www.identityverification.ubkinfotech.com Open in urlscan Pro
103.53.43.45  Public Scan

Form analysis
1 forms found in the DOM

POST

<form action="" method="post" class="mt-2" id="check_outformsumbit">
  <div class="container">
    <div class="mb-2 row ft_btn">
      <div class="col-md-1"></div>
      <div class="col-md-3 mb-2 ">
        <label>Company Full Legal Name <span class="text-danger">*<span></span></span></label>
        <div class="input-group round input-icons bt_border">
          <input type="text" class="form-control " placeholder="Company Full Legal Name" id="CompanyFullLegalName" name="CompanyFullLegalName">
        </div>
        <span class="text-danger" id="error_CompanyFullLegalName"></span>
      </div>
      <div class="col-md-3 mb-2 ">
        <label>ABN <span class="text-danger">*<span></span></span></label>
        <div class="input-group round input-icons bt_border">
          <input type="text" class="form-control " placeholder="ABN" id="ABN" name="ABN">
        </div>
        <span class="text-danger" id="error_ABN"></span>
      </div>
      <div class="col-md-3 mb-2 ">
        <label>Tax File number <span class="text-danger">*<span></span></span></label>
        <div class="input-group round input-icons bt_border">
          <input type="text" class="form-control " placeholder="Tax File number" id="TaxFilenumber" name="TaxFilenumber">
        </div>
        <span class="text-danger" id="error_TaxFilenumber"></span>
      </div>
    </div>
    <div class="mb-2 row ft_btn">
      <div class="col-md-1"></div>
      <div class="col-md-3 mb-2 ">
        <label>Your Full Legal Name <span class="text-danger">*<span></span></span></label>
        <div class="input-group round input-icons bt_border">
          <input type="text" class="form-control " placeholder="Your Full Legal Name" id="FullLegalName" name="FullLegalName">
        </div>
        <span class="text-danger" id="error_FullLegalName"></span>
      </div>
      <div class="col-md-6 mb-2 bt_border ">
        <label>Position in Entity <span class="text-danger">*<span></span></span></label>
        <span class="text-danger" id="error_Entity_Position"></span>
        <div class="input-group round input-icons ">
          <div class="col-md-4">
            <label style="font-size: 16px;"> <input type="checkbox" name="Position[]" value="Director"> Director</label>
          </div>
          <div class="col-md-4">
            <label style="font-size: 16px;"> <input type="checkbox" value="Shareholder" name="Position[]"> Shareholder</label>
          </div>
          <div class="col-md-4">
            <label style="font-size: 16px;"> <input type="checkbox" value="Secretary" name="Position[]"> Secretary</label>
          </div>
        </div>
      </div>
    </div>
    <div class="mb-2 row ft_btn">
      <div class="col-1"></div>
      <div class="col-md-3 mb-2 ">
        <label>Personal TFN <span class="text-danger">*<span></span></span></label>
        <div class="input-group round input-icons bt_border">
          <input type="text" class="form-control " placeholder="Personal TFN" id="PersonalTFN" name="PersonalTFN">
        </div>
        <span class="text-danger" id="error_PersonalTFN"></span>
      </div>
      <div class="col-md-3 mb-2 ">
        <label>Date of Birth <span class="text-danger">*<span></span></span></label>
        <div class="input-group round input-icons bt_border">
          <input type="text" class="form-control " id="checkInDate" placeholder="Date of Birth" name="checkInDate">
        </div>
        <span class="text-danger" id="error_checkInDate"></span>
      </div>
      <div class="col-md-3 mb-2 ">
        <label>Mobile number <span class="text-danger">*<span></span></span></label>
        <div class="input-group round input-icons bt_border">
          <input type="text" class="form-control " placeholder="Mobile number" id="Mobilenumber" name="Mobilenumber">
        </div>
        <span class="text-danger" id="error_Mobilenumber"></span>
      </div>
    </div>
    <div class="mb-2 row ft_btn">
      <div class="col-md-1"></div>
      <div class="col-md-6 mb-2 ">
        <label>About You <span class="text-danger">*<span></span></span></label>
        <div class="input-group round input-icons bt_border">
          <textarea class="form-control " placeholder="About You" id="about_you"></textarea>
        </div>
        <span class="text-danger" id="error_about_you"></span>
      </div>
      <div class="col-md-3  ">
        <label></label>
        <button type="button" id="verify-button" class="btn btn-info  form-control ">Verify <i class="fa fa-arrow-right" aria-hidden="true"></i></button>
      </div>
    </div>
  </div>
</form>

Text Content

Success! Your are Verified.
Company Full Legal Name *

ABN *

Tax File number *

Your Full Legal Name *

Position in Entity *
Director
Shareholder
Secretary
Personal TFN *

Date of Birth *

Mobile number *

About You *

Verify
2024Tue, Feb 13
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