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Submitted URL: http://s.przelewy24.pl/0tqK40xL2JHW
Effective URL: https://sklep.przelewy24.pl/zakup.php?z24_id_sprzedawcy=128603&z24_kwota=636650&z24_currency=pln&z24_nazwa=1004141600%2C+zaw...
Submission: On February 23 via manual from ES — Scanned from PL
Effective URL: https://sklep.przelewy24.pl/zakup.php?z24_id_sprzedawcy=128603&z24_kwota=636650&z24_currency=pln&z24_nazwa=1004141600%2C+zaw...
Submission: On February 23 via manual from ES — Scanned from PL
Form analysis 1 forms found in the DOM
POST zakup.php
<form action="zakup.php" style="margin:0; padding:0;" method="post" onsubmit="if(k24_zgoda.checked==false){alert('Aby dokonać zakupu musisz wyrazić zgodę na przetwarzanie Twoich danych.'); return false;}">
<input type="hidden" name="z24_id_sprzedawcy" value="128603">
<input type="hidden" name="z24_return_url" value="">
<input type="hidden" name="z24_nazwa" value="1004141600, zawieszka złota">
<input type="hidden" name="z24_opis" value="wpłata za zawieszkę 1004141600">
<input type="hidden" name="z24_kwota" value="6366.50">
<input type="hidden" name="z24_currency" value="PLN">
<input type="hidden" name="z24_language" value="pl">
<input type="hidden" name="z24_crc" value="d4d8e2a5">
<input type="hidden" name="a" value="submit_za">
<div class="top">
<div class="topIn"><a href="http://www.przelewy24.pl/" target="_blank"><img src="/template/img/logo.png" alt="Przelewy24" title="Przelewy24" border="0"></a>
<h1>FORMULARZ ZAMÓWIENIA <span style="padding-left: 20px;">2024/02/23 15:22</span></h1>
</div>
</div>
<div class="tyt">
<div class="tytIn">
<h2>Dane sprzedawcy</h2>
</div>
</div>
<div class="form">
<div class="formIn">
<div class="pos"><label for="">Nazwa sprzedawcy:</label><span>Tous Poland Sp. z o.o.</span></div>
<div class="pos"><label for="">Adres:</label><span>Emili Plater 53</span><label class="kr" for="">Kod, miasto:</label><span>00-113 Warszawa</span></div>
</div>
</div>
<div class="tyt">
<div class="tytIn">
<h2>Zamówienie</h2>
</div>
</div>
<div class="form">
<div class="formIn">
<div class="pos"><label for="">Tytuł płatności:</label><input readonly="" type="text" class="txt txtsr2" value="1004141600, zawieszka złota"><label class="kr" for="">Do zapłaty:</label><input readonly="" value="6366.50 PLN" type="text"
class="txt txtkr2 amount"></div>
<div class="pos"><label for="">Uwagi:</label><input readonly="" value="wpłata za zawieszkę 1004141600" type="text" class="txt"></div>
</div>
</div>
<div class="tyt">
<div class="tytIn">
<h2>Dane kupującego </h2>
</div>
</div>
<div class="form">
<div class="formIn">
<div class="pos">
<label for="">Imię i nazwisko *:</label><input name="k24_nazwa" value="JAKUB HEŁKA" type="text" class="txt txtsr3 ">
<label class="kr" for="">Firma:</label><input name="k24_firma" type="text" value="KANCELARIA NOTARIALNA ANNA KOS&JAKUB HEŁKA" class="txt txtsr3 " style="width:190px;">
<label class="kr" for="">NIP:</label><input name="k24_nip" value="" type="text" class="txt txtkr3 ">
</div>
<div class="pos">
<label for="">Miasto *:</label><input name="k24_miasto" value="KIELCE" type="text" class="txt txtsr3 ">
<label class="kr" for="">Kod *:</label><input name="k24_kod" value="25-217" type="text" class="txt txtkr ">
<label class="kr" for="">Kraj:</label><span class="country"><select name="k24_kraj" class="txts">
<option value="AFG">Afghanistan</option>
<option value="AL">Albania</option>
<option value="AND">Andorra</option>
<option value="RA">Argentina</option>
<option value="AUS">Australia</option>
<option value="A">Austria</option>
<option value="AZE">Azerbaijan</option>
<option value="BRN">Bahrain</option>
<option value="GGY">Bailiwick of Guernsey</option>
<option value="BGD">Bangladesh</option>
<option value="BY">Belarus</option>
<option value="B">Belgium</option>
<option value="BOL">Bolivia</option>
<option value="BIH">Bosnia and Herzegowina</option>
<option value="BR">Brazil</option>
<option value="BN">Brunei Darussalam</option>
<option value="BG">Bulgaria</option>
<option value="KHM">Cambodia</option>
<option value="CDN">Canada</option>
<option value="RCH">Chile</option>
<option value="PRC">China</option>
<option value="COL">Colombia</option>
<option value="CRI">Costa Rica</option>
<option value="HR">Croatia</option>
<option value="CY">Cyprus</option>
<option value="CZ">Czech Republic</option>
<option value="DK">Denmark</option>
<option value="DOM">Dominican Republic</option>
<option value="ECU">Ecuador</option>
<option value="ET">Egypt</option>
<option value="EST">Estonia</option>
<option value="FJI">Fiji</option>
<option value="FIN">Finland</option>
<option value="F">France</option>
<option value="PYF">French Polynesia</option>
<option value="GEO">Georgia</option>
<option value="DE">Germany</option>
<option value="GHA">Ghana</option>
<option value="GBZ">Gibraltar</option>
<option value="GR">Greece</option>
<option value="GRL">Greenland</option>
<option value="GUM">Guam</option>
<option value="HK">Hong Kong</option>
<option value="H">Hungary</option>
<option value="IS">Iceland</option>
<option value="IND">India</option>
<option value="IDN">Indonesia</option>
<option value="IRL">Ireland</option>
<option value="IRQ">Iraq</option>
<option value="IL">Israel</option>
<option value="I">Italy</option>
<option value="J">Japan</option>
<option value="KAZ">Kazakhstan</option>
<option value="KOR">Korea, Republic of</option>
<option value="KWT">Kuwait</option>
<option value="LAO">Lao People's Democratic Republic</option>
<option value="LV">Latvia</option>
<option value="LBY">Libyan Arab Jamahiriya</option>
<option value="FL">Liechtenstein</option>
<option value="LT">Lithuania</option>
<option value="L">Luxembourg</option>
<option value="MAC">Macau</option>
<option value="MDG">Madagascar</option>
<option value="MYS">Malaysia</option>
<option value="MDV">Maldives</option>
<option value="MLT">Malta</option>
<option value="MTQ">Martinique</option>
<option value="MEX">Mexico</option>
<option value="MDA">Moldova, Republic of</option>
<option value="MCO">Monaco</option>
<option value="MNG">Mongolia</option>
<option value="MSR">Morocco</option>
<option value="MZ">Mozambique</option>
<option value="NAM">Namibia</option>
<option value="NL">Netherlands</option>
<option value="NZL">New Zealand</option>
<option value="NGA">Nigeria</option>
<option value="N">Norway</option>
<option value="NZ">New Zealand</option>
<option value="OM">Oman</option>
<option value="PAK">Pakistan</option>
<option value="PER">Peru</option>
<option value="PHL">Philippines</option>
<option value="PL" selected="">Polska</option>
<option value="P">Portugal</option>
<option value="PRI">Puerto Rico</option>
<option value="QAT">Qatar</option>
<option value="REU">Reunion</option>
<option value="RO">Romania</option>
<option value="RUS">Russian Federation</option>
<option value="RWA">Rwanda</option>
<option value="KSI">Saudi Arabia</option>
<option value="SEN">Senegal</option>
<option value="SCG">Serbia and Montenegro</option>
<option value="SYC">Seychelles</option>
<option value="SG">Singapore</option>
<option value="SK">Slovakia (Slovak Republic)</option>
<option value="SLO">Slovenia</option>
<option value="ZAF">South Africa</option>
<option value="KR">South Korea</option>
<option value="E">Spain</option>
<option value="LKA">Sri Lanka</option>
<option value="S">Sweden</option>
<option value="CH">Switzerland</option>
<option value="TWN">Taiwan</option>
<option value="THA">Thailand</option>
<option value="TTO">Trinidad and Tobago</option>
<option value="TUN">Tunisia</option>
<option value="TR">Turkey</option>
<option value="UGA">Uganda</option>
<option value="UA">Ukraine</option>
<option value="AE">United Arab Emirates</option>
<option value="UK">United Kingdom</option>
<option value="USA">United States</option>
<option value="URY">Uruguay</option>
<option value="UZB">Uzbekistan</option>
<option value="VEN">Venezuela</option>
<option value="VNM">Vietnam</option>
</select></span>
</div>
<div class="pos">
<label for="">Ulica *:</label><input name="k24_ulica" value="UL.GENERAŁA WŁADYSŁAWA ANDERSA" type="text" class="txt txtsr4 ">
<label class="kr" for="">Nr domu *:</label><input name="k24_numer_dom" value="7" type="text" class="txt txtkr ">
<label class="kr" for="">Nr lokalu:</label><input name="k24_numer_lok" type="text" value="U7" class="txt txtkr ">
</div>
<div class="pos"><label for="">Adres e-mail *:</label><input value="domuniab@gmail.com" name="k24_email" type="text" class="txt txtsr4 ">
<label class="kr" for="">Telefon:</label><input name="k24_telefon" type="text" value="508485788" class="txt txtsr5 ">
</div>
<div class="pos"><input name="k24_zgoda" id="k24_zgoda" class="zgoda-chbx" type="checkbox" style="display: none;"><label class="zgoda" for="k24_zgoda" style="display: none;"> Tak, wyrażam zgodę na przetwarzanie moich danych osobowych przez
firmę Tous Poland Sp. z o.o. i PayPro S.A. w celach realizacji zamówienia.</label></div>
</div>
</div>
<div class="button">
<div class="buttonIn"><input name="submit_" type="button" value="anuluj" class="push push2" onclick="window.location.href=''">
<button name="submit_zamow" type="submit" value="zapłać z Przelewy24" class="push">zapłać z Przelewy24</button>
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</div>
</div>
<div class="foot">
<div class="footIn">Copyrights © PayPro S.A. All rights reserved. <br> PayPro S.A. | Poznań 60-198, ul. Pastelowa 8| tel. +48 61 642 93 44, e-mail: serwis@przelewy24.pl </div>
</div>
</form>Text Content
FORMULARZ ZAMÓWIENIA 2024/02/23 15:22 DANE SPRZEDAWCY Nazwa sprzedawcy:Tous Poland Sp. z o.o. Adres:Emili Plater 53Kod, miasto:00-113 Warszawa ZAMÓWIENIE Tytuł płatności:Do zapłaty: Uwagi: DANE KUPUJĄCEGO Imię i nazwisko *: Firma: NIP: Miasto *: Kod *: Kraj:AfghanistanAlbaniaAndorraArgentinaAustraliaAustriaAzerbaijanBahrainBailiwick of GuernseyBangladeshBelarusBelgiumBoliviaBosnia and HerzegowinaBrazilBrunei DarussalamBulgariaCambodiaCanadaChileChinaColombiaCosta RicaCroatiaCyprusCzech RepublicDenmarkDominican RepublicEcuadorEgyptEstoniaFijiFinlandFranceFrench PolynesiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGuamHong KongHungaryIcelandIndiaIndonesiaIrelandIraqIsraelItalyJapanKazakhstanKorea, Republic ofKuwaitLao People's Democratic RepublicLatviaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalaysiaMaldivesMaltaMartiniqueMexicoMoldova, Republic ofMonacoMongoliaMoroccoMozambiqueNamibiaNetherlandsNew ZealandNigeriaNorwayNew ZealandOmanPakistanPeruPhilippinesPolskaPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaudi ArabiaSenegalSerbia and MontenegroSeychellesSingaporeSlovakia (Slovak Republic)SloveniaSouth AfricaSouth KoreaSpainSri LankaSwedenSwitzerlandTaiwanThailandTrinidad and TobagoTunisiaTurkeyUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVenezuelaVietnam Ulica *: Nr domu *: Nr lokalu: Adres e-mail *: Telefon: Tak, wyrażam zgodę na przetwarzanie moich danych osobowych przez firmę Tous Poland Sp. z o.o. i PayPro S.A. w celach realizacji zamówienia. zapłać z Przelewy24 Copyrights © PayPro S.A. All rights reserved. PayPro S.A. | Poznań 60-198, ul. Pastelowa 8| tel. +48 61 642 93 44, e-mail: serwis@przelewy24.pl