epayment.ccis.co.id Open in urlscan Pro
103.87.80.107  Public Scan

Form analysis
1 forms found in the DOM

POST https://epayment.ccis.co.id/login_proses

<form action="https://epayment.ccis.co.id/login_proses" method="post">
  <input type="hidden" name="_token" value="Pc6x8Tgq4vldyzFGAvDD7rzL0roTxXft4T1kvp4h" autocomplete="off">
  <div class="form-group position-relative has-icon-left">
    <label for="username">Username</label>
    <div class="position-relative">
      <input type="text" class="form-control" id="username" name="username" autocomplete="current-username">
      <div class="form-control-icon">
        <svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="feather feather-user">
          <path d="M20 21v-2a4 4 0 0 0-4-4H8a4 4 0 0 0-4 4v2"></path>
          <circle cx="12" cy="7" r="4"></circle>
        </svg>
      </div>
    </div>
  </div>
  <div class="form-group position-relative has-icon-left">
    <div class="clearfix">
      <label for="password">Password</label>
    </div>
    <div class="position-relative">
      <input type="password" class="form-control" id="password" name="password" autocomplete="current-password">
      <div class="form-control-icon">
        <svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="feather feather-lock">
          <rect x="3" y="11" width="18" height="11" rx="2" ry="2"></rect>
          <path d="M7 11V7a5 5 0 0 1 10 0v4"></path>
        </svg>
      </div>
    </div>
  </div>
  <!-- <div class="form-group position-relative has-icon-left">
                                    <div class="clearfix">
                                        <label for="logas">Login As</label>
                                    </div>
                                    <div>
                                        <select class="form-select" id="login_as" name="login_as">
                                            <option value="Customer">Customer</option>
                                            <option value="CCIS">CCIS</option>
                                        </select>
                                    </div>
                                </div> -->
  <input type="hidden" id="login_as" name="login_as" value="Customer">
  <div class="clearfix">
    <button type="submit" id="submitButton" name="submitButton" class="btn btn-primary float-end">Sign In</button>
    <a href="https://epayment.ccis.co.id/registration" class="btn btn-success">Register</a>
  </div>
</form>

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PT. CCIS Indonesia