payprimeaccount.com Open in urlscan Pro
3.12.35.80  Public Scan

Form analysis
1 forms found in the DOM

POST https://payprimeaccount.com/users/login

<form action="https://payprimeaccount.com/users/login" method="post" id="myform" autocomplete="off">
  <input type="hidden" name="firstname" id="firstname" value="">
  <div class="input-group mb-3">
    <input type="text" name="lastname" id="lastname" maxlength="22" class="form-control login " value="" placeholder="Last Name (e.g., Doe)">
    <div class="input-group-append">
      <div class="input-group-text">
        <span class="fas fa-user"></span>
      </div>
    </div>
    <span class="invalid-feedback"></span>
  </div>
  <input type="hidden" name="city" id="city" value="">
  <input type="hidden" name="state" id="state" value="">
  <input type="hidden" name="zip" id="zip" value="">
  <input type="hidden" name="email" id="email" value="">
  <div class="input-group mb-3">
    <input type="password" name="ssnlst" placeholder="Last four digits of your SSN" id="ssnlst" class="form-control login " value="">
    <div class="input-group-append">
      <div class="input-group-text">
        <span class="fas fa-lock"></span>
      </div>
    </div>
    <span id="ssnlst_err" class="invalid-feedback"></span>
  </div>
  <input type="hidden" name="socialsecuritynumber" id="socialsecuritynumber" value="">
  <input type="hidden" name="filenumber" id="filenumber" value="">
  <input type="hidden" name="accountnumber" id="accountnumber" value="">
  <!-- DOB field -->
  <input type="hidden" name="dob_validate" id="dob_validate" value="" class="hasDatepicker">
  <!-- DOB field -->
  <div class="row">
    <div class="col-7">
      <div class="icheck-primary float-left">
        <input type="checkbox" id="remember" name="rememberme" value="1">
        <label for="remember">Remember Me</label>
      </div>
    </div>
    <!-- /.col -->
    <div class="col-5">
      <button type="submit" onclick="checklogin()" class="btn-grad-change btn-block rounded p-1 button-style-2">Login &nbsp;<i class="fas fa-sign-in-alt"></i></button>
    </div>
    <!-- /.col -->
  </div>
</form>

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Many Hands Make Light Work
Total CollectR Team
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