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www.employmentlawgroup.com Open in urlscan Pro
141.193.213.11  Public Scan

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Submitted URL: https://payments.employmentlawgroup.com/
Effective URL: https://www.employmentlawgroup.com/payments/
Submission: On February 27 via automatic, source certstream-suspicious — Scanned from DE

Form analysis 4 forms found in the DOM

https://www.employmentlawgroup.com

<form id="cse-search-box" action="https://www.employmentlawgroup.com" class="d-lg-none pt-3">
  <div class="input-group mb-2 mr-sm-2">
    <div class="input-group-prepend">
      <div class="input-group-text">
        <a href="#" onclick="jQuery('#cse-search-box').submit();">
												<svg xmlns="http://www.w3.org/2000/svg" height="24" viewBox="0 0 24 24" width="24">
													<path d="M0 0h24v24H0z" fill="none"></path>
													<path d="M15.5 14h-.79l-.28-.27C15.41 12.59 16 11.11 16 9.5 16 5.91 13.09 3 9.5 3S3 5.91 3 9.5 5.91 16 9.5 16c1.61 0 3.09-.59 4.23-1.57l.27.28v.79l5 4.99L20.49 19l-4.99-5zm-6 0C7.01 14 5 11.99 5 9.5S7.01 5 9.5 5 14 7.01 14 9.5 11.99 14 9.5 14z"></path>
												</svg>
											</a>
      </div>
    </div>
    <input type="search" class="form-control" name="s" id="q2" placeholder="Search …">
  </div>
</form>

https://www.employmentlawgroup.com

<form id="cse-search-box" action="https://www.employmentlawgroup.com" class="py-3 constrain">
  <div class="input-group mb-2 mr-sm-2">
    <div class="input-group-prepend">
      <div class="input-group-text">
        <a href="#" onclick="jQuery('#cse-search-box').submit();">
											<svg xmlns="http://www.w3.org/2000/svg" height="24" viewBox="0 0 24 24" width="24">
												<path d="M0 0h24v24H0z" fill="none"></path>
												<path d="M15.5 14h-.79l-.28-.27C15.41 12.59 16 11.11 16 9.5 16 5.91 13.09 3 9.5 3S3 5.91 3 9.5 5.91 16 9.5 16c1.61 0 3.09-.59 4.23-1.57l.27.28v.79l5 4.99L20.49 19l-4.99-5zm-6 0C7.01 14 5 11.99 5 9.5S7.01 5 9.5 5 14 7.01 14 9.5 11.99 14 9.5 14z"></path>
											</svg>
										</a>
      </div>
    </div>
    <input type="search" class="form-control" name="s" id="q2" placeholder="Search …">
  </div>
</form>

https://www.employmentlawgroup.com

<form id="cse-search-box" action="https://www.employmentlawgroup.com" class="d-lg-none pt-3">
  <div class="input-group mb-2 mr-sm-2">
    <div class="input-group-prepend">
      <div class="input-group-text">
        <a href="#" onclick="jQuery('#cse-search-box').submit();">
														<svg xmlns="http://www.w3.org/2000/svg" height="24" viewBox="0 0 24 24" width="24">
															<path d="M0 0h24v24H0z" fill="none"></path>
															<path d="M15.5 14h-.79l-.28-.27C15.41 12.59 16 11.11 16 9.5 16 5.91 13.09 3 9.5 3S3 5.91 3 9.5 5.91 16 9.5 16c1.61 0 3.09-.59 4.23-1.57l.27.28v.79l5 4.99L20.49 19l-4.99-5zm-6 0C7.01 14 5 11.99 5 9.5S7.01 5 9.5 5 14 7.01 14 9.5 11.99 14 9.5 14z"></path>
														</svg>
													</a>
      </div>
    </div>
    <input type="search" class="form-control" name="s" id="q2" placeholder="Search …">
  </div>
</form>

POST https://www.employmentlawgroup.com/wp-content/themes/TELG-2/ssl_submit.php

<form action="https://www.employmentlawgroup.com/wp-content/themes/TELG-2/ssl_submit.php" method="post" id="paymentForm" novalidate="">
  <p class="text-danger">All fields are required</p>
  <div class="form-row">
    <div class="form-group col-sm-12">
      <label for="ssl_first_name">First Name:</label>
      <input id="ssl_first_name" name="ssl_first_name" type="text" class="form-control" value="" required="">
      <div class="invalid-feedback"> Please enter your first name. </div>
    </div>
    <div class="form-group col-sm-12">
      <label for="ssl_last_name">Last Name:</label>
      <input id="ssl_last_name" name="ssl_last_name" type="text" class="form-control" value="" required="">
      <div class="invalid-feedback"> Please enter your last name. </div>
    </div>
    <div class="form-group col-sm-12">
      <label for="ssl_avs_address">Address:</label>
      <input id="ssl_avs_address" name="ssl_avs_address" type="text" class="form-control" value="" required="">
      <div class="invalid-feedback"> Please enter your full address. </div>
    </div>
    <div class="form-group col-sm-12">
      <label for="ssl_avs_zip">Zip Code:</label>
      <input id="ssl_avs_zip" name="ssl_avs_zip" type="text" class="form-control" value="" required="">
      <div class="invalid-feedback"> Please enter a valid ZIP Code. </div>
    </div>
    <div class="form-group col-sm-12">
      <label for="ssl_phone">Phone Number:</label>
      <input id="ssl_phone" name="ssl_phone" type="phone" class="form-control" value="" pattern="[0-9]{10}" maxlength="40" required="">
      <div class="invalid-feedback"> Please enter a 10 digit phone number. </div>
    </div>
    <div class="form-group col-sm-12">
      <label for="ssl_email">Email Address:</label>
      <input id="ssl_email" name="ssl_email" type="email" class="form-control" value="" required="">
      <div class="invalid-feedback"> Please enter a valid email address. </div>
    </div>
    <div class="form-group col-sm-12">
      <label for="ssl_amount">Payment Amount:</label>
      <input id="ssl_amount" name="ssl_amount" type="text" class="form-control" value="" required="">
      <div class="invalid-feedback"> Please enter the amount you would like to pay. </div>
    </div>
    <div class="form-group col-sm-12">
      <label for="ssl_card_number">Credit Card Number:</label>
      <input id="ssl_card_number" name="ssl_card_number" type="text" class="form-control" value="" required="">
      <div class="invalid-feedback"> Please enter your credit card number. </div>
    </div>
    <div class="form-group col-sm-12">
      <label for="ssl_exp_date">Expiration Date:</label>
      <input id="ssl_exp_date" name="ssl_exp_date" type="text" class="form-control" value="" placeholder="MMYY" required="">
      <div class="invalid-feedback"> Please enter the expiration date of your credit card. </div>
    </div>
    <div class="form-group col-sm-12">
      <label for="ssl_cvv2cvc2">CVV Number:</label>
      <input id="ssl_cvv2cvc2" name="ssl_cvv2cvc2" type="text" class="form-control" value="" required="">
      <a href="#" class="finePrint" onclick="showCvvHelp();return false;">Click here for help on this</a>
      <div class="invalid-feedback"> Please enter the CVV code of your credit card. </div>
    </div>
    <div class="form-group col-md-12">
      <div class="text-danger">
        <p>Please review your data and, when its correct, click below to pay online. <br><strong>Your credit card will be charged when you click below.</strong></p>
      </div>
      <button type="submit" class="btn btn-primary">Pay Now</button>
      <br><br>
      <img class="lazy img-fluid" data-lazy="https://www.employmentlawgroup.com/wp-content/themes/TELG-2/images/Amex-Multi-4-Horiz-220x53.jpg" src="data:image/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw=="
        alt="American Express, Mastercard, Visa, Discover">
    </div>
  </div>
</form>

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   * Media Coverage
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Home > Online Payment Submission


ONLINE PAYMENT SUBMISSION

All fields are required

First Name:
Please enter your first name.
Last Name:
Please enter your last name.
Address:
Please enter your full address.
Zip Code:
Please enter a valid ZIP Code.
Phone Number:
Please enter a 10 digit phone number.
Email Address:
Please enter a valid email address.
Payment Amount:
Please enter the amount you would like to pay.
Credit Card Number:
Please enter your credit card number.
Expiration Date:
Please enter the expiration date of your credit card.
CVV Number: Click here for help on this
Please enter the CVV code of your credit card.

Please review your data and, when its correct, click below to pay online.
Your credit card will be charged when you click below.

Pay Now




VISA®, MASTERCARD®, AND DISCOVER® CARDHOLDERS:

Turn your card over and look at the signature box. You should see either the
entire 16-digit credit card number or just the last four digits followed by a
special 3-digit code. This 3-digit code is your CVV number / Card Security Code.


AMERICAN EXPRESS® CARDHOLDERS:

Look for the 4-digit code printed on the front of your card just above and to
the right of your main credit card number. This 4-digit code is your Card
Identification Number (CID). The CID is the four-digit code printed just above
the Account Number.

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