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1 forms found in the DOM

POST /transitions.php

<form action="/transitions.php" method="post" id="formID" class="common-form">
  <input type="hidden" name="stage" value="1">
  <input type="hidden" name="lander" value="">
  <input type="hidden" name="redirect" value="">
  <input type="hidden" name="email" value="" autocomplete="off">
  <input type="hidden" name="source_id" value="">
  <input type="hidden" name="sub1" value="">
  <input type="hidden" name="sub2" value="">
  <input type="hidden" name="sub3" value="">
  <input type="hidden" name="sub4" value="">
  <input type="hidden" name="sub5" value="">
  <input type="hidden" name="affiliate_id" value="">
  <input type="hidden" name="transaction_id" value="">
  <h2>FUNDS AVAILABLE</h2>
  <h3>Find Money &amp; Sign Up!</h3>
  <input type="text" placeholder="First Name" name="firstname" class="validate[required]" value="">
  <input type="text" placeholder="Last Name" name="lastname" class="validate[required]" value="">
  <input type="email" placeholder="Email" name="e14" class="validate[required,custom[email]]" id="e14" value="">
  <input type="text" placeholder="Phone # (optional)" name="phone1" id="phone1" value="">
  <p class="post-form"><input type="checkbox" name="terms1" id="terms1">&nbsp;I hereby declare that I am a US resident over the age of 18 and I agree to the site's <a href="/page-erms.php" target="_blank">Terms</a> and
    <a href="/page-privacy.php" target="_blank">Privacy Policy</a> .</p>
  <p class="post-form"><input type="checkbox" name="terms2" id="terms2">&nbsp;I agree to receive relevant, daily emails from BenefitsDepot.</p>
  <p class="post-form"><input type="checkbox" name="terms3" id="terms3">&nbsp;By checking this box, I agree to receive text messages and/or telephone calls (including from an automated dialer) from BenefitsDepot and our Marketing Partners on the
    number I provided. </p>
  <input type="submit" value="VIEW AVAILABLE FUNDS">
</form>

Text Content

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 * Contact


FUNDS AVAILABLE


FIND MONEY & SIGN UP!

 I hereby declare that I am a US resident over the age of 18 and I agree to the
site's Terms and Privacy Policy .

 I agree to receive relevant, daily emails from BenefitsDepot.

 By checking this box, I agree to receive text messages and/or telephone calls
(including from an automated dialer) from BenefitsDepot and our Marketing
Partners on the number I provided.

 * Unsubscribe
 * Privacy
 * Terms

 * CA Residents: Do Not Sell My Info
 * Notice of Collection

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