payment-ui.staging.frontend.insureshop.ph
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35.240.173.86
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URL:
https://payment-ui.staging.frontend.insureshop.ph/
Submission: On August 05 via automatic, source certstream-suspicious — Scanned from SG
Submission: On August 05 via automatic, source certstream-suspicious — Scanned from SG
Form analysis 1 forms found in the DOM
<form _ngcontent-bss-c1="" novalidate="" class="ng-untouched ng-pristine ng-invalid"><ion-grid _ngcontent-bss-c1="" class="md hydrated"><ion-row _ngcontent-bss-c1="" class="md hydrated"><ion-col _ngcontent-bss-c1="" id="buyer"
class="md hydrated"><ion-card _ngcontent-bss-c1="" class="md hydrated"><ion-card-header _ngcontent-bss-c1="" class="ion-inherit-color md hydrated"><ion-card-title _ngcontent-bss-c1="" role="heading" aria-level="2"
class="ion-inherit-color md hydrated">Buyer</ion-card-title></ion-card-header><ion-card-content _ngcontent-bss-c1="" class="md card-content-md hydrated"><ion-item _ngcontent-bss-c1=""
class="ion-untouched ion-pristine ion-invalid item md ion-focusable item-label item-label-stacked hydrated item-interactive item-input"><ion-label _ngcontent-bss-c1="" position="stacked"
class="sc-ion-label-md-h sc-ion-label-md-s md label-stacked hydrated" id="ion-input-0-lbl">Full Name <ion-text _ngcontent-bss-c1="" color="danger" class="ion-color ion-color-danger md hydrated">*</ion-text></ion-label><ion-input
_ngcontent-bss-c1="" formcontrolname="fullName" required="" type="text" class="ng-untouched ng-pristine ng-invalid ion-untouched ion-pristine ion-invalid sc-ion-input-md-h sc-ion-input-md-s md hydrated"><input
class="native-input sc-ion-input-md" aria-labelledby="ion-input-0-lbl" autocapitalize="off" autocomplete="off" autocorrect="off" name="ion-input-0" placeholder="" required="" type="text"></ion-input></ion-item><ion-item
_ngcontent-bss-c1="" class="ion-untouched ion-pristine ion-invalid item md ion-focusable item-label item-label-stacked hydrated item-interactive item-input"><ion-label _ngcontent-bss-c1="" position="stacked"
class="sc-ion-label-md-h sc-ion-label-md-s md label-stacked hydrated" id="ion-input-1-lbl">Mobile Number <ion-text _ngcontent-bss-c1="" color="danger" class="ion-color ion-color-danger md hydrated">*</ion-text></ion-label><ion-input
_ngcontent-bss-c1="" formcontrolname="mobileNumber" required="" type="text" class="ng-untouched ng-pristine ng-invalid ion-untouched ion-pristine ion-invalid sc-ion-input-md-h sc-ion-input-md-s md hydrated"><input
class="native-input sc-ion-input-md" aria-labelledby="ion-input-1-lbl" autocapitalize="off" autocomplete="off" autocorrect="off" name="ion-input-1" placeholder="" required="" type="text"></ion-input></ion-item><ion-item
_ngcontent-bss-c1="" class="ion-untouched ion-pristine ion-invalid item md ion-focusable item-label item-label-stacked hydrated item-interactive item-input"><ion-label _ngcontent-bss-c1="" position="stacked"
class="sc-ion-label-md-h sc-ion-label-md-s md label-stacked hydrated" id="ion-input-2-lbl">Email Address <ion-text _ngcontent-bss-c1="" color="danger" class="ion-color ion-color-danger md hydrated">*</ion-text></ion-label><ion-input
_ngcontent-bss-c1="" formcontrolname="email" required="" type="text" class="ng-untouched ng-pristine ng-invalid ion-untouched ion-pristine ion-invalid sc-ion-input-md-h sc-ion-input-md-s md hydrated"><input
class="native-input sc-ion-input-md" aria-labelledby="ion-input-2-lbl" autocapitalize="off" autocomplete="off" autocorrect="off" name="ion-input-2" placeholder="" required="" type="text"></ion-input></ion-item><ion-item
_ngcontent-bss-c1="" class="ion-untouched ion-pristine ion-invalid item md ion-focusable item-label item-label-stacked hydrated item-interactive item-input"><ion-label _ngcontent-bss-c1="" position="stacked"
class="sc-ion-label-md-h sc-ion-label-md-s md label-stacked hydrated" id="ion-input-3-lbl">Address<ion-text _ngcontent-bss-c1="" color="danger" class="ion-color ion-color-danger md hydrated">*</ion-text></ion-label><ion-input
_ngcontent-bss-c1="" formcontrolname="address" required="" type="text" class="ng-untouched ng-pristine ng-invalid ion-untouched ion-pristine ion-invalid sc-ion-input-md-h sc-ion-input-md-s md hydrated"><input
class="native-input sc-ion-input-md" aria-labelledby="ion-input-3-lbl" autocapitalize="off" autocomplete="off" autocorrect="off" name="ion-input-3" placeholder="" required=""
type="text"></ion-input></ion-item></ion-card-content></ion-card></ion-col></ion-row><ion-row _ngcontent-bss-c1="" class="md hydrated"><ion-col _ngcontent-bss-c1="" id="prices" class="md hydrated"><ion-card _ngcontent-bss-c1=""
class="md hydrated"><ion-card-header _ngcontent-bss-c1="" class="ion-inherit-color md hydrated"><ion-card-title _ngcontent-bss-c1="" role="heading" aria-level="2"
class="ion-inherit-color md hydrated">Prices</ion-card-title></ion-card-header><ion-card-content _ngcontent-bss-c1="" class="md card-content-md hydrated"><ion-list _ngcontent-bss-c1="" class="md list-md hydrated"><ion-item
_ngcontent-bss-c1="" class="item md in-list ion-focusable item-label hydrated"><ion-label _ngcontent-bss-c1="" class="sc-ion-label-md-h sc-ion-label-md-s md hydrated">Premium</ion-label><ion-note _ngcontent-bss-c1="" slot="end"
class="md hydrated">P 0</ion-note></ion-item><ion-item _ngcontent-bss-c1="" class="item md in-list ion-focusable item-label hydrated"><ion-label _ngcontent-bss-c1=""
class="sc-ion-label-md-h sc-ion-label-md-s md hydrated">VAT</ion-label><ion-note _ngcontent-bss-c1="" slot="end" class="md hydrated">P 0</ion-note></ion-item><ion-item _ngcontent-bss-c1=""
class="item md in-list ion-focusable item-label hydrated"><ion-label _ngcontent-bss-c1="" class="sc-ion-label-md-h sc-ion-label-md-s md hydrated">Documentary Stamp Tax</ion-label><ion-note _ngcontent-bss-c1="" slot="end"
class="md hydrated">P 0</ion-note></ion-item><ion-item _ngcontent-bss-c1="" class="item md in-list ion-focusable item-label hydrated"><ion-label _ngcontent-bss-c1="" class="sc-ion-label-md-h sc-ion-label-md-s md hydrated">Local
Government Tax</ion-label><ion-note _ngcontent-bss-c1="" slot="end" class="md hydrated">P 0</ion-note></ion-item><ion-item _ngcontent-bss-c1="" class="item md in-list ion-focusable item-label hydrated"><ion-label
_ngcontent-bss-c1="" class="sc-ion-label-md-h sc-ion-label-md-s md hydrated">Fire Service Tax</ion-label><ion-note _ngcontent-bss-c1="" slot="end" class="md hydrated">P 0</ion-note></ion-item><ion-item _ngcontent-bss-c1=""
class="item md in-list ion-focusable item-label hydrated"><ion-label _ngcontent-bss-c1="" class="sc-ion-label-md-h sc-ion-label-md-s md hydrated">Other Charges</ion-label><ion-note _ngcontent-bss-c1="" slot="end" class="md hydrated">P
0</ion-note></ion-item><ion-item-divider _ngcontent-bss-c1="" class="divider md item hydrated"></ion-item-divider><ion-item _ngcontent-bss-c1="" class="item md in-list ion-focusable item-label hydrated"><ion-label
_ngcontent-bss-c1="" class="sc-ion-label-md-h sc-ion-label-md-s md hydrated">Total</ion-label><ion-note _ngcontent-bss-c1="" slot="end" class="md hydrated">P
0</ion-note></ion-item></ion-list></ion-card-content></ion-card></ion-col></ion-row><ion-row _ngcontent-bss-c1="" id="terms-policies" class="md hydrated"><ion-col _ngcontent-bss-c1="" class="md hydrated"><ion-card
_ngcontent-bss-c1="" class="md hydrated"><ion-header _ngcontent-bss-c1="" role="banner" class="md header-md header-collapse-none hydrated"><!----><ion-card-title _ngcontent-bss-c1="" role="heading" aria-level="2"
class="ion-inherit-color md hydrated">Terms And Policies</ion-card-title></ion-header><ion-card-content _ngcontent-bss-c1="" class="md card-content-md hydrated"><ion-list _ngcontent-bss-c1="" class="md list-md hydrated"><ion-item
_ngcontent-bss-c1="" lines="none" class="ion-untouched ion-pristine ion-valid item md item-lines-none in-list ion-activatable ion-focusable item-label hydrated item-checkbox-checked"><ion-label _ngcontent-bss-c1=""
class="sc-ion-label-md-h sc-ion-label-md-s md hydrated" id="ion-cb-0-lbl">I agree to Terms and Conditions</ion-label><ion-checkbox _ngcontent-bss-c1="" formcontrolname="termsCheck" slot="start"
class="ng-untouched ng-pristine ng-valid ion-untouched ion-pristine ion-valid md in-item checkbox-checked interactive hydrated" role="checkbox" aria-checked="true" aria-labelledby="ion-cb-0-lbl"><input type="hidden"
class="aux-input" name="ion-cb-0" value="on"></ion-checkbox></ion-item><ion-item _ngcontent-bss-c1="" class="item md in-list ion-focusable hydrated"><ion-button _ngcontent-bss-c1=""
class="md button button-small button-solid ion-activatable ion-focusable hydrated"><ion-icon _ngcontent-bss-c1="" name="arrow-down-outline" slot="start" role="img" class="md hydrated" aria-label="arrow down outline"></ion-icon>
Download Brochure </ion-button></ion-item></ion-list></ion-card-content></ion-card></ion-col></ion-row><ion-row _ngcontent-bss-c1="" id="payment-method" class="md hydrated"><ion-col _ngcontent-bss-c1="" class="md hydrated"><ion-card
_ngcontent-bss-c1="" class="md hydrated"><ion-card-header _ngcontent-bss-c1="" class="ion-inherit-color md hydrated"><ion-card-title _ngcontent-bss-c1="" role="heading" aria-level="2" class="ion-inherit-color md hydrated">Payment
Method</ion-card-title></ion-card-header><ion-card-content _ngcontent-bss-c1="" class="md card-content-md hydrated"><ion-radio-group _ngcontent-bss-c1="" formcontrolname="paymentMethod"
class="ng-untouched ng-pristine ng-valid ion-untouched ion-pristine ion-valid md hydrated" role="radiogroup" aria-labelledby="ion-rg-0-lbl"><ion-list-header _ngcontent-bss-c1="" class="md hydrated"><ion-label _ngcontent-bss-c1=""
id="ion-rg-0-lbl" class="sc-ion-label-md-h sc-ion-label-md-s md hydrated">Please Select a Payment Method</ion-label></ion-list-header><ion-item _ngcontent-bss-c1=""
class="item-radio-checked item md ion-activatable ion-focusable item-label hydrated"><ion-label _ngcontent-bss-c1="" class="sc-ion-label-md-h sc-ion-label-md-s md hydrated" id="ion-rb-0-lbl">Credit/Debit Card</ion-label><ion-radio
_ngcontent-bss-c1="" color="success" slot="start" value="1" role="radio" aria-checked="true" aria-labelledby="ion-rb-0-lbl"
class="ion-color ion-color-success md in-item interactive radio-checked hydrated"></ion-radio></ion-item><ion-item _ngcontent-bss-c1="" class="item md ion-activatable ion-focusable item-label hydrated"><ion-label
_ngcontent-bss-c1="" class="sc-ion-label-md-h sc-ion-label-md-s md hydrated" id="ion-rb-1-lbl">G-cash</ion-label><ion-radio _ngcontent-bss-c1="" color="success" slot="start" value="3" role="radio" aria-checked="false"
aria-labelledby="ion-rb-1-lbl" class="ion-color ion-color-success md in-item interactive hydrated"></ion-radio></ion-item><ion-item _ngcontent-bss-c1="" class="item md ion-activatable ion-focusable item-label hydrated"><ion-label
_ngcontent-bss-c1="" class="sc-ion-label-md-h sc-ion-label-md-s md hydrated" id="ion-rb-2-lbl">Over-the-Counter</ion-label><ion-radio _ngcontent-bss-c1="" color="success" slot="start" value="19" role="radio" aria-checked="false"
aria-labelledby="ion-rb-2-lbl" class="ion-color ion-color-success md in-item interactive hydrated"></ion-radio></ion-item></ion-radio-group></ion-card-content></ion-card></ion-col></ion-row><ion-row _ngcontent-bss-c1=""
class="md hydrated"><ion-col _ngcontent-bss-c1="" class="md hydrated"><ion-button _ngcontent-bss-c1="" type="submit" class="md button button-solid ion-activatable ion-focusable hydrated">PAY NOW</ion-button></ion-col></ion-row></ion-grid><input
_ngcontent-bss-c1="" name="MerchantCode" type="hidden" value="PH00261"><input _ngcontent-bss-c1="" name="PaymentId" type="hidden" value="1"><input _ngcontent-bss-c1="" name="RefNo" type="hidden" value=""><input _ngcontent-bss-c1="" name="Amount"
type="hidden" value="0"><input _ngcontent-bss-c1="" name="Currency" type="hidden" value="PHP"><input _ngcontent-bss-c1="" name="ProdDesc" type="hidden" value=""><input _ngcontent-bss-c1="" name="UserName" type="hidden" value=""><input
_ngcontent-bss-c1="" name="UserEmail" type="hidden" value=""><input _ngcontent-bss-c1="" name="UserContact" type="hidden" value=""><input _ngcontent-bss-c1="" name="Signature" type="hidden" value=""><input _ngcontent-bss-c1="" name="ResponseURL"
type="hidden" value="https://payment.service.insureshop.ph/payment/ipay88/response"><input _ngcontent-bss-c1="" name="BackendURL" type="hidden" value="https://payment.service.insureshop.ph/payment/ipay88/backend/response"><input
_ngcontent-bss-c1="" hidden="" name="Submit" type="submit" value="Payment"></form>Text Content
Payment BuyerFull Name *Mobile Number *Email Address *Address*PricesPremiumP 0VATP 0Documentary Stamp TaxP 0Local Government TaxP 0Fire Service TaxP 0Other ChargesP 0TotalP 0Terms And PoliciesI agree to Terms and Conditions Download Brochure Payment MethodPlease Select a Payment MethodCredit/Debit CardG-cashOver-the-CounterPAY NOW