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Submitted URL: https://www.morrison-ins.com/v/e/ac1df20c5028
Effective URL: https://www.cfluent.com/cscoact/users/profile.php?pageid=110&PHPSESSID=v0bfal61q6tmq4nv74a175tcl2
Submission: On July 21 via manual from AU — Scanned from DE
Effective URL: https://www.cfluent.com/cscoact/users/profile.php?pageid=110&PHPSESSID=v0bfal61q6tmq4nv74a175tcl2
Submission: On July 21 via manual from AU — Scanned from DE
Form analysis 1 forms found in the DOM
Name: form1 — POST /cscoact/users/updateprofilepass_process.php
<form action="/cscoact/users/updateprofilepass_process.php" method="post" name="form1">
<table width="100%" border="0">
<tbody>
<tr>
<td colspan="3"> </td>
</tr>
<tr valign="top">
<td width="23%">
<!-- START LEFT NAV -->
<table width="100%" border="0" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td width="0%">
<div class="left_collumn_bg"></div>
</td>
<td width="100%">
<div class="collumn_bg"><span class="collumn_header_text">Update Profile </span></div>
</td>
<td width="0%">
<div class="right_collumn_bg"></div>
</td>
</tr>
</tbody>
</table>
<table width="100%" border="0" cellpadding="0" cellspacing="0" class="collumn_box_lf_bt_rt">
<tbody>
<tr>
<td>
<table width="100%" border="0" class="collumn_overviewtable">
<tbody>
<tr>
<td>Please verify that the contact information we have for you is up-to-date. <br> <br> <em>Required fields are marked with an *</em></td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
<!-- END LEFT NAV -->
</td>
<td width="2%"> </td>
<td width="75%"><input name="fun" type="hidden" value="">
<table width="100%" border="0" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td width="0%">
<div class="left_collumn_bg"></div>
</td>
<td width="100%">
<div class="collumn_bg"><span class="collumn_header_text">Profile</span></div>
</td>
<td width="0%">
<div class="right_collumn_bg"></div>
</td>
</tr>
</tbody>
</table>
<table width="100%" border="0" cellpadding="0" cellspacing="0" class="collumn_box_lf_bt_rt">
<tbody>
<tr>
<td>
<table width="100%" border="0" class="collumn_overviewtable">
<tbody>
<tr>
<td width="22%"><span class="field_lables">First Name*</span></td>
<td width="78%"> <input name="txtfname" type="text" size="60" value="Andrew"> </td>
</tr>
<tr>
<td><span class="field_lables">Last Name*</span></td>
<td> <input name="txtlname" type="text" size="60" value="Smith"> </td>
</tr>
<tr>
<td><span class="field_lables">Phone Number*</span></td>
<td> <input name="txtphone" type="text" size="60" value="07811867493"> </td>
</tr>
<tr>
<td><span class="field_lables">Email Address</span></td>
<td>andrew.smith@uk.qbe.com</td>
</tr>
<tr>
<td><span class="field_lables">Zip*</span></td>
<td><input name="txtzip" type="text" value="" size="8" maxlength="5"></td>
</tr>
<tr>
<td><span class="field_lables">Fax Number</span></td>
<td> <input name="txtfax" type="text" size="60" value=""> </td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td>
<div align="right"> </div>
</td>
</tr>
</tbody>
</table>
<br>
<table width="100%" border="0" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td width="0%">
<div class="left_collumn_bg"></div>
</td>
<td width="100%">
<div class="collumn_bg"><span class="collumn_header_text">Password</span></div>
</td>
<td width="0%">
<div class="right_collumn_bg"></div>
</td>
</tr>
</tbody>
</table>
<table width="100%" border="0" cellpadding="0" cellspacing="0" class="collumn_box_lf_bt_rt">
<tbody>
<tr>
<td>
<table width="100%" border="0" class="collumn_overviewtable">
<tbody>
<tr>
<td><span class="field_lables">Password*</span></td>
<td> <input name="password1" type="password" size="60" value=""> </td>
</tr>
<tr>
<td width="22%"><span class="field_lables">Re-Enter Password*</span></td>
<td width="78%"> <input name="password2" type="password" size="60" value=""> </td>
</tr>
<tr>
<td><span class="field_lables">Secret Question*</span></td>
<td> <select name="lstsecquestion">
<option value="111">Favorite City?</option>
<option value="222">Name of your first pet?</option>
<option value="333">Name of street where you were raised?</option>
<option value="334">What was the name of your high school?</option>
<option value="335">What is your father's middle name?</option>
<option value="336">In what city did you meet your spouse for the first time?</option>
<option value="337">As a child, what did you want to be when you grew up?</option>
<option value="338">What is your paternal grandfather's first name?</option>
<option value="339">What is the first name of your oldest nephew?</option>
</select> </td>
</tr>
<tr>
<td><span class="field_lables">Answer*</span></td>
<td> <input name="txtsecquansw" type="text" size="60" value=""> </td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td>
<div align="right"> </div>
</td>
</tr>
</tbody>
</table>
<br> <br> <input name="Submit" type="submit" value="Update Profile">
<!-- END -->
</td>
</tr>
<tr>
<td colspan="3"> </td>
</tr>
</tbody>
</table>
</form>Text Content
Morrison Insurance Agency's Insurance Zone Go to our web site: https://www.morrison-ins.com | Home | Login Welcome to Morrison Insurance Agency's Insurance Zone. Please complete your profile below. Update Profile Please verify that the contact information we have for you is up-to-date. Required fields are marked with an * Profile First Name* Last Name* Phone Number* Email Address andrew.smith@uk.qbe.com Zip* Fax Number Password Password* Re-Enter Password* Secret Question* Favorite City? Name of your first pet? Name of street where you were raised? What was the name of your high school? What is your father's middle name? In what city did you meet your spouse for the first time? As a child, what did you want to be when you grew up? What is your paternal grandfather's first name? What is the first name of your oldest nephew? Answer* Copyright © 2004 - 2022 Confluency Solutions . All rights reserved.