www.kitgov.com Open in urlscan Pro
202.36.56.243  Public Scan

Form analysis
1 forms found in the DOM

Name: form1 — POST

<form name="form1" method="post" action="" onsubmit="return submit_check_t();" id="form1">
  <div class="form-group"><label><i class="fas fa-pen"></i>戶籍鄉鎮里鄰<small>Household Registration Address</small></label>
    <div class="col-md-6" style="padding: 0px;"><select id="city" class="form-control form-control-sm el-reset">
        <option value="">請選擇縣市(City/County)</option>
        <option value="基隆市">基隆市</option>
        <option value="臺北市">臺北市</option>
        <option value="新北市">新北市</option>
        <option value="桃園市">桃園市</option>
        <option value="新竹市">新竹市</option>
        <option value="新竹縣">新竹縣</option>
        <option value="苗栗縣">苗栗縣</option>
        <option value="臺中市">臺中市</option>
        <option value="彰化縣">彰化縣</option>
        <option value="南投縣">南投縣</option>
        <option value="雲林縣">雲林縣</option>
        <option value="嘉義市">嘉義市</option>
        <option value="嘉義縣">嘉義縣</option>
        <option value="臺南市">臺南市</option>
        <option value="高雄市">高雄市</option>
        <option value="屏東縣">屏東縣</option>
        <option value="臺東縣">臺東縣</option>
        <option value="花蓮縣">花蓮縣</option>
        <option value="宜蘭縣">宜蘭縣</option>
        <option value="澎湖縣">澎湖縣</option>
        <option value="金門縣">金門縣</option>
        <option value="連江縣">連江縣</option>
      </select></div>
    <div class="col-md-6" style="padding: 0px; margin-top: 10px;"><select name="cityarea" class="form-control form-control-sm el-reset" id="cityarea">
        <option value="">請選擇鄉鎮市區(District/Township)</option>
      </select></div>
    <div class="col-md-6" style="padding: 0px; margin-top: 10px;"><select name="street" class="form-control form-control-sm el-reset" id="street">
        <option value="">請選擇村里(Village)</option>
      </select></div>
    <div class="col-md-6 input-group input-group-sm" style="padding: 0px; margin-top: 10px;"><input type="text" maxlength="400" id="neighborhood" class="form-control form-control-sm el-reset" required="">
      <div class="input-group-prepend"><span class="input-group-text">鄰(Neighborhood)</span></div>
    </div>
  </div>
</form>

Text Content

申請紓困補貼

APPLY FOR EPIDEMIC SUBSIDY

請填寫身分證明資料
Please fill in your identification information

--------------------------------------------------------------------------------

姓名 Full Name
國民身分證統一編號ID card No/residence permit
戶籍鄉鎮里鄰Household Registration Address
請選擇縣市(City/County)基隆市臺北市新北市桃園市新竹市新竹縣苗栗縣臺中市彰化縣南投縣雲林縣嘉義市嘉義縣臺南市高雄市屏東縣臺東縣花蓮縣宜蘭縣澎湖縣金門縣連江縣
請選擇鄉鎮市區(District/Township)
請選擇村里(Village)
鄰(Neighborhood)
下一步 (Next)

提示


關閉