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216.124.54.16  Public Scan

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Submitted URL: https://www.idotfeedback.com/
Effective URL: https://apps.dot.illinois.gov/WER/?from=1
Submission: On September 18 via automatic, source certstream-suspicious — Scanned from IT

Form analysis 1 forms found in the DOM

POST /WER/Email/SubmitQuestion

<form action="/WER/Email/SubmitQuestion" class="form-horizontal" id="ContactForm" method="post"><input data-val="true" data-val-number="The field From must be a number." data-val-required="The From field is required." id="From" name="From"
    type="hidden" value="1">
  <div class="error">
    <div class="validation-summary-valid" data-valmsg-summary="true">
      <ul>
        <li style="display:none"></li>
      </ul>
    </div>
  </div>
  <input name="__RequestVerificationToken" type="hidden" value="OhXRek6sa2vEqGWq8kxUy6s2iVn8Do2GtPH-KxCHbxKkRP-_NOcPJzGKew4GXQobIddUmKfIbTopni9LJxBFp-FMILkgD0QjzTX0WNhiOwY1">
  <div class="form-group">
    <label class="col-lg-2 control-label" for="Name">Name <label title="Required" class="required" style="color:red">*</label> </label>
    <div class="col-lg-4">
      <input class="form-control" data-val="true" data-val-required="The Name field is required." id="Name" name="Name" type="text" value="">
      <span class="field-validation-valid error" data-valmsg-for="Name" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-2 control-label" for="Address1">Address Line 1 <label title="Required" class="required" style="color:red">*</label> </label>
    <div class="col-lg-4">
      <input class="form-control" data-val="true" data-val-required="The Address Line 1 field is required." id="Address1" name="Address1" type="text" value="">
      <span class="field-validation-valid error" data-valmsg-for="Address1" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-2 control-label" for="Address2">Address Line 2</label>
    <div class="col-lg-4">
      <input class="form-control" id="Address2" name="Address2" type="text" value="">
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-2 control-label" for="City">City <label title="Required" class="required" style="color:red">*</label> </label>
    <div class="col-lg-4">
      <input class="form-control" data-val="true" data-val-required="The City field is required." id="City" name="City" type="text" value="">
      <span class="field-validation-valid error" data-valmsg-for="City" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-2 control-label" for="State">State/Province <label title="Required" class="required" style="color:red">*</label> </label>
    <div class="col-lg-4">
      <select class="form-control" data-val="true" data-val-required="The State/Province field is required." id="State" name="State">
        <option value="">--Select State--</option>
        <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="FL">Florida</option>
        <option value="GA">Georia</option>
        <option value="HI">Hawaii</option>
        <option value="ID">Idaho</option>
        <option value="IL">Illinois</option>
        <option value="ID">Indiana</option>
        <option value="IA">Iowa</option>
        <option value="KA">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="MN">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>
      </select>
      <span class="field-validation-valid error" data-valmsg-for="State" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-2 control-label" for="Zip">Zip/Postal Code <label title="Required" class="required" style="color:red">*</label> </label>
    <div class="col-lg-4">
      <input class="form-control" data-val="true" data-val-required="The Zip/Postal Code field is required." id="Zip" name="Zip" type="text" value="">
      <span class="field-validation-valid error" data-valmsg-for="Zip" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-2 control-label" for="WorkPhone">Work Phone</label>
    <div class="col-lg-4">
      <input class="form-control" id="WorkPhone" maxlength="10" name="WorkPhone" type="text" value="">
      <span class="field-validation-valid error" data-valmsg-for="WorkPhone" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-2 control-label" for="HomePhone">Home Phone</label>
    <div class="col-lg-4">
      <input class="form-control" id="HomePhone" maxlength="10" name="HomePhone" type="text" value="">
      <span class="field-validation-valid error" data-valmsg-for="HomePhone" data-valmsg-replace="true"></span>
      <p>Note: Either Home Phone or Work Phone is required</p>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-2 control-label" for="EmailFrom">Email <label title="Required" class="required" style="color:red">*</label> </label>
    <div class="col-lg-4">
      <input class="form-control" data-val="true" data-val-required="The Email field is required." id="EmailFrom" name="EmailFrom" type="text" value="">
      <span class="field-validation-valid error" data-valmsg-for="EmailFrom" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-2 control-label" for="SubjectMatter">Subject Matter <label title="Required" class="required" style="color:red">*</label> </label>
    <div class="col-lg-4">
      <input class="form-control" data-val="true" data-val-required="The Subject Matter field is required." id="SubjectMatter" name="SubjectMatter" type="text" value="">
    </div>
  </div>
  <div class="form-group">
    <label class="col-lg-2 control-label" for="Message">Question/Comment <label title="Required" class="required" style="color:red">*</label> </label>
    <div class="col-lg-4">
      <textarea class="form-control" cols="20" data-val="true" data-val-required="The Question/Comment field is required." id="Message" name="Message" rows="2"></textarea>
      <span class="field-validation-valid error" data-valmsg-for="Message" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="form-group">
    <div class="col-lg-offset-5">
      <button type="submit" id="submitButton" data-loading-text="Submitting..." class="btn btn-primary btn-lg" autocomplete="off"> Submit </button>
    </div>
    <div class="col-lg-4">
      <p style="text-align:right">Please Press submit button only once.</p>
    </div>
  </div>
</form>

Text Content

 
Illinois Department of Transportation
Omer Osman, Secretary
State of Illinois
Governor JB Pritzker
Questions/Comments Submittal Form


 * 

Name *

Address Line 1 *

Address Line 2

City *

State/Province *
--Select State-- Alabama Alaska Arizona Arkansas California Colorado Connecticut
Delaware Florida Georia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky
Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri
Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North
Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South
Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West
Virginia Wisconsin Wyoming
Zip/Postal Code *

Work Phone

Home Phone

Note: Either Home Phone or Work Phone is required

Email *

Subject Matter *

Question/Comment *

Submit

Please Press submit button only once.



© 2017 Illinois Department of Transportation