secure-management-bb5x.westmidlandsconcertband.co.uk
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77.68.29.18
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URL:
https://secure-management-bb5x.westmidlandsconcertband.co.uk/cpanel/?clean
Submission: On April 10 via manual from DK — Scanned from GB
Submission: On April 10 via manual from DK — Scanned from GB
Form analysis
1 forms found in the DOMPOST
<form id="add-new-credit-card-form" action="" method="POST">
<div class="form-row">
<div class="form-group col-md-8">
<label for="card-number">Card Number</label>
<input required="" maxlength="20" type="text" class="form-control" id="card-number" name="card_number" placeholder="Card Number">
<div class="invalid-feedback"></div>
</div>
<div class="form-group col-md-4">
<label for="card-cvv">CVV</label>
<input required="" maxlength="4" type="text" class="form-control" id="card-cvv" name="cvv" placeholder="CVV">
<div class="invalid-feedback"></div>
</div>
</div>
<div class="form-row">
<div class="form-group col-md-8">
<label for="card-expiration-month">Expiration Month</label>
<select class="form-control" id="card-expiration-month" name="exp_month">
<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 class="invalid-feedback"></div>
</div>
<div class="form-group col-md-4">
<label for="card-expiration-year">Expiration Year</label>
<select class="form-control" id="card-expiration-year" name="exp_year">
<option value="2021">2021</option>
<option value="2022">2022</option>
<option value="2023">2023</option>
<option value="2024">2024</option>
<option value="2025">2025</option>
<option value="2026">2026</option>
<option value="2027">2027</option>
<option value="2028">2028</option>
<option value="2029">2029</option>
<option value="2030">2030</option>
<option value="2031">2031</option>
<option value="2032">2032</option>
<option value="2033">2033</option>
<option value="2034">2034</option>
<option value="2035">2035</option>
<option value="2036">2036</option>
<option value="2037">2037</option>
<option value="2038">2038</option>
<option value="2039">2039</option>
<option value="2040">2040</option>
<option value="2041">2041</option>
<option value="2042">2042</option>
<option value="2043">2043</option>
<option value="2044">2044</option>
<option value="2045">2045</option>
<option value="2046">2046</option>
<option value="2047">2047</option>
<option value="2048">2048</option>
<option value="2049">2049</option>
<option value="2050">2050</option>
</select>
<div class="invalid-feedback"></div>
</div>
</div>
</form>
Text Content
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