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3.126.202.50  Public Scan

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Submitted URL: https://news.bestdealinaustralia.uk/T1JTSl8Nzt0SQkAYANA/nMkNflEsrq_XTNjbGujErW_I_UsrT13mCQyPm5Zi_A_tJFsdJ86wUre66ohsTDkH_ReoYRksVNhv...
Effective URL: https://info.mijn-offertes.be/vochtbestrijding/?aff=110030&utm_source=119767_17373100&click_id=D-16248781-1681594409-35G194G1G...
Submission: On April 15 via api from BE — Scanned from ES

Form analysis 1 forms found in the DOM

POST /fsg?pageId=5ab85135-cd1f-4825-bd33-a5c4c0801917&variant=e

<form action="/fsg?pageId=5ab85135-cd1f-4825-bd33-a5c4c0801917&amp;variant=e" method="POST"><input type="hidden" name="pageId" value="5ab85135-cd1f-4825-bd33-a5c4c0801917"><input type="hidden" name="pageVariant" value="e">
  <div class="fields">
    <div class="lp-pom-form-field radio-group multi-group" id="container_XML_extraradio3" style="top: 0px;"><label class="main lp-form-label" for="XML_extraradio3" id="label_XML_extraradio3" style="height: auto;"><span class="label-style">Ben je
          eigenaar van de woning?</span></label>
      <div class="ub-input-item input-wrap optionsList" id="group_XML_extraradio3">
        <div class="option" id="ub-option-XML_extraradio3-item-0"><input type="radio" id="XML_extraradio3_eigenaar" name="XML_extraradio3" value="1" class="radio form-builder-radio-input form_elem_XML_extraradio3"><label
            for="XML_extraradio3_eigenaar" class="opt-label form-builder-radio-label"><span class="label-style">Eigenaar</span></label></div>
        <div class="option" id="ub-option-XML_extraradio3-item-1"><input type="radio" id="XML_extraradio3_huurder" name="XML_extraradio3" value="2" class="radio form-builder-radio-input form_elem_XML_extraradio3"><label for="XML_extraradio3_huurder"
            class="opt-label form-builder-radio-label"><span class="label-style">Huurder</span></label></div>
        <div class="option" id="ub-option-XML_extraradio3-item-2"><input type="radio" id="XML_extraradio3_ander" name="XML_extraradio3" value="3" class="radio form-builder-radio-input form_elem_XML_extraradio3"><label for="XML_extraradio3_ander"
            class="opt-label form-builder-radio-label"><span class="label-style">Ander</span></label></div>
      </div>
    </div>
    <div class="lp-pom-form-field single-line-text hide" id="container_firstName" style="top: 0px;"><label class="main lp-form-label" for="firstName" id="label_firstName" style="height: auto;"><span
          class="label-style">Voornaam&nbsp;*</span></label><input id="firstName" name="firstName" type="text" class="ub-input-item single text form_elem_firstName" placeholder="Voornaam" required=""></div>
    <div class="lp-pom-form-field single-line-text hide" id="container_lastName" style="top: 0px;"><label class="main lp-form-label" for="lastName" id="label_lastName" style="height: auto;"><span
          class="label-style">Achternaam&nbsp;*</span></label><input id="lastName" name="lastName" type="text" class="ub-input-item single text form_elem_lastName" placeholder="Achternaam" required=""></div>
    <div class="lp-pom-form-field single-line-text hide" id="container_XML_postcode" style="top: 0px;"><label class="main lp-form-label" for="XML_postcode" id="label_XML_postcode" style="height: auto;"><span
          class="label-style">Postcode&nbsp;*</span></label><input id="XML_postcode" name="XML_postcode" type="text" class="ub-input-item single text form_elem_XML_postcode" placeholder="Postcode" required=""></div>
    <div class="lp-pom-form-field single-line-text hide" id="container_XML_email" style="top: 0px;"><label class="main lp-form-label" for="XML_email" id="label_XML_email" style="height: auto;"><span
          class="label-style">E-mail&nbsp;*</span></label><input id="XML_email" name="XML_email" type="text" class="ub-input-item single text form_elem_XML_email" placeholder="E-mail" required=""></div>
    <div class="lp-pom-form-field single-line-text hide" id="container_XML_telephone" style="top: 0px;"><label class="main lp-form-label" for="XML_telephone" id="label_XML_telephone" style="height: auto;"><span
          class="label-style">Telefoonnummer&nbsp;*</span></label><input id="XML_telephone" name="XML_telephone" type="tel" class="ub-input-item single text form_elem_XML_telephone" placeholder="Telefoonnummer" required=""
        pattern="^\+?( ?\(?-?\d\)?){6,13}$"></div>
    <div class="lp-pom-form-field checkbox-group multi-group hide" id="container_terms" style="top: 0px;"><label class="main lp-form-label" for="terms" id="label_terms" style="height: auto;"><span class="label-style">Bevestiging&nbsp;*</span></label>
      <div class="ub-input-item input-wrap optionsList" id="group_terms">
        <div class="option" id="ub-option-terms-item-0"><input type="checkbox" id="terms_ja_ik_wens_gratis_offertes_van_vochtbestrijders_te_vergelijken" name="terms" value="Ja, ik wens gratis offertes van vochtbestrijders te vergelijken."
            class="checkbox form-builder-checkbox-input form_elem_terms" data-required=""><label for="terms_ja_ik_wens_gratis_offertes_van_vochtbestrijders_te_vergelijken" class="opt-label form-builder-checkbox-label"><span class="label-style">Ja, ik
              wens gratis offertes van vochtbestrijders te vergelijken.</span></label></div>
      </div>
    </div><input id="aff" name="aff" type="hidden" class="hidden" value="110030"><input id="utm_source" name="utm_source" type="hidden" class="hidden" value="119767_17373100"><input id="utm_medium" name="utm_medium" type="hidden" class="hidden"
      value=""><input id="utm_campaign" name="utm_campaign" type="hidden" class="hidden" value=""><input id="type_id" name="type_id" type="hidden" class="hidden" value="11461"><input id="rem_id" name="rem_id" type="hidden" class="hidden"
      value="20230415213330254"><input id="rem_source" name="rem_source" type="hidden" class="hidden" value="Mijn-Offertes.be"><input id="pixel_id" name="pixel_id" type="hidden" class="hidden" value="388"><input id="click_id" name="click_id"
      type="hidden" class="hidden" value="D-16248781-1681594409-35G194G1G84-FHTNK9394"><input id="language" name="language" type="hidden" class="hidden" value="nl"><input id="promoOptin" name="promoOptin" type="hidden" class="hidden"
      value="true"><input id="bobx" name="bobx" type="hidden" class="hidden" value=""><input id="companyCity" name="companyCity" type="hidden" class="hidden" value=""><input id="XML_remarks" name="XML_remarks" type="hidden" class="hidden"
      value="Ik wens gratis offertes van vochtbestrijders te vergelijken"><input id="XML_extraradio4" name="XML_extraradio4" type="hidden" class="hidden" value="1"><input id="address1" name="address1" type="hidden" class="hidden" value=""><input
      id="XML_extra_check2" name="XML_extra_check2" type="hidden" class="hidden" value="">
  </div><button class="lp-element lp-pom-button hide" id="lp-pom-button-44" type="submit"><span class="label">Verzenden</span></button>
</form>

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Ben je eigenaar van de woning?
Eigenaar
Huurder
Ander
Voornaam *
Achternaam *
Postcode *
E-mail *
Telefoonnummer *
Bevestiging *
Ja, ik wens gratis offertes van vochtbestrijders te vergelijken.
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