www.pengaduan-internal.akbarmuchbarak.web.id Open in urlscan Pro
45.13.255.214  Public Scan

Form analysis
1 forms found in the DOM

https://www.pengaduan-internal.akbarmuchbarak.web.id/public/pengajuan/baru

<form action="https://www.pengaduan-internal.akbarmuchbarak.web.id/public/pengajuan/baru">
  <div class="mb-3"><label class="form-label" for="card-email">Email address</label><input class="form-control" id="card-email" type="email" autocomplete="off"></div>
  <div class="mb-3">
    <div class="d-flex justify-content-between"><label class="form-label" for="card-password">Password</label></div><input class="form-control" id="card-password" autocomplete="off" type="password">
  </div>
  <div class="row flex-between-center">
    <div class="col-auto">
      <div class="form-check mb-0"><input class="form-check-input" type="checkbox" id="card-checkbox" checked="checked"><label class="form-check-label mb-0" for="card-checkbox">Remember me</label></div>
    </div>
    <div class="col-auto"><a class="fs--1" href="https://www.pengaduan-internal.akbarmuchbarak.web.id/public/auth/forgot-password">Forgot Password?</a></div>
  </div>
  <div class="mb-3"><button class="btn btn-primary d-block w-100 mt-3" type="submit" name="submit">Log in</button></div>
</form>

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