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www.primesavingsoutlet.com Open in urlscan Pro
2606:4700:3031::6815:44c0  Public Scan

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Submitted URL: http://rackpower.info/index.php/campaigns/fr493of4xa4f3/track-url/wg8077hga72bc/0dc16fe940925072a0ea6f891955dac037792349
Effective URL: https://www.primesavingsoutlet.com/AI1moS/?_ef_transaction_id=92ccf77770b84f168927dffdd56ba692&AFFID=15&C1=455&C2=INM046597ce633822...
Submission: On February 29 via api from US — Scanned from US

Form analysis 1 forms found in the DOM

Name: downsell_form1 — POST ajax.php?method=downsell1

<form method="post" action="ajax.php?method=downsell1" name="downsell_form1" id="downsell_form1" accept-charset="utf-8" enctype="application/x-www-form-urlencoded;charset=utf-8" novalidate="novalidate">
  <div class="row mb-2">
    <div class="col-6">
      <label>First Name:</label>
      <input placeholder="First Name" type="text" class="form-control required py-0 px-2" style="--bs-bg-opacity: 0.1" name="firstName" data-error-message="Please enter your first name." value="">
    </div>
    <div class="col-6">
      <label>Last Name:</label>
      <input placeholder="Last Name" type="text" class="form-control required py-0 px-2" style="--bs-bg-opacity: 0.1" name="lastName" data-error-message="Please enter your last name." value="">
    </div>
  </div>
  <div class="row mb-2">
    <div class="col-12">
      <label>Email:</label>
      <input placeholder="Email" type="email" class="form-control required py-0 px-2" style="--bs-bg-opacity: 0.1" name="email" data-error-message="Please enter a valid email address." value="">
    </div>
  </div>
  <div class="row mb-2">
    <div class="col-12">
      <label>Phone:</label>
      <input type="tel" name="phone" maxlength="10" data-min-length="10" data-max-length="10" placeholder="Phone" class="form-control required py-0 px-2" style="--bs-bg-opacity: 0.1" data-error-message="Please enter a valid contact number."
        onkeyup="javascript: this.value = this.value.replace(/[^0-9]/g, '');" value="">
    </div>
  </div>
  <div class="row mb-2">
    <div class="col-12">
      <label>State:</label>
      <select name="shippingState" type="text" class="py-0 px-2 form-control required" placeholder="shipping state" data-error-message="Please select your state/province." data-field="state">
        <option value="" selected="selected">Select State</option>
        <option value="AL">Alabama</option>
        <option value="AZ">Arizona</option>
        <option value="AR">Arkansas</option>
        <option value="CA">California</option>
        <option value="CO">Colorado</option>
        <option value="CT">Connecticut</option>
        <option value="DE">Delaware</option>
        <option value="DC">District of Columbia</option>
        <option value="FL">Florida</option>
        <option value="GA">Georgia</option>
        <option value="ID">Idaho</option>
        <option value="IL">Illinois</option>
        <option value="IN">Indiana</option>
        <option value="IA">Iowa</option>
        <option value="KS">Kansas</option>
        <option value="KY">Kentucky</option>
        <option value="LA">Louisiana</option>
        <option value="ME">Maine</option>
        <option value="MD">Maryland</option>
        <option value="MA">Massachusetts</option>
        <option value="MI">Michigan</option>
        <option value="MN">Minnesota</option>
        <option value="MS">Mississippi</option>
        <option value="MO">Missouri</option>
        <option value="MT">Montana</option>
        <option value="NE">Nebraska</option>
        <option value="NV">Nevada</option>
        <option value="NH">New Hampshire</option>
        <option value="NJ">New Jersey</option>
        <option value="NM">New Mexico</option>
        <option value="NY">New York</option>
        <option value="NC">North Carolina</option>
        <option value="ND">North Dakota</option>
        <option value="OH">Ohio</option>
        <option value="OK">Oklahoma</option>
        <option value="OR">Oregon</option>
        <option value="PA">Pennsylvania</option>
        <option value="RI">Rhode Island</option>
        <option value="SC">South Carolina</option>
        <option value="SD">South Dakota</option>
        <option value="TN">Tennessee</option>
        <option value="TX">Texas</option>
        <option value="UT">Utah</option>
        <option value="VT">Vermont</option>
        <option value="VA">Virginia</option>
        <option value="WA">Washington</option>
        <option value="WV">West Virginia</option>
        <option value="WI">Wisconsin</option>
        <option value="WY">Wyoming</option>
      </select>
    </div>
  </div>
  <div class="row mb-2">
    <div class="col-12">
      <label>Zip Code:</label>
      <input type="tel" placeholder="Zip or Postal Code" name="shippingZip" class="form-control required py-0 px-2" style="--bs-bg-opacity: 0.1" data-error-message="Please enter a valid zip code." id="zipCode" value="">
    </div>
  </div>
  <div class="row mb-2">
    <div class="col-12">
      <label>Address:</label>
      <input type="text" class="form-control required py-0 px-2 pac-target-input" style="--bs-bg-opacity: 0.1" name="shippingAddress1" placeholder="Address" data-error-message="Please enter your address." value="" autocomplete="off">
    </div>
  </div>
  <div class="row mb-2">
    <div class="col-12">
      <label>City:</label>
      <input placeholder="City" type="text" name="shippingCity" class="form-control required py-0 px-2" style="--bs-bg-opacity: 0.1" data-error-message="Please enter your city." value="">
    </div>
  </div>
  <div class="row mb-2">
    <div class="col-12">
      <label>Country:</label>
      <select name="shippingCountry" class="form-control required py-0 px-2 no-error" data-selected="US" data-error-message="Please select your country." id="country">
        <option value="">Select Country</option>
        <option value="US">United States</option>
        <option value="CA">Canada</option>
      </select>
    </div>
  </div>
  <div class="row mb-2">
    <div class="col-12">
      <p class="bill_as_ship">
        <label>Billing same as Shipping</label>
        <input type="radio" name="billingSameAsShipping" value="yes" checked="checked"> YES <input type="radio" name="billingSameAsShipping" value="no"> NO
      </p>
    </div>
  </div>
  <div id="billing" class="billing-info" style="display: none">
    <div class="row mb-2">
      <div class="col-12">
        <label>Billing First Name:</label>
        <input type="text" class="form-control py-0 px-2" style="--bs-bg-opacity: 0.1" name="billingFirstName" placeholder="Billing First Name" data-error-message="Please enter your billing first name.">
      </div>
    </div>
    <div class="row mb-2">
      <div class="col-12">
        <label>Billing Last Name:</label>
        <input type="text" class="form-control py-0 px-2" style="--bs-bg-opacity: 0.1" name="billingLastName" placeholder="Billing Last Name" data-error-message="Please enter your billing last name.">
      </div>
    </div>
    <div class="row mb-2">
      <div class="col-12">
        <label>Billing Address</label>
        <input type="text" class="form-control py-0 px-2" style="--bs-bg-opacity: 0.1" name="billingAddress1" placeholder="Billing Address" data-error-message="Please enter your billing address.">
      </div>
    </div>
    <div class="row mb-2">
      <div class="col-12">
        <label>Billing City</label>
        <input type="text" class="form-control py-0 px-2" style="--bs-bg-opacity: 0.1" name="billingCity" placeholder="Billing City" data-error-message="Please enter your billing city.">
      </div>
    </div>
    <div class="row mb-2">
      <div class="col-12">
        <label>Billing Country</label>
        <select name="billingCountry" class="form-control py-0 px-2" data-selected="US" data-error-message="Please select your billing country." id="billingCountry">
          <option value="">Select Country</option>
        </select>
      </div>
    </div>
    <div class="row mb-2">
      <div class="col-12">
        <label for="billingState">Billing State:</label>
        <input type="text" class="form-control py-0 px-2" style="--bs-bg-opacity: 0.1" name="billingState" id="billingState" placeholder="Billing State" data-error-message="Please enter your billing state / province." readonly="">
      </div>
    </div>
    <div class="row mb-2">
      <div class="col-12">
        <label>Billing Zip or Postal Code:</label>
        <input type="text" placeholder="Billing Zip Code" class="form-control py-0 px-2" style="--bs-bg-opacity: 0.1" name="billingZip" data-error-message="Please enter a valid billing zip code." id="billingZipCode">
      </div>
    </div>
  </div>
  <div class="row mb-2">
    <select name="creditCardType" style="display:none;" data-error-message=" ">
      <option value="">Card Type</option>
      <option value="visa">Visa</option>
      <option value="master">Master Card</option>
    </select>
    <div class="col-12">
      <label>Credit Card Number:</label>
      <div class="position-relative ccards">
        <input name="creditCardNumber" id="creditCardNumber" placeholder="---- ---- ---- ----" type="tel" style="--bs-bg-opacity: 0.1" class="form-control required py-0 ps-2" maxlength="19" data-min-length="16" data-max-length="16"
          data-error-message="Please enter a valid card number." onkeyup="javascript: this.value = this.value.replace(/[^0-9]/g, '');">
        <div class="float-card">
          <img alt="mcLogo" src="/AI1moS/app/desktop/images/mcLogo.png" class="img-card">
          <img alt="visaLogo" src="/AI1moS/app/desktop/images/visaLogo.png" class="img-card">
        </div>
      </div>
    </div>
  </div>
  <div class="row mb-3">
    <div class="col-6">
      <label>Valid Thru:</label>
      <select name="expmonth" class="form-control required py-0 px-2" data-error-message="Please select a valid expiry month.">
        <option value="">Month</option>
        <option value="01">(01) January</option>
        <option value="02">(02) February</option>
        <option value="03">(03) March</option>
        <option value="04">(04) April</option>
        <option value="05">(05) May</option>
        <option value="06">(06) June</option>
        <option value="07">(07) July</option>
        <option value="08">(08) August</option>
        <option value="09">(09) September</option>
        <option value="10">(10) October</option>
        <option value="11">(11) November</option>
        <option value="12">(12) December</option>
      </select>
    </div>
    <div class="col-6">
      <label></label>
      <select name="expyear" class="required form-control mt-1" data-error-message="Please select a valid expiry year.">
        <option value="">Year</option>
        <option value="24">2024</option>
        <option value="25">2025</option>
        <option value="26">2026</option>
        <option value="27">2027</option>
        <option value="28">2028</option>
        <option value="29">2029</option>
        <option value="30">2030</option>
        <option value="31">2031</option>
        <option value="32">2032</option>
        <option value="33">2033</option>
        <option value="34">2034</option>
        <option value="35">2035</option>
        <option value="36">2036</option>
        <option value="37">2037</option>
        <option value="38">2038</option>
        <option value="39">2039</option>
        <option value="40">2040</option>
        <option value="41">2041</option>
        <option value="42">2042</option>
        <option value="43">2043</option>
      </select>
    </div>
  </div>
  <div class="row mb-3">
    <div class="col-6">
      <label>CVV:</label>
      <div class="position-relative">
        <input type="tel" name="CVV" id="cvvNo" placeholder="CVV" class="form-control required py-0 px-2" style="--bs-bg-opacity: 0.1" maxlength="3" data-min-length="3" data-max-length="3" data-error-message="Please enter a valid CVV code."
          onkeyup="javascript: this.value = this.value.replace(/[^0-9]/g, '');">
        <a data-vbtype="iframe" href="cvv.php" data-title="What is CVV?" data-ratio="full" class="nav-links venobox cvvmove vbox-item"><svg viewBox="0 0 24 24" focusable="false" class="qs-icon">
                    <path fill="currentColor" d="M12,0A12,12,0,1,0,24,12,12.013,12.013,0,0,0,12,0Zm0,19a1.5,1.5,0,1,1,1.5-1.5A1.5,1.5,0,0,1,12,19Zm1.6-6.08a1,1,0,0,0-.6.917,1,1,0,1,1-2,0,3,3,0,0,1,1.8-2.75A2,2,0,1,0,10,9.255a1,1,0,1,1-2,0,4,4,0,1,1,5.6,3.666Z"></path>
                  </svg></a>
      </div>
    </div>
  </div>
  <div class="row mb-2">
    <div class="col-12">
      <button id="submitBtn" style="padding: 10px 15px" type="button" class="btn btn-lg btn-primary w-100">SUBMIT</button>
    </div>
  </div>
  <div class="row mb-2">
    <div class="col-12 ptext text-center">
      <p> Contact us for any questions or concerns <a href="tel:+1-877-286-0052"> +1-877-286-0052. </a>
      </p>
    </div>
  </div>
  <p id="loading-indicator" style="display:none;">Processing...</p>
  <input type="hidden" name="csrf_token" value="b3c8ce3d6fc8acda0a162f497413194727d7065050a5673a368d13216a0f3970">
</form>

Text Content

First Name:
Last Name:
Email:
Phone:
State: Select
StateAlabamaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of
ColumbiaFloridaGeorgiaIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew
HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth
DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth
DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Zip Code:
Address:
City:
Country: Select CountryUnited StatesCanada

Billing same as Shipping YES NO

Billing First Name:
Billing Last Name:
Billing Address
Billing City
Billing Country Select Country
Billing State:
Billing Zip or Postal Code:
Card Type Visa Master Card
Credit Card Number:

Valid Thru: Month(01) January(02) February(03) March(04) April(05) May(06)
June(07) July(08) August(09) September(10) October(11) November(12) December
Year20242025202620272028202920302031203220332034203520362037203820392040204120422043
CVV:

SUBMIT

Contact us for any questions or concerns +1-877-286-0052.

Processing...