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stp1.elixierofferz.xyz Open in urlscan Pro
2606:4700:3037::6815:5929  Public Scan

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URL: https://stp1.elixierofferz.xyz/?affId=1&c1=999&c2=f45e5f92281c4eb9b1c75ede9d22cedc&c3=ea58c6928e3b494dbd5b1c7ebee7f65a&image=ht...
Submission: On May 07 via manual from US — Scanned from DE

Form analysis 1 forms found in the DOM

<form id="billing-form">
  <div class="row flex-column-reverse flex-md-row">
    <div class="col-lg-6 col-sm-12  ">
      <div class="forms-wrapper">
        <p class="forms-header ">Shipping Information</p>
        <div class="css-cocn0m">
          <div class="css-8atqhb"><input placeholder="First Name" type="text" name="firstName" required="" aria-required="true" class="chakra-input css-hpxu7q"></div>
        </div>
        <div class="css-cocn0m">
          <div class="css-8atqhb"><input placeholder="Last Name" type="text" name="lastName" required="" aria-required="true" class="chakra-input css-hpxu7q"></div>
        </div>
        <div class="css-cocn0m">
          <div class="css-8atqhb"><input placeholder="Email" type="email" name="email" required="" aria-required="true" class="chakra-input css-hpxu7q"></div>
        </div>
        <div class="css-cocn0m">
          <div class="css-8atqhb"><input placeholder="Phone" maxlength="10" pattern="^[0-9]{10,11}$" name="phone" type="tel" required="" aria-required="true" class="chakra-input css-ytskvu"></div>
        </div>
        <div class="css-cocn0m">
          <div class="css-8atqhb"><input placeholder="Address" name="address" required="" aria-required="true" class="chakra-input css-hpxu7q"></div>
        </div>
        <div class="css-cocn0m">
          <div class="css-8atqhb"><input placeholder="Zip Code" maxlength="5" type="tel" name="zipCode" required="" aria-required="true" class="chakra-input css-f6gl9w"></div>
        </div>
        <div class="css-cocn0m">
          <div class="css-8atqhb"><input placeholder="City" type="text" name="city" required="" aria-required="true" class="chakra-input css-hpxu7q"></div>
        </div>
        <div class="css-cocn0m">
          <div class="css-8atqhb">
            <div class="chakra-select__wrapper css-42b2qy"><select name="state" data-threeds="country" type="text" required="" aria-required="true" class="chakra-select css-1u4bgtw">
                <option value="">Select State</option>
                <option value="AL">Alabama (AL)</option>
                <option value="AK">Alaska (AK)</option>
                <option value="AZ">Arizona (AZ)</option>
                <option value="AR">Arkansas (AR)</option>
                <option value="CA">California (CA)</option>
                <option value="CO">Colorado (CO)</option>
                <option value="CT">Connecticut (CT)</option>
                <option value="DE">Delaware (DE)</option>
                <option value="DC">District of Columbia (DC)</option>
                <option value="FL">Florida (FL)</option>
                <option value="GA">Georgia (GA)</option>
                <option value="HI">Hawaii (HI)</option>
                <option value="ID">Idaho (ID)</option>
                <option value="IL">Illinois (IL)</option>
                <option value="IN">Indiana (IN)</option>
                <option value="IA">Iowa (IA)</option>
                <option value="KS">Kansas (KS)</option>
                <option value="KY">Kentucky (KY)</option>
                <option value="LA">Louisiana (LA)</option>
                <option value="ME">Maine (ME)</option>
                <option value="MD">Maryland (MD)</option>
                <option value="MA">Massachusetts (MA)</option>
                <option value="MI">Michigan (MI)</option>
                <option value="MN">Minnesota (MN)</option>
                <option value="MS">Mississippi (MS)</option>
                <option value="MO">Missouri (MO)</option>
                <option value="MT">Montana (MT)</option>
                <option value="NE">Nebraska (NE)</option>
                <option value="NV">Nevada (NV)</option>
                <option value="NH">New Hampshire (NH)</option>
                <option value="NJ">New Jersey (NJ)</option>
                <option value="NM">New Mexico (NM)</option>
                <option value="NY">New York (NY)</option>
                <option value="NC">North Carolina (NC)</option>
                <option value="ND">North Dakota (ND)</option>
                <option value="OH">Ohio (OH)</option>
                <option value="OK">Oklahoma (OK)</option>
                <option value="OR">Oregon (OR)</option>
                <option value="PA">Pennsylvania (PA)</option>
                <option value="RI">Rhode Island (RI)</option>
                <option value="SC">South Carolina (SC)</option>
                <option value="SD">South Dakota (SD)</option>
                <option value="TN">Tennessee (TN)</option>
                <option value="TX">Texas (TX)</option>
                <option value="UT">Utah (UT)</option>
                <option value="VT">Vermont (VT)</option>
                <option value="VA">Virginia (VA)</option>
                <option value="WA">Washington (WA)</option>
                <option value="WV">West Virginia (WV)</option>
                <option value="WI">Wisconsin (WI)</option>
                <option value="WY">Wyoming (WY)</option>
              </select>
              <div class="chakra-select__icon-wrapper css-iohxn1"><svg viewBox="0 0 24 24" role="presentation" class="chakra-select__icon" focusable="false" aria-hidden="true" style="width: 1em; height: 1em; color: currentcolor;">
                  <path fill="currentColor" d="M16.59 8.59L12 13.17 7.41 8.59 6 10l6 6 6-6z"></path>
                </svg></div>
            </div>
          </div>
        </div>
      </div><br>
      <div class="forms-wrapper">
        <p class="forms-header ">Payment Information</p>
        <div class="css-cocn0m">
          <div class="css-8atqhb"><input placeholder="Credit Card Number" maxlength="16" type="tel" data-threeds="pan" name="cardNumber" required="" aria-required="true" class="chakra-input css-ytskvu" value=""></div>
        </div>
        <div class="css-cocn0m">
          <div class="css-8atqhb">
            <div class="chakra-select__wrapper css-42b2qy"><select name="cardMonth" data-threeds="month" type="text" required="" aria-required="true" class="chakra-select css-1u4bgtw">
                <option value="">Month</option>
                <option value="01">(01) January</option>
                <option value="02">(02) February</option>
                <option value="03">(03) March</option>
                <option value="04">(04) April</option>
                <option value="05">(05) May</option>
                <option value="06">(06) June</option>
                <option value="07">(07) July</option>
                <option value="08">(08) August</option>
                <option value="09">(09) September</option>
                <option value="10">(10) October</option>
                <option value="11">(11) November</option>
                <option value="12">(12) December</option>
              </select>
              <div class="chakra-select__icon-wrapper css-iohxn1"><svg viewBox="0 0 24 24" role="presentation" class="chakra-select__icon" focusable="false" aria-hidden="true" style="width: 1em; height: 1em; color: currentcolor;">
                  <path fill="currentColor" d="M16.59 8.59L12 13.17 7.41 8.59 6 10l6 6 6-6z"></path>
                </svg></div>
            </div>
          </div>
        </div>
        <div class="css-cocn0m">
          <div class="css-8atqhb">
            <div class="chakra-input__group css-bx0blc" data-group="true">
              <div class="chakra-select__wrapper css-42b2qy"><select name="cardYear" data-threeds="year" type="text" required="" aria-required="true" class="chakra-select css-1u4bgtw">
                  <option value="">Year</option>
                  <option value="2024">2024</option>
                  <option value="2025">2025</option>
                  <option value="2026">2026</option>
                  <option value="2027">2027</option>
                  <option value="2028">2028</option>
                  <option value="2029">2029</option>
                  <option value="2030">2030</option>
                  <option value="2031">2031</option>
                  <option value="2032">2032</option>
                  <option value="2033">2033</option>
                  <option value="2034">2034</option>
                  <option value="2035">2035</option>
                  <option value="2036">2036</option>
                  <option value="2037">2037</option>
                  <option value="2038">2038</option>
                </select>
                <div class="chakra-select__icon-wrapper css-iohxn1"><svg viewBox="0 0 24 24" role="presentation" class="chakra-select__icon" focusable="false" aria-hidden="true" style="width: 1em; height: 1em; color: currentcolor;">
                    <path fill="currentColor" d="M16.59 8.59L12 13.17 7.41 8.59 6 10l6 6 6-6z"></path>
                  </svg></div>
              </div>
            </div>
          </div>
        </div>
        <div class="css-cocn0m">
          <div class="css-8atqhb"><input placeholder="CVV" maxlength="3" type="tel" name="cvv" required="" aria-required="true" class="chakra-input css-f6gl9w"></div>
        </div>
      </div>
    </div>
    <div class="col-lg-6 col-sm-12 mobile-versin ">
      <div class="overview">
        <p class="order-summary">Order Summary</p>
        <div class="summary">
          <div class="price-overview">
            <div style="font-size: 20px; color: rgb(35, 47, 62); text-transform: capitalize;">Bose Smart Speaker 500</div>
          </div><img src="https://i.imgur.com/ACaBOvI.png"><br>
          <div class="price-overview">
            <div>Amount to be paid :</div>
            <p>$2.85</p>
          </div>
          <div class="price-overview" style="padding-top: 10px;">
            <div style="color: rgb(198, 9, 11);">TOTAL:</div>
            <p style="color: rgb(198, 9, 11);">$2.85</p>
          </div>
        </div>
      </div><button class="order-button d-none d-md-block">Rush my order</button>
    </div>
  </div><button class="order-button  d-block d-md-none">Rush my order</button><br><br>
</form>

Text Content



Shipping Information








Select StateAlabama (AL)Alaska (AK)Arizona (AZ)Arkansas (AR)California
(CA)Colorado (CO)Connecticut (CT)Delaware (DE)District of Columbia (DC)Florida
(FL)Georgia (GA)Hawaii (HI)Idaho (ID)Illinois (IL)Indiana (IN)Iowa (IA)Kansas
(KS)Kentucky (KY)Louisiana (LA)Maine (ME)Maryland (MD)Massachusetts (MA)Michigan
(MI)Minnesota (MN)Mississippi (MS)Missouri (MO)Montana (MT)Nebraska (NE)Nevada
(NV)New Hampshire (NH)New Jersey (NJ)New Mexico (NM)New York (NY)North Carolina
(NC)North Dakota (ND)Ohio (OH)Oklahoma (OK)Oregon (OR)Pennsylvania (PA)Rhode
Island (RI)South Carolina (SC)South Dakota (SD)Tennessee (TN)Texas (TX)Utah
(UT)Vermont (VT)Virginia (VA)Washington (WA)West Virginia (WV)Wisconsin
(WI)Wyoming (WY)



Payment Information


Month(01) January(02) February(03) March(04) April(05) May(06) June(07) July(08)
August(09) September(10) October(11) November(12) December

Year202420252026202720282029203020312032203320342035203620372038



Order Summary

Bose Smart Speaker 500

Amount to be paid :

$2.85

TOTAL:

$2.85

Rush my order
Rush my order