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garantias.novicompu.com Open in urlscan Pro
2606:4700:20::681a:8f1  Public Scan

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URL: https://garantias.novicompu.com/
Submission: On July 03 via api from US — Scanned from DE

Form analysis 1 forms found in the DOM

<form class="user-form mt-4 invoice-form">
  <div><label class="mb-3 form-label" for="formInvoiceCode">Código de Factura</label>
    <div class="d-flex"><input placeholder="Ingrese el código de factura" type="text" id="formInvoiceCode" class="input-invoice-code form-control" value=""></div>
  </div>
  <div><label class="form-label" for="formName">Nombre <span style="color: red;">*</span></label><input name="name" placeholder="Ingrese su nombre" maxlength="50" required="" type="text" id="formName" class="input-invoice-code form-control" value="">
  </div>
  <div><label class="form-label" for="formBirthdate">Fecha de Nacimiento <span style="color: red;">*</span></label><input name="birthdate" min="1900-01-01" max="2024-07-03" placeholder="Ingrese su fecha de nacimiento" required="" type="date"
      id="formBirthdate" class="input-invoice-code form-control" value=""></div>
  <div><label class="form-label" for="formAddress">Dirección <span style="color: red;">*</span></label><input name="address" placeholder="Ingrese su dirección" maxlength="100" required="" type="text" id="formAddress"
      class="input-invoice-code form-control" value=""></div>
  <div><label class="form-label" for="formEmail">Correo Electrónico <span style="color: red;">*</span></label><input name="email" placeholder="Ingrese su correo electrónico" maxlength="50" required="" type="email" id="formEmail"
      class="input-invoice-code form-control" value=""></div>
  <div><label class="form-label" for="formPhone">Teléfono <span style="color: red;">*</span></label><input name="phone" placeholder="Ingrese su teléfono" maxlength="20" type="text" id="formPhone" class="input-invoice-code form-control" value="">
  </div>
  <div>
    <div class="checkbox-terms form-check"><input type="checkbox" id="formTerms" class="form-check-input"><label title="" for="formTerms" class="form-check-label"><span>Acepto los
          <a href="https://www.iubenda.com/privacy-policy/36820790/legal" target="_blank" rel="noopener noreferrer">términos y condiciones</a></span></label></div>
  </div><br><button type="submit" disabled="" class="btn-invoice-code btn btn-primary">Enviar</button>
</form>

Text Content

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VALIDACIÓN DE GARANTÍA

Código de Factura

Nombre *
Fecha de Nacimiento *
Dirección *
Correo Electrónico *
Teléfono *
Acepto los términos y condiciones

Enviar