amazon-giveaway.vqmjc.cc Open in urlscan Pro
172.67.196.180 Public Scan

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URL:
https://amazon-giveaway.vqmjc.cc/
Submission Tags: @phishunt_io
Submission: On September 24 via api (September 24th 2024, 9:03:06 pm UTC) from DE — Scanned from DE

Form analysis
2 forms found in the DOM

<form data-v-d1962f06="" class="row g-3 needs-validation" novalidate=""><input data-v-d1962f06="" id="leadid_token" name="universal_leadid" type="hidden" value="5A09E1B1-84FE-6BC1-6932-B03B15C8668C"><label data-v-d1962f06="" type="hidden"
    for="leadid_token" style="display: none;"></label><input data-v-d1962f06="" type="hidden" id="leadid_tcpa_disclosure" name="leadid_tcpa_disclosure" value=""><label data-v-d1962f06="" type="hidden" for="leadid_tcpa_disclosure"
    style="display: none;">TCPA (Telephone Consumer Protection Act) Compliance Statement:By providing your contact information, you consent to receive calls, text messages, and/or emails from us or our authorized representatives regarding products
    and services. This consent applies to both landline and mobile phone numbers. Please note that your consent is not a condition of purchasing any products or services. If you wish to opt out of receiving further communications, you can do so by
    contacting us directly or using the unsubscribe option provided in our communications.We respect your privacy and adhere to all applicable TCPA regulations. Your information will not be shared with any third parties for marketing purposes without
    your explicit consent.If you have any questions or concerns regarding our TCPA compliance or the use of your personal information, please contact us.</label>
  <div data-v-d1962f06="" class="col-12"><label data-v-d1962f06="" for="inputFirstName" class="form-label">First Name</label><input data-v-d1962f06="" type="text" class="form-control input-lg" id="inputFirstName" name="FirstName" required=""></div>
  <div data-v-d1962f06="" class="col-12"><label data-v-d1962f06="" for="inputLastName" class="form-label">Last Name</label><input data-v-d1962f06="" type="text" class="form-control input-lg" id="inputLastName" name="LastName" required=""></div>
  <div data-v-d1962f06="" class="col-12"><label data-v-d1962f06="" for="inputEmail" class="form-label">E-mail</label><input data-v-d1962f06="" type="email" class="form-control input-lg" id="inputEmail" name="Email" required=""></div>
  <div data-v-d1962f06="" class="col-12"><label data-v-d1962f06="" for="inputAddress" class="form-label">Address 1</label><input data-v-d1962f06="" type="text" class="form-control input-lg autocomplete pac-target-input" id="inputAddress"
      placeholder="" modelvalue="" language="en" lang="en" name="Address" required="" autocomplete="off"></div>
  <div data-v-d1962f06="" class="col-12"><label data-v-d1962f06="" for="inputZip" class="form-label">Zip</label><input data-v-d1962f06="" type="text" class="form-control input-lg" id="inputZip" required="" maxlength="5" autocomplete="off" name="Zip">
  </div>
  <div data-v-d1962f06="" class="col-6"><label data-v-d1962f06="" for="inputCity" class="form-label">City</label><input data-v-d1962f06="" type="text" class="form-control input-lg" id="inputCity" name="City" required=""></div>
  <div data-v-d1962f06="" class="col-6"><label data-v-d1962f06="" for="inputState" class="form-label">State</label><select data-v-d1962f06="" id="inputState" class="form-select required" name="State" required="">
      <option selected="" value="" data-v-d1962f06="">Select State</option>
      <option value="AL" data-v-d1962f06="">Alabama</option>
      <option value="AK" data-v-d1962f06="">Alaska</option>
      <option value="AZ" data-v-d1962f06="">Arizona</option>
      <option value="AR" data-v-d1962f06="">Arkansas</option>
      <option value="CA" data-v-d1962f06="">California</option>
      <option value="CO" data-v-d1962f06="">Colorado</option>
      <option value="CT" data-v-d1962f06="">Connecticut</option>
      <option value="DE" data-v-d1962f06="">Delaware</option>
      <option value="DC" data-v-d1962f06="">District Of Columbia</option>
      <option value="FL" data-v-d1962f06="">Florida</option>
      <option value="GA" data-v-d1962f06="">Georgia</option>
      <option value="HI" data-v-d1962f06="">Hawaii</option>
      <option value="ID" data-v-d1962f06="">Idaho</option>
      <option value="IL" data-v-d1962f06="">Illinois</option>
      <option value="IN" data-v-d1962f06="">Indiana</option>
      <option value="IA" data-v-d1962f06="">Iowa</option>
      <option value="KS" data-v-d1962f06="">Kansas</option>
      <option value="KY" data-v-d1962f06="">Kentucky</option>
      <option value="LA" data-v-d1962f06="">Louisiana</option>
      <option value="ME" data-v-d1962f06="">Maine</option>
      <option value="MD" data-v-d1962f06="">Maryland</option>
      <option value="MA" data-v-d1962f06="">Massachusetts</option>
      <option value="MI" data-v-d1962f06="">Michigan</option>
      <option value="MN" data-v-d1962f06="">Minnesota</option>
      <option value="MS" data-v-d1962f06="">Mississippi</option>
      <option value="MO" data-v-d1962f06="">Missouri</option>
      <option value="MT" data-v-d1962f06="">Montana</option>
      <option value="NE" data-v-d1962f06="">Nebraska</option>
      <option value="NV" data-v-d1962f06="">Nevada</option>
      <option value="NH" data-v-d1962f06="">New Hampshire</option>
      <option value="NJ" data-v-d1962f06="">New Jersey</option>
      <option value="NM" data-v-d1962f06="">New Mexico</option>
      <option value="NY" data-v-d1962f06="">New York</option>
      <option value="NC" data-v-d1962f06="">North Carolina</option>
      <option value="ND" data-v-d1962f06="">North Dakota</option>
      <option value="OH" data-v-d1962f06="">Ohio</option>
      <option value="OK" data-v-d1962f06="">Oklahoma</option>
      <option value="OR" data-v-d1962f06="">Oregon</option>
      <option value="PA" data-v-d1962f06="">Pennsylvania</option>
      <option value="RI" data-v-d1962f06="">Rhode Island</option>
      <option value="SC" data-v-d1962f06="">South Carolina</option>
      <option value="SD" data-v-d1962f06="">South Dakota</option>
      <option value="TN" data-v-d1962f06="">Tennessee</option>
      <option value="TX" data-v-d1962f06="">Texas</option>
      <option value="UT" data-v-d1962f06="">Utah</option>
      <option value="VT" data-v-d1962f06="">Vermont</option>
      <option value="VA" data-v-d1962f06="">Virginia</option>
      <option value="WA" data-v-d1962f06="">Washington</option>
      <option value="WV" data-v-d1962f06="">West Virginia</option>
      <option value="WI" data-v-d1962f06="">Wisconsin</option>
      <option value="WY" data-v-d1962f06="">Wyoming</option>
    </select></div>
  <div data-v-d1962f06="" class="col-12"><label data-v-d1962f06="" for="Date" class="form-label">Date of Birth</label>
    <div data-v-d1962f06="" class="row row-spacing">
      <div data-v-d1962f06="" class="col-4"><select data-v-d1962f06="" id="inputMonth" class="required form-select" name="Month" required="">
          <option data-v-d1962f06="" value="">Month</option>
          <option data-v-d1962f06="" value="1">Jan</option>
          <option data-v-d1962f06="" value="2">Feb</option>
          <option data-v-d1962f06="" value="3">Mar</option>
          <option data-v-d1962f06="" value="4">Apr</option>
          <option data-v-d1962f06="" value="5">May</option>
          <option data-v-d1962f06="" value="6">Jun</option>
          <option data-v-d1962f06="" value="7">Jul</option>
          <option data-v-d1962f06="" value="8">Aug</option>
          <option data-v-d1962f06="" value="9">Sep</option>
          <option data-v-d1962f06="" value="10">Oct</option>
          <option data-v-d1962f06="" value="11">Nov</option>
          <option data-v-d1962f06="" value="12">Dec</option>
        </select></div>
      <div data-v-d1962f06="" class="col-4"><select data-v-d1962f06="" id="inputDay" class="form-select required" name="Day" required="">
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          <option data-v-d1962f06="" value="1">1</option>
          <option data-v-d1962f06="" value="2">2</option>
          <option data-v-d1962f06="" value="3">3</option>
          <option data-v-d1962f06="" value="4">4</option>
          <option data-v-d1962f06="" value="5">5</option>
          <option data-v-d1962f06="" value="6">6</option>
          <option data-v-d1962f06="" value="7">7</option>
          <option data-v-d1962f06="" value="8">8</option>
          <option data-v-d1962f06="" value="9">9</option>
          <option data-v-d1962f06="" value="10">10</option>
          <option data-v-d1962f06="" value="11">11</option>
          <option data-v-d1962f06="" value="12">12</option>
          <option data-v-d1962f06="" value="13">13</option>
          <option data-v-d1962f06="" value="14">14</option>
          <option data-v-d1962f06="" value="15">15</option>
          <option data-v-d1962f06="" value="16">16</option>
          <option data-v-d1962f06="" value="17">17</option>
          <option data-v-d1962f06="" value="18">18</option>
          <option data-v-d1962f06="" value="19">19</option>
          <option data-v-d1962f06="" value="20">20</option>
          <option data-v-d1962f06="" value="21">21</option>
          <option data-v-d1962f06="" value="22">22</option>
          <option data-v-d1962f06="" value="23">23</option>
          <option data-v-d1962f06="" value="24">24</option>
          <option data-v-d1962f06="" value="25">25</option>
          <option data-v-d1962f06="" value="26">26</option>
          <option data-v-d1962f06="" value="27">27</option>
          <option data-v-d1962f06="" value="28">28</option>
          <option data-v-d1962f06="" value="29">29</option>
          <option data-v-d1962f06="" value="30">30</option>
          <option data-v-d1962f06="" value="31">31</option>
        </select></div>
      <div data-v-d1962f06="" class="col-4"><select data-v-d1962f06="" id="inputYear" class="form-select required" name="Year" required="">
          <option data-v-d1962f06="" value="">Year</option>
          <option data-v-d1962f06="" value="2024">2024</option>
          <option data-v-d1962f06="" value="2023">2023</option>
          <option data-v-d1962f06="" value="2022">2022</option>
          <option data-v-d1962f06="" value="2021">2021</option>
          <option data-v-d1962f06="" value="2020">2020</option>
          <option data-v-d1962f06="" value="2019">2019</option>
          <option data-v-d1962f06="" value="2018">2018</option>
          <option data-v-d1962f06="" value="2017">2017</option>
          <option data-v-d1962f06="" value="2016">2016</option>
          <option data-v-d1962f06="" value="2015">2015</option>
          <option data-v-d1962f06="" value="2014">2014</option>
          <option data-v-d1962f06="" value="2013">2013</option>
          <option data-v-d1962f06="" value="2012">2012</option>
          <option data-v-d1962f06="" value="2011">2011</option>
          <option data-v-d1962f06="" value="2010">2010</option>
          <option data-v-d1962f06="" value="2009">2009</option>
          <option data-v-d1962f06="" value="2008">2008</option>
          <option data-v-d1962f06="" value="2007">2007</option>
          <option data-v-d1962f06="" value="2006">2006</option>
          <option data-v-d1962f06="" value="2005">2005</option>
          <option data-v-d1962f06="" value="2004">2004</option>
          <option data-v-d1962f06="" value="2003">2003</option>
          <option data-v-d1962f06="" value="2002">2002</option>
          <option data-v-d1962f06="" value="2001">2001</option>
          <option data-v-d1962f06="" value="2000">2000</option>
          <option data-v-d1962f06="" value="1999">1999</option>
          <option data-v-d1962f06="" value="1998">1998</option>
          <option data-v-d1962f06="" value="1997">1997</option>
          <option data-v-d1962f06="" value="1996">1996</option>
          <option data-v-d1962f06="" value="1995">1995</option>
          <option data-v-d1962f06="" value="1994">1994</option>
          <option data-v-d1962f06="" value="1993">1993</option>
          <option data-v-d1962f06="" value="1992">1992</option>
          <option data-v-d1962f06="" value="1991">1991</option>
          <option data-v-d1962f06="" value="1990">1990</option>
          <option data-v-d1962f06="" value="1989">1989</option>
          <option data-v-d1962f06="" value="1988">1988</option>
          <option data-v-d1962f06="" value="1987">1987</option>
          <option data-v-d1962f06="" value="1986">1986</option>
          <option data-v-d1962f06="" value="1985">1985</option>
          <option data-v-d1962f06="" value="1984">1984</option>
          <option data-v-d1962f06="" value="1983">1983</option>
          <option data-v-d1962f06="" value="1982">1982</option>
          <option data-v-d1962f06="" value="1981">1981</option>
          <option data-v-d1962f06="" value="1980">1980</option>
          <option data-v-d1962f06="" value="1979">1979</option>
          <option data-v-d1962f06="" value="1978">1978</option>
          <option data-v-d1962f06="" value="1977">1977</option>
          <option data-v-d1962f06="" value="1976">1976</option>
          <option data-v-d1962f06="" value="1975">1975</option>
          <option data-v-d1962f06="" value="1974">1974</option>
          <option data-v-d1962f06="" value="1973">1973</option>
          <option data-v-d1962f06="" value="1972">1972</option>
          <option data-v-d1962f06="" value="1971">1971</option>
          <option data-v-d1962f06="" value="1970">1970</option>
          <option data-v-d1962f06="" value="1969">1969</option>
          <option data-v-d1962f06="" value="1968">1968</option>
          <option data-v-d1962f06="" value="1967">1967</option>
          <option data-v-d1962f06="" value="1966">1966</option>
          <option data-v-d1962f06="" value="1965">1965</option>
          <option data-v-d1962f06="" value="1964">1964</option>
          <option data-v-d1962f06="" value="1963">1963</option>
          <option data-v-d1962f06="" value="1962">1962</option>
          <option data-v-d1962f06="" value="1961">1961</option>
          <option data-v-d1962f06="" value="1960">1960</option>
          <option data-v-d1962f06="" value="1959">1959</option>
          <option data-v-d1962f06="" value="1958">1958</option>
          <option data-v-d1962f06="" value="1957">1957</option>
          <option data-v-d1962f06="" value="1956">1956</option>
          <option data-v-d1962f06="" value="1955">1955</option>
          <option data-v-d1962f06="" value="1954">1954</option>
          <option data-v-d1962f06="" value="1953">1953</option>
          <option data-v-d1962f06="" value="1952">1952</option>
          <option data-v-d1962f06="" value="1951">1951</option>
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          <option data-v-d1962f06="" value="1948">1948</option>
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          <option data-v-d1962f06="" value="1946">1946</option>
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          <option data-v-d1962f06="" value="1944">1944</option>
          <option data-v-d1962f06="" value="1943">1943</option>
          <option data-v-d1962f06="" value="1942">1942</option>
          <option data-v-d1962f06="" value="1941">1941</option>
          <option data-v-d1962f06="" value="1940">1940</option>
          <option data-v-d1962f06="" value="1939">1939</option>
          <option data-v-d1962f06="" value="1938">1938</option>
          <option data-v-d1962f06="" value="1937">1937</option>
          <option data-v-d1962f06="" value="1936">1936</option>
          <option data-v-d1962f06="" value="1935">1935</option>
          <option data-v-d1962f06="" value="1934">1934</option>
          <option data-v-d1962f06="" value="1933">1933</option>
          <option data-v-d1962f06="" value="1932">1932</option>
          <option data-v-d1962f06="" value="1931">1931</option>
          <option data-v-d1962f06="" value="1930">1930</option>
          <option data-v-d1962f06="" value="1929">1929</option>
          <option data-v-d1962f06="" value="1928">1928</option>
          <option data-v-d1962f06="" value="1927">1927</option>
          <option data-v-d1962f06="" value="1926">1926</option>
          <option data-v-d1962f06="" value="1925">1925</option>
        </select></div>
    </div>
  </div>
  <div data-v-d1962f06="" class="col-12"><label data-v-d1962f06="" for="inputState" class="form-label">Gender</label><select data-v-d1962f06="" id="inputGender" class="form-select required" name="Gender" required="">
      <option data-v-d1962f06="" value="">Select Gender</option>
      <option data-v-d1962f06="" value="Male">Male</option>
      <option data-v-d1962f06="" value="Male">Female</option>
    </select></div>
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  <div data-v-d1962f06="" class="global-consent"> By clicking Continue, I agree to receive email from localhost and affiliated brands that may be of interest to me. I also agree to the
    <a data-v-d1962f06="" href="/terms-and-conditions" target="“_blank”" style="color: rgb(94, 139, 184);">Terms &amp; Conditions</a>&nbsp;(including mandatory
    arbitration),&nbsp;<a data-v-d1962f06="" href="/privacy-policy" target="_blank" style="color: rgb(94, 139, 184);">Privacy Policy</a>, and site visit recordation by TrustedForm and Jornaya. </div><input type="hidden" name="xxTrustedFormCertUrl"
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    Consumer Protection Act) Compliance Statement:By providing your contact information, you consent to receive calls, text messages, and/or emails from us or our authorized representatives regarding products and services. This consent applies to
    both landline and mobile phone numbers. Please note that your consent is not a condition of purchasing any products or services. If you wish to opt out of receiving further communications, you can do so by contacting us directly or using the
    unsubscribe option provided in our communications.We respect your privacy and adhere to all applicable TCPA regulations. Your information will not be shared with any third parties for marketing purposes without your explicit consent.If you have
    any questions or concerns regarding our TCPA compliance or the use of your personal information, please contact us.</label>
  <div data-v-d1962f06="" class="col-12"><label data-v-d1962f06="" for="inputPhone" class="form-label">Phone</label><input data-v-d1962f06="" type="tel" class="form-control input-lg" id="inputPhone" name="Phone" placeholder="XXX-XXX-XXXX" required=""
      maxlength="10"></div>
  <div data-v-d1962f06="" class="global-consent"> By clicking the “Continue” button, I give my affirmative express consent authorizing My American Prizes, Support First, Unified Marketing Partner LLC, JobblyPro, Purpose Health, and
    <a data-v-d1962f06="" href="/marketing-partners-r" target="_blank" style="color: rgb(94, 139, 184);">Marketing Partners</a> to contact me by text messages or telephone including the use of an autodialer. I confirm the number I provided above is
    accurate and I am the regular user. I am willing to incur charges from my phone company for these contacts. This consent applies even if my number is on a Federal or State Do-Not-Call List. I understand that consent isn’t required to participate
    and that I can revoke my consent for calls by any reasonable means. <a data-v-d1962f06="" notcpaconsent="" href="javascript:void(0)" style="color: rgb(94, 139, 184);">Click here</a> to continue without providing consent. </div>
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</form>

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Continue below to continue
TCPA (Telephone Consumer Protection Act) Compliance Statement:By providing your
contact information, you consent to receive calls, text messages, and/or emails
from us or our authorized representatives regarding products and services. This
consent applies to both landline and mobile phone numbers. Please note that your
consent is not a condition of purchasing any products or services. If you wish
to opt out of receiving further communications, you can do so by contacting us
directly or using the unsubscribe option provided in our communications.We
respect your privacy and adhere to all applicable TCPA regulations. Your
information will not be shared with any third parties for marketing purposes
without your explicit consent.If you have any questions or concerns regarding
our TCPA compliance or the use of your personal information, please contact us.
First Name
Last Name
E-mail
Address 1
Zip
City
StateSelect
StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict
Of
ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew
HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth
DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth
DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Date of Birth
MonthJanFebMarAprMayJunJulAugSepOctNovDec
Day12345678910111213141516171819202122232425262728293031
Year2024202320222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925
GenderSelect GenderMaleFemale
Continue
By clicking Continue, I agree to receive email from localhost and affiliated
brands that may be of interest to me. I also agree to the Terms &
Conditions (including mandatory arbitration), Privacy Policy, and site visit
recordation by TrustedForm and Jornaya.
TCPA (Telephone Consumer Protection Act) Compliance Statement:By providing your
contact information, you consent to receive calls, text messages, and/or emails
from us or our authorized representatives regarding products and services. This
consent applies to both landline and mobile phone numbers. Please note that your
consent is not a condition of purchasing any products or services. If you wish
to opt out of receiving further communications, you can do so by contacting us
directly or using the unsubscribe option provided in our communications.We
respect your privacy and adhere to all applicable TCPA regulations. Your
information will not be shared with any third parties for marketing purposes
without your explicit consent.If you have any questions or concerns regarding
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