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garantias.kwmarket.co Open in urlscan Pro
146.20.110.107  Public Scan

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URL: https://garantias.kwmarket.co/
Submission: On April 06 via automatic, source certstream-suspicious — Scanned from DE

Form analysis 1 forms found in the DOM

<form id="formContact" class="g-3 needs-validation" novalidate="">
  <div class="box-form">
    <h1>Registro de garantías</h1>
    <div class="row">
      <div class="col-md-6 input-box">
        <label><b>Nombre</b></label>
        <input type="text" class="form-control" onclick="setSuccessFor(this)" placeholder="Nombres" id="name">
        <small class="msj"></small>
      </div>
      <div class="col-md-6 input-box">
        <label><b>Apellidos</b></label>
        <input type="text" placeholder="Apellidos" onclick="setSuccessFor(this)" class="form-control" id="lastname">
        <small class="msj"></small>
      </div>
      <div class="col-md-6 input-box">
        <label><b>Teléfono</b></label>
        <input type="number" class="form-control" onclick="setSuccessFor(this)" placeholder="Teléfono" id="phone">
        <small class="msj"></small>
      </div>
      <div class="col-md-6 input-box">
        <label><b>Celular</b></label>
        <input type="number" class="form-control" onclick="setSuccessFor(this)" placeholder="Celular" id="cellphone">
        <small class="msj"></small>
      </div>
      <div class="col-md-6 input-box">
        <label><b>Email</b></label>
        <input type="email" class="form-control" onclick="setSuccessFor(this)" placeholder="Correo" id="email">
        <small class="msj"></small>
      </div>
      <div class="col-md-6 input-box">
        <label><b>Fecha de compra</b></label>
        <input type="date" class="form-control" onclick="setSuccessFor(this)" placeholder="Fecha de Compra" id="date">
        <small class="msj"></small>
      </div>
      <div class="col-md-6 input-box">
        <label><b>Lugar de Compra</b></label>
        <select id="place" class="form-control" onclick="setSuccessFor(this)">
          <option>-Seleccione establecimiento de compra-</option>
          <option>Éxito</option>
          <option>Homecenter</option>
          <option>Home Sentry</option>
          <option>Pepeganga</option>
          <option>Alkosto</option>
          <option>Easy</option>
          <option>Makro</option>
          <option>Falabella</option>
          <option>Jumbo</option>
          <option>Carulla</option>
          <option>La 14</option>
          <option>Olimpica</option>
          <option>Otro</option>
        </select>
        <small class="msj"></small>
      </div>
      <div class="col-md-6 input-box">
        <label><b>Observaciones</b></label>
        <textarea class="form-control" id="observation" rows="1"></textarea>
        <small class="msj"></small>
      </div>
    </div>
    <div class="row" id="chargeProduct">
      <div class="col-sm-12 input-box">
        <div class="center">
          <a id="addProduct" class="btn btn-info" style="color: #fff;">Agregar Producto</a>
        </div>
      </div>
      <div class="row">
        <div class="col-sm-4 input-box">
          <label><b>Marca</b></label>
          <select class="form-control brand" onclick="setSuccessFor(this)">
            <option value="">-Seleccione marca-</option>
            <option>Bergner</option>
            <option>Kw</option>
            <option>Libbey</option>
            <option>Thermos</option>
            <option>Pyr O Rey</option>
            <option>Otro</option>
          </select>
          <small class="msj"></small>
        </div>
        <div class="col-sm-3 input-box">
          <label><b>Referencia</b></label>
          <input type="text" class="form-control ref" placeholder="Referencia" onclick="setSuccessFor(this)" id="ref">
          <small class="msj"></small>
        </div>
        <div class="col-sm-2 input-box">
          <label><b>Precio</b></label>
          <input type="number" class="form-control price" placeholder="Precio" onclick="setSuccessFor(this)" id="price">
          <small class="msj"></small>
        </div>
        <div class="col-sm-2 input-box">
          <label><b>Cantidad</b></label>
          <input type="number" id="tentacles" class="form-control amount" onclick="setSuccessFor(this)" placeholder="Cantidad" name="tentacles" min="1" max="100">
          <small class="msj"></small>
        </div>
      </div>
      <hr>
    </div>
    <div class="row">
      <div class="col-md-12">
        <div class="form-check">
          <input class="form-check-input" type="checkbox" id="invalidCheck">
          <small class="msj"></small>
          <label class="form-check-label" for="invalidCheck">
            <a href="https://www.kwc.com.co/pages/politica-de-tratamiento-de-proteccion-de-datos-personales" target="_blank">
                                    Aceptar Habeas Data
                                </a>
          </label>
        </div>
        <div class="invalid-feedback">Debes aceptar Habeas Data</div>
      </div>
      <div class="col-12">
        <div class="center">
          <button type="submit" class="boton" id="btnRegister">Registrar</button>
        </div>
      </div>
    </div>
    <div id="notification" class="notification" style="display:none;">
    </div>
  </div>
</form>

Text Content

REGISTRO DE GARANTÍAS

Nombre
Apellidos
Teléfono
Celular
Email
Fecha de compra
Lugar de Compra -Seleccione establecimiento de compra- Éxito Homecenter Home
Sentry Pepeganga Alkosto Easy Makro Falabella Jumbo Carulla La 14 Olimpica Otro
Observaciones
Agregar Producto
Marca -Seleccione marca- Bergner Kw Libbey Thermos Pyr O Rey Otro
Referencia
Precio
Cantidad

--------------------------------------------------------------------------------

Aceptar Habeas Data
Debes aceptar Habeas Data
Registrar