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mkt.egoi.page Open in urlscan Pro
2a0b:4d07:101::1  Public Scan

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URL: https://mkt.egoi.page/1e9e7aPV/chqespeciallyrlz1C1CHBD_en__943__91e9e7aPVidAAQkADc2NTgxZDUzLWFlNWEtNDEwOS1h
Submission: On March 16 via manual from US — Scanned from DE

Form analysis 1 forms found in the DOM

<form>
  <div style="" class="field-container">
    <div style=" icon-position:left; fields-font-family:arial; fields-font-color:#000000;">
      <div class="row">
        <div class="col-12 label" style="color: #FFFFFF;font-family: 'Roboto', sans-serif;">E-mail</div>
        <div class="col-12">
          <div class="input-group"> <input class="form-control has-left-icon" type="email" style="font-family: 'Roboto', sans-serif;" placeholder=""> <span class="input-group-text required-asterisk"><svg xmlns="http://www.w3.org/2000/svg"
                viewBox="0 0 384 512">
                <path
                  d="M192 32c17.7 0 32 14.3 32 32V199.5l111.5-66.9c15.2-9.1 34.8-4.2 43.9 11s4.2 34.8-11 43.9L254.2 256l114.3 68.6c15.2 9.1 20.1 28.7 11 43.9s-28.7 20.1-43.9 11L224 312.5V448c0 17.7-14.3 32-32 32s-32-14.3-32-32V312.5L48.5 379.4c-15.2 9.1-34.8 4.2-43.9-11s-4.2-34.8 11-43.9L129.8 256 15.5 187.4c-15.2-9.1-20.1-28.7-11-43.9s28.7-20.1 43.9-11L160 199.5V64c0-17.7 14.3-32 32-32z">
                </path>
              </svg></span> </div>
        </div>
      </div>
    </div>
  </div>
  <div style="" class="field-container">
    <div style=" fields-font-family:arial; fields-font-color:#000000; display:vertical; link-color:#0645AD; font-size:15px;">
      <div class="row">
        <div class="col-12 label svelte-hgd3ce" style="color: #FFFFFF;font-family: 'Roboto', sans-serif;">Please follow the instructions</div>
        <div class="col-12 svelte-hgd3ce">
          <div style="display: flex;">
            <div class="form-check"><input class="form-check-input" name="consent" type="checkbox" style="width: 20px !important;height: 20px !important;" value="any"> <label for="consent" class="form-check-label"
                style="color: #FFFFFF;font-family: 'Roboto', sans-serif;">I accept the <a target="_blank" class="link svelte-hgd3ce" rel="noreferrer" href="#" style="font-family: 'Roboto', sans-serif;color: #0645AD;">Terms and Conditions.</a> <span
                  class="required svelte-hgd3ce">*</span></label></div>
          </div>
        </div>
      </div>
    </div>
  </div>
  <div class="field-container" style="display: flex;justify-content: center;"><small class="help error" style="font-family: 'Roboto', sans-serif;color: #FFFFFF;"></small></div>
  <div style="display: flex;justify-content: center;"><button type="button"
      style="line-height: 1.5;padding: 9px 18px 9px 18px; font-size: 15px;color: #FFFFFF;font-family: 'Source Sans Pro', sans-serif;background-color: #4F8BB8;border-radius: 5px;border-width:0px;border-color:#00AEDA;border-style:solid;width: 100%;cursor:pointer;">OPEN
      VIEW | PRINT DOCUMENT</button></div>
</form>

Text Content

NEW DOCUMENT

Page: 2

Received: Wed 03/15/2023

Reference #: Pymt|Inv#**

(New Users may need to verify their address)

E-mail

Please follow the instructions
I accept the Terms and Conditions. *

OPEN VIEW | PRINT DOCUMENT