us-cashisgoodkvg.lp.kgaleads.com
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urlscan Pro
18.165.183.58
Public Scan
URL:
http://us-cashisgoodkvg.lp.kgaleads.com/
Submission: On February 17 via api from US — Scanned from DE
Submission: On February 17 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
Name: form —
<form name="form" id="form" ng-submit="validateForm()" autocomplete="off" novalidate=""
class="ng-pristine ng-invalid-required ng-valid-minlength ng-valid-maxlength ng-valid-email ng-invalid-gender ng-invalid-first_name ng-invalid-last_name ng-invalid-email_address ng-invalid-date_of_birth ng-invalid-phone_cell ng-invalid-city ng-invalid-zip_code ng-invalid ng-invalid-address">
<!---->
<div ng-repeat="field in flow.currentStep.settings.fields">
<!---->
<div ng-hide="lead.hide_fields.indexOf(field) != -1 && form[field].$valid" ng-if="field == 'title' || field == 'gender'" class="row form-item-show-hide" data-form-items="gender">
<div class="col-xs-12 form-group">
<!---->
<div ng-repeat="title in formSettings[field].options" class="gender-radio-container" ng-class="{ 'has-error' : form[field].$invalid && form.$submitted }">
<div class="gender-radio" ng-click="lead.title = title.title; lead.gender = title.gender" ng-class="{ 'has-success' : form[field].$valid && lead.gender == title.gender }">
<span ng-show="lead[field] == title[field]" class="glyphicon glyphicon-ok ng-hide"></span>
</div>
<div class="gender-radio-label">Mr.</div>
</div><!---->
<div ng-repeat="title in formSettings[field].options" class="gender-radio-container" ng-class="{ 'has-error' : form[field].$invalid && form.$submitted }">
<div class="gender-radio" ng-click="lead.title = title.title; lead.gender = title.gender" ng-class="{ 'has-success' : form[field].$valid && lead.gender == title.gender }">
<span ng-show="lead[field] == title[field]" class="glyphicon glyphicon-ok ng-hide"></span>
</div>
<div class="gender-radio-label">Mrs</div>
</div><!---->
</div>
<input-field field="gender"><!---->
<!----><input ng-hide="field == 'opt_in' || field == 'zip_code_nl'" ng-if="required && validate && template !== 'twentytwenty'" type="hidden" name="gender"
class="inputfield data-gap form-control form-input ng-pristine ng-untouched ng-empty ng-valid-minlength ng-valid-maxlength inputfield-desktop data-gap-desktop ng-invalid ng-invalid-gender" ng-model="lead[field]" minlength="" maxlength=""
value="" placeholder="Gender" api-validator="" ng-readonly="fieldSettings.readonly" ng-class="{'inputfield-desktop data-gap-desktop' : deviceType == 'web'}"><!---->
<!---->
<!-- twentytwenty input-field -->
<!----></input-field>
</div><!---->
<!---->
<!---->
<!---->
<!---->
</div><!---->
<div ng-repeat="field in flow.currentStep.settings.fields">
<!---->
<!---->
<div ng-hide="lead.hide_fields.indexOf(field) != -1 && form[field].$valid" ng-if="field == 'first_name' || field == 'last_name' || field == 'email_address' || field == 'phone_cell'" class="form-group form-item-show-hide"
ng-class="{ 'has-error' : form[field].$invalid && form.$submitted, 'has-success' : form[field].$valid }">
<!---->
<input-field field="first_name"><!---->
<!----><input ng-hide="field == 'opt_in' || field == 'zip_code_nl'" ng-if="required && validate && template !== 'twentytwenty'" type="text" name="first_name"
class="inputfield data-gap form-control form-input ng-pristine ng-untouched ng-empty ng-valid-minlength ng-valid-maxlength inputfield-desktop data-gap-desktop ng-invalid ng-invalid-first_name" ng-model="lead[field]" minlength="2"
maxlength="50" value="" placeholder="First name" api-validator="" ng-readonly="fieldSettings.readonly" ng-class="{'inputfield-desktop data-gap-desktop' : deviceType == 'web'}"><!---->
<!---->
<!-- twentytwenty input-field -->
<!----></input-field>
</div><!---->
<!---->
<!---->
<!---->
</div><!---->
<div ng-repeat="field in flow.currentStep.settings.fields">
<!---->
<!---->
<div ng-hide="lead.hide_fields.indexOf(field) != -1 && form[field].$valid" ng-if="field == 'first_name' || field == 'last_name' || field == 'email_address' || field == 'phone_cell'" class="form-group form-item-show-hide"
ng-class="{ 'has-error' : form[field].$invalid && form.$submitted, 'has-success' : form[field].$valid }">
<!---->
<input-field field="last_name"><!---->
<!----><input ng-hide="field == 'opt_in' || field == 'zip_code_nl'" ng-if="required && validate && template !== 'twentytwenty'" type="text" name="last_name"
class="inputfield data-gap form-control form-input ng-pristine ng-untouched ng-empty ng-valid-minlength ng-valid-maxlength inputfield-desktop data-gap-desktop ng-invalid ng-invalid-last_name" ng-model="lead[field]" minlength="2"
maxlength="50" value="" placeholder="Last name" api-validator="" ng-readonly="fieldSettings.readonly" ng-class="{'inputfield-desktop data-gap-desktop' : deviceType == 'web'}"><!---->
<!---->
<!-- twentytwenty input-field -->
<!----></input-field>
</div><!---->
<!---->
<!---->
<!---->
</div><!---->
<div ng-repeat="field in flow.currentStep.settings.fields">
<!---->
<!---->
<div ng-hide="lead.hide_fields.indexOf(field) != -1 && form[field].$valid" ng-if="field == 'first_name' || field == 'last_name' || field == 'email_address' || field == 'phone_cell'" class="form-group form-item-show-hide"
ng-class="{ 'has-error' : form[field].$invalid && form.$submitted, 'has-success' : form[field].$valid }">
<!---->
<input-field field="email_address"><!---->
<!----><input ng-hide="field == 'opt_in' || field == 'zip_code_nl'" ng-if="required && validate && template !== 'twentytwenty'" type="email" name="email_address"
class="inputfield data-gap form-control form-input ng-pristine ng-untouched ng-empty ng-valid-email ng-valid-minlength ng-valid-maxlength inputfield-desktop data-gap-desktop ng-invalid ng-invalid-email_address" ng-model="lead[field]"
minlength="5" maxlength="50" value="" placeholder="Email" api-validator="" ng-readonly="fieldSettings.readonly" ng-class="{'inputfield-desktop data-gap-desktop' : deviceType == 'web'}"><!---->
<!---->
<!-- twentytwenty input-field -->
<!----></input-field>
</div><!---->
<!---->
<!---->
<!---->
</div><!---->
<div ng-repeat="field in flow.currentStep.settings.fields">
<!---->
<!---->
<!---->
<!---->
<div ng-if="field == 'date_of_birth'" ng-hide="lead.hide_fields.indexOf('date_of_birth') != -1 && form[field].$valid" class="form-group form-item-show-hide" data-form-items="date_of_birth"
ng-class="{ 'has-error' : form[field].$invalid && form.$submitted, 'has-success' : form[field].$valid }">
<date-selector lead="lead"><!---->
<!---->
<div ng-if="styling && styling == 'mobile'" class="row">
<div class="col-xs-12">
<label class="form-label">Date of birth:</label>
</div>
<div class="col-xs-12">
<!---->
<div ng-repeat="item in dateFormat track by $index" class="select-dob styled-select slate select-dob-0 select-dob-m" ng-class="{ 'select-dob-y' : item == 'YYYY', 'select-dob-m' : item == 'MM', 'select-dob-d' : item == 'DD' }">
<!----><select ng-if="item == 'MM'" ng-model="lead.date_m" name="date_m" class="form-control select-custom-style form-input ng-pristine ng-untouched ng-valid ng-empty" ng-options="item.value as item.name for item in months"
ng-change="setDateOfBirth()">
<option value="" selected="selected">MM</option>
<option label="January" value="string:01">January</option>
<option label="February" value="string:02">February</option>
<option label="March" value="string:03">March</option>
<option label="April" value="string:04">April</option>
<option label="May" value="string:05">May</option>
<option label="June" value="string:06">June</option>
<option label="July" value="string:07">July</option>
<option label="August" value="string:08">August</option>
<option label="September" value="string:09">September</option>
<option label="October" value="string:10">October</option>
<option label="November" value="string:11">November</option>
<option label="December" value="string:12">December</option>
</select><!---->
<!---->
<!---->
</div><!---->
<div ng-repeat="item in dateFormat track by $index" class="select-dob styled-select slate select-dob-1 select-dob-d" ng-class="{ 'select-dob-y' : item == 'YYYY', 'select-dob-m' : item == 'MM', 'select-dob-d' : item == 'DD' }">
<!---->
<!----><select ng-if="item == 'DD'" ng-model="lead.date_d" name="date_d" class="form-control select-custom-style form-input ng-pristine ng-untouched ng-valid ng-empty" ng-options="day for day in days" ng-change="setDateOfBirth()">
<option value="" selected="selected">DD</option>
<option label="01" value="string:01">01</option>
<option label="02" value="string:02">02</option>
<option label="03" value="string:03">03</option>
<option label="04" value="string:04">04</option>
<option label="05" value="string:05">05</option>
<option label="06" value="string:06">06</option>
<option label="07" value="string:07">07</option>
<option label="08" value="string:08">08</option>
<option label="09" value="string:09">09</option>
<option label="10" value="string:10">10</option>
<option label="11" value="string:11">11</option>
<option label="12" value="string:12">12</option>
<option label="13" value="string:13">13</option>
<option label="14" value="string:14">14</option>
<option label="15" value="string:15">15</option>
<option label="16" value="string:16">16</option>
<option label="17" value="string:17">17</option>
<option label="18" value="string:18">18</option>
<option label="19" value="string:19">19</option>
<option label="20" value="string:20">20</option>
<option label="21" value="string:21">21</option>
<option label="22" value="string:22">22</option>
<option label="23" value="string:23">23</option>
<option label="24" value="string:24">24</option>
<option label="25" value="string:25">25</option>
<option label="26" value="string:26">26</option>
<option label="27" value="string:27">27</option>
<option label="28" value="string:28">28</option>
<option label="29" value="string:29">29</option>
<option label="30" value="string:30">30</option>
<option label="31" value="string:31">31</option>
</select><!---->
<!---->
</div><!---->
<div ng-repeat="item in dateFormat track by $index" class="select-dob styled-select slate select-dob-2 select-dob-y" ng-class="{ 'select-dob-y' : item == 'YYYY', 'select-dob-m' : item == 'MM', 'select-dob-d' : item == 'DD' }">
<!---->
<!---->
<!----><select ng-if="item == 'YYYY'" ng-model="lead.date_y" name="date_y" class="form-control select-custom-style form-input ng-pristine ng-untouched ng-valid ng-empty" ng-options="year for year in years" ng-change="setDateOfBirth()">
<option value="" selected="selected">YYYY</option>
<option label="2010" value="string:2010">2010</option>
<option label="2009" value="string:2009">2009</option>
<option label="2008" value="string:2008">2008</option>
<option label="2007" value="string:2007">2007</option>
<option label="2006" value="string:2006">2006</option>
<option label="2005" value="string:2005">2005</option>
<option label="2004" value="string:2004">2004</option>
<option label="2003" value="string:2003">2003</option>
<option label="2002" value="string:2002">2002</option>
<option label="2001" value="string:2001">2001</option>
<option label="2000" value="string:2000">2000</option>
<option label="1999" value="string:1999">1999</option>
<option label="1998" value="string:1998">1998</option>
<option label="1997" value="string:1997">1997</option>
<option label="1996" value="string:1996">1996</option>
<option label="1995" value="string:1995">1995</option>
<option label="1994" value="string:1994">1994</option>
<option label="1993" value="string:1993">1993</option>
<option label="1992" value="string:1992">1992</option>
<option label="1991" value="string:1991">1991</option>
<option label="1990" value="string:1990">1990</option>
<option label="1989" value="string:1989">1989</option>
<option label="1988" value="string:1988">1988</option>
<option label="1987" value="string:1987">1987</option>
<option label="1986" value="string:1986">1986</option>
<option label="1985" value="string:1985">1985</option>
<option label="1984" value="string:1984">1984</option>
<option label="1983" value="string:1983">1983</option>
<option label="1982" value="string:1982">1982</option>
<option label="1981" value="string:1981">1981</option>
<option label="1980" value="string:1980">1980</option>
<option label="1979" value="string:1979">1979</option>
<option label="1978" value="string:1978">1978</option>
<option label="1977" value="string:1977">1977</option>
<option label="1976" value="string:1976">1976</option>
<option label="1975" value="string:1975">1975</option>
<option label="1974" value="string:1974">1974</option>
<option label="1973" value="string:1973">1973</option>
<option label="1972" value="string:1972">1972</option>
<option label="1971" value="string:1971">1971</option>
<option label="1970" value="string:1970">1970</option>
<option label="1969" value="string:1969">1969</option>
<option label="1968" value="string:1968">1968</option>
<option label="1967" value="string:1967">1967</option>
<option label="1966" value="string:1966">1966</option>
<option label="1965" value="string:1965">1965</option>
<option label="1964" value="string:1964">1964</option>
<option label="1963" value="string:1963">1963</option>
<option label="1962" value="string:1962">1962</option>
<option label="1961" value="string:1961">1961</option>
<option label="1960" value="string:1960">1960</option>
<option label="1959" value="string:1959">1959</option>
<option label="1958" value="string:1958">1958</option>
<option label="1957" value="string:1957">1957</option>
<option label="1956" value="string:1956">1956</option>
<option label="1955" value="string:1955">1955</option>
<option label="1954" value="string:1954">1954</option>
<option label="1953" value="string:1953">1953</option>
<option label="1952" value="string:1952">1952</option>
<option label="1951" value="string:1951">1951</option>
<option label="1950" value="string:1950">1950</option>
<option label="1949" value="string:1949">1949</option>
<option label="1948" value="string:1948">1948</option>
<option label="1947" value="string:1947">1947</option>
<option label="1946" value="string:1946">1946</option>
<option label="1945" value="string:1945">1945</option>
<option label="1944" value="string:1944">1944</option>
<option label="1943" value="string:1943">1943</option>
<option label="1942" value="string:1942">1942</option>
<option label="1941" value="string:1941">1941</option>
<option label="1940" value="string:1940">1940</option>
<option label="1939" value="string:1939">1939</option>
<option label="1938" value="string:1938">1938</option>
<option label="1937" value="string:1937">1937</option>
<option label="1936" value="string:1936">1936</option>
<option label="1935" value="string:1935">1935</option>
<option label="1934" value="string:1934">1934</option>
</select><!---->
</div><!---->
</div>
</div><!---->
<!---->
<!---->
<!---->
<!---->
<input-field lead="lead" field="date_of_birth" validateform="validateForm()"><!---->
<!----><input ng-hide="field == 'opt_in' || field == 'zip_code_nl'" ng-if="required && validate && template !== 'twentytwenty'" type="hidden" name="date_of_birth"
class="inputfield data-gap form-control form-input ng-pristine ng-untouched ng-empty ng-valid-minlength ng-valid-maxlength inputfield-desktop data-gap-desktop ng-invalid ng-invalid-date_of_birth" ng-model="lead[field]" minlength=""
maxlength="" value="" placeholder="Date of birth:" api-validator="" ng-readonly="fieldSettings.readonly" ng-class="{'inputfield-desktop data-gap-desktop' : deviceType == 'web'}"><!---->
<!---->
<!-- twentytwenty input-field -->
<!----></input-field>
</date-selector>
</div><!---->
<!---->
</div><!---->
<div ng-repeat="field in flow.currentStep.settings.fields">
<!---->
<!---->
<div ng-hide="lead.hide_fields.indexOf(field) != -1 && form[field].$valid" ng-if="field == 'first_name' || field == 'last_name' || field == 'email_address' || field == 'phone_cell'" class="form-group form-item-show-hide"
ng-class="{ 'has-error' : form[field].$invalid && form.$submitted, 'has-success' : form[field].$valid }">
<!----><phone-cell-multiple ng-if="field == 'phone_cell' && flow.survey.locale == 'en_US'" lead="lead"><!----><label ng-if="flow.landing_page.settings.template != 'lp2' && flow.landing_page.settings.template != 'lp2amazon'"
class="form-label">Mobile number:</label><!----><input type="tel" id="phone_cell_1" name="phone_cell_1" class="form-control form-input ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-valid-minlength ng-valid-maxlength"
maxlength="3" ng-minlength="3" ng-model="lead.phone_cell_1" ng-required="true" ng-change="setPhoneCell()" required="required"><input type="tel" id="phone_cell_2" name="phone_cell_2"
class="form-control form-input ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-valid-minlength ng-valid-maxlength" maxlength="3" ng-minlength="3" ng-model="lead.phone_cell_2" ng-required="true" ng-change="setPhoneCell()"
required="required"><input type="tel" id="phone_cell_3" name="phone_cell_3" class="form-control form-input ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-valid-minlength ng-valid-maxlength" maxlength="4"
ng-minlength="4" ng-model="lead.phone_cell_3" ng-required="true" ng-change="setPhoneCell()" required="required"></phone-cell-multiple><!---->
<input-field field="phone_cell"><!---->
<!----><input ng-hide="field == 'opt_in' || field == 'zip_code_nl'" ng-if="required && validate && template !== 'twentytwenty'" type="hidden" name="phone_cell"
class="inputfield data-gap form-control form-input ng-pristine ng-untouched ng-empty ng-valid-minlength ng-valid-maxlength inputfield-desktop data-gap-desktop ng-invalid ng-invalid-phone_cell" ng-model="lead[field]" minlength="10"
maxlength="10" value="" placeholder="Mobile number" api-validator="" ng-readonly="fieldSettings.readonly" ng-class="{'inputfield-desktop data-gap-desktop' : deviceType == 'web'}"><!---->
<!---->
<!-- twentytwenty input-field -->
<!----></input-field>
</div><!---->
<!---->
<!---->
<!---->
</div><!---->
<div ng-repeat="field in flow.currentStep.settings.fields">
<!---->
<!---->
<!---->
<!---->
<!---->
<div ng-if="field == 'address_fields'">
<!---->
<!---->
<!---->
<div ng-if="flow.survey.locale == 'en_AU' || flow.survey.locale == 'en_NZ' || flow.survey.locale == 'fr_FR' || flow.survey.locale == 'en_CA' || flow.survey.locale == 'en_US' || flow.survey.locale == 'en_ZA' || flow.survey.locale == 'el_GR'">
<div class="row">
<div class="col-xs-12 form-group form-item-show-hide" data-form-items="zip_code" ng-hide="form['zip_code'].$valid" ng-class="{ 'has-error' : form['zip_code'].$invalid && form.$submitted, 'has-success' : form['zip_code'].$valid }">
<input-field field="zip_code"><!---->
<!----><input ng-hide="field == 'opt_in' || field == 'zip_code_nl'" ng-if="required && validate && template !== 'twentytwenty'" type="tel" name="zip_code"
class="inputfield data-gap form-control form-input ng-pristine ng-untouched ng-empty ng-valid-minlength ng-valid-maxlength inputfield-desktop data-gap-desktop ng-invalid ng-invalid-zip_code" ng-model="lead[field]" minlength="5"
maxlength="5" value="" placeholder="ZIP code" api-validator="" ng-readonly="fieldSettings.readonly" ng-class="{'inputfield-desktop data-gap-desktop' : deviceType == 'web'}"><!---->
<!---->
<!-- twentytwenty input-field -->
<!----></input-field>
</div>
<div ng-show="lead.city" class="col-xs-12 form-item-show-hide" data-form-items="city" ng-hide="form['city'].$valid && flow.survey.locale != 'en_AU'"
ng-class="{ 'has-error' : form['city'].$invalid && form.$submitted, 'has-success' : form['city'].$valid }">
<city-select field="city"><!----><!---->
<div ng-if="options.length <= 1" class="form-group"><input-field lead="lead" field="city" validateform="validateForm()"><!---->
<!----><input ng-hide="field == 'opt_in' || field == 'zip_code_nl'" ng-if="required && validate && template !== 'twentytwenty'" type="hidden" name="city"
class="inputfield data-gap form-control form-input ng-pristine ng-untouched ng-empty ng-valid-minlength ng-valid-maxlength inputfield-desktop data-gap-desktop ng-invalid ng-invalid-city" ng-model="lead[field]" minlength="2"
maxlength="50" value="" placeholder="City" api-validator="" ng-readonly="fieldSettings.readonly" ng-class="{'inputfield-desktop data-gap-desktop' : deviceType == 'web'}"><!---->
<!---->
<!-- twentytwenty input-field -->
<!----></input-field></div><!---->
</city-select>
</div>
<div class="col-xs-12 form-group" ng-class="{ 'has-error' : form['address'].$invalid && form.$submitted, 'has-success' : form['address'].$valid }">
<input-field field="address"><!---->
<!----><input ng-hide="field == 'opt_in' || field == 'zip_code_nl'" ng-if="required && validate && template !== 'twentytwenty'" type="text" name="address"
class="inputfield data-gap form-control form-input ng-pristine ng-untouched ng-empty ng-valid-minlength ng-valid-maxlength inputfield-desktop data-gap-desktop ng-invalid ng-invalid-address" ng-model="lead[field]" minlength="2"
maxlength="50" value="" placeholder="Street Address" api-validator="" ng-readonly="fieldSettings.readonly" ng-class="{'inputfield-desktop data-gap-desktop' : deviceType == 'web'}"><!---->
<!---->
<!-- twentytwenty input-field -->
<!----></input-field>
</div>
</div>
</div><!---->
<!---->
<!---->
</div><!---->
</div><!---->
<!---->
<!----><input ng-if="flow.survey.locale == 'en_US'" id="leadid_token" type="hidden" value="46211BBC-F0D5-A8E5-4813-FD144076E58A"><!---->
<div class="row">
<div class="col-xs-12">
<div class="form-group">
<button type="submit" class="btn btn-primary btn-submit" ng-class="{ 'btn-success' : form.$valid }" form="form">
<!----> <!----><span ng-if="flow.currentStep.settings.fields.length > 1">Continue</span><!---->
<!---->
<!----> </button>
<!---->
<!----><img ng-if="flow.survey.locale != 'en_AU'" src="/templates/surfeyo_2/images/icon-safe-server-en.png" class="img-responsive pull-right"><!---->
<!---->
</div>
</div>
</div>
<!---->
<input type="hidden" name="xxTrustedFormToken" id="xxTrustedFormToken_0" value="https://cert.trustedform.com/ee758d1bc896b14b8a0009dc84a13ebe124c835a"><input type="hidden" name="xxTrustedFormCertUrl" id="xxTrustedFormCertUrl_0"
value="https://cert.trustedform.com/ee758d1bc896b14b8a0009dc84a13ebe124c835a"><input type="hidden" name="xxTrustedFormPingUrl" id="xxTrustedFormPingUrl_0"
value="https://ping.trustedform.com/0.CVKiEi6gYZyJMdw9GM9teAAAeOsTIpUF3G8hiVAXE4tgm3KuN-MvppWtyDGN_V5vh-rbpNde.KIOal8gdFD6WBN7apwGJ5Q.58HGmdRQhHUHRyr2MXnYAg">
</form>Text Content
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