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portal.service.bellmer.com Open in urlscan Pro
2a0a:de40:0:1000::46  Public Scan

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Submitted URL: https://portal.service.bellmer.com/
Effective URL: https://portal.service.bellmer.com/license/requestNew
Submission: On February 28 via automatic, source certstream-suspicious — Scanned from DE

Form analysis 1 forms found in the DOM

POST /license/sendLicenseRequest

<form action="/license/sendLicenseRequest" method="post">
  <input type="hidden" name="SYNCHRONIZER_TOKEN" value="01506efa-63f2-4889-863a-f8882e3ae19d" id="SYNCHRONIZER_TOKEN">
  <input type="hidden" name="SYNCHRONIZER_URI" value="/license/requestNew" id="SYNCHRONIZER_URI">
  <div class="card mb-3 cxo-css-form-card " id="">
    <div class="card-body px-5 " id="">
      <div class="row justify-content-between">
        <div class="col-xl-8">
          <div class="form-outline">
            <input type="text" name="company" value="" class="form-control " id="company">
            <label for="company" class="form-label" style="margin-left: 0px;">Firma <i class="fas fa-fw fa-asterisk fa-form-required"></i></label>
            <div class="form-notch">
              <div class="form-notch-leading" style="width: 9px;"></div>
              <div class="form-notch-middle" style="width: 628.8px;"></div>
              <div class="form-notch-trailing"></div>
            </div>
          </div>
        </div>
        <div class="col-xl-4"></div>
      </div>
      <div class="row justify-content-between">
        <div class="col-xl-8">
          <div class="form-outline">
            <input type="text" name="contactPerson" value="" class="form-control " id="contactPerson">
            <label for="contactPerson" class="form-label" style="margin-left: 0px;">Ansprechpartner <i class="fas fa-fw fa-asterisk fa-form-required"></i></label>
            <div class="form-notch">
              <div class="form-notch-leading" style="width: 9px;"></div>
              <div class="form-notch-middle" style="width: 628.8px;"></div>
              <div class="form-notch-trailing"></div>
            </div>
          </div>
        </div>
        <div class="col-xl-4"></div>
      </div>
      <div class="row justify-content-between">
        <div class="col-xl-8">
          <div class="form-outline">
            <input type="text" name="email" value="" class="form-control " id="email">
            <label for="email" class="form-label" style="margin-left: 0px;">E-Mail Ansprechpartner <i class="fas fa-fw fa-asterisk fa-form-required"></i></label>
            <div class="form-notch">
              <div class="form-notch-leading" style="width: 9px;"></div>
              <div class="form-notch-middle" style="width: 628.8px;"></div>
              <div class="form-notch-trailing"></div>
            </div>
          </div>
        </div>
        <div class="col-xl-4"></div>
      </div>
      <div class="row justify-content-between">
        <div class="col-xl-8">
          <div class="form-outline">
            <input type="text" name="confirmationNumber" value="" class="form-control " id="confirmationNumber">
            <label for="confirmationNumber" class="form-label" style="margin-left: 0px;">Auftragsnummer</label>
            <div class="form-notch">
              <div class="form-notch-leading" style="width: 9px;"></div>
              <div class="form-notch-middle" style="width: 628.8px;"></div>
              <div class="form-notch-trailing"></div>
            </div>
          </div>
        </div>
        <div class="col-xl-4"></div>
      </div>
    </div>
  </div>
  <div class="page-footer-buttons-wrapper">
    <div class="page-footer-buttons-wrapper">
      <input type="submit" class="license-request-button" name="license-request" value="license-request" style="display: none" id="license-request">
      <a href="javascript:void(0);" title="Lizenz anfordern" onclick="$(this).closest('form').find('input[name=license-request].license-request-button').click();common.showLoading($('#requestNew'));" class="action-button license-request btn btn-primary ">
                            <i class="fa-fw fas fa-file-upload"></i>&nbsp;Lizenz anfordern
                        </a>
    </div>
  </div>
</form>

Text Content

NEUE LIZENZ ANFORDERN

Firma


Ansprechpartner


E-Mail Ansprechpartner


Auftragsnummer


 Lizenz anfordern
 * Datenschutz
 * Impressum