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ca-newpaycardnami.lpca.brk-leads.net Open in urlscan Pro
2606:4700:7::60  Public Scan

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Submitted URL: https://allpixels2befired.com/?a=3039&oc=38876&c=72998&m=7&s1=9HZJBK&s2=e199b308341b4177acf0ff77e3563a40&first_name=&last_name...
Effective URL: https://ca-newpaycardnami.lpca.brk-leads.net/
Submission: On August 26 via api from US — Scanned from US

Form analysis 1 forms found in the DOM

<form>
  <div class="static bg-white  md:bg-bgWebS5 
                         md:mb-1 lg:px-0">
    <div class="py-2 border-t border-b border-black md:border-t-2 md:border-b-2 mb-3 md:mb-6 text-center">Where do we ship your FREE prize?</div>
    <div class="flex flex-col relative undefined">
      <div class="flex gap-1 mb-3">
        <div class="text-right mr-10 ml-1 flex items-center"><input type="radio" id="male" name="gender" class="hidden outline-none bg-none focus:outline-none" value="male"><label for="male" class="relative radio-yogo2-inactive"><svg
              aria-hidden="true" focusable="false" data-prefix="fas" data-icon="check" class="svg-inline--fa fa-check fa-w-16 fa-lg absolute top-1/2 left-1/2 transform -translate-x-1/2 -translate-y-1/2 invisible" role="img"
              xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512">
              <path fill="currentColor"
                d="M173.898 439.404l-166.4-166.4c-9.997-9.997-9.997-26.206 0-36.204l36.203-36.204c9.997-9.998 26.207-9.998 36.204 0L192 312.69 432.095 72.596c9.997-9.997 26.207-9.997 36.204 0l36.203 36.204c9.997 9.997 9.997 26.206 0 36.204l-294.4 294.401c-9.998 9.997-26.207 9.997-36.204-.001z">
              </path>
            </svg></label><span class="pl-2 text-sm">Mr.</span></div>
        <div class="text-right mr-10 ml-1 flex items-center"><input type="radio" id="female" name="gender" class="hidden outline-none bg-none focus:outline-none" value="male"><label for="female" class="relative radio-yogo2-inactive"><svg
              aria-hidden="true" focusable="false" data-prefix="fas" data-icon="check" class="svg-inline--fa fa-check fa-w-16 fa-lg absolute top-1/2 left-1/2 transform -translate-x-1/2 -translate-y-1/2 invisible" role="img"
              xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512">
              <path fill="currentColor"
                d="M173.898 439.404l-166.4-166.4c-9.997-9.997-9.997-26.206 0-36.204l36.203-36.204c9.997-9.998 26.207-9.998 36.204 0L192 312.69 432.095 72.596c9.997-9.997 26.207-9.997 36.204 0l36.203 36.204c9.997 9.997 9.997 26.206 0 36.204l-294.4 294.401c-9.998 9.997-26.207 9.997-36.204-.001z">
              </path>
            </svg></label><span class="pl-2 text-sm">Mrs</span></div>
      </div>
    </div>
    <div class="flex flex-col relative undefined">
      <div class="flex flex-row w-full gap-1">
        <div class="flex w-1/2">
          <div class="w-full relative">
            <div class="relative input-wrapper"><input min="" max="" name="first_name" type="text" placeholder="First name" class="input-surfeyo mb-2"></div>
          </div>
        </div>
        <div class="flex w-1/2">
          <div class="w-full relative">
            <div class="relative input-wrapper"><input min="" max="" name="last_name" type="text" placeholder="Last name" class="input-surfeyo mb-2"></div>
          </div>
        </div>
      </div>
    </div>
    <div class="flex flex-col relative undefined"><span class="text-sm text-left pb-1 pl-1 ">Date of birth:</span>
      <div class="flex flex-row w-full gap-1">
        <div class="w-full relative">
          <div class="relative input-wrapper"><select min="1" max="31" name="DD" type="tel" placeholder="Day" class="input-surfeyo mb-2 text-[#555]">
              <option> Day </option>
              <option value="1">01</option>
              <option value="2">02</option>
              <option value="3">03</option>
              <option value="4">04</option>
              <option value="5">05</option>
              <option value="6">06</option>
              <option value="7">07</option>
              <option value="8">08</option>
              <option value="9">09</option>
              <option value="10">10</option>
              <option value="11">11</option>
              <option value="12">12</option>
              <option value="13">13</option>
              <option value="14">14</option>
              <option value="15">15</option>
              <option value="16">16</option>
              <option value="17">17</option>
              <option value="18">18</option>
              <option value="19">19</option>
              <option value="20">20</option>
              <option value="21">21</option>
              <option value="22">22</option>
              <option value="23">23</option>
              <option value="24">24</option>
              <option value="25">25</option>
              <option value="26">26</option>
              <option value="27">27</option>
              <option value="28">28</option>
              <option value="29">29</option>
              <option value="30">30</option>
              <option value="31">31</option>
            </select></div>
        </div>
        <div class="w-full relative">
          <div class="relative input-wrapper"><select min="1" max="12" name="MM" type="tel" placeholder="Month" class="input-surfeyo mb-2 text-[#555]">
              <option> Month </option>
              <option value="01">January</option>
              <option value="02">February</option>
              <option value="03">March</option>
              <option value="04">April</option>
              <option value="05">May</option>
              <option value="06">June</option>
              <option value="07">July</option>
              <option value="08">August</option>
              <option value="09">September</option>
              <option value="10">October</option>
              <option value="11">November</option>
              <option value="12">December</option>
            </select></div>
        </div>
        <div class="w-full relative">
          <div class="relative input-wrapper"><select min="1904" max="2010" name="YYYY" type="tel" placeholder="Year" class="input-surfeyo mb-2 text-[#555]">
              <option> Year </option>
              <option value="2010">2010</option>
              <option value="2009">2009</option>
              <option value="2008">2008</option>
              <option value="2007">2007</option>
              <option value="2006">2006</option>
              <option value="2005">2005</option>
              <option value="2004">2004</option>
              <option value="2003">2003</option>
              <option value="2002">2002</option>
              <option value="2001">2001</option>
              <option value="2000">2000</option>
              <option value="1999">1999</option>
              <option value="1998">1998</option>
              <option value="1997">1997</option>
              <option value="1996">1996</option>
              <option value="1995">1995</option>
              <option value="1994">1994</option>
              <option value="1993">1993</option>
              <option value="1992">1992</option>
              <option value="1991">1991</option>
              <option value="1990">1990</option>
              <option value="1989">1989</option>
              <option value="1988">1988</option>
              <option value="1987">1987</option>
              <option value="1986">1986</option>
              <option value="1985">1985</option>
              <option value="1984">1984</option>
              <option value="1983">1983</option>
              <option value="1982">1982</option>
              <option value="1981">1981</option>
              <option value="1980">1980</option>
              <option value="1979">1979</option>
              <option value="1978">1978</option>
              <option value="1977">1977</option>
              <option value="1976">1976</option>
              <option value="1975">1975</option>
              <option value="1974">1974</option>
              <option value="1973">1973</option>
              <option value="1972">1972</option>
              <option value="1971">1971</option>
              <option value="1970">1970</option>
              <option value="1969">1969</option>
              <option value="1968">1968</option>
              <option value="1967">1967</option>
              <option value="1966">1966</option>
              <option value="1965">1965</option>
              <option value="1964">1964</option>
              <option value="1963">1963</option>
              <option value="1962">1962</option>
              <option value="1961">1961</option>
              <option value="1960">1960</option>
              <option value="1959">1959</option>
              <option value="1958">1958</option>
              <option value="1957">1957</option>
              <option value="1956">1956</option>
              <option value="1955">1955</option>
              <option value="1954">1954</option>
              <option value="1953">1953</option>
              <option value="1952">1952</option>
              <option value="1951">1951</option>
              <option value="1950">1950</option>
              <option value="1949">1949</option>
              <option value="1948">1948</option>
              <option value="1947">1947</option>
              <option value="1946">1946</option>
              <option value="1945">1945</option>
              <option value="1944">1944</option>
              <option value="1943">1943</option>
              <option value="1942">1942</option>
              <option value="1941">1941</option>
              <option value="1940">1940</option>
              <option value="1939">1939</option>
              <option value="1938">1938</option>
              <option value="1937">1937</option>
              <option value="1936">1936</option>
              <option value="1935">1935</option>
              <option value="1934">1934</option>
              <option value="1933">1933</option>
              <option value="1932">1932</option>
              <option value="1931">1931</option>
              <option value="1930">1930</option>
              <option value="1929">1929</option>
              <option value="1928">1928</option>
              <option value="1927">1927</option>
              <option value="1926">1926</option>
              <option value="1925">1925</option>
              <option value="1924">1924</option>
              <option value="1923">1923</option>
              <option value="1922">1922</option>
              <option value="1921">1921</option>
              <option value="1920">1920</option>
              <option value="1919">1919</option>
              <option value="1918">1918</option>
              <option value="1917">1917</option>
              <option value="1916">1916</option>
              <option value="1915">1915</option>
              <option value="1914">1914</option>
              <option value="1913">1913</option>
              <option value="1912">1912</option>
              <option value="1911">1911</option>
              <option value="1910">1910</option>
              <option value="1909">1909</option>
              <option value="1908">1908</option>
              <option value="1907">1907</option>
              <option value="1906">1906</option>
              <option value="1905">1905</option>
              <option value="1904">1904</option>
            </select></div>
        </div>
      </div>
    </div>
    <div class="flex flex-col relative undefined">
      <div class="w-full relative">
        <div class="relative input-wrapper"><input name="email_address" min="" max="" type="email" placeholder="Email" class="input-surfeyo mb-2" maxlength="50"></div>
      </div>
    </div>
    <div class="flex flex-col relative undefined">
      <div class="w-full relative">
        <div class="relative input-wrapper"><input name="phone_cell" min="" max="" type="tel" placeholder="Mobile number" class="input-surfeyo mb-2" maxlength="10" value=""></div>
      </div>
    </div>
    <div class="flex flex-col relative undefined">
      <div>
        <div class=" w-full gap-1">
          <div class="w-full ">
            <div class="">
              <div class="w-full relative">
                <div class="relative input-wrapper"><input id="zip_code" min="" max="" name="zip_code" type="text" placeholder="Postal Code" class="input-surfeyo mb-2" maxlength="7"></div>
              </div>
            </div>
          </div>
          <div class="w-full ">
            <div class="">
              <div class="w-full relative">
                <div class="relative input-wrapper"><input id="city" min="" max="" name="city" type="text" placeholder="City" class="input-surfeyo mb-2" maxlength="50"></div>
              </div>
            </div>
          </div>
        </div>
        <div class=" w-full gap-1">
          <div class="w-full ">
            <div class="">
              <div class="w-full relative">
                <div class="relative input-wrapper"><input id="address" min="" max="" name="address" type="text" placeholder="Address" class="input-surfeyo mb-2" maxlength="50"></div>
              </div>
            </div>
          </div>
        </div>
      </div>
    </div>
    <div class="flex flex-col relative undefined"></div>
    <div class="flex flex-col relative undefined"></div>
  </div>
  <div class="flex flex-col gap-4 my-2 px-1">
    <div class="text-xs">
      <div class="">
        <div class="md:mt-0 flex flex-col text-start gap-4">
          <div class="text-xs">By participating in this promotion I give my consent to be contacted directly by <span ng-click="showSponsors()" class="underline" style="color: black; text-decoration: underline; cursor: pointer;">sponsors</span> and
            other <span ng-click="showAdvertisers()" class="underline" style="color: black; text-decoration: underline; cursor: pointer;">service partners</span>.* The purpose is to bring you in contact with sponsors who ask for your consent. At your
            participation your preference for communication channel via e-mail, mobile phone and own (mobile) websites are processed in line with the promotional terms and privacy policy of Yousweeps and previously consumed products and services.
          </div>
        </div>
      </div>
    </div>
  </div>
  <div class="text-center">
    <div class="text-[11px]"></div><button class=" px-4 py-3 border-[3px] 
                        border-white shadow-lg font-semibold text-center text-shadow-md w-full mb-2  text-white uppercase text-xl bg-greenButtonS5">Continue</button>
  </div><input type="hidden" name="xxTrustedFormCertUrl" value="https://cert.trustedform.com/6afec7edab57ecadd0c5cf38819393435949a666" id="xxTrustedFormCertUrl_0"><input type="hidden" name="xxTrustedFormToken"
    value="https://cert.trustedform.com/6afec7edab57ecadd0c5cf38819393435949a666" id="xxTrustedFormToken_0"><input type="hidden" name="xxTrustedFormPingUrl"
    value="https://ping.trustedform.com/0.l3lGbufaSff4Wki1-vncYAQPHiNxGULO_oQnmYMXtRPGHhADIsVUyuFRzIwL1uqjzGbuyr4.-GNmVEYdKgScrJBOu_fI4A.OBRdVxvpsBabbPJ_pA7Byw" id="xxTrustedFormPingUrl_0">
</form>

Text Content

Limited supply! Be quick!
Average user rating: ★★★★☆
Sandra V. just finished a Survey!
Congratulations you qualified!

Congratulations you qualified!
9782911749
Where do we ship your FREE prize?
Mr.
Mrs

Date of birth:
Day 01020304050607080910111213141516171819202122232425262728293031
Month JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember
Year
20102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904





By participating in this promotion I give my consent to be contacted directly by
sponsors and other service partners.* The purpose is to bring you in contact
with sponsors who ask for your consent. At your participation your preference
for communication channel via e-mail, mobile phone and own (mobile) websites are
processed in line with the promotional terms and privacy policy of Yousweeps and
previously consumed products and services.

Continue

You Sweeps
The information that you provide will be handled by Media Pay Plus LTD
(Arch.Makariou III, 161 office 5 Limassol, Cyprus, 3027, hereinafter 'MPP) in
accordance with the Privacy Act and PIPEDA legislation. By submitting a
completed questionnaire, you agree that Media Pay Plus LTD may use your email
address to send information and promotions concerning third party products and
services and also supply your contact information and questionnaire responses to
companies so that they may use them to contact you by mail, phone or email to
send offers and promote services based on your preferences. By responding to a
question you expressly consent to that named organization, preferred supplier
and listed sponsors to contact you on the details provided for the specified
marketing until you opt out from the named organization, preferred supplier or
listed sponsor or could not be contacted by phone within the first 90 days of
your consent. Media Pay Plus LTD is not affiliated with, sponsored by or
endorsed by any of the listed products or retailers. Trademarks, service marks,
logos (including, without limitation, the individual names of products and
retailers) are the property of their respective owners. Media Pay Plus LTD
receives marketing fees from advertisers including financial institutions.
Closing dates: there are three promotional closing dates with new prize winners,
on every end date of the trimester on 30 April 2024 (trimester 1), 31 August
2024 (trimester 2) and 31 December 2024 (trimester 3). You should always read
their terms and conditions and/or product disclosure statement.

© 2024 YouSweeps | Privacy PolicyClick here. *if you do not wish to give your
consent for the disclosure of data to third parties.