payments.lesar.co.uk Open in urlscan Pro
167.172.63.92  Public Scan

Form analysis
1 forms found in the DOM

POST /payment

<form action="/payment" method="post">
  <input type="hidden" name="_token" value="zcXCjNW0ScY5Y6SFzXyrBlKCzQfQHTsRKjeNiTvw">
  <div class="mb-5">
    <label class="font-medium mb-2 text-gray-800 flex justify-between items-center"><span>Email Address *</span><span class="text-sm text-gray-600">Required</span></label>
    <input type="email" class="border border-gray-2 p-3 text-gray-800 w-full rounded-md" placeholder="Email Address" name="email" required="">
  </div>
  <div class="flex mb-5 -mx-5">
    <div class="flex-1 mx-5">
      <label class="font-medium mb-2 text-gray-800 flex justify-between items-center"><span>Our Reference *</span><span class="text-sm text-gray-600">Required</span></label>
      <input type="text" class="border border-gray-2 p-3 text-gray-800 w-full rounded-md" placeholder="Our Reference*" name="orderno" required="">
    </div>
    <div class="flex-1 mx-5">
      <label class="font-medium mb-2 text-gray-800 flex justify-between items-center"><span>Full Amount *</span><span class="text-sm text-gray-600">Required</span></label>
      <input type="text" class="border border-gray-2 p-3 text-gray-800 w-full rounded-md" placeholder="Amount*" name="value" required="">
    </div>
  </div>
  <div class="mb-5 mt-10">
    <button type="submit" class="block w-full p-3 bg-green-500 font-medium text-white rounded">Proceed to make payment</button>
  </div>
  <div class="mt-10 text-center">
    <img src="/paypal-applepay-gpay-visa-mastercard-maestro-stripe.svg" class="m-auto">
  </div>
</form>

Text Content

Email Address *Required
Our Reference *Required
Full Amount *Required
Proceed to make payment


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