mydailyprzstr.com
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2606:4700:3035::6815:444f
Public Scan
Submitted URL: http://www.lpdreamforge.com/3wbz8f/25t2mfz4/?sub1=wvhecb1kn0i2cb43jivbdno2
Effective URL: https://mydailyprzstr.com/v10vpa920292/?affId=34&c1=64&c2=6074f573f2794ff4b93c6164690fc978&c3=1346823
Submission: On August 02 via api from US — Scanned from DE
Effective URL: https://mydailyprzstr.com/v10vpa920292/?affId=34&c1=64&c2=6074f573f2794ff4b93c6164690fc978&c3=1346823
Submission: On August 02 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
Name: downsell_form1 — POST ajax.php?method=downsell1
<form method="post" action="ajax.php?method=downsell1" name="downsell_form1" accept-charset="utf-8" enctype="application/x-www-form-urlencoded;charset=utf-8" novalidate="novalidate">
<div class="row mb-2">
<div class="col-6">
<label for="fname">First Name:</label>
<input placeholder="First Name" id="first_name" type="text" class="form-control required py-0 px-2" style="--bs-bg-opacity: .1;" name="firstName" data-error-message="Please enter your first name!">
</div>
<div class="col-6">
<label for="lname">Last Name:</label>
<input placeholder="Last Name" id="last_name" type="text" class="form-control required py-0 px-2" style="--bs-bg-opacity: .1;" name="lastName" data-error-message="Please enter your last name!">
</div>
</div>
<div class="row mb-2">
<div class="col-12">
<label for="email">Email:</label>
<input placeholder="Email" id="email_address" type="email" class="form-control required py-0 px-2" style="--bs-bg-opacity: .1;" name="email" data-error-message="Please enter a valid email id!">
</div>
</div>
<div class="row mb-2">
<div class="col-12">
<label for="phone">Phone:</label>
<input type="tel" name="phone" id="phone" maxlength="10" data-min-length="10" data-max-length="10" placeholder="Phone" class="form-control required py-0 px-2" style="--bs-bg-opacity: .1;"
data-error-message="Please enter a valid contact number!" onkeyup="javascript: this.value = this.value.replace(/[^0-9]/g, '');">
</div>
</div>
<div class="row mb-2">
<div class="col-12">
<span for="zipcode" class="labelTitel">Zip or Postal Code:</span>
<input class="form-control required" name="shippingZip" placeholder="Postal Code*" title="Postal Code" type="text" minlength="7" maxlength="7" value="" data-error-message="Please enter a valid Postal Code!">
</div>
</div>
<div class="row mb-2">
<div class="col-12">
<label for="address">Address:</label>
<input type="text" class="form-control required py-0 px-2" style="--bs-bg-opacity: .1;" name="shippingAddress1" placeholder="Address" data-error-message="Please enter your address!">
</div>
</div>
<div class="row mb-2">
<div class="col-12">
<label for="city">City:</label>
<input placeholder="City" type="text" name="shippingCity" class="form-control required py-0 px-2" style="--bs-bg-opacity: .1;" data-error-message="Please enter your city!">
</div>
</div>
<div class="row mb-2">
<div class="col-12">
<label for="country">Country:</label>
<select name="shippingCountry" class="form-control required py-0 px-2 no-error" data-selected="CA" data-error-message="Please select your country!">
<option value="CA">Canada</option>
</select>
</div>
</div>
<div class="row mb-2">
<div class="col-12">
<span for="country">Province:</span>
<select name="shippingState" type="text" placeholder="Your Province" class="form-control required py-0 px-2" data-selected="" data-error-message="Please select your Province!" readonly="readonly">
<option value="" selected="selected">Select State</option>
<option value="AB">Alberta</option>
<option value="BC">British Columbia</option>
<option value="MB">Manitoba</option>
<option value="NB">New Brunswick</option>
<option value="NL">Newfoundland and Labrador</option>
<option value="NT">Northwest Territories</option>
<option value="NS">Nova Scotia</option>
<option value="NU">Nunavut</option>
<option value="ON">Ontario</option>
<option value="PE">Prince Edward Island</option>
<option value="QC">Quebec</option>
<option value="SK">Saskatchewan</option>
<option value="YT">Yukon</option>
</select>
</div>
</div>
<div class="row mb-2">
<div class="col-12">
<p class="bill_as_ship">
<label>Billing same as Shipping</label>
<input type="radio" name="billingSameAsShipping" value="yes" checked="checked"> YES <input type="radio" name="billingSameAsShipping" value="no"> NO
</p>
</div>
</div>
<div class="billing-info" style="display:none;">
<div class="row mb-2">
<div class="col-12">
<label for="country">Billing First Name:</label>
<input type="text" class="form-control py-0 px-2" style="--bs-bg-opacity: .1;" name="billingFirstName" placeholder="Billing First Name" data-error-message="Please enter your billing first name!">
</div>
</div>
<div class="row mb-2">
<div class="col-12">
<label for="country">Billing Last Name:</label>
<input type="text" class="form-control py-0 px-2" style="--bs-bg-opacity: .1;" name="billingLastName" placeholder="Billing Last Name" data-error-message="Please enter your billing last name!">
</div>
</div>
<div class="row mb-2">
<div class="col-12">
<label>Billing Address:</label>
<input type="text" class="form-control py-0 px-2" style="--bs-bg-opacity: .1;" name="billingAddress1" placeholder="Billing Address" data-error-message="Please enter your billing address!">
</div>
</div>
<div class="row mb-2">
<div class="col-12">
<label>Billing City:</label>
<input type="text" class="form-control py-0 px-2" style="--bs-bg-opacity: .1;" name="billingCity" placeholder="Billing City" data-error-message="Please enter your billing City!">
</div>
</div>
<div class="row mb-2">
<div class="col-12">
<label>Billing Country:</label>
<select name="billingCountry" class="form-control py-0 px-2" data-selected="US" data-error-message="Please select your billing country!">
<option value="">Select Country</option>
</select>
</div>
</div>
<div class="row mb-2">
<div class="col-12">
<span for="country">Billing Province:</span>
<input type="text" class="form-control py-0 px-2" style="--bs-bg-opacity: .1;" name="billingState" placeholder="Billing Province" data-error-message="Please enter your billing Province!" readonly="">
</div>
</div>
<div class="row mb-2">
<div class="col-12">
<label for="zipcode">Billing Zip or Postal Code:</label>
<input class="form-control" name="billingZip" placeholder="Postal Code*" title="Postal Code" type="text" minlength="7" maxlength="7" value="" data-error-message="Please enter a valid Postal Code!">
</div>
</div>
</div>
<div class="row mb-2">
<select name="creditCardType" data-deselect="false" style="display:none" class="required" data-error-message="Please select valid card type!">
<option value="">Card Type</option>
<option value="master">Master Card</option>
<option value="visa">Visa</option>
</select>
<div class="col-12 ">
<label for="ccard">Credit Card Number:</label>
<div class="position-relative ccards">
<input name="creditCardNumber" placeholder="---- ---- ---- ----" type="tel" style="--bs-bg-opacity: .1;" class="form-control required py-0 ps-2" maxlength="16" data-min-length="16" data-max-length="16"
data-error-message="Please enter a valid card number!" onkeyup="javascript: this.value = this.value.replace(/[^0-9]/g, '');" data-threeds="pan">
<div class="float-card">
<img alt="mcLogo" src="/v10vpa920292/app/desktop/images/mcLogo.png" class="img-card">
<img alt="visaLogo" src="/v10vpa920292/app/desktop/images/visaLogo.png" class="img-card">
</div>
</div>
</div>
</div>
<div class="row mb-3">
<div class="col-6">
<label for="validMonth">Valid Thru:</label>
<select name="expmonth" class="form-control required py-0 px-2" data-error-message="Please select a valid expiry month!" data-threeds="month">
<option value="">Month</option>
<option value="01">(01) January</option>
<option value="02">(02) February</option>
<option value="03">(03) March</option>
<option value="04">(04) April</option>
<option value="05">(05) May</option>
<option value="06">(06) June</option>
<option value="07">(07) July</option>
<option value="08">(08) August</option>
<option value="09">(09) September</option>
<option value="10">(10) October</option>
<option value="11">(11) November</option>
<option value="12">(12) December</option>
</select>
</div>
<div class="col-6">
<label for="validYear"> </label>
<select name="expyear" class="required form-control" data-error-message="Please select a valid expiry year!" data-threeds="year">
<option value="">Year</option>
<option value="24">2024</option>
<option value="25">2025</option>
<option value="26">2026</option>
<option value="27">2027</option>
<option value="28">2028</option>
<option value="29">2029</option>
<option value="30">2030</option>
<option value="31">2031</option>
<option value="32">2032</option>
<option value="33">2033</option>
<option value="34">2034</option>
<option value="35">2035</option>
<option value="36">2036</option>
<option value="37">2037</option>
<option value="38">2038</option>
<option value="39">2039</option>
<option value="40">2040</option>
<option value="41">2041</option>
<option value="42">2042</option>
<option value="43">2043</option>
</select>
</div>
</div>
<div class="row mb-3">
<div class="col-6">
<label for="lname">CVV:</label>
<div class="position-relative">
<input type="tel" name="CVV" placeholder="cvv" class="form-control required py-0 px-2" id="lname" style="--bs-bg-opacity: .1;" maxlength="3" data-min-length="3" data-max-length="3" data-error-message="Please enter a valid CVV code!"
onkeyup="javascript: this.value = this.value.replace(/[^0-9]/g, '');">
<svg viewBox="0 0 24 24" focusable="false" class="qs-icon" onclick="javascript:openNewWindow('cvv.html','modal');">
<path fill="currentColor"
d="M12,0A12,12,0,1,0,24,12,12.013,12.013,0,0,0,12,0Zm0,19a1.5,1.5,0,1,1,1.5-1.5A1.5,1.5,0,0,1,12,19Zm1.6-6.08a1,1,0,0,0-.6.917,1,1,0,1,1-2,0,3,3,0,0,1,1.8-2.75A2,2,0,1,0,10,9.255a1,1,0,1,1-2,0,4,4,0,1,1,5.6,3.666Z">
</path>
</svg>
</div>
</div>
</div>
<div class="row mb-2">
<div class="col-12">
<input style="padding:10px 15px;" type="submit" class="btn btn-lg btn-primary w-100 orderButton" value="SUBMIT">
</div>
</div>
<div class="row mb-2">
<div class="col-12 ptext text-center">
<p style="margin-top: 8px;">Your IP Address has been logged for fraud protection.</p>
<p>Contact us for any questions or concerns <a href="tel:888-791-0112"> 888-791-0112 </a><a>.</a></p><a>
</a>
</div><a>
</a>
</div><a>
</a><input type="hidden" name="cavv" id="cavv" value=""><input type="hidden" name="eci" id="eci" value=""><input type="hidden" name="xid" id="xid" value=""><input type="hidden" name="status" id="status" value=""><input type="hidden" id="amt"
value="29.85"><input type="hidden" name="protocolVersion" id="protocolVersion" value=""><input type="hidden" name="authenticationValue" id="authenticationValue" value=""><input type="hidden" name="dsTransactionId" id="dsTransactionId"
value=""><input type="hidden" name="split_cavv" id="split_cavv" value=""><input type="hidden" name="split_eci" id="split_eci" value=""><input type="hidden" name="split_xid" id="split_xid" value=""><input type="hidden" name="split_status"
id="split_status" value=""><input type="hidden" id="split_main_amt" value="149.35"><input type="hidden" name="split_protocolVersion" id="split_protocolVersion" value=""><input type="hidden" name="split_authenticationValue"
id="split_authenticationValue" value=""><input type="hidden" name="split_dsTransactionId" id="split_dsTransactionId" value="">
</form>Text Content
First Name: Last Name: Email: Phone: Zip or Postal Code: Address: City: Country: Canada Province: Select StateAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Billing same as Shipping YES NO Billing First Name: Billing Last Name: Billing Address: Billing City: Billing Country: Select Country Billing Province: Billing Zip or Postal Code: Card Type Master Card Visa Credit Card Number: Valid Thru: Month(01) January(02) February(03) March(04) April(05) May(06) June(07) July(08) August(09) September(10) October(11) November(12) December Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 CVV: Your IP Address has been logged for fraud protection. Contact us for any questions or concerns 888-791-0112 . Processing...