plugin.autoglasscrm.anala.us
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104.207.139.178
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URL:
https://plugin.autoglasscrm.anala.us/
Submission: On December 13 via api from US — Scanned from US
Submission: On December 13 via api from US — Scanned from US
Form analysis
2 forms found in the DOMPOST
<form id="agcrm-vd-search-form" class="agcrm-vd-search-form" method="post" action="" onsubmit="return false;">
<div id="agcrm-vd-search-vin" class="agcrm-vd-search-div">
<label for="vd-search">Tu VIN</label>
<input type="text" id="vd-search" name="s" value="" placeholder="Buscar">
</div>
<div id="agcrm-vd-search-tag" class="agcrm-vd-search-div hidden">
<label for="vd-tag">Placa</label>
<input type="text" id="vd-tag" name="tag" value="" placeholder="Buscar">
<label for="vd-tag-state">Estado</label>
<select id="vd-tag-state" name="state">
<option value="">Por favor selecciona…</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="DC">District Of Columbia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">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="NM">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>
</div>
<div id="agcrm-vd-search-ymmb" class="agcrm-vd-search-div hidden">
<label for="ymmb-year">Año</label>
<select id="ymmb-year" name="year">
<option value="" selected="">Por favor selecciona…</option>
<option>2024</option>
<option>2023</option>
<option>2022</option>
<option>2021</option>
<option>2020</option>
<option>2019</option>
<option>2018</option>
<option>2017</option>
<option>2016</option>
<option>2015</option>
<option>2014</option>
<option>2013</option>
<option>2012</option>
<option>2011</option>
<option>2010</option>
<option>2009</option>
<option>2008</option>
<option>2007</option>
<option>2006</option>
<option>2005</option>
<option>2004</option>
<option>2003</option>
<option>2002</option>
<option>2001</option>
<option>2000</option>
<option>1999</option>
<option>1998</option>
<option>1997</option>
<option>1996</option>
<option>1995</option>
<option>1994</option>
<option>1993</option>
<option>1992</option>
<option>1991</option>
<option>1990</option>
<option>1989</option>
<option>1988</option>
<option>1987</option>
<option>1986</option>
<option>1985</option>
<option>1984</option>
<option>1983</option>
<option>1982</option>
<option>1981</option>
<option>1980</option>
<option>1979</option>
<option>1978</option>
<option>1977</option>
<option>1976</option>
<option>1975</option>
</select>
<label for="ymmb-make">Hacer</label>
<select id="ymmb-make" name="make">
<option value="">Cargando…</option>
</select>
<label for="ymmb-model">Modelo</label>
<select id="ymmb-model" name="model">
<option value="" selected="">Seleccione la marca (arriba)</option>
</select>
<label for="ymmb-body">Cuerpo</label>
<select id="ymmb-body" name="body">
<option value="" selected="">Seleccione el modelo (arriba)</option>
</select>
</div>
<label for="agcrm-vd-glass-type">Tipo de cristal</label>
<select id="agcrm-vd-glass-type" name="type">
<option value="1">Vidrio trasero</option>
<option value="2">Vidrio de la puerta</option>
<option value="21">Vidrio para division</option>
<option value="3">Ventanilla trasera</option>
<option value="19">Quemacocos</option>
<option value="22">Vidrio de ventilación</option>
<option value="4" selected="">Parabrisas</option>
<option value="23">Parabrisas de camión</option>
</select>
<div class="agcrm-vd-search-buttons">
<button type="button" id="agcrm-vd-run-search" class="btn-dark">Buscar VIN</button> <button type="button" id="agcrm-vd-reset-form" class="btn-dark">Restablecer</button>
</div>
</form>
<form id="customer-information-form" class="">
<label for="first-name">Nombre <span class="is-required">*</span></label>
<input type="text" name="firstName" id="first-name" maxlength="30">
<label for="last-name">Apellido <span class="is-required">*</span></label>
<input type="text" name="lastName" id="last-name" maxlength="30">
<label for="phone">Teléfono <span class="is-required">*</span></label>
<input type="text" name="phone" id="phone" maxlength="15">
<label for="email">Correo electrónico <span class="is-required">*</span></label>
<input type="text" name="email" id="email" maxlength="60">
<label for="address">Dirección</label>
<input type="text" name="address1" id="address" maxlength="60">
<label for="city">Ciudad</label>
<input type="text" name="city" id="city" maxlength="40">
<label for="state">State</label>
<select name="state" id="state">
<option value="">Seleccione un 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="DC">District Of Columbia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">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="NM">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>
<label for="zip">Código Postal</label>
<input type="text" name="zip" id="zip" maxlength="10">
<div class="insurance-container">
<h4 class="heading open">Detalles del seguro (opcional)</h4>
<div class="insurance-details">
<label for="insurance-company">Compañía</label>
<input type="text" name="insuranceCompany" id="insurance-company" maxlength="30">
<label for="insurance-deductible">Deducible</label>
<input type="number" name="insuranceDeductible" id="insurance-deductible" maxlength="10">
</div>
</div>
</form>
Text Content
Saltar al contenido AutoGlassCRM Test * AutoGlassCRM AUTOGLASSCRM * VIN * Placa * Año, Marca, Modelo Tu VIN Placa Estado Por favor selecciona… Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia 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 Año Por favor selecciona… 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 Hacer Cargando… Modelo Seleccione la marca (arriba) Cuerpo Seleccione el modelo (arriba) Tipo de cristal Vidrio trasero Vidrio de la puerta Vidrio para division Ventanilla trasera Quemacocos Vidrio de ventilación Parabrisas Parabrisas de camión Buscar VIN Restablecer Opciones… 1 Piece (Car/Minivan/SUV/Truck) Rear Left (Van Only) Rear Right (Van Only) Opciones… Front Left Front Right Rear Left Rear Right Other Opciones… Rear Left (Car/Minivan/SUV/Truck) Rear Right (Car/Minivan/SUV/Truck) Left (Van Only) Right (Van Only) Opciones… Front Left Front Right Opciones… 1 Piece Left Side Right Side Both Sides Elige un día * Lapso de tiempo Preferido * Por la Mañana Por la Tarde Nombre * Apellido * Teléfono * Correo electrónico * Dirección Ciudad State Seleccione un state… Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia 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 Código Postal DETALLES DEL SEGURO (OPCIONAL) Compañía Deducible Entregar