motorleads.mutualng.com Open in urlscan Pro
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2 forms found in the DOM

POST /#wpcf7-f5-p6-o1

<form action="/#wpcf7-f5-p6-o1" method="post" class="wpcf7-form init" aria-label="Contact form" novalidate="novalidate" data-status="init">
  <div style="display: none;">
    <input type="hidden" name="_wpcf7" value="5">
    <input type="hidden" name="_wpcf7_version" value="5.7.3">
    <input type="hidden" name="_wpcf7_locale" value="en_US">
    <input type="hidden" name="_wpcf7_unit_tag" value="wpcf7-f5-p6-o1">
    <input type="hidden" name="_wpcf7_container_post" value="6">
    <input type="hidden" name="_wpcf7_posted_data_hash" value="">
  </div>
  <p>Which of our Motor Insurance Plan are you interested in?<br>
    <span class="wpcf7-form-control-wrap" data-name="policy"><span class="wpcf7-form-control wpcf7-radio"><span class="wpcf7-list-item first"><label><input type="radio" name="policy" value="Comprehensive Motor Insurance" checked="checked"
              tabindex=""><span class="wpcf7-list-item-label">Comprehensive Motor Insurance</span></label></span><span class="wpcf7-list-item last"><label><input type="radio" name="policy" value="Third Party Motor Insurance" tabindex=""><span
              class="wpcf7-list-item-label">Third Party Motor Insurance</span></label></span></span></span>
  </p>
  <p><label>Full Name<br>
      <span class="wpcf7-form-control-wrap" data-name="fullname"><input size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true" aria-invalid="false" placeholder="Abdul Okafor" value="" type="text"
          name="fullname"></span></label>
  </p>
  <p>Gender<br>
    <span class="wpcf7-form-control-wrap" data-name="gender"><span class="wpcf7-form-control wpcf7-radio"><span class="wpcf7-list-item first"><label><input type="radio" name="gender" value="Male" checked="checked" tabindex=""><span
              class="wpcf7-list-item-label">Male</span></label></span><span class="wpcf7-list-item last"><label><input type="radio" name="gender" value="Female" tabindex=""><span
              class="wpcf7-list-item-label">Female</span></label></span></span></span>
  </p>
  <p><label>Location<br>
      <span class="wpcf7-form-control-wrap" data-name="location"><input size="40" class="wpcf7-form-control wpcf7-text" aria-invalid="false" placeholder="Yaba, Lagos" value="" type="text" name="location"></span></label>
  </p>
  <p><label>Phone Number<br>
      <span class="wpcf7-form-control-wrap" data-name="phonenumber"><input size="40" class="wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-required wpcf7-validates-as-tel" aria-required="true" aria-invalid="false"
          placeholder="08012345678" value="" type="tel" name="phonenumber"></span></label>
  </p>
  <p><label> Your email<br>
      <span class="wpcf7-form-control-wrap" data-name="email"><input size="40" class="wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-required wpcf7-validates-as-email" aria-required="true" aria-invalid="false"
          placeholder="abdulokafor@gmail.com" value="" type="email" name="email"></span> </label>
  </p>
  <p><label>Vehicle Make &amp; Model<br>
      <span class="wpcf7-form-control-wrap" data-name="vehicle-make-model"><input size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true" aria-invalid="false" placeholder="E.g Toyota Corolla" value=""
          type="text" name="vehicle-make-model"></span></label>
  </p>
  <p><label>Estimated Value of Vehicle<br>
      <span class="wpcf7-form-control-wrap" data-name="estimated-value-of-vehicle"><input size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true" aria-invalid="false" placeholder="N3,000,000" value=""
          type="text" name="estimated-value-of-vehicle"></span></label>
  </p>
  <p><label> Do you have any question or comment?<br>
      <span class="wpcf7-form-control-wrap" data-name="your-message"><textarea cols="40" rows="10" class="wpcf7-form-control wpcf7-textarea" aria-invalid="false" name="your-message"></textarea></span> </label>
  </p>
  <p><label>Just to confirm you're human<br>
      <span class="wpcf7-form-control-wrap" data-name="quiz-875"><label><span class="wpcf7-quiz-label">10 + 10</span> <input size="40" class="wpcf7-form-control wpcf7-quiz" autocomplete="off" aria-required="true" aria-invalid="false" type="text"
            name="quiz-875"></label><input type="hidden" name="_wpcf7_quiz_answer_quiz-875" value="0e95f62869c3cf5dfe8898bf9ab6d177"></span></label>
  </p>
  <p><input class="wpcf7-form-control has-spinner wpcf7-submit" type="submit" value="Submit"><span class="wpcf7-spinner"></span>
  </p>
  <div class="wpcf7-response-output" aria-hidden="true"></div>
</form>

GET https://motorleads.mutualng.com/

<form role="search" method="get" class="search-form" action="https://motorleads.mutualng.com/">
  <label for="search-form-1">Search…</label>
  <input type="search" id="search-form-1" class="search-field" value="" name="s">
  <input type="submit" class="search-submit" value="Search">
</form>

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MUTUAL BENEFITS ASSURANCE PLC.

Thanks for your interest in our insurance policy. Kindly complete our simple
quote form below and we will get in touch with you.

Which of our Motor Insurance Plan are you interested in?
Comprehensive Motor InsuranceThird Party Motor Insurance

Full Name


Gender
MaleFemale

Location


Phone Number


Your email


Vehicle Make & Model


Estimated Value of Vehicle


Do you have any question or comment?


Just to confirm you're human
10 + 10




Search…


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