claim.claimservice.app Open in urlscan Pro
13.225.78.20  Public Scan

Form analysis
1 forms found in the DOM

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<form action="#" data-hs-cf-bound="true">
  <div class="sm:rounded sm:shadow sm:px-40 sm:py-50 sm:bg-white">
    <h1 class="mb-30 sm:my-30 sm:mt-0 mx-10 sm:mx-20 lg:mx-0 text-center sm:text-left text-center">Sign in to view and manage your claim</h1>
    <div class="shadow-sm py-25 px-12 rounded bg-white sm:shadow-none sm:py-0 sm:px-0 sm:rounded-0 sm:bg-transparent">
      <div>
        <h3 class="separator-text mb-25 sm:mb-30"><span>Continue with</span></h3>
      </div>
      <div class="flex sm:justify-center justify-between"><button type="button" class="outline-none focus:outline-none mr-5 login-button border-google text-google hover:text-white hover:bg-google"><svg class="inline mr-15" width="18" height="18">
            <path
              d="M9.127 7.218v3.564s3.506-.005 4.934-.005c-.774 2.311-1.976 3.57-4.934 3.57-2.995 0-5.332-2.394-5.332-5.347 0-2.953 2.337-5.347 5.332-5.347 1.583 0 2.605.55 3.543 1.314.75-.74.688-.846 2.598-2.625A9.164 9.164 0 009.127 0C4.087 0 0 4.03 0 9s4.087 9 9.127 9c7.533 0 9.375-6.47 8.765-10.782H9.127"
              fill="#DB5340" fill-rule="evenodd"></path>
          </svg><span>Google</span></button><button type="button" class="outline-none focus:outline-none ml-5 login-button border-facebook text-facebook hover:text-white hover:bg-facebook"><svg class="inline mr-15" width="18" height="18">
            <path
              d="M18 17.007a.993.993 0 01-.993.993H12.42v-6.97h2.34l.35-2.717h-2.69V6.579c0-.787.218-1.323 1.346-1.323h1.439v-2.43a19.143 19.143 0 00-2.096-.108c-2.074 0-3.494 1.266-3.494 3.591v2.004H7.269v2.716h2.346V18H.993A.993.993 0 010 17.007V.993C0 .445.445 0 .993 0h16.014c.548 0 .993.445.993.993v16.014"
              fill="#3E579B" fill-rule="evenodd"></path>
          </svg> <span>Facebook</span></button></div>
      <div>
        <h3 class="separator-text my-25 sm:my-30 mt-40 sm:mt-45"><span>Or using your email address</span></h3>
      </div>
      <div class="fieldset sm:flex-row">
        <div class="input-group sm:max-w-315" style="margin-left:;margin-top:"><label class="mb-10 px-15 lg:px-0 font-pt-sans block text-gray-400 font-bold h-20 text-base label-description" for="email">What is your email address?</label><input
            type="text" id="email" data-hj-allow="true" name="email" placeholder="Your email" class="form-input w-full placeholder-gray-300" aria-invalid="false" value=""></div>
        <div class="input-group sm:max-w-315" style="margin-left:;margin-top:"><label class="mb-10 px-15 lg:px-0 font-pt-sans block text-gray-400 font-bold h-20 text-base label-description" for="password">Password (at least 8
            characters)</label><input type="password" id="password" data-hj-allow="true" name="password" placeholder="Create new password" class="form-input w-full placeholder-gray-300" aria-invalid="false" value=""></div>
      </div>
    </div>
    <div class="flex m-auto flex-col align-center items-center justify-center mx-8 sm:mx-0"><button class="button button-primary button-medium mt-25 sm:w-170" disabled="">Log in<svg alt="Continue icon" class="inline ml-15 fill-button-text-color"
          width="9" height="14">
          <path d="M1.884 13a.634.634 0 01-.43-.166.563.563 0 01-.012-.825L6.52 7.06 1.18 1.996a.563.563 0 010-.825.64.64 0 01.87 0l5.77 5.47c.238.226.24.59.006.82l-5.5 5.363a.638.638 0 01-.442.176z" fill="#FFF" fill-rule="nonzero" stroke="#FFF"
            stroke-width=".923"></path>
        </svg></button>
      <p class="p-10 m-15">Forgot password? <a href="/forgot-password" rel="noreferrer">Reset it now</a></p>
    </div>
  </div>
</form>

Text Content

Claim service powered by


SIGN IN TO VIEW AND MANAGE YOUR CLAIM


CONTINUE WITH

Google Facebook


OR USING YOUR EMAIL ADDRESS

What is your email address?
Password (at least 8 characters)
Log in

Forgot password? Reset it now



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