credit.jpesa.com Open in urlscan Pro
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Form analysis
1 forms found in the DOM

POST index.php

<form action="index.php" id="callback" method="post">
  <input type="hidden" name="dad" value="index">
  <input type="hidden" name="jc" value="callback">
  <input type="hidden" name="a" value="save">
  <input type="hidden" name="recaptcha_response" id="recaptchaResponse">
  <div class="row">
    <div class="col-md-12">
      <h4>Fill out the form below and a friendly JPesa International customer service rep will call you back shortly.</h4>
      <div class="portlet-body form">
        <div class="form-body">
          <div class="form-group form-md-line-input has-error form-md-floating-label">
            <div class="input-icon">
              <input type="text" name="phone" required="required" class="form-control">
              <label for="form_control_1">Contact Number</label>
              <span class="help-block">We'd prefer to contact you on your mobile.</span> <i class="icon-call-out"></i>
            </div>
          </div>
          <div class="form-group form-md-line-input has-success form-md-floating-label">
            <div class="input-icon">
              <input type="email" name="email" class="form-control">
              <label for="form_control_1">Email Address</label>
              <span class="help-block">Your email address (Optional)</span> <i class="icon-envelope-letter"></i>
            </div>
          </div>
          <div class="form-group form-md-line-input has-success form-md-floating-label">
            <div class="input-icon">
              <input type="text" name="name" class="form-control">
              <label for="form_control_1">Your Name</label>
              <span class="help-block">Your first &amp; last name (Optional)</span> <i class="icon-user"></i>
            </div>
          </div>
        </div>
        <div class="form-actions "> <small> We are collecting your information for the purpose of contacting you about the acquisition by you of JPesa International services only. Please see JPesa International's
            <a href="index.php?dad=index&amp;jc=ppolicy" target="_blank">Privacy Policy</a> for details on how to access or correct your information, or to make a complaint about a privacy matter. </small> </div>
      </div>
    </div>
  </div>
</form>

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PERSONAL LOAN AT 15% PER MONTH STARTING FROM 5%

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ABOUT

JPesa is the safer, easier way to pay and get paid online. The service allows
anyone to pay in any way they prefer, including through mobile money, credit
cards, ban... Read More


CONTACTS

[T] (256) 414 670513
[E] info@jpesa.com
[A] Plot Z, Akright City Bwebajja, P.O. BOX 22930, Kampala.

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Copyright (C) 2013 - 2023 The Great Seven. All rights reserved. Licensed to
JPesa International

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WE CAN CALL YOU BACK!

FILL OUT THE FORM BELOW AND A FRIENDLY JPESA INTERNATIONAL CUSTOMER SERVICE REP
WILL CALL YOU BACK SHORTLY.

Contact Number We'd prefer to contact you on your mobile.
Email Address Your email address (Optional)
Your Name Your first & last name (Optional)
We are collecting your information for the purpose of contacting you about the
acquisition by you of JPesa International services only. Please see JPesa
International's Privacy Policy for details on how to access or correct your
information, or to make a complaint about a privacy matter.
Close Request a Callback

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