index: -1"><span for="tos_agree" class="w-form-label">I agree to ICICI Bank’s
<a href="https://www.icicibank.com/terms-condition/credit-card-terms-and-conditions.page" target="_blank" class="text-blue-500"><strong>Terms & Conditions</strong></a> and
<a href="https://www.icicibank.com/managed-assets/docs/personal/cards/MITC_cc.pdf" target="_blank" class="text-blue-500"><strong>Most Important Terms & Conditions</strong></a></span>
</label>
</div>
</div>
</div>
</form>
Text Content
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