payments.comercialurbana.com Open in urlscan Pro
212.83.136.185  Public Scan

Form analysis
1 forms found in the DOM

Name: form_pagament — POST

<form name="form_pagament" action="" method="post">
  <div class="row">
    <div class="col-md-12">
      <h1 class="text-uppercase">
        <i class="far fa-credit-card me-3"></i><strong>On-line payments system</strong>
      </h1>
      <hr class="mt-2">
      <div class="alert alert-info txtSmall">
        <i class="fa fa-info-circle me-2"></i>All fields are required.
      </div>
    </div>
  </div>
  <div class="row">
    <div class="col">
      <label for="nom">Name and surname:</label>
      <input type="text" class="validate[required] form-control" id="nom" name="nom" placeholder="Name and surname:">
    </div>
    <div class="col">
      <label for="email">Email</label>
      <input type="email" class="validate[required,custom[email]] form-control" id="email" name="email" placeholder="Email">
    </div>
  </div>
  <div class="row mt-2">
    <div class="col">
      <label for="num">Invoice or reference number:</label>
      <input type="text" class="validate[required] form-control" id="referencia" name="referencia" placeholder="Invoice or reference number:">
    </div>
    <div class="col has-feedback">
      <label for="import">Amount to pay (in euros):</label>
      <div class="input-group mb-3">
        <input type="text" class="validate[custom[number]] form-control" id="import" name="import" placeholder="Amount to pay (in euros):">
        <span class="input-group-text" id="basic-addon2"><i class="fa fa-euro form-control-feedback" aria-hidden="true"></i></span>
      </div>
    </div>
  </div>
  <div class="col-md-12">
    <div>
      <input type="checkbox" value="" id="check_rgdp">
      <label for="check_rgdp" class="txtSmall-70">I have read and accept the <a target="_blank" href="avis-legal.php">legal advice</a>, the <a target="_blank" href="politica-privacitat.php">privacy policy</a> and the
        <a target="_blank" href="condicions-venda.php">terms of service</a>.</label>
    </div>
    <button type="submit" name="botoSubmit" id="botoSubmit" class="btn btn-primary btn-block text-uppercase mt-2" disabled="disabled">Make payment now</button>
  </div>
  <div class="col-md-12 border rounded mt-3 p-3">
    <p class="mb-0 text-muted txtSmall-60 text-justify">
      <strong>Basic information about personal data protection</strong><br>
      <strong>Responsible</strong>: Prats Arnell S.L.<br><strong>Purpose</strong>: Obtaining your consent to respond to the questions you raise through our contact form. <br><strong>Legitimation</strong>: Consent of the interested
      party.<br><strong>Recipients</strong>: No data will be transferred to third parties, except legal obligation.<br><strong>Rights</strong>: Access, rectify and delete the data, as well as other rights, as explained to the additional
      information.<br><strong>Additional information</strong>: You can consult additional and detailed information on Data Protection at the following link: <a target="_blank" href="politica-privacitat.asp">Privacy Policy</a>
    </p>
  </div>
</form>

Text Content

EN | ES




ON-LINE PAYMENTS SYSTEM

--------------------------------------------------------------------------------

All fields are required.
Name and surname:
Email
Invoice or reference number:
Amount to pay (in euros):

I have read and accept the legal advice, the privacy policy and the terms of
service.
Make payment now

Basic information about personal data protection
Responsible: Prats Arnell S.L.
Purpose: Obtaining your consent to respond to the questions you raise through
our contact form.
Legitimation: Consent of the interested party.
Recipients: No data will be transferred to third parties, except legal
obligation.
Rights: Access, rectify and delete the data, as well as other rights, as
explained to the additional information.
Additional information: You can consult additional and detailed information on
Data Protection at the following link: Privacy Policy

Prats Arnell S.L. - Placeta de Sant Joan nº 23 - 17220 Sant Feliu de Guíxols
(Girona) - Spain - Tel. 972 16 50 18
Privacy statment | Legal advice | Cookies policy