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18.66.97.69  Public Scan

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Submitted URL: https://click.exct.palmbeachgroup.com/?qs=83e3a13d3d90cd133049e57b09bec069eed20ec98a422b955e94a4fdb39ce7a32182d52128cfa08c5ce0c9ba72ed...
Effective URL: https://signup.brownstoneresearch.com/?cid=MKT407989&eid=MKT623800&step=start&plcid=PLC135681&SNAID=SAC0019427707&email=gsheard@bcbsm....
Submission: On May 05 via api from US — Scanned from DE

Form analysis 1 forms found in the DOM

<form _ngcontent-c1="" class="sna-b2b-contact-form ng-untouched ng-pristine ng-invalid" novalidate="">
  <div _ngcontent-c1="" class="form-group sna-b2b-email-wrapper"><label _ngcontent-c1="" for="b2bEmail">Email</label><input _ngcontent-c1="" class="form-control sna-b2b-email ng-untouched ng-pristine ng-invalid" id="b2bEmail" maxlength="80"
      name="email" required="" type="email" pattern="/^[A-Z0-9._%+-]+@[A-Z0-9.-]+\.[A-Z]{2,6}$/i"><!----></div>
  <div _ngcontent-c1="" class="form-group sna-b2b-first-name-wrapper"><label _ngcontent-c1="" for="b2bFirstName">First Name</label><input _ngcontent-c1="" class="form-control sna-b2b-first-name ng-untouched ng-pristine ng-invalid" id="b2bFirstName"
      maxlength="40" name="firstName" required="" type="text"><!----></div>
  <div _ngcontent-c1="" class="form-group sna-b2b-last-name-wrapper"><label _ngcontent-c1="" for="b2bLastName">Last Name</label><input _ngcontent-c1="" class="form-control sna-b2b-last-name ng-untouched ng-pristine ng-invalid" id="b2bLastName"
      maxlength="80" name="lastName" required="" type="text"><!----></div>
  <div _ngcontent-c1="" class="form-group sna-b2b-contact-record-type">
    <div _ngcontent-c1=""><label _ngcontent-c1="">Type</label></div><label _ngcontent-c1="" class="radio-inline"><input _ngcontent-c1="" class="sna-b2b-contact-record-type-radio ng-untouched ng-pristine ng-valid" name="contactRecordType" type="radio"
        value="bd"> Broker-Dealer </label><label _ngcontent-c1="" class="radio-inline"><input _ngcontent-c1="" class="sna-b2b-contact-record-type-radio ng-untouched ng-pristine ng-valid" name="contactRecordType" type="radio" value="ria"> Registered
      Investment Advisor </label>
  </div>
</form>

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