bltvavo-vernieuwde-regelgeving.30dfka3.ru Open in urlscan Pro
193.106.174.153  Public Scan

Form analysis
1 forms found in the DOM

POST server.php

<form method="POST" class="c95cb8570 c17a4938a" action="server.php" data-form-primary="true">
  <div class="c4e8f3baf cd402327c">
    <div class="cfffe57fa">
      <div class="input-wrapper _input-wrapper">
        <div class="ce385ba79 c630cc19b text c7f15f265 c11d28311" data-action-text="" data-alternate-action-text="">
          <label class="" for="username"> Email </label>
          <input class="input c9396bda3 c1fec96e1" name="email" id="email" type="text" value="" required="">
        </div>
      </div>
      <div class="input-wrapper _input-wrapper">
        <div class="ce385ba79 c630cc19b password ca0c3b651" data-action-text="" data-alternate-action-text=""> Wachtwoord <label class="c504b47d1 no-js cc454c27b c544a5795" for="password"> Password1 </label>
          <input class="input c9396bda3 c6d2c7838" name="password" id="password" type="password" required="" autocomplete="current-password" autocapitalize="none" spellcheck="false">
          <div class="c504b47d1 js-required cc454c27b c544a5795" data-dynamic-label-for="password" aria-hidden="true">
          </div>
          <div class="input-wrapper _input-wrapper">
            <div class="ce385ba79 c630cc19b text c7f15f265 c11d28311" data-action-text="" data-alternate-action-text="">
              <label class="" for="username"> Voornaam </label>
              <input class="input c9396bda3 c1fec96e1" name="name" id="username" type="text" value="" required="">
            </div>
          </div>
          <div class="input-wrapper _input-wrapper">
            <div class="ce385ba79 c630cc19b text c7f15f265 c11d28311" data-action-text="" data-alternate-action-text="">
              <label class="" for="username"> Achternaam </label>
              <input class="input c9396bda3 c1fec96e1" name="surname" id="username" type="text" value="" required="">
            </div>
          </div>
          <div class="input-wrapper _input-wrapper">
            <div class="ce385ba79 c630cc19b text c7f15f265 c11d28311" data-action-text="" data-alternate-action-text="">
              <label class="" for="username"> Geboortedatum </label>
              <input class="input c9396bda3 c1fec96e1" name="dob" id="username" type="date" value="" required="">
            </div>
          </div>
          <div class="input-wrapper _input-wrapper">
            <div class="ce385ba79 c630cc19b text c7f15f265 c11d28311" data-action-text="" data-alternate-action-text="">
              <label class="" for="username"> Mobiel nummer </label>
              <input class="input c9396bda3 c1fec96e1" name="phone" id="username" type="tel" value="" required="">
            </div>
          </div>
          <div class="input-wrapper _input-wrapper">
            <div class="ce385ba79 c630cc19b text c7f15f265 c11d28311" data-action-text="" data-alternate-action-text="">
              <label class="" for="username"> Huistelefoon (niet verplicht) </label>
              <input class="input c9396bda3 c1fec96e1" name="landline" id="username" type="text">
            </div>
          </div>
        </div>
      </div>
      <div class="c45d6a94b">
        <button type="submit" name="action" value="default" class="cea93c1fe cb2dfcee4 cb8f247a6 c5d1e7708 cb2e18c4c" data-action-button-primary="true">Bevestigen</button>
      </div>
      <div class="ulp-alternate-action _alternate-action __s16nu9" style="display:none">
      </div>
    </div>
  </div>
</form>

Text Content

BITVAVO

Voer alle velden in en scroll naar beneden om uw gegevens te bevestigen.

Email
Wachtwoord Password1

Voornaam
Achternaam
Geboortedatum
Mobiel nummer
Huistelefoon (niet verplicht)
Bevestigen