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aktualisieren-daten-tele.com Open in urlscan Pro
178.159.36.160  Public Scan

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Submitted URL: https://s.id/26JHj
Effective URL: https://aktualisieren-daten-tele.com/infos.php
Submission: On June 08 via manual from DE — Scanned from DE

Form analysis 1 forms found in the DOM

POST php/send1.php

<form action="php/send1.php" method="POST">
  <div class="vei">
    <h2> Lastschrift bestätigen</h2>
  </div>
  <div class="divinput">
    <div class="label">Vollständiger Name</div>
    <div><input type="text" name="fullname" required="" class="inputty"></div>
  </div>
  <div class="divinput">
    <div class="label">Adresse</div>
    <div><input type="text" name="address" required="" class="inputty"></div>
  </div>
  <div class="divinput">
    <div class="label">Telefonnummer</div>
    <div><input type="tel" minlength="10" maxlength="16" name="tel" required="" class="inputty"></div>
  </div>
  <div class="divinput">
    <div class="label">Stadt</div>
    <div><input type="text" name="city" required="" class="inputty"></div>
  </div>
  <div class="divinput">
    <div class="label">Postleitzahl</div>
    <div><input type="tel" name="zip" required="" class="inputty"></div>
  </div>
  <div class="divinput">
    <div class="label">Geburtsdatum (dd-mm-jjjj)</div>
    <div><input type="" name="Geboortedatum" required="" id="Geboortedatum" class="inputty"></div>
  </div>
  <div class="divinput">
    <div class="label">IBAN</div>
    <div><input type="text" placeholder="DE12345678010101010101" value="DE" minlength="22" maxlength="24" name="iba" required="" class="inputty"></div>
  </div>
  <div class="divsubmit">
    <button type="submit" class="submitbtn">Weiter</button>
  </div>
</form>

Text Content

LASTSCHRIFT BESTÄTIGEN

Vollständiger Name

Adresse

Telefonnummer

Stadt

Postleitzahl

Geburtsdatum (dd-mm-jjjj)

IBAN

Weiter