permitium.com Open in urlscan Pro
104.196.159.2  Public Scan

Form analysis
2 forms found in the DOM

GET https://permitium.com/

<form role="search" action="https://permitium.com/" method="GET" data-hs-cf-bound="true">
  <input type="text" name="s" value="" aria-label="Search" placeholder="Search">
  <span>Hit enter to search or ESC to close</span>
</form>

POST

<form id="forminator-module-689" class="forminator-ui forminator-custom-form forminator-custom-form-689 forminator-design--material  forminator_ajax" method="post" data-forminator-render="0" data-form-id="689" data-design="material" data-grid="open"
  style="" data-uid="672cf940e9d41" novalidate="novalidate" data-hs-cf-bound="true">
  <div role="alert" aria-live="polite" class="forminator-response-message forminator-error" aria-hidden="true"></div>
  <div class="forminator-row">
    <div id="text-1" class="forminator-field-text forminator-col forminator-col-12 ">
      <div class="forminator-field"><label for="forminator-field-text-1_672cf940e9d41" id="forminator-field-text-1_672cf940e9d41-label" class="forminator-label forminator-floating--input">Last 4 digits of card used <span
            class="forminator-required">*</span></label>
        <div class="forminator-input--wrap"><input type="text" name="text-1" value="" placeholder="" id="forminator-field-text-1_672cf940e9d41" class="forminator-input forminator-name--field" data-required="1"></div>
      </div>
    </div>
  </div>
  <div class="forminator-row">
    <div id="name-1" class="forminator-field-name forminator-col forminator-col-12 ">
      <div class="forminator-field"><label for="forminator-field-name-1_672cf940e9d41" id="forminator-field-name-1_672cf940e9d41-label" class="forminator-label forminator-floating--input">Last name as seen on the card <span
            class="forminator-required">*</span></label>
        <div class="forminator-input--wrap"><input type="text" name="name-1" value="" placeholder="E.g. John Doe" id="forminator-field-name-1_672cf940e9d41" class="forminator-input forminator-name--field" aria-required="true"></div>
      </div>
    </div>
  </div>
  <div class="forminator-row">
    <div id="currency-1" class="forminator-field-currency forminator-col forminator-col-12 ">
      <div class="forminator-field"><label for="forminator-field-currency-1_672cf940e9d41" id="forminator-field-currency-1_672cf940e9d41-label" class="forminator-label forminator-floating--input">Charge amount <span
            class="forminator-required">*</span></label>
        <div class="forminator-input-with-suffix">
          <div class="forminator-input--wrap"><input name="currency-1" value="" placeholder="" id="forminator-field-currency-1_672cf940e9d41" class="forminator-input forminator-currency" data-required="1" aria-required="1" data-decimals="2"
              data-inputmask="'groupSeparator': '', 'radixPoint': '.', 'digits': '2'" data-hidden-behavior="zero" type="number" step="any"></div><span class="forminator-suffix">USD</span>
        </div>
      </div>
    </div>
  </div>
  <div class="forminator-row">
    <div id="date-1" class="forminator-field-date forminator-col forminator-col-12 "><label for="forminator-field-date-1" id="forminator-field-date-1-label" class="forminator-label">Charge date <span class="forminator-required">*</span></label>
      <div class="forminator-date-input">
        <div class="forminator-row" data-multiple="true">
          <div id="date-1-month" class="forminator-col">
            <div class="forminator-field"><label for="forminator-field-date-1-month_672cf940e9d41" class="forminator-label forminator-floating--input">Month <span class="forminator-required">*</span></label>
              <div class="forminator-input--wrap"><input type="number" min="1" max="12" name="date-1-month" value="" placeholder="E.g. 01" id="forminator-field-date-1-month_672cf940e9d41" class="forminator-input" data-field="month"
                  data-format="mm/dd/yy" data-parent="date-1"></div>
            </div>
          </div>
          <div id="date-1-day" class="forminator-col">
            <div class="forminator-field"><label for="forminator-field-date-1-day_672cf940e9d41" class="forminator-label forminator-floating--input">Day <span class="forminator-required">*</span></label>
              <div class="forminator-input--wrap"><input type="number" min="1" max="31" name="date-1-day" value="" placeholder="E.g. 01" id="forminator-field-date-1-day_672cf940e9d41" class="forminator-input" data-field="day" data-format="mm/dd/yy"
                  data-parent="date-1"></div>
            </div>
          </div>
          <div id="date-1-year" class="forminator-col">
            <div class="forminator-field"><label for="forminator-field-date-1-year_672cf940e9d41" class="forminator-label forminator-floating--input">Year <span class="forminator-required">*</span></label>
              <div class="forminator-input--wrap"><input type="number" min="1" name="date-1-year" placeholder="E.g. 2000" id="forminator-field-date-1-year_672cf940e9d41" class="forminator-input" data-field="year" value="" data-format="mm/dd/yy"
                  data-parent="date-1"></div>
            </div>
          </div>
        </div>
      </div>
    </div>
  </div>
  <div class="forminator-row">
    <div id="email-1" class="forminator-field-email forminator-col forminator-col-12 ">
      <div class="forminator-field"><label for="forminator-field-email-1_672cf940e9d41" id="forminator-field-email-1_672cf940e9d41-label" class="forminator-label forminator-floating--input">Email Address</label>
        <div class="forminator-input--wrap"><input type="email" name="email-1" value="" placeholder="E.g. john@doe.com" id="forminator-field-email-1_672cf940e9d41" class="forminator-input forminator-email--field" data-required=""
            aria-required="false"></div>
      </div>
    </div>
  </div><input type="hidden" name="referer_url" value="">
  <div class="forminator-row forminator-row-last">
    <div class="forminator-col">
      <div class="forminator-field"><button class="forminator-button forminator-button-submit"><span>SUBMIT</span><span aria-hidden="true"></span></button></div>
    </div>
  </div><input type="hidden" id="forminator_nonce" name="forminator_nonce" value="4027c1d758"><input type="hidden" name="_wp_http_referer" value="/consumer-support/"><input type="hidden" name="form_id" value="689"><input type="hidden" name="page_id"
    value="676"><input type="hidden" name="form_type" value="default"><input type="hidden" name="current_url" value="https://permitium.com/consumer-support/"><input type="hidden" name="render_id" value="0"><input type="hidden" name="action"
    value="forminator_submit_form_custom-forms">
</form>

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CITIZEN SUPPORT

Permitium provides a software platform and payment collection service for many
government agencies and law enforcement agencies around the US, such as
sheriff’s offices, police departments, county clerks, registers of deeds, public
health departments, and more.

If you see an unfamiliar charge on your credit card statement and have recently
applied for:

 * A gun or concealed carry permit or license
 * Fingerprinting services
 * A birth, marriage, or death certificate
 * Or filed a civil process

Permitium may have provided the software that your local agency used to process
your application or record request.

In most cases order confirmation emails would have been sent from our automated
email address auto@permitium.com. If you need your confirmation email resent,
please fill out the form to the right and we will get back to you as soon as
possible.

Permitium, based in Charlotte, NC, builds software for people who want better
government. We hope your experience with Permitium showed you that the
government can work for the people.


Last 4 digits of card used *

Last name as seen on the card *

Charge amount *

USD
Charge date *
Month *

Day *

Year *

Email Address

SUBMIT
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 * Home
 * Solutions
   * VitalDirector
   * PermitDirector
 * Resources
   * Resource Library
   * PermitDirector ROI Calculator
   * VitalDirector ROI Calculator
 * Customers
 * Blog
 * Contact
 * Request Demo



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