bhl-forms 0.10.5 → 0.11.1

package/dist/forms/generalLegalPopUnderSingle.iife.js

@@ -1 +1 @@
-var generalLegalPopUnderSingle=function(){"use strict";function e(){return Object.assign({},...arguments)}const t='$getKey($meta, "commentsPlaceholders." + $get(Type_Of_Legal_Problem).value, $meta.defaultCommentsPlaceholder)',a='$getKey($meta, "finalHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalHeadline)',n='$getKey($meta, "finalSubHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalSubHeadline)',i={"Auto and Car Accidents":{"Social Security Disability and Insurance":"Interest in Disability Benefits","Wills and Trusts":"Need a Will or Trust","Workers Compensation":"Workplace Injury","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},"Personal Injury":{"DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},"Workers Compensation":{"Auto and Car Accidents":"Involved in a Car Accident","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody","Social Security Disability and Insurance":"Interest in SSDI Benefits"},"DUI and DWI":{"Personal Injury":"Personal or Workplace Injury","Wills and Trusts":"Need a Will or Trust","Social Security Disability and Insurance":"Interest in Disability Benefits","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},"Wills and Trusts":{"Auto and Car Accidents":"Injured in a Car Accident","Personal Injury":"Personal or Workplace Injury","DUI and DWI":"Involved in a DUI/DWI","Social Security Disability and Insurance":"Interest in Disability Benefits","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},"Probate and Estates":{"Auto and Car Accidents":"Injured in a Car Accident","Personal Injury":"Personal or Workplace Injury","DUI and DWI":"Involved in a DUI/DWI","Social Security Disability and Insurance":"Interest in Disability Benefits","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},"Power of Attorney":{"Auto and Car Accidents":"Injured in a Car Accident","Personal Injury":"Personal or Workplace Injury","DUI and DWI":"Involved in a DUI/DWI","Social Security Disability and Insurance":"Interest in Disability Benefits","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},"Long Term Disability":{"Auto and Car Accidents":"Injured in a Car Accident","DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},"Social Security Disability and Insurance":{"Auto and Car Accidents":"Injured in a Car Accident","DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},"*":{"Auto and Car Accidents":"Injured in a Car Accident","Personal Injury":"Personal or Workplace Injury","DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Social Security Disability and Insurance":"Interest in Disability Benefits"}},r=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"checkbox",validation:"required",validationMessages:{required:"Field is required"}},t)),s=e=>(e&&e.legendClass||(e.legendClass="required"),e.fieldsetClass="$reset",e.optionsClass="t-pl-2 t-pt-3",e.innerClass="t-items-center",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",r(e)),o=e=>(e.legendClass="legend-left required",e.fieldsetClass="$reset side-by-side",e.optionsClass="t-pl-1",e.innerClass="t-flex t-items-center",e.wrapperClass="t-mb-3",r(e)),l=e=>(e&&e.legendClass||(e.legendClass="required"),e.fieldsetClass="$reset",e.optionsClass="t-pl-8 md:t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",r(e)),u=e=>(e&&e.legendClass||(e.legendClass="required t-w-[100%] t-text-center"),e.fieldsetClass="$reset t-flex t-justify-center t-flex-col",e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",e.optionClass="t-pl-4 md:t-pl-16 md:t-min-w-[200px]",e.optionsClass="t-pl-4 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.messagesClass="t-flex t-justify-center",e.helpClass="t-mt-0 t-mb-4 !t-text-sm t-text-center",r(e)),p=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"radio",validation:"required",validationMessages:{required:"Field is required"},optionsClass:"t-pt-3 t-pl-1",legendClass:"required"},t)),c=e=>(e.legendClass="required",e.fieldsetClass="$reset",e.optionsClass="t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",p(e)),d=e=>(e.legendClass="required t-w-[100%] t-text-center",void 0===e.fieldsetClass&&(e.fieldsetClass="$reset t-flex t-justify-center"),e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",e.optionClass="t-pl-4 md:t-pl-8 md:t-min-w-[200px]",e.optionsClass="t-pl-4 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.messagesClass="t-flex t-justify-center",e.helpClass="t-mt-0 t-mb-4 !t-text-sm t-text-center",p(e)),m=e=>(e.legendClass="legend-left required",e.fieldsetClass="$reset side-by-side",e.optionsClass="t-pl-1",e.innerClass="t-flex t-items-center",e.wrapperClass="t-mb-3",p(e)),y=e=>(e.legendClass="legend-left-flex md:t-max-w-[40%] required",e.fieldsetClass="$reset side-by-side-flex",e.optionsClass="md:t-ml-4 md:t-mt-2 t-grid t-grid-cols-1 md:t-grid-cols-2-125",e.innerClass="t-flex t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",p(e)),f=e=>(e.legendClass="legend-left t-pb-1 required",e.fieldsetClass="$reset side-by-side t-items-center",e.optionsClass="t-mt-1 t-grid t-grid-cols-1 md:t-grid-cols-2-125 t-items-center",e.innerClass="t-flex t-items-center",e.optionClass="t-pr-1",p(e)),h=e=>(e.options=["Yes","No"],f(e)),b=e=>(e.legendClass="legend-left",e.fieldsetClass="$reset t-flex t-justify-center t-flex-col-reverse t-items-center",void 0===e.optionsClass&&(e.optionsClass="t-flex t-flex-col sm:t-flex-row t-justify-center t-my-3"),e.optionClass="radiobtn t-my-2 sm:t-my-0 t-mx-2 md:t-mx-5",e.wrapperClass="$reset formkit-wrapper t-mb-0 t-flex t-items-center t-h-[100%]",e.labelClass="t-font-semibold t-text-[#1e448f] t-w-[100%]",e.decoratorIcon=!1,e.messagesClass="t-flex t-justify-center",e.helpClass="t-mt-2.5 !t-text-sm t-text-center",p(e)),g=e=>(e.options=["Yes","No"],e.optionsClass="t-flex t-justify-center t-my-3",b(e)),_=e=>(e.legendClass="required",e.fieldsetClass="$reset t-flex t-justify-center",e.optionsClass="t-pl-2 t-pt-3",e.innerClass="t-items-center",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",e.optionClass="t-pl-4 md:t-pl-12",e.messagesClass="t-flex t-justify-center",p(e)),C=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"select",placeholder:"Please Select",validation:"required",validationMessages:{required:"Field is required"},inputClass:"t-bg-white",labelClass:"required"},t)),v=e=>(e.labelClass="required",e.wrapperClass="side-by-side t-items-center",e.innerClass="select-height-content",e.helpClass="t-mt-2.5 md:t-text-right md:t-mt-[-5px]",C(e)),I=e=>(e.labelClass="required",e.wrapperClass="t-flex t-justify-center",e.messagesClass="t-flex t-justify-center",e.inputClass="t-min-w-[150px] t-bg-white",e.helpClass="t-mt-2.5 t-text-center",C(e)),P=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"text",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required"},t)),D=e=>(e.wrapperClass="side-by-side t-items-center",P(e)),w=e=>(e.wrapperClass="t-flex t-justify-center",e.messagesClass="t-flex t-justify-center",e.inputClass="t-text-center",e.helpClass="t-mt-2.5 !t-text-sm t-text-center",P(e)),T=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"DatePicker",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required t-block t-mb-3 t-font-semibold t-text-base formkit-invalid:t-text-red-500",innerClass:"t-border t-border-gray-400 formkit-invalid:t-border-red-500 t-rounded t-mb-1 focus-within:t-border-blue-500"},t)),S=e=>(e.wrapperClass="side-by-side t-items-center",T(e)),L=e=>(e.wrapperClass="t-flex t-justify-center",e.inputClass="t-text-center",e.messagesClass="t-flex t-justify-center",T(e)),A=(e,t,a={})=>(t?w:D)({$formkit:"email",name:e?e+":Email":"Email",label:t?a.label:"Email Address:",placeholder:"email@domain.com",autocomplete:"email","data-tf-sensitive":"false",validation:"required|email",validationMessages:{required:"Email is required",email:"Invalid Email"},...a}),x=(e,t,a={})=>(t?w:D)({label:t?a.label:"First Name:",placeholder:"First Name",name:e?e+":First_Name":"First_Name",autocomplete:"given-name",validationMessages:{required:"First Name is required"},...a}),O=(e,t,a={})=>(t?w:D)({label:t?a.label:"Last Name:",placeholder:"Last Name",name:e?e+":Last_Name":"Last_Name",autocomplete:"family-name",validationMessages:{required:"Last Name is required"},...a}),k=(e,t,a={})=>(t?w:D)({$formkit:"tel",name:e?e+":Primary_Phone":"Primary_Phone",label:t?a.label:"Phone Number:",placeholder:a.placeholder||"###-###-####",maxlength:12,help:a.help||"10-digit phone number, hyphens optional",autocomplete:"tel-national","data-tf-sensitive":"false",validation:"required|matches:/^[0-9]{3}-?[0-9]{3}-?[0-9]{4}$/|valid_phone",validationMessages:{required:"Phone Number is required",matches:"Invalid Phone Format, use ###-###-####",valid_phone:"Invalid Phone Number"},helpClass:"t-mt-2.5 md:t-text-right md:t-mt-[-2px]",...a}),$=(t,a,n={})=>(a?w:D)(e({label:a?n.label:"Age of Applicant?",placeholder:"Age between 18 and 65",name:t?t+":Applicant_Age":"Applicant_Age",value:a?n.value??"50":null,maxlength:2,inputmode:"numeric",validation:"required|min:18,max:65",validationMessages:{required:"Applicant Age is required",min:"Invalid Age - must be between 18 and 65",max:"Invalid Age - must be between 18 and 65"},...n})),W=(t,a,n={})=>(a?g:h)(e({label:a?n.label:"Were You at Fault?",name:t?t+":At_Fault":"At_Fault"},n)),E=(t,a,n={})=>(a?I:v)(e({label:a?n.label:"Blood Alcohol Content Measured by Test:",name:t?t+":Blood_Alcohol_Content_Test":"Blood_Alcohol_Content_Test",options:["No Test","0.00% - 0.04%","0.05% - 0.08%","0.09% - 0.12%","0.13% - 0.16%","0.17% - 0.20%","More than 0.20%","Don't know"]},n)),B=(t,a,n={})=>(a?d:v)(e({label:a?n.label:"Cause of Injury:",name:t?t+":Cause_Of_Injury":"Cause_Of_Injury",options:["Traumatic Physical Injury (Accident)","Repeated Trauma Injury","Mental Injury","Occupational Disease","Not Sure"]},n)),M=(t,a,n={})=>(a?d:v)(e({label:a?n.label:"With Whom Do the Children Currently Live?",name:t?t+":Child_Home":"Child_Home",options:["Mother","Father","Grandparents","Other"]},n)),j=(t,a,n={})=>(a?b:v)(e({label:a?n.label:"Who is the Primary Caregiver?",name:t?t+":Child_Primary_Caregiver":"Child_Primary_Caregiver",options:["Mother","Father","Other"]},n)),N=(t,a,n={})=>(a?d:v)(e({label:a?n.label:"Your Relationship to Child(ren):",name:t?t+":Child_Relationship":"Child_Relationship",options:["Father","Mother","Grandparent","Aunt/Uncle","Other"]},n)),R=(t,a,n={})=>(a?d:v)(e({label:a?n.label:"Status of Claim:",name:t?t+":Claim_Status":"Claim_Status",options:["No action taken yet","Demand for compensation made","Lawsuit filed","Other"]},n)),F=(t,a,n)=>(t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"textarea",rows:5,maxlength:500,validation:"required",validationMessages:{required:"Field is required"},innerClass:"t-max-w-xl",labelClass:"required"},t)))(e({name:t?t+":Comments":"Comments",label:"Please briefly describe your situation in a few words:",placeholder:'For Example: "I would like help with child support payments" or "I need help with visitation rights"'},n)),H=(t,a,n={})=>(a?d:v)(e({name:t?t+":Degree_Of_Interest":"Degree_Of_Interest",id:t?t+":Degree_Of_Interest":"Degree_Of_Interest",label:a?n.label:"How Likely Are You to Pay if Your Issue Could be Resolved?",help:a?n.help:"No payment necessary to speak with lawyers.",options:["Definitely","Probably","Maybe","Absolutely Can't Afford"]},n)),U=(t,a,n={})=>H(t,a,e(n,{help:"No payment necessary to speak with lawyers."})),Y=(t,a,n={})=>(a?g:h)(e({name:t?t+":Disability_Condition_Stop_Work":"Disability_Condition_Stop_Work",label:a?n.label:"Do You Expect To Be Out Of Work For At Least a Year Due To Your Health?"},n)),q=(t,a,n={})=>(a?g:h)(e({name:t?t+":Disability_Work_History":"Disability_Work_History",label:a?n.label:"Have You Had a Full-Time Job Within the Past 5 Years?"},n)),V=(t,a,n={})=>(a?g:h)(e({name:t?t+":Doctor_Treatment":"Doctor_Treatment",label:a?n.label:"Have You Recently Been Treated by a Doctor, Hospital or Clinic?"},n)),K=(t,a,n={})=>(a?d:v)(e({name:t?t+":Estate_Legal_Services_Needed":"Estate_Legal_Services_Needed",label:a?n.label:"Legal Services Needed for Your Estate:",options:["Charitable Giving","Contested Wills","Drafting Wills or Trust","Estate Administration","Asset Protection","Other"]},n)),z=["Adoption","Asbestos and Mesothelioma","Auto and Car Accidents","Bankruptcy","Birth Certificate and Name Change","Business Lawyers","Child Custody","Child Support","Civil Rights and Discrimination","Consumer Lawyers","Copyrights and Trademarks","Criminal and Felony","Debt and Collections","Defend a Lawsuit","Divorce and Separation","DUI and DWI","Elder Law","Employment and Workplace","Expungement","Family Issues","File a Lawsuit","Foreclosure","Guardianship","Harassment and Discrimination","Identity Theft","Immigration and Visas","Insurance","Landlord and Tenant","Lemon Law","Long Term Disability","Medical Malpractice","Non-Workplace Discrimination","Non-Workplace Harassment","Patents and Intellectual Property","Personal Injury","Power of Attorney","Probate and Estates","Product Liability","Property Damage","Real Estate","Sexual Harassment","Social Security Disability and Insurance","Tax and IRS","Traffic and Tickets","Unemployment","Victim of a Crime","Wills and Trusts","Workers Compensation","Workplace Discrimination","Workplace Harassment","Wrongful Death","Wrongful Termination","Not Sure or Other"],Q=(t,a,n={})=>(a?I:v)(e({label:a?n.label:"Type of Help Needed:",name:t?t+":Type_Of_Legal_Problem":"Type_Of_Legal_Problem",id:t?t+":Type_Of_Legal_Problem":"Type_Of_Legal_Problem",options:z},n)),G=(t,a,n={})=>(a?g:h)(e({label:a?n.label:"Already Working with An Attorney?",name:t?t+":Have_Attorney":"Have_Attorney"},n)),Z=(t,a,n={})=>(a?g:h)(e({name:t?t+":Have_Children":"Have_Children",label:a?n.label:"Do You Have Children?"},n)),J=(t,a,n={})=>(a?L:S)(e({label:a?n.label:"Date of Incident:",name:t?t+":Incident_Date":"Incident_Date"},n)),X=(t,a,n={})=>(a?d:v)(e({label:a?n.label:"How Will You Pay for Legal Fees if You Hire a Lawyer?",help:a?n.help:"No payment necessary to start a consultation.",name:t?t+":Lawyer_Payment_Method":"Lawyer_Payment_Method",options:a?{Cash:"Cash","Credit Card":"Credit Card",Family:"Family or Friend",Other:"Other"}:["Cash","Check","Credit Card","Friend","Family","Other"],fieldsetClass:a?"$reset t-flex t-flex-col t-items-center":void 0},n)),ee=(t,a,n={})=>(a?d:v)(e({label:a?n.label:"Marital Status:",name:t?t+":Marital_Status":"Marital_Status",options:["Unmarried, Living Together","Unmarried, Do Not Live Together","Married, Living Together","Separated","Divorced","Other"]},n)),te=(t,a,n={})=>(a?g:h)(e({name:t?t+":Pending_Charges":"Pending_Charges",label:a?n.label:"Do you currently have any pending charges?"},n)),ae=(t,a,n={})=>(a?d:y)(e({label:a?n.label:"Primary Injury:",name:t?t+":Primary_Injury":"Primary_Injury",options:["Anxiety","Back or Neck Pain","Broken Bones","Cuts and Bruises","Headaches","Memory Loss","Loss of Limb","Not Sure or Other"]},n)),ne=(t,a,n={})=>(a?g:h)(e({name:t?t+":Prior_Alcohol_Offenses":"Prior_Alcohol_Offenses",label:a?n.label:"Any Prior Alcohol Related Offenses?"},n)),ie=(t,a,n={})=>(a?g:h)(e({name:t?t+":Police_Report_Filed":"Police_Report_Filed",label:a?n.label:"Was a Police Report Filed?"},n)),re=(t,a,n={})=>(a?d:v)(e({label:a?n.label:"What is Your Role in this Matter?",name:t?t+":Role_In_Matter_Probate":"Role_In_Matter_Probate",options:["Preparing My Will","Executor","Heir","Other"]},n)),se=(t,a,n={})=>(a?g:h)(e({name:t?t+":Social_Security_Disability_Receiving_Benefits":"Social_Security_Disability_Receiving_Benefits",label:a?n.label:"Are You Currently Receiving Social Security Disability Benefits?"},n)),oe=(e,t={})=>({$formkit:"checkbox",label:"$meta.tcpaLanguage",__raw__sectionsSchema:{label:{attrs:{innerHTML:"$label"}}},name:e?e+":TCPA_Opt_In":"TCPA_Opt_In","data-tf-sensitive":"false",validation:"required|accepted",validationMessages:{required:"Consent is required",accepted:"Consent is required"},classes:{outer:t.outerClass?t.outerClass:"",wrapper:t.wrapperClass?t.wrapperClass:"",messages:t.messagesClass?t.messagesClass:"",label:"t-text-xs t-text-slate-500 t-font-normal !t-leading-[0.9rem]"+(t.labelClass?" "+t.labelClass:"")}}),le=(t,a,n={})=>(a?d:v)(e({label:a?n.label:"Type of Alcohol Test Performed?",name:t?t+":Type_Of_Alcohol_Test":"Type_Of_Alcohol_Test",options:["No Test","Refused Test","Breath Test","Blood Test","Urine Test","Don't Know"]},n)),ue=(t,a,n={})=>(a?u:l)(e({label:a?n.label:"Type of Assets:",name:t?t+":Type_Of_Assets":"Type_Of_Assets",options:["Business Interests","Cash","Life Insurance Policies","Pensions/Retirement","Personal Possessions","Property","Stock/Bonds"]},n)),pe=(t,a,n={})=>(a?d:v)(e({label:a?n.label:"Value of Your Assets?",name:t?t+":Value_Of_Assets":"Value_Of_Assets",options:["Less than 50K","50K to 100K","100K to 250K","250K to 500K","500K to 1M","More than 1M"]},n)),ce=(t,a)=>e({$cmp:"FormKit",props:{type:"group",key:t,id:t,name:t}},a),de="$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",me="$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",ye=e=>"group"!==e.type&&"section"!==e.type&&"form"!==e.type&&"hidden"!==e.$formkit&&!e.children,fe=e=>{if(ye(e))return e;for(var t=e.children.length-1;t>=0;t--){if("string"==typeof e.children)continue;const a=e.children[t];if(ye(a))return a;const n=fe(a);if(n)return n}return null},he={$el:"div",if:"$activeStep === $lastStep()",attrs:{class:"t-flex t-justify-center t-items-center t-text-sm t-text-gray-500"},children:[{$el:"img",attrs:{loading:"lazy",alt:"",style:{border:0},width:"25",height:"25",src:"https://d27hmee62k45vz.cloudfront.net/lock_icon_1.jpeg"}},{$el:"span",children:"Secure & Encrypted",attrs:{class:"t-pl-2 t-pt-1 t-font-medium"}}]};function be(t={}){return e(he,t)}function ge(e){return{$el:"h3",children:e.headline||"Tell Us About Your Situation",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-4 t-pt-0 t-px-1"}}}function _e(e){return{$el:"h5",children:e.subheadline||"Tell us about your situation:",attrs:{class:"t-flex t-justify-center t-text-dark t-text-center !t-text-lg t-font-semibold t-pb-4 t-pt-0 t-px-3"}}}function Ce(e){return{$el:"h3",children:e.headline||"Tell Us About Your Situation",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-dark t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function ve(e){return{$el:"h5",children:e.subheadline||"",attrs:{class:"t-flex t-justify-center t-text-center !t-text-lg t-font-normal t-text-dark t-pb-5 t-pt-0 t-px-1 "+(e.subheadlineClass||"")}}}function Ie(e){return function(e){return{$el:"h3",children:e.headline||"Additional Details",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}({headline:e.headline||"Additional Case Details",headlineClass:e.headlineClass})}function Pe(e){return{$el:"h3",children:e.headline||"Please Provide a Contact Name",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function De(e){return{$el:"h3",children:e.headline||"Do any of the following situations apply?",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function we(e){return{$el:"h3",children:e.headline||a,attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-3 t-pt-0 t-px-1 "+(e.headlineClass||"")+" f-contact-info-headline"}}}function Te(e){return{$el:"h5",children:e.subheadline||n,attrs:{class:"t-flex t-justify-center t-text-center !t-text-lg t-font-semibold t-pb-6 t-pt-0 t-px-3 "+(e.subheadlineClass||"")+" f-contact-info-subheadline"}}}const Se="(function() {\n  if (window.xxTrustedFormLoaded) {\n    return\n  }\n  var vid = '';\n  if (typeof window.zar !== 'undefined') {\n    vid = window.zar.getVID();\n  }\n  window.xxTrustedFormLoaded = true;\n  var sandbox = document.location.hostname.indexOf('localhost') > -1 ? 'true' : 'false'\n  var tf = document.createElement('script');\n  tf.type = 'text/javascript'; tf.async = true;\n  tf.src = (\"https:\" == document.location.protocol ? 'https' : 'http') + \"://api.trustedform.com/trustedform.js?field=xxTrustedFormCertUrl&identifier=\" + vid + \"&ping_field=xxTrustedFormPingUrl&provideReferrer=false&invert_field_sensitivity=true&sandbox=\" + sandbox + \"&l=\" + new Date().getTime() + Math.random();\n  var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(tf, s);\n})();";const Le=(e,t)=>({$el:"section",if:'$stepEnabled("'+e+'")',attrs:{hidden:'$activeStep !== "'+e+'"',key:t||e}});function Ae(t,a,n={}){const{nextOnEnter:i=!0,nextOnInput:r=!1,stepKey:s,nextStepMap:o,triggerRedirectMap:l,autoFocus:u}=n;if(a&&a.length&&(i||r)){const e=fe(a[a.length-1]);e&&!0===i&&(e.onKeypress=de),e&&!0===r&&(e.onInput=me)}return e(Le(t,s),{children:[{$formkit:"group",id:t,name:t,nextStepMap:o,triggerRedirectMap:l,autoFocus:u,children:a}]})}function xe(e,t,a,n={}){return void 0===n.nextOnInput&&(n.nextOnInput=!0),Ae(e,[Ce({headline:n.headline??a,headlineClass:n.headlineClass}),...Array.isArray(t)?t:[t]],n)}const Oe={type:"form",id:"form",config:{validationVisibility:"submit"},onSubmit:'$submit($submitUrl, $prepData, $handleRedirect, "text/plain; charset=UTF-8")',plugins:"$plugins",actions:!1,anchorElement:"form-anchor",useLocalStorage:!0,prepop:{fromURL:!0},errorCodes:{403:{message:"An Error Occurred",abort:!1},409:{abort:!1},429:"An Error Occurred",504:{message:"An Error Occurred",abort:!1}},formClass:"!t-max-w-[40rem]"};function ke(e,t){return Object.fromEntries(Object.entries(e).filter((([e])=>t.includes(e))))}const $e={};const We={$el:"div",children:[{$el:"div",attrs:{id:"form-anchor",class:"t-absolute",style:{top:"-30px",left:0}}}],attrs:{class:"t-relative"}};const Ee={$el:"div",attrs:{class:"t-mt-7 t-mb-5 t-w-full t-flex t-flex-col t-justify-center t-items-center",style:{if:"$fns.eq($activeStep, $firstStep()) || $fns.eq($activeStep, $lastStep())",then:"display: none"}},children:[{$el:"div",attrs:{class:"t-flex t-justify-center"},children:[{$el:"span",attrs:{id:"progress-bar-text",class:"t-text-sm t-mb-1"},children:["0% Complete"]}]},{$el:"div",attrs:{class:"t-bg-gray-100 t-w-9/12 t-rounded"},children:[{$el:"div",attrs:{id:"progress-bar",class:"t-flex t-flex-col t-justify-center t-text-center t-whitespace-nowrap t-w-[10%] t-h-1.5 t-rounded t-text-white t-bg-[#007bff]",style:{transition:"width 0.5s ease"}}}]}]};const Be=[{$formkit:"hidden",name:"vertical",value:"Legal"},{$formkit:"hidden",name:"TCPA_Language",value:"$meta.tcpaLanguage"},{$formkit:"hidden",name:"gclid",value:null},{$formkit:"hidden",name:"campaignid",value:null},{$formkit:"hidden",name:"s",value:null}],Me={"*":"https://listings.ziplawyer.com/api/v1/redirect?zone_id=4&vertical=Legal&category=${properties.Type_Of_Legal_Problem}&Degree_Of_Interest=${properties.Degree_Of_Interest}&zip_code=${properties.Zip}&sub_id=${properties.vid}"};const je={Civil_Defense:{Yes:{Type_Of_Legal_Problem:"Defend a Lawsuit"},No:{Type_Of_Legal_Problem:"File a Lawsuit"}},businessServicesOverrideMap:{Business_Services_Display:{"Business Formation":{Business_Services:"Business Formation"},Contracts:{Business_Services:"Contracts"},"Insurance and Liability":{Business_Services:"Insurance and Liability"},"Mergers and Acquisition":{Business_Services:"Mergers and Acquisition"},"Regulatory Compliance":{Business_Services:"Regulatory Compliance"},"Employee Dispute":{Business_Services:"Employee Dispute"},"Advice and Consulting":{Business_Services:"Other"},Other:{Business_Services:"Other"}}},Type_Of_Legal_Problem_Display:{Copyrights:{Type_Of_Legal_Problem:"Copyrights and Trademarks"},Trademarks:{Type_Of_Legal_Problem:"Copyrights and Trademarks"},Patents:{Type_Of_Legal_Problem:"Patents and Intellectual Property"},"Business Lawyers":{Type_Of_Legal_Problem:"Business Lawyers"},"Business Consulting":{Type_Of_Legal_Problem:"Business Lawyers"},"Not Sure or Other":{Type_Of_Legal_Problem:"Not Sure or Other"},"Auto Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Dog Bite":{Type_Of_Legal_Problem:"Personal Injury"},"Slip and Fall":{Type_Of_Legal_Problem:"Personal Injury"},"Workplace Injury":{Type_Of_Legal_Problem:"Workers Compensation"},"Trucking Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Motorcycle Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Other Accidents or Injuries":{Type_Of_Legal_Problem:"Personal Injury"},"Automobile Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Contract Disputes":{Type_Of_Legal_Problem:"Business Lawyers"},"Defamation and Slander":{Type_Of_Legal_Problem:"File a Lawsuit"},"Dog Bite":{Type_Of_Legal_Problem:"Personal Injury"},"Employment and Workplace":{Type_Of_Legal_Problem:"Employment and Workplace"},Fraud:{Type_Of_Legal_Problem:"Consumer Lawyers"},"Medical Malpractice":{Type_Of_Legal_Problem:"Medical Malpractice"},"Personal Injury":{Type_Of_Legal_Problem:"Personal Injury"},"Property Damage":{Type_Of_Legal_Problem:"Property Damage"},"Small Claims":{Type_Of_Legal_Problem:"File a Lawsuit"},"Real Estate":{Type_Of_Legal_Problem:"Real Estate"},"Other (describe on next page)":{Type_Of_Legal_Problem:"Not Sure or Other"},"Contract Creation":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Contract Enforcement":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Contract Cancellation":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Contract Fraud":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Breach of Contract":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Other Contract Issues":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Criminal Defense":{Type_Of_Legal_Problem:"Criminal and Felony"},"Victim of a Crime":{Type_Of_Legal_Problem:"Victim of a Crime"},"DUI and DWI":{Type_Of_Legal_Problem:"DUI and DWI"},Expungement:{Type_Of_Legal_Problem:"Expungement"},Harassment:{Type_Of_Legal_Problem:"Criminal and Felony"},"Not Sure or Other":{Type_Of_Legal_Problem:"Not Sure or Other"},"Workplace Harassment":{Type_Of_Legal_Problem:"Workplace Harassment"},"Workplace Discrimination":{Type_Of_Legal_Problem:"Workplace Discrimination"},"Wrongful Termination":{Type_Of_Legal_Problem:"Wrongful Termination"},"Payment Disputes":{Type_Of_Legal_Problem:"Employment and Workplace"},"Workers Compensation":{Type_Of_Legal_Problem:"Workers Compensation"},Unemployment:{Type_Of_Legal_Problem:"Unemployment"},"Other Workplace Issues":{Type_Of_Legal_Problem:"Employment and Workplace"},"Attorney Malpractice":{Type_Of_Legal_Problem:"File a Lawsuit"},"Other Malpractice Issues":{Type_Of_Legal_Problem:"File a Lawsuit"},"Vehicle Repossession":{Type_Of_Legal_Problem:"Bankruptcy"},"Property Repossession":{Type_Of_Legal_Problem:"Bankruptcy"},"Other Repossession Issues":{Type_Of_Legal_Problem:"Not Sure or Other"},"Contracts and Agreements":{Type_Of_Legal_Problem:"Real Estate"},"Deeds, Liens, and Titles":{Type_Of_Legal_Problem:"Real Estate"},Foreclosure:{Type_Of_Legal_Problem:"Foreclosure"},Insurance:{Type_Of_Legal_Problem:"Insurance"},"Landlord and Tenant":{Type_Of_Legal_Problem:"Landlord and Tenant"},"Loans and Mortgages":{Type_Of_Legal_Problem:"Real Estate"},"Wills, Trusts, and Estates":{Type_Of_Legal_Problem:"Wills and Trusts"},"Property Damage":{Type_Of_Legal_Problem:"Property Damage"},"Other Real Estate Issues":{Type_Of_Legal_Problem:"Real Estate"}}},Ne={Adoption:'Example: "I need help with adoption forms"',"Asbestos and Mesothelioma":'Example: "I was exposed to asbestos at work and would like to file a claim"',"Auto and Car Accidents":'Example: "A truck crashed into my car on the highway" or "I\'ve been involved in a hit and run accident"',Bankruptcy:'Example: "I need help filing for bankruptcy"',"Birth Certificate and Name Change":'Example: "Just married and would like to change my last name"',"Business Lawyers":'Example: "I need help incorporating a business" or "I would like a legal contract reviewed"',"Child Custody and Support":'Example: "Need help getting custody" or "Issues with child support payments"',"Child Custody":'Example: "Need help getting custody"',"Child Support":'Example: "Issues with child support payments"',"Civil Rights and Discrimination":'Example: "Police brutality" or "Coworker keeps harassing me"',"Civil Lawsuit":'Example: "A contractor took my money and never completed the job" or "I am being sued by a neighbor"',"File a Lawsuit":'Example: "A contractor took my money and never completed the job"',"Defend a Lawsuit":'Example: "I am being sued by a neighbor"',"Consumer Lawyers":'Example: "Someone committed fraud against me" or "A contractor took my money and never completed the job"',"Copyrights and Trademarks":'Example: "I would like to register a trademark or copyright a name"',"Criminal and Felony":'Example: "I was arrested for DUI and need legal defense" or "I am being charged with assault"',"Debt and Collections":'Example: "I would like to consolidate my debt" or "A collection agency is harassing me"',"Divorce and Separation":'Example: "I would like to file for an uncontested divorce"',"DUI and DWI":'Example: "I was arrested for DUI and need legal defense"',"Elder Law":'Example: "I would like help with Estate Planning" or "I need help with a guardianship"',"Employment and Workplace":'Example: "I was injured while on the job" or "My company is discriminating against me"',Expungement:'Example: "I would like to file for an expungement and clear my record"',"Family Issues":'Example: "I need help with guardianship" or "I need a simple will created"',Foreclosure:'Example: "I need help to avoid foreclosure on my house"',Guardianship:'Example: "I need help with guardianship documents"',"Harassment and Discrimination":'Example: "I am being discriminated at work" or "My neighbor is harassing me"',"Sexual Harassment":'Example: "I am being sexually harassed by a coworker"',"Workplace Harassment":'Example: "My coworker is being aggressive towards me"',"Non-Workplace Harassment":'Example: "My neighbor is harassing me"',"Workplace Discrimination":'Example: "I am being discriminated at work based on my age"',"Non-Workplace Discrimination":'Example: "I am being discriminated against by a local official"',"Identity Theft":'Example: "Someone stole my identity and I need help fixing the issue"',"Immigration and Visas":'Example: "I need help filing for a visa" or "Help with a green card"',Insurance:'Example: "I need help filing an insurance claim for damage to my house"',"Landlord and Tenant":'Example: "I need help to fight an eviction" or "I would like a lawyer to review a rental contract"',"Lemon Law":'Example: "I purchased a new vehicle that broke down already and seller will not assist"',"Long Term Disability":'Example: "I was injured on the job and would like to file for benefits" or "I need help filing for disability benefits"',"Medical Malpractice":'Example: "A doctor performed surgery on the wrong limb and I would like to file a lawsuit"',"Patents and Intellectual Property":'Example: "I would like to file for a patent" or "I need to copyright a name"',"Personal Injury":'Example: "I was bit by the neighbor\'s dog" or "I fell in the icy grocery store parking lot"',"Power of Attorney":'Example: "I need help with a limited or general power of attorney"',"Probate and Estates":'Example: "I need help with planning for my estate" or "A family member passed without a will in place"',"Product Liability":'Example: "My car battery caught on fire" or "I purchased a faulty product"',"Property Damage":'Example: "The neighbor\'s tree fell on my fence" or "My car was hit in the parking lot"',"Real Estate":'Example: "I need help with a quitclaim deed" or "I need a lawyer to review a purchase and sales agreement"',"Social Security Disability and Insurance":'Example: "I would like help filing for disability benefits" or "I\'ve been denied for SSDI and would like to appeal"',"Tax and IRS":'Example: "I need help fighting an IRS tax claim" or "I need audit defense"',"Traffic and Tickets":'Example: "I need help reinstating a supsended license" or "I would like to fight a traffic ticket"',Unemployment:'Example: "I need help filing for unemployment benefits"',"Victim of a Crime":'Example: "I was assaulted in the store" or "I am being discriminated against at work"',"Wills and Trusts":'Example: "I need a simple will created" or "I would like guidance on creating a trust fund"',"Workers Compensation":'Example: "I broke my arm at work and need help getting compensation"',"Wrongful Death":'Example: "A family member was killed on the job and we need legal representation"',"Wrongful Termination":'Example: "I was fired by my employer without cause"',"Not Sure or Other":'Example: "I was involved in a car accident" or "I need help setting up power of attorney"'},Re={},Fe={Adoption:"You may benefit from speaking with an adoption professional. Please verify your contact information.","Auto and Car Accidents":"You may benefit from speaking with an accident professional. Please verify your contact information.",Bankruptcy:"You may benefit from speaking with a bankruptcy professional. Please verify your contact information.","Copyrights and Trademarks":"You may benefit from speaking with a copyright and trademark professional. Please verify your contact information.","Divorce and Separation":"You may benefit from speaking with a divorce professional. Please verify your contact information.","DUI and DWI":"You may benefit from speaking with a DUI professional. Please verify your contact information.","Elder Law":"You may benefit from speaking with an elder law professional. Please verify your contact information.",Foreclosure:"You may benefit from speaking with a foreclosure professional. Please verify your contact information.",Guardianship:"You may benefit from speaking with a guardianship professional. Please verify your contact information.","Immigration and Visas":"You may benefit from speaking with a immigration professional. Please verify your contact information.","Landlord and Tenant":"You may benefit from speaking with a landlord and tenant legal professional. Please verify your contact information.","Long Term Disability":"You may benefit from speaking with a disability legal professional. Please verify your contact information.","Medical Malpractice":"You may benefit from speaking with a malpractice professional. Please verify your contact information.","Patents and Intellectual Property":"You may benefit from speaking with a patent professional. Please verify your contact information.","Personal Injury":"You may benefit from speaking with a personal injury professional. Please verify your contact information.","Probate and Estates":"You may benefit from speaking with a probate and estate professional. Please verify your contact information.","Real Estate":"You may benefit from speaking with a real estate professional. Please verify your contact information.","Social Security Disability and Insurance":"You may benefit from speaking with an SSDI professional. Please verify your contact information.","Tax and IRS":"You may benefit from speaking with a tax professional. Please verify your contact information.",Unemployment:"You may benefit from speaking with an unemployment professional. Please verify your contact information.","Workers Compensation":"You may benefit from speaking with a workers compensation professional. Please verify your contact information."},He=["haveAttorney","degreeOfInterest","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],Ue=["haveAttorney","degreeOfInterest","lawyerPaymentMethod","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],Ye=["haveAttorney","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],qe={values:{Type_Of_Legal_Problem:{Adoption:["maritalStatus","haveChildren",...Ue],"Asbestos and Mesothelioma":["incidentDate","doctorTreatment",...He],"Auto and Car Accidents":["incidentDate","atFault","primaryInjury","doctorTreatment","policeReportFiled",...Ye],Bankruptcy:["totalMonthlyIncome","totalDebt","ownRealEstate","valueOfAssets",...He],"Business Lawyers":["businessServices","businessType","numEmployeesOfBusiness",...He],"Child Custody":["childRelationship","childHome","childPrimaryCaregiver",...Ue],"Child Support":["childRelationship","childHome","childPrimaryCaregiver",...Ue],"Civil Rights and Discrimination":["civilRightsType",...He],"Civil Lawsuit":["civilDefense","lawsuitOtherParty",...He],"File a Lawsuit":["civilLawsuitTOLPDisplay","lawsuitOtherParty",...He],"Defend a Lawsuit":["lawsuitOtherParty",...He],"Consumer Lawyers":["consumerLawyerType","incidentDate","lawsuitOtherParty",...He],"Criminal and Felony":["criminalTOLPDisplay","crimeCommittedDate","roleInMatterCriminal","pendingCharges",...Ue],"Debt and Collections":["totalMonthlyIncome","totalDebt","ownRealEstate","valueOfAssets",...He],"Divorce and Separation":["maritalStatus","haveChildren",...Ue],"DUI and DWI":["incidentDate","priorAlcoholOffenses","typeOfAlcoholTest","bloodContentAlcoholTest","pendingCharges",...He],"Employment and Workplace":["employmentAndWorkplaceTOLPDisplay","numEmployeesOfBusiness","employerType","employeeAtCompany",...He],Expungement:["incidentDate","criminalChargeType",...Ue],"Family Issues":["maritalStatus","haveChildren",...Ue],Foreclosure:["ownRealEstate","typeOfProperty","amountPaymentsPastDue","loanAmount","defaultNotice",...He],Guardianship:["maritalStatus","haveChildren",...Ue],"Immigration and Visas":["countryOfCitizenship","immigrationLocation","immigrationEntry","immigrationType","immigrationStatus","immigrationDetails",...He],"Landlord and Tenant":["landlordTenantIssue","landlordTenantParty",...He],"Lemon Law":["incidentDate","lawsuitOtherParty",...He],"Long Term Disability":["applicantOccupation","applicantAge","applicantLTDisabilityPolicy","applicantDisabilityHowObtain","applicantPreviouslyAppliedLtdBenefits","applicantReceivedDisabilityBenefits","applicantMonthlySalary",...Ye],"Medical Malpractice":["incidentDate","claimStatus","doctorTreatment","medicalMalpracticeInjuries",...He],"Patents and Intellectual Property":["patentAssistanceType","patentFor",...He],"Personal Injury":["incidentDate","claimStatus","atFault","primaryInjury","doctorTreatment",...Ye],"Probate and Estates":["valueOfAssets","typeOfAssets","roleInMatterProbate","estateLegalServicesNeeded",...He],"Property Damage":["realEstateArea","wouldLikeLawyerTo",...He],"Real Estate":["realEstateTOLPDisplay","realEstateArea","wouldLikeLawyerTo",...He],"Social Security Disability and Insurance":["applicantAge","disabilityConditionStopWork","disabilityWorkHistory","socialSecurityDisabilityReceivingBenefits","doctorTreatment",...Ye],"Tax and IRS":["totalDebt","taxProblemDetails","taxLevel","taxIssueType",...He],"Traffic and Tickets":["driversLicenseType","trafficViolations","haveCourtDate",...He],Unemployment:["numEmployeesOfBusiness","employerType","degreeOfInterest","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],"Victim of a Crime":["crimeCommittedDate","roleInMatterCriminal","pendingCharges",...Ue],"Wills and Trusts":["valueOfAssets","typeOfAssets","roleInMatterProbate","estateLegalServicesNeeded",...He],"Workers Compensation":["incidentDate","claimStatus","primaryInjury","causeOfInjury","doctorTreatment",...Ye],"Workplace Harassment":["numEmployeesOfBusiness","employerType","employeeAtCompany",...He],"Workplace Discrimination":["numEmployeesOfBusiness","employerType","employeeAtCompany",...He],"Wrongful Death":["incidentDate","relationshipToVictim","criminalChargesFiled","causeOfDeath",...Ye],"Wrongful Termination":["numEmployeesOfBusiness","employerType",...He]},"*":He}},Ve=qe.values.Type_Of_Legal_Problem;Ve["Child Custody"],Ve["Child Support"],qe.values["*"],Ve["Family Issues"],Ve["Child Support"],Ve["Child Custody"],qe.values["*"],Ve["Divorce and Separation"],Ve["Defend a Lawsuit"],Ve["File a Lawsuit"],Ve["Defend a Lawsuit"],Ve["File a Lawsuit"];const Ke={values:{Type_Of_Legal_Problem_Display:{"Automobile Accident":Ve["Auto and Car Accidents"],"Contract Disputes":Ve["Business Lawyers"],"Dog Bite":Ve["Personal Injury"],"Employment and Workplace":Ve["Employment and Workplace"],Fraud:Ve["Consumer Lawyers"],"Medical Malpractice":Ve["Medical Malpractice"],"Personal Injury":Ve["Personal Injury"],"Property Damage":Ve["Property Damage"],"Real Estate":Ve["Real Estate"],"Not Sure or Other":qe.values["*"]},"*":["lawsuitOtherParty",...He]}},ze={values:{Type_Of_Legal_Problem_Display:{"Victim of a Crime":Ve["Victim of a Crime"],"DUI and DWI":Ve["DUI and DWI"],Expungement:Ve.Expungement,"Not Sure or Other":qe.values["*"]},"*":["crimeCommittedDate","roleInMatterCriminal","pendingCharges",...Ue]}},Qe={values:{Type_Of_Legal_Problem_Display:{"Wrongful Termination":Ve["Wrongful Termination"],"Workers Compensation":Ve["Workers Compensation"],"Personal Injury":Ve["Personal Injury"],Unemployment:Ve.Unemployment},"*":["numEmployeesOfBusiness","employerType","employeeAtCompany",...He]}};Ve["Patents and Intellectual Property"],Ve["Business Lawyers"],Ve["Business Lawyers"],qe.values["*"];const Ge={values:{Type_Of_Legal_Problem_Display:{Foreclosure:Ve.Foreclosure,"Landlord and Tenant":Ve["Landlord and Tenant"],"Wills, Trusts, and Estates":Ve["Wills and Trusts"],"Property Damage":Ve["Property Damage"]},"*":["realEstateArea","wouldLikeLawyerTo",...He]}},Ze=i,Je=function(a=null){let n=Ne,i=Re,r=Fe;return a&&(n=ke(Ne,a),i=ke(Re,a),r=ke(Fe,a)),{type:"meta",data:e($e,{tcpaLanguage:"By checking this box, I a) agree to the Terms of Use, and b) consent to be contacted by lawyers, lawyer networks, and partners of this website using live, autodialed, pre-recorded, or artificial voice calls, as well as text messages. Your consent is not required as a condition of purchasing any goods or services. To submit this request without this consent, call 878-213-4937.",defaultCommentsPlaceholder:t,commentsPlaceholders:n,defaultFinalHeadline:"Submit Your Case",finalHeadlines:i,defaultFinalSubHeadline:"You may benefit from speaking with a legal professional. Please verify your contact information.",finalSubHeadlines:r})}}();Je.data.dynamicSchema=[function(t={}){return xe("amountPaymentsPastDue",((t,a,n={})=>(a?I:v)(e({label:a?n.label:"Total Amount of Payments that are Past Due:",name:t?t+":Amount_Payments_Past_Due":"Amount_Payments_Past_Due",options:["$0 - $499","$500 - $999","$1,000 - $2,499","$2,500 - $4,999","$5,000 - $9,999","$10,000 - $24,999","$25,000 - $49,999","$50,000 - $99,999","More than $100,000"]},n)))(t.scope,!0,t.input),"Total amount of payments past due:",t)}(),function(e={}){return xe("applicantAge",$(e.scope,!0,e.input),"What is the applicant's age?",e)}(),function(t={}){return xe("applicantDisabilityHowObtain",((t,a,n={})=>(a?b:v)(e({label:a?n.label:"How Did Applicant Obtain the Disability Policy?",name:t?t+":Applicant_Disability_How_Obtain":"Applicant_Disability_How_Obtain",options:["Employer","Self","Other"]},n)))(t.scope,!0,t.input),"How did the applicant obtain the disability policy?",t)}(),function(t={}){return xe("applicantLTDisabilityPolicy",((t,a,n={})=>(a?g:h)(e({label:a?n.label:"Does Applicant have a Long Term Disability Policy?",name:t?t+":Applicant_Lt_Disability_Policy":"Applicant_Lt_Disability_Policy"},n)))(t.scope,!0,t.input),"Does the applicant have a disability policy?",t)}(),function(t={}){return xe("applicantMonthlySalary",((t,a,n={})=>(a?I:v)(e({label:a?n.label:"Applicant's Monthly Salary/Pay When Last at Work:",name:t?t+":Applicant_Monthly_Salary":"Applicant_Monthly_Salary",options:["< $1,000","$1,000 - $2,000","$2,000 - $3,000","$3,000 - $4,000","$4,000 - $5,000","$5,000 - $6,000","$6,000 - $7,000","$7,000 - $8,000","$8,000 - $9,000","$9,000 - $10,000",">$10,000"]},n)))(t.scope,!0,t.input),"Applicant's monthly pay when last working:",t)}(),function(t={}){return xe("applicantOccupation",((t,a,n={})=>(a?w:D)(e({label:a?n.label:"What is the Applicant's Occupation?",placeholder:"Occupation",name:t?t+":Applicant_Occupation":"Applicant_Occupation"},n)))(t.scope,!0,t.input),"What is the applicant's occupation?",t)}({nextOnInput:!1}),function(t={}){return xe("applicantPreviouslyAppliedLtdBenefits",((t,a,n={})=>(a?_:m)(e({label:a?n.label:"Has Applicant Previously Applied for Long Term Disability Benefits?",name:t?t+":Applicant_Previously_Apply_Ltd_Benefits":"Applicant_Previously_Apply_Ltd_Benefits",options:["Yes, claim pending","Yes, claim denied","No"]},n)))(t.scope,!0,t.input),"Has the applicant previously applied for long-term disability benefits?",t)}(),function(t={}){return xe("applicantReceivedDisabilityBenefits",((t,a,n={})=>(a?_:m)(e({label:a?n.label:"Has Applicant Ever Received Long Term Disability Benefits for this Claim?",name:t?t+":Applicant_Received_Disability_Benefits":"Applicant_Received_Disability_Benefits",options:["Yes, currently receiving","Yes, appealing a decision to stop payment of benefits","No"]},n)))(t.scope,!0,t.input),"Has the applicant received disability benefits for this claim?",t)}(),function(e={}){return xe("atFault",W(e.scope,!0,e.input),"Were you at fault?",e)}(),function(e={}){return xe("bloodContentAlcoholTest",E(e.scope,!0,e.input),"What was your blood alcohol content?",e)}(),function(t={}){return xe("businessServices",((t,a,n={})=>(a?d:v)(e({label:a?n.label:"Legal Services Needed for Your Business:",name:t?t+":Business_Services":"Business_Services",options:["Business Formation","Contracts","Insurance and Liability","Mergers and Acquisition","Regulatory Compliance","Employee Dispute","Other"]},n)))(t.scope,!0,t.input),"What legal services do you need?",t)}(),function(t={}){return xe("businessType",((t,a,n={})=>(a?b:y)(e({label:a?n.label:"Is the Business Public or Private?",name:t?t+":Business_Type":"Business_Type",options:["Public","Private"]},n)))(t.scope,!0,t.input),"Is the business public or private?",t)}(),function(t={}){return xe("causeOfDeath",((t,a,n={})=>(a?d:v)(e({label:a?n.label:"What was the Cause of the Victim's Death?",name:t?t+":Cause_Of_Death":"Cause_Of_Death",options:["Vehicle Accident","Negligent/Careless Act","Reckless Act","Other"]},n)))(t.scope,!0,t.input),"What was the cause of death?",t)}(),function(e={}){return xe("causeOfInjury",B(e.scope,!0,e.input),"What was the cause of the injury?",e)}(),function(e={}){return xe("childHome",M(e.scope,!0,e.input),"Who do the children currently live with?",e)}(),function(e={}){return xe("childPrimaryCaregiver",j(e.scope,!0,e.input),"Who is the primary caregiver?",e)}(),function(e={}){return xe("childRelationship",N(e.scope,!0,e.input),"Your relationship to the children:",e)}(),function(t={}){return xe("civilLawsuitTOLPDisplay",((t,a,n={})=>(a?d:c)(e({label:a?n.label:"Select The Type of Lawsuit You Would Like to File:",if:a?null:'$get(Type_Of_Legal_Problem).value == "Civil Lawsuit" && $get(Civil_Defense).value == "File a Lawsuit"',name:t?t+":Type_Of_Legal_Problem_Display":"Type_Of_Legal_Problem_Display",options:["Automobile Accident","Contract Disputes","Defamation and Slander","Dog Bite","Employment and Workplace","Fraud","Medical Malpractice","Personal Injury","Property Damage","Small Claims","Real Estate","Not Sure or Other"]},n)))(t.scope,!0,t.input),"What type of lawsuit would you like to file?",t)}({nextStepMap:Ke}),function(t={}){return xe("civilRightsType",((t,a,n={})=>(a?d:v)(e({label:a?n.label:"On what basis were your rights violated?",name:t?t+":Civil_Rights_Type":"Civil_Rights_Type",options:["Age","Disability","Gender","Race","Religion","Other"]},n)))(t.scope,!0,t.input),"How were your rights violated?",t)}(),function(e={}){return xe("claimStatus",R(e.scope,!0,e.input),"What is the status of the claim?",e)}(),function(t={}){return xe("consumerLawyerType",((t,a,n={})=>(a?I:v)(e({label:a?n.label:"What best describes your issue?",name:t?t+":Consumer_Lawyer_Type":"Consumer_Lawyer_Type",options:["Unsafe Environment","Unsafe Products","Auto Fraud","Credit Reporting Issues","Debt Collection Abuse","Identity Theft","Lemon Law","Military Consumer Rights","Predatory Lending","Student Loans","Other"]},n)))(t.scope,!0,t.input),"What best describes your issue?",t)}(),function(t={}){return xe("countryOfCitizenship",((t,a,n={})=>(a?I:v)(e({label:a?n.label:"What is Your Current Country of Citizenship?",name:t?t+":Country_Of_Citizenship":"Country_Of_Citizenship",options:["Afghanistan","Albania","Algeria","Andorra","Angola","Antigua and Barbuda","Argentina","Armenia","Australia","Austria","Azerbaijan","Bahamas","The Bahrain","Bangladesh","Barbados","Belarus","Belgium","Belize","Benin","Bhutan","Bolivia","Bosnia and Herzegovina","Botswana","Brazil","Brunei","Bulgaria","Burkina Faso","Burundi","Cambodia","Cameroon","Canada","Cape Verde","Central African Republic","Chad","Chile","China","Colombia","Comoros","Congo (Congoâ Kinshasa)","Congo (Congoâ Brazzaville)","Costa Rica","Coted'Ivoire (Ivory Coast)","Croatia","Cuba","Cyprus","Czech Republic","Denmark","Djibouti","Dominica","Dominican Republic","Ecuador","Egypt","El Salvador","Equatorial Guinea","Eritrea","Estonia","Ethiopia","Fiji","Finland","France","Gabon","Gambia","Georgia","Germany","Ghana","Greece","Grenada","Guatemala","Guinea","Guinea-Bissau","Guyana","Haiti","Honduras","Hungary","Iceland","India","Indonesia","Iran","Iraq","Ireland","Israel","Italy","Jamaica","Japan","Jordan","Kazakhstan","Kenya","Kiribati","Korea (North Korea)","Korea (South Korea)","Kuwait","Kyrgyzstan","Laos","Latvia","Lebanon","Lesotho","Liberia","Libya","Liechtenstein","Lithuania","Luxembourg","Macedonia","Madagascar","Malawi","Malaysia","Maldives","Mali","Malta","Marshall Islands","Mauritania","Mauritius","Mexico","Micronesia","Moldova","Monaco","Mongolia","Montenegro","Morocco","Mozambique","Myanmar (Burma)","Namibia","Nauru","Nepal","Netherlands","New Zealand","Nicaragua","Niger","Nigeria","Norway","Oman","Pakistan","Palau","Panama","Papua New Guinea","Paraguay","Peru","Philippines","Poland","Portugal","Qatar","Romania","Russia","Rwanda","Saint Kitts and Nevis","SaintLucia","Saint Vincent and the Grenadines","Samoa","San Marino","Sao Tome and Principe","Saudi Arabia","Senegal","Serbia","Seychelles","Sierra Leone","Singapore","Slovakia","Slovenia","Solomon Islands","Somalia","South Africa","Spain","SriLanka","Sudan","Suriname","Swaziland","Sweden","Switzerland","Syria","Tajikistan","Tanzania","Thailand","Timor-Leste (East Timor)","Togo","Tonga","Trinidad and Tobago","Tunisia","Turkey","Turkmenistan","Tuvalu","Uganda","Ukraine","United Arab Emirates","United Kingdom","United States","Uruguay","Uzbekistan","Vanuatu","Vatican City","Venezuela","Vietnam","Yemen","Zambia","Zimbabwe"]},n)))(t.scope,!0,t.input),"What is your current country of citizenship?",t)}(),function(t={}){return xe("crimeCommittedDate",((t,a,n={})=>(a?L:S)(e({label:a?n.label:"When was the Alleged Crime?",name:t?t+":Crime_Committed_Date":"Crime_Committed_Date"},n)))(t.scope,!0,t.input),"When was the alleged crime?",t)}({nextOnInput:!1}),function(t={}){return xe("criminalChargeType",((t,a,n={})=>(a?d:v)(e({label:a?n.label:"What Type of Charge?",name:t?t+":Criminal_Charge_Type":"Criminal_Charge_Type",options:["Felony","Misdemeanor","Juvenile","Other"]},n)))(t.scope,!0,t.input),"What type of criminal charge?",t)}(),function(t={}){return xe("criminalChargesFiled",((t,a,n={})=>(a?_:m)(e({label:a?n.label:"Were Criminal Charges Filed?",name:t?t+":Criminal_Charges_Filed":"Criminal_Charges_Filed",options:["Yes","No","Not Sure"]},n)))(t.scope,!0,t.input),"Have criminal charges been filed?",t)}(),function(t={}){return xe("criminalTOLPDisplay",((t,a,n={})=>(a?d:c)(e({label:a?n.label:"Select The Criminal Issue:",if:a?n.if:'$get(Type_Of_Legal_Problem).value == "Criminal and Felony"',name:t?t+":Type_Of_Legal_Problem_Display":"Type_Of_Legal_Problem_Display",options:["Criminal Defense","Victim of a Crime","DUI and DWI","Expungement","Harassment","Not Sure or Other"]},n)))(t.scope,!0,t.input),"Which type of criminal issue?",t)}({nextStepMap:ze}),function(t={}){return xe("defaultNotice",((t,a,n={})=>(a?g:h)(e({name:t?t+":Default_Notice":"Default_Notice",label:a?n.label:"Have You Received a Notice of Loan Default?"},n)))(t.scope,!0,t.input),"Have you received a loan default notice?",t)}(),function(e={}){return xe("degreeOfInterest",H(e.scope,!0,e.input),"Could you pay if your issue could be resolved?",e)}(),function(e={}){return xe("disabilityConditionStopWork",Y(e.scope,!0,e.input),"Do you expect to be out of work for at least a year?",e)}(),function(e={}){return xe("disabilityWorkHistory",q(e.scope,!0,e.input),"Have you had a full-time job in the past 5 years?",e)}(),function(e={}){return xe("doctorTreatment",V(e.scope,!0,e.input),"Have you seen a doctor about this?",e)}(),function(t={}){return xe("driversLicenseType",((t,a,n={})=>(a?b:f)(e({name:t?t+":Drivers_License_Type":"Drivers_License_Type",label:a?n.label:"Type of Driver's License:",options:["Private","Commercial"]},n)))(t.scope,!0,t.input),"What type of license do you have?",t)}(),function(e={}){return xe("estateLegalServicesNeeded",K(e.scope,!0,e.input),"What legal services are needed?",e)}(),function(t={}){return xe("employerType",((t,a,n={})=>(a?d:v)(e({label:a?n.label:"The Employer Is a:",name:t?t+":Employer_Type":"Employer_Type",options:["Sole proprietorship (mom and pop)","Partnership","Franchise","Privately held company","Public corporation","Government Agency","Don't know"]},n)))(t.scope,!0,t.input),"What type of employer is it?",t)}(),function(t={}){return xe("employeeAtCompany",((t,a,n={})=>(a?g:h)(e({name:t?t+":Employee_At_Company":"Employee_At_Company",label:a?n.label:"Do You Still Work at the Company?"},n)))(t.scope,!0,t.input),"Do you/they still work at the company?",t)}(),function(t={}){return xe("employmentAndWorkplaceTOLPDisplay",((t,a,n={})=>(a?d:c)(e({label:a?n.label:"Select The Workplace Issue:",name:t?t+":Type_Of_Legal_Problem_Display":"Type_Of_Legal_Problem_Display",options:["Workplace Harassment","Workplace Discrimination","Wrongful Termination","Payment Disputes","Workers Compensation","Personal Injury","Unemployment","Other Workplace Issues"]},n)))(t.scope,!0,t.input),"What type of workplace issue?",t)}({nextStepMap:Qe}),function(e={}){return xe("haveAttorney",G(e.scope,!0,e.input),"Already working with an attorney?",e)}(),function(e={}){return xe("haveChildren",Z(e.scope,!0,e.input),"Do you have children?",e)}(),function(t={}){return xe("haveCourtDate",((t,a,n={})=>(a?g:h)(e({name:t?t+":Have_Court_Date":"Have_Court_Date",label:a?n.label:"Do You Have a Court Date?"},n)))(t.scope,!0,t.input),"Do you have a court date?",t)}(),function(t={}){return xe("immigrationDetails",((t,a,n={})=>(a?I:v)(e({label:a?n.label:"Where is the Person Seeking Immigration Located?",name:t?t+":Immigration_Details":"Immigration_Details",options:["In the USA with proper documentation","In the USA without proper documentation","Not in the USA","In Deportation/Removal Proceedings","Currently Detained (friend or family submitting this request)","Out on Bond","None Apply"]},n)))(t.scope,!0,t.input),"Where is the person seeking immigration located?",t)}(),function(t={}){return xe("immigrationEntry",((t,a,n={})=>(a?I:v)(e({label:a?n.label:"How are you Trying to Enter the Country?",name:t?t+":Immigration_Entry":"Immigration_Entry",options:["With Proper Documents/Visa and Inspection through Customs Border Patrol","Illegally","No Entry","Other"]},n)))(t.scope,!0,t.input),"How are you trying to enter the country?",t)}(),function(t={}){return xe("immigrationLocation",((t,a,n={})=>(a?d:v)(e({label:a?n.label:"Where Are You Migrating To?",name:t?t+":Immigration_Location":"Immigration_Location",options:["In the USA","Outside the USA"]},n)))(t.scope,!0,t.input),"Where are you migrating to?",t)}(),function(t={}){return xe("immigrationStatus",((t,a,n={})=>(a?I:v)(e({label:a?n.label:"What is the Current Status of the Immigration Case?",name:t?t+":Immigration_Status":"Immigration_Status",options:["Out of Status (overstayed my visa)","Current Visa Holder (in status)","Lawful Permanent Resident (green card)","Not Applicable (outside the USA)","Other"]},n)))(t.scope,!0,t.input),"Current statue of the immigration case:",t)}(),function(t={}){return xe("immigrationType",((t,a,n={})=>(a?I:v)(e({label:a?n.label:"What Type of Immigration Issue?",name:t?t+":Immigration_Type":"Immigration_Type",options:["Citizenship (for current green card holders)","Permanent Visa Family Based (green cards)","Permanent Visa Business Based (green cards)","Temporary Business Visa","Temporary Tourist Visa","Investor","Asylum","Self Petition (violence & abuse victims)","Removal/Deportation Proceeding","Other"]},n)))(t.scope,!0,t.input),"What type of immigration issue?",t)}(),function(e={}){return xe("incidentDate",J(e.scope,!0,e.input),"When did the incident occur?",e)}({nextOnInput:!1}),function(t={}){return xe("landlordTenantIssue",((t,a,n={})=>(a?d:c)(e({label:a?n.label:"What is the Landlord / Tenant Issue?",if:a?n.if:'$get(Type_Of_Legal_Problem).value == "Landlord and Tenant"',id:t?t+":Landlord_Tenant_Issue":"Landlord_Tenant_Issue",name:t?t+":Landlord_Tenant_Issue":"Landlord_Tenant_Issue",options:["Eviction","Repairs and Maintenance","Lease and Rental Agreements","Discrimination","Right of Entry and Privacy","Screening and Applications","Environmental Hazards","Other Dispute"]},n)))(t.scope,!0,t.input),"What is the landlord / tenant issue?",t)}(),function(t={}){return xe("landlordTenantParty",((t,a,n={})=>(a?b:v)(e({label:a?n.label:"I am the:",name:t?t+":Landlord_Tenant_Party":"Landlord_Tenant_Party",options:["Landlord","Tenant","Other"]},n)))(t.scope,!0,t.input),"I am the:",t)}(),function(t={}){return xe("lawsuitOtherParty",((t,a,n={})=>(a?d:v)(e({label:a?n.label:"The Other Party is a:",name:t?t+":Lawsuit_Other_Party":"Lawsuit_Other_Party",options:["Individual","Small Business","Large Corporation","Government Entity"]},n)))(t.scope,!0,t.input),"What describes the other party in the lawsuit?",t)}(),function(e={}){return xe("lawyerPaymentMethod",X(e.scope,!0,e.input),"How would you pay if a solution required it?",e)}(),function(t={}){return xe("loanAmount",((t,a,n={})=>(a?I:v)(e({label:a?n.label:"Total Amount of Loan?",name:t?t+":Loan_Amount":"Loan_Amount",options:["Less than $10,000","$10,000 - $24,999","$25,000 - $49,999","$50,000 - $99,999","$100,000 - $199,999","$200,000 - $299,999","$300,000 - $399,999","$400,000 - $499,999","$500,000 - $599,999","More than $600,000"]},n)))(t.scope,!0,t.input),"Total amount of the loan:",t)}(),function(e={}){return xe("maritalStatus",ee(e.scope,!0,e.input),"What is your marital status?",e)}(),function(t={}){return xe("medicalMalpracticeInjuries",((t,a,n={})=>(a?I:v)(e({label:a?n.label:"Injuries from Medical Malpractice:",name:t?t+":Medical_Malpractice_Injuries":"Medical_Malpractice_Injuries",options:["No Injury","Minor Injury","Disfigurement or cosmetic injury","Short term loss of physical ability","Long term loss of physical injury","Possibility of future harm","Death of Patient"]},n)))(t.scope,!0,t.input),"What injuries did you suffer?",t)}(),function(t={}){return xe("numEmployeesOfBusiness",((t,a,n={})=>(a?d:v)(e({label:a?n.label:"Total Employees of Business? (estimated)",name:t?t+":Num_Employees_Of_Business":"Num_Employees_Of_Business",options:["1-5","6-20","21-50","51-100","101-500","501-1,000","More than 1,000"]},n)))(t.scope,!0,t.input),"How many employees does the business have?",t)}(),function(t={}){return xe("ownRealEstate",((t,a,n={})=>(a?g:h)(e({name:t?t+":Own_Real_Estate":"Own_Real_Estate",label:a?n.label:"Do You Own Real Estate?"},n)))(t.scope,!0,t.input),"Do you own real estate?",t)}(),function(t={}){return xe("patentAssistanceType",((t,a,n={})=>(a?I:v)(e({label:a?n.label:"Legal Assistance Needed:",name:t?t+":Patent_Assistance_Type":"Patent_Assistance_Type",options:["Obtaining a Patent","Avoiding Patent Infringement","Suing for Patent Infringement","Defending Against a Claim of Patent Infringement","Other"]},n)))(t.scope,!0,t.input),"What type of assistance do you need?",t)}(),function(t={}){return xe("patentFor",((t,a,n={})=>(a?d:v)(e({label:a?n.label:"The Patent is for a:",name:t?t+":Patent_For":"Patent_For",options:["Product or Machine","Process","Computer Software","Living Organism or Plant","Ornamental Design","Other"]},n)))(t.scope,!0,t.input),"What is the patent for?",t)}(),function(e={}){return xe("pendingCharges",te(e.scope,!0,e.input),"Do you have any pending charges?",e)}(),function(e={}){return xe("policeReportFiled",ie(e.scope,!0,e.input),"Was a police report filed?",e)}(),function(e={}){return xe("primaryInjury",ae(e.scope,!0,e.input),"What was the primary injury?",e)}(),function(e={}){return xe("priorAlcoholOffenses",ne(e.scope,!0,e.input),"Do you have prior alcohol offenses?",e)}(),function(t={}){return xe("realEstateArea",((t,a,n={})=>(a?d:v)(e({label:a?n.label:"Area of Real Estate:",name:t?t+":Real_Estate_Area":"Real_Estate_Area",options:["Condos and Coops","Construction Disputes","Purchase/Sale Contract","Refinancing Agreement","Title and Boundary Disputes","Zoning, Planning and Land Use","Property Deeds and Transfers","Liens","Other"]},n)))(t.scope,!0,t.input),"What area of real estate?",t)}(),function(t={}){return xe("realEstateTOLPDisplay",((t,a,n={})=>(a?d:c)(e({label:a?n.label:"Select The Real Estate Issue:",if:a?n.if:'$get(Type_Of_Legal_Problem).value == "Real Estate"',name:t?t+":Type_Of_Legal_Problem_Display":"Type_Of_Legal_Problem_Display",options:["Contracts and Agreements","Deeds, Liens, and Titles","Foreclosure","Insurance","Landlord and Tenant","Loans and Mortgages","Wills, Trusts, and Estates","Property Damage","Not Sure or Other"]},n)))(t.scope,!0,t.input),"What type of real estate issue?",t)}({nextStepMap:Ge}),function(t={}){return xe("relationshipToVictim",((t,a,n={})=>(a?d:v)(e({label:a?n.label:"Relationship to the Victim:",name:t?t+":Relationship_To_Victim":"Relationship_To_Victim",options:["Parent","Spouse","Sibling","Friend","Other"]},n)))(t.scope,!0,t.input),"What is your relationship to the victim?",t)}(),function(t={}){return xe("roleInMatterCriminal",((t,a,n={})=>(a?_:m)(e({label:a?n.label:"What is Your Role in this Matter?",name:t?t+":Role_In_Matter_Criminal":"Role_In_Matter_Criminal",options:["I have been accused","I am acting on behalf of someone who has been accused","Other"]},n)))(t.scope,!0,t.input),"What is your role in this matter?",t)}(),function(e={}){return xe("roleInMatterProbate",re(e.scope,!0,e.input),"What is your role in this matter?",e)}(),function(e={}){return xe("socialSecurityDisabilityReceivingBenefits",se(e.scope,!0,e.input),"Are you receiving Social Security Disability benefits?",e)}(),function(t={}){return xe("taxIssueType",((t,a,n={})=>(a?d:v)(e({label:a?n.label:"Type of Tax Issue:",name:t?t+":Tax_Issue_Type":"Tax_Issue_Type",options:["Income","Property","Corporate"]},n)))(t.scope,!0,t.input),"What type of tax issue?",t)}(),function(t={}){return xe("taxLevel",((t,a,n={})=>(a?d:v)(e({label:a?n.label:"Which Level of Tax Issue?",name:t?t+":Tax_Level":"Tax_Level",options:["Federal","State","Local"]},n)))(t.scope,!0,t.input),"What level of tax issue?",t)}(),function(t={}){return xe("taxProblemDetails",((t,a,n={})=>(a?I:v)(e({label:a?n.label:"Details of Tax Problem:",name:t?t+":Tax_Problem_Details":"Tax_Problem_Details",options:["Assets Seized","Bank Account Levied","Cannot Pay Taxes","Innocent Spouse","Lien Filed","Received Audit Notice","Unpaid Interest","Wage Garnishment","Other"]},n)))(t.scope,!0,t.input),"Details of the tax problem:",t)}(),function(t={}){return xe("totalDebt",((t,a,n={})=>(a?d:v)(e({label:a?n.label:"Total Debt?",name:t?t+":Total_Debt":"Total_Debt",options:["Less than 5K","5K to 10K","10K to 20K","20K to 50K","More than 50K"]},n)))(t.scope,!0,t.input),"What is your total debt?",t)}(),function(t={}){return xe("totalMonthlyIncome",((t,a,n={})=>(a?I:v)(e({label:a?n.label:"Total Monthly Income?",name:t?t+":Total_Monthly_Income":"Total_Monthly_Income",options:["Less than 1K","1K to 2K","2K to 3K","3K to 4K","4K to 5K","5K to 7K","7K to 10K","10K to 15K","More than 15K"]},n)))(t.scope,!0,t.input),"What is your total monthly income?",t)}(),function(t={}){return xe("trafficViolations",((t,a,n={})=>(a?I:v)(e({label:a?n.label:"Which Type of Violation?",name:t?t+":Traffic_Violations":"Traffic_Violations",options:["Disregarding a Red Light","Disregarding a Stop Sign","DMV Letter About License","DUI/DWI","Failure to Appear in Court","License Suspended/Revoked","Minor in Possession of Alcohol","No Child Safety Seat","No Liability Insurance","No Seat Belt","Open Container of Alcohol","Parking Ticket","Racing","Speeding","Unpaid Traffic Tickets","Warrant Issue for Arrest","Other Violation"]},n)))(t.scope,!0,t.input),"What type of traffic violation?",t)}(),function(e={}){return xe("typeOfAlcoholTest",le(e.scope,!0,e.input),"What type of alcohol test was performed?",e)}(),function(e={}){return void 0===e.nextOnInput&&(e.nextOnInput=!1),xe("typeOfAssets",ue(e.scope,!0,e.input),"What type of assets are involved?",e)}(),function(t={}){return xe("typeOfProperty",((t,a,n={})=>(a?d:v)(e({label:a?n.label:"Type of Property:",name:t?t+":Type_Of_Property":"Type_Of_Property",options:["Residential","Commercial","Industrial","Agricultural","Recreational","Other"]},n)))(t.scope,!0,t.input),"What type of property is involved?",t)}(),function(e={}){return xe("valueOfAssets",pe(e.scope,!0,e.input),"What is the value of your assets?",e)}(),function(t={}){return xe("veteransDisabilityApplied",((t,a,n={})=>(a?I:v)(e({label:a?n.label:"Has the Applicant Applied for VA Disability Compensation?",name:t?t+":Veterans_Disability_Applied":"Veterans_Disability_Applied",options:["Yes, Claim filed and awaiting decision","Yes, Claim denied","Yes, Claim on appeal","Yes, Claim approved","Yes, Benefits awarded","No, Claim has not been filed"]},n)))(t.scope,!0,t.input),"Has the applicant applied for VA disability benefits?",t)}(),function(t={}){return xe("veteransDisabilityConditions",((t,a,n={})=>(a?s:o)(e({label:a?n.label:"What Service Connected Conditions Does the Applicant Have?",name:t?t+":Veterans_Disability_Conditions":"Veterans_Disability_Conditions",options:["Traumatic Physical Injury (broken bones, loss of limb)","Mental Injury","Occupational Disease","Repeated Trauma Injury","Other"]},n)))(t.scope,!0,t.input),"What conditions or injuries are applicable?",t)}(),function(t={}){return xe("veteransDisabilityInjured",((t,a,n={})=>(a?g:h)(e({name:t?t+":Veterans_Disability_Injured":"Veterans_Disability_Injured",label:a?n.label:"Was the Applicant Hurt While on Duty or is the Condition Related to Military Service?"},n)))(t.scope,!0,t.input),"Is the condition or injury related to military service?",t)}(),function(t={}){return xe("veteransDisabilityRelationship",((t,a,n={})=>(a?I:v)(e({label:a?n.label:"What is Your Relationship to the Applicant?",name:t?t+":Veterans_Disability_Relationship":"Veterans_Disability_Relationship",options:["Self, Active Duty","Self, Active Reserve","Self, Discharged from Active Duty","Self, Discharged as Reservist","Surviving Family Member","Other"]},n)))(t.scope,!0,t.input),"What is your relationship to the applicant?",t)}(),function(t={}){return xe("wouldLikeLawyerTo",((t,a,n={})=>(a?_:m)(e({label:a?n.label:"I Would Like a Lawyer to:",name:t?t+":Would_Like_Lawyer_To":"Would_Like_Lawyer_To",options:["Give me general advice to protect my interests","Act as my agent in the transaction","Assist me in the remaining stages of the transaction","Bring a lawsuit against another party","Defend against a lawsuit filed by another party","Other"]},n)))(t.scope,!0,t.input),"I would like the lawyer to:",t)}(),function(e={}){return xe("zipcode",((e,t,a={})=>(t?w:D)({label:t?a.label:"Zip Code:",help:t?a.help??"We try to match you with local help":null,placeholder:"#####",name:e?e+":Zip":"Zip",maxlength:5,inputmode:"numeric",autocomplete:"postal-code",validation:"required|matches:/^[0-9]{5}$/",validationMessages:{required:"Zip Code is required",matches:"Invalid Zip Code"},...a}))(e.scope,!0,e.input),"Please verify your Zip Code",e)}(),function(e={}){return Ae("commentsWithBankruptcy",[Ie(e),F(e.scope,0,{label:void 0===e.label?"Please briefly describe your legal issue in a few words:":e.label,placeholder:e.placeholder||t,inputClass:void 0===e.inputClass?"!t-h-32":e.inputClass}),o({label:"I'd also like a consult for bankruptcy or debt elimination (optional)",help:"Note: you will be contacted separately by a bankruptcy/debt expert",name:a?a+":CrossSell_Bankruptcy":"CrossSell_Bankruptcy",id:a?a+":CrossSell_Bankruptcy":"CrossSell_Bankruptcy",if:'$getVal($get(form), "Type_Of_Legal_Problem") != "Bankruptcy" && ($getVal($get(form), "Degree_Of_Interest") == "Absolutely Can\'t Afford" || $getVal($get(form), "Degree_Of_Interest") == "Maybe" || $getVal($get(form), "Degree_Of_Interest") == "Probably")',validation:null,helpClass:"!t-text-sm"}),{$el:"div",if:"$get(CrossSell_Bankruptcy).value == true",children:[F("CrossSell:Bankruptcy",0,{label:"Bankruptcy or debt details:",placeholder:"Please describe your bankrtupcy or debt situation in a few words...",inputClass:"!t-h-16"})]}],{nextOnEnter:!1});var a}({label:null,headline:"Please briefly describe your situation:",headlineClass:"!t-text-dark"}),function(e={}){return e.nextOnInput=!1,e.stepKey="$get(Type_Of_Legal_Problem).value",Ae("legalCrossSells",[De(e),l({id:"Legal_CrossSells",name:"Legal_CrossSells",help:'Just hit "Next" if none apply',helpClass:"t-text-center !t-text-sm",validation:null,options:'$getCrossSellOptions($get(form), $getVal($get(form), "Type_Of_Legal_Problem"))'})],e)}({headlineClass:"!t-text-dark",nextStepMap:{values:{Legal_CrossSells:{"Auto and Car Accidents":["autoAndCarAccidentCrossSellQuestions"],"Personal Injury":["personalInjuryCrossSellQuestions"],"Workers Compensation":["workersCompensationCrossSellQuestions"],"DUI and DWI":["duiAndDWICrossSellQuestions"],"Long Term Disability":["longTermDisabilityCrossSellQuestions"],"Social Security Disability and Insurance":["ssdiCrossSellQuestions"],Bankruptcy:["bankruptcyCrossSellQuestions"],"Power of Attorney":["powerOfAttorneyCrossSellQuestions"],"Wills and Trusts":["willsAndTrustsCrossSellQuestions"],"Divorce and Separation":["divorceAndSeparationCrossSellQuestions"],"Child Custody":["childCustodyCrossSellQuestions"]},"*":["firstAndLast","contactInfo"]},appendSteps:["firstAndLast","contactInfo"],matchesAllowed:1}}),function(e={}){return Ae("autoAndCarAccidentCrossSellQuestions",[ge({headline:"You May Be Entitled To Compensation"}),_e({subheadline:"Tell us about your accident:"}),(t="true",a="CrossSell:Auto_and_Car_Accidents",ce("AutoAndCarAccidentsQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Auto and Car Accidents"',children:[G(a),J(a),W(a),ae(a),V(a),ie(a)]})),F("CrossSell:Auto_and_Car_Accidents",0,{label:"Accident Description:",placeholder:"Please describe your accident in a few words...",inputClass:"!t-h-16"})],e);var t,a}(),function(e={}){return Ae("personalInjuryCrossSellQuestions",[ge({headline:"You May Be Entitled To Compensation"}),_e({subheadline:"Tell us about your injury:"}),(t="true",a="CrossSell:Personal_Injury",ce("PersonalInjuryQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Personal Injury"',children:[G(a),J(a),R(a),W(a),ae(a),V(a)]})),F("CrossSell:Personal_Injury",0,{label:"Injury Description:",placeholder:"Please describe your injury in a few words...",inputClass:"!t-h-16"})],e);var t,a}(),function(e={}){return Ae("workersCompensationCrossSellQuestions",[ge({headline:"You May Be Entitled To Benefits"}),_e({subheadline:"Tell us about your injury:"}),(t="true",a="CrossSell:Workers_Compensation",ce("WorkersCompensationQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Workers Compensation"',children:[G(a),J(a),R(a),ae(a),B(a),V(a)]})),F("CrossSell:Workers_Compensation",0,{label:"Injury Description:",placeholder:"Please describe your injury in a few words...",inputClass:"!t-h-16"})],e);var t,a}(),function(e={}){return Ae("duiAndDWICrossSellQuestions",[ge({headline:"About Your DUI/DWI"}),(t="true",a="CrossSell:DUI_and_DWI",ce("DUIAndDWIQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "DUI and DWI"',children:[G(a),J(a),ne(a),le(a),E(a),te(a),U(a)]})),F("CrossSell:DUI_and_DWI",0,{label:"Incident Description:",placeholder:"Please describe your incident in a few words...",inputClass:"!t-h-16"})],e);var t,a}(),function(e={}){return Ae("ssdiCrossSellQuestions",[ge({headline:"You May Be Entitled To Benefits"}),_e({subheadline:"Tell us about your disability:"}),(t="true",a="CrossSell:Social_Security_Disability_and_Insurance",ce("SocialSecurityDisabilityAndInsuranceQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Social Security Disability and Insurance"',children:[G(a),$(a),Y(a),q(a),se(a),V(a)]})),F("CrossSell:Social_Security_Disability_and_Insurance",0,{label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"})],e);var t,a}(),function(e={}){return Ae("powerOfAttorneyCrossSellQuestions",[ge({headline:"Power of Attorney Information"}),(t="true",a="CrossSell:Power_of_Attorney",ce("PowerofAttorneyQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Power of Attorney"',children:[G(a),U(a)]})),F("CrossSell:Power_of_Attorney",0,{label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"})],e);var t,a}(),function(e={}){return Ae("willsAndTrustsCrossSellQuestions",[ge({headline:"Will or Trust Information"}),(t="true",a="CrossSell:Wills_and_Trusts",ce("WillsAndTrustsQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Wills and Trusts"',children:[G(a),pe(a),ue(a),re(a),K(a),U(a)]})),F("CrossSell:Wills_and_Trusts",0,{label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"})],e);var t,a}(),function(e={}){return Ae("divorceAndSeparationCrossSellQuestions",[ge({headline:"Divorce or Separation Information"}),(t="true",a="CrossSell:Divorce_and_Separation",ce("DivorceQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Divorce and Separation"',children:[G(a),ee(a),Z(a),H(a),X(a)]})),F("CrossSell:Divorce_and_Separation",0,{label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"})],e);var t,a}(),function(e={}){return Ae("childCustodyCrossSellQuestions",[ge({headline:"Child Custody Information"}),(t="true",a="CrossSell:Child_Custody",ce("ChildCustodyQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Child Custody"',children:[G(a),N(a),M(a),j(a),H(a),X(a)]})),F("CrossSell:Child_Custody",0,{label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"})],e);var t,a}(),function(e={}){return Ae("firstAndLast",[Pe({headline:e.headline??"Who is looking for help?",headlineClass:e.headlineClass}),ve({subheadline:e.subheadline??"Note: we never share info without consent",subheadlineClass:"!t-text-sm !t-text-gray-500"}),x(e.scope),O(e.scope)],e)}({headlineClass:"!t-text-dark"})];const Xe=[Je,e(We,et),{$cmp:"FormKit",props:function(t){const a=e(Oe,t);return a.formId&&!a.name&&(a.name=a.formId),a}({formId:"generalLegalSingle",redirectMap:function(t){return e(Me,t)}(),valueOverrideMap:je,crossSellOptionMap:Ze}),children:[function(t){return e(Ee,t)}(),function(t={}){return e(function(e={}){return{$el:"h1",attrs:{class:"t-flex t-justify-center t-text-center t-text-[2rem] t-font-semibold t-pt-5 t-px-7 md:t-px-3 "+(e.headlineClass||"")+" f-first-headline"}}}(t),t)}({children:'$urlParam("hl", "Need Legal Help? Start Here!")',if:"$activeStep === $firstStep()"}),function(t={}){return e(function(e={}){return{$el:"h3",attrs:{class:"t-flex t-justify-center t-text-center t-text-[1.1rem] md:t-text-[1.2rem] t-font-medium t-text-blue-500 t-px-10 "+(e.subheadlineClass||"")+" f-first-subheadline"}}}(t),t)}({children:'$urlParam("shl", "Our Service is Fast and Free!")',if:"$activeStep === $firstStep()"}),...Be,{$el:"div",attrs:{class:"form-body"},children:[function(e={}){return Ae("generalTOLP",[Q(e.scope,!0,e.input)],e)}({nextOnInput:!1,nextStepMap:qe,headlineClass:"t-text-lg",input:{placeholder:"Select a Category",innerClass:"!t-max-w-[275px] md:!t-max-w-xl"}}),function(e="Type_Of_Legal_Problem"){return{$cmp:"FormKitSchema",if:"$get("+e+").value",props:{schema:"$meta.dynamicSchema",data:"$buildData($meta)"}}}(),function(e={}){return Ae("contactInfo",[we(e),Te(e),{$el:"script",if:"$activeStep === $lastStep()",children:Se},A(e.scope),k(e.scope),oe(e.scope),be()],{nextOnEnter:!1})}(),((e={})=>({$el:"div",attrs:{class:{if:"$activeStep === $firstStep()",then:"step-nav "+(e.firstStepButtonClass||"!t-justify-center sm:!t-justify-between"),else:"step-nav !t-justify-between"}},children:[{$formkit:"button",name:"back_button",onClick:"$setPreviousStep($prevStepFunc($get(form)))",children:"Back",outerClass:{if:"$activeStep === $firstStep()",then:"t-hidden sm:t-block",else:""},style:{if:"$activeStep === $firstStep()",then:"display: none;"},classes:{input:(e.inputClass||"")+" f-navigation-input"}},{$formkit:"button",name:"next_button",onClick:"$setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form)))",children:{if:"$activeStep === $firstStep()",then:e.startText||"Start",else:"Next"},outerClass:{if:"$activeStep === $lastStep()",then:"t-hidden",else:""},style:{if:"$activeStep === $lastStep()",then:"display: none;"},classes:{input:(e.inputClass||"")+" f-navigation-input"}},{$formkit:"submit",name:"submit_button",label:e.submitLabel||"Submit",if:"$activeStep === $lastStep()",style:{if:"$activeStep !== $lastStep()",then:"display: none;"},classes:{input:(e.inputClass||"")+" !t-ml-2 sm:!t-ml-auto f-navigation-input"}}]}))(),{$el:"pre",if:'$urlParam("fdbg", "") == 1',children:[{$el:"pre",children:"$stringify( $get(form).value )",attrs:{class:"t-text-xs",style:"overflow: scroll"}},{$el:"pre",children:["activeStep: ","$activeStep"],attrs:{class:"t-text-xs",style:"overflow: scroll"}},{$el:"pre",children:["stepHistory: ","$stepHistory"],attrs:{class:"t-text-xs",style:"overflow: scroll"}},{$el:"pre",children:["stepQueue: ","$stepQueue"],attrs:{class:"t-text-xs",style:"overflow: scroll"}},{$el:"pre",children:["steps: ","$stepKeys()"],attrs:{class:"t-text-xs",style:"overflow: scroll"}}]}]}]}];var et;const tt=Xe.find((e=>"FormKit"===e.$cmp));return tt.props.name="generalLegalPopUnderSingle",tt.props.formId="generalLegalPopUnderSingle",tt.props.popUnderMap={"*":"/thank-you"},Xe}();
+var generalLegalPopUnderSingle=function(){"use strict";function e(){return Object.assign({},...arguments)}const t='$getKey($meta, "commentsPlaceholders." + $get(Type_Of_Legal_Problem).value, $meta.defaultCommentsPlaceholder)',a='$getKey($meta, "finalHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalHeadline)',n='$getKey($meta, "finalSubHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalSubHeadline)',i={"Auto and Car Accidents":{"Social Security Disability and Insurance":"Interest in Disability Benefits","Wills and Trusts":"Need a Will or Trust","Workers Compensation":"Workplace Injury","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},"Personal Injury":{"DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},"Workers Compensation":{"Auto and Car Accidents":"Involved in a Car Accident","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody","Social Security Disability and Insurance":"Interest in SSDI Benefits"},"DUI and DWI":{"Personal Injury":"Personal or Workplace Injury","Wills and Trusts":"Need a Will or Trust","Social Security Disability and Insurance":"Interest in Disability Benefits","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},"Wills and Trusts":{"Auto and Car Accidents":"Injured in a Car Accident","Personal Injury":"Personal or Workplace Injury","DUI and DWI":"Involved in a DUI/DWI","Social Security Disability and Insurance":"Interest in Disability Benefits","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},"Probate and Estates":{"Auto and Car Accidents":"Injured in a Car Accident","Personal Injury":"Personal or Workplace Injury","DUI and DWI":"Involved in a DUI/DWI","Social Security Disability and Insurance":"Interest in Disability Benefits","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},"Power of Attorney":{"Auto and Car Accidents":"Injured in a Car Accident","Personal Injury":"Personal or Workplace Injury","DUI and DWI":"Involved in a DUI/DWI","Social Security Disability and Insurance":"Interest in Disability Benefits","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},"Long Term Disability":{"Auto and Car Accidents":"Injured in a Car Accident","DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},"Social Security Disability and Insurance":{"Auto and Car Accidents":"Injured in a Car Accident","DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},"*":{"Auto and Car Accidents":"Injured in a Car Accident","Personal Injury":"Personal or Workplace Injury","DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Social Security Disability and Insurance":"Interest in Disability Benefits"}},r=e=>(e.name&&!e.id&&(e.id=e.name),e),s=t=>(r(t),e({$formkit:"checkbox",validation:"required",validationMessages:{required:"Field is required"}},t)),o=e=>(e&&e.legendClass||(e.legendClass="required"),e.fieldsetClass="$reset",e.optionsClass="t-pl-2 t-pt-3",e.innerClass="t-items-center",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",s(e)),l=e=>(e.legendClass="legend-left required",e.fieldsetClass="$reset side-by-side",e.optionsClass="t-pl-1",e.innerClass="t-flex t-items-center",e.wrapperClass="t-mb-3",s(e)),u=e=>(e&&e.legendClass||(e.legendClass="required"),e.fieldsetClass="$reset",e.optionsClass="t-pl-8 md:t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",s(e)),p=e=>(e&&e.legendClass||(e.legendClass="required t-w-[100%] t-text-center"),e.fieldsetClass="$reset t-flex t-justify-center t-flex-col",e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",e.optionClass="t-pl-4 md:t-pl-16 md:t-min-w-[200px]",e.optionsClass="t-pl-4 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.messagesClass="t-flex t-justify-center",e.helpClass="t-mt-0 t-mb-4 !t-text-sm t-text-center",s(e)),d=t=>(r(t),e({$formkit:"radio",validation:"required",validationMessages:{required:"Field is required"},optionsClass:"t-pt-3 t-pl-1",legendClass:"required"},t)),c=e=>(e.legendClass="required",e.fieldsetClass="$reset",e.optionsClass="t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",d(e)),m=e=>(e.legendClass="required t-w-[100%] t-text-center",void 0===e.fieldsetClass&&(e.fieldsetClass="$reset t-flex t-justify-center"),e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",e.optionClass="t-pl-4 md:t-pl-8 md:t-min-w-[200px]",e.optionsClass="t-pl-4 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.messagesClass="t-flex t-justify-center",e.helpClass="t-mt-0 t-mb-4 !t-text-sm t-text-center",d(e)),y=e=>(e.legendClass="legend-left required",e.fieldsetClass="$reset side-by-side",e.optionsClass="t-pl-1",e.innerClass="t-flex t-items-center",e.wrapperClass="t-mb-3",d(e)),f=e=>(e.legendClass="legend-left-flex md:t-max-w-[40%] required",e.fieldsetClass="$reset side-by-side-flex",e.optionsClass="md:t-ml-4 md:t-mt-2 t-grid t-grid-cols-1 md:t-grid-cols-2-125",e.innerClass="t-flex t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",d(e)),h=e=>(e.legendClass="legend-left t-pb-1 required",e.fieldsetClass="$reset side-by-side t-items-center",e.optionsClass="t-mt-1 t-grid t-grid-cols-1 md:t-grid-cols-2-125 t-items-center",e.innerClass="t-flex t-items-center",e.optionClass="t-pr-1",d(e)),b=e=>(e.options=["Yes","No"],h(e)),g=e=>(e.legendClass="legend-left",e.fieldsetClass="$reset t-flex t-justify-center t-flex-col-reverse t-items-center",void 0===e.optionsClass&&(e.optionsClass="t-flex t-flex-col sm:t-flex-row t-justify-center t-my-3"),e.optionClass="radiobtn t-my-2 sm:t-my-0 t-mx-2 md:t-mx-5",e.wrapperClass="$reset formkit-wrapper t-mb-0 t-flex t-items-center t-h-[100%]",e.labelClass="t-font-semibold t-text-[#1e448f] t-w-[100%]",e.decoratorIcon=!1,e.messagesClass="t-flex t-justify-center",e.helpClass="t-mt-2.5 !t-text-sm t-text-center",d(e)),_=e=>(e.options=["Yes","No"],e.optionsClass="t-flex t-justify-center t-my-3",g(e)),C=e=>(e.legendClass="required",e.fieldsetClass="$reset t-flex t-justify-center",e.optionsClass="t-pl-2 t-pt-3",e.innerClass="t-items-center",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",e.optionClass="t-pl-4 md:t-pl-12",e.messagesClass="t-flex t-justify-center",d(e)),v=t=>(r(t),e({$formkit:"select",placeholder:"Please Select",validation:"required",validationMessages:{required:"Field is required"},inputClass:"t-bg-white",labelClass:"required"},t)),I=e=>(e.labelClass="required",e.wrapperClass="side-by-side t-items-center",e.innerClass="select-height-content",e.helpClass="t-mt-2.5 md:t-text-right md:t-mt-[-5px]",v(e)),P=e=>(e.labelClass="required",e.wrapperClass="t-flex t-justify-center",e.messagesClass="t-flex t-justify-center",e.inputClass="t-min-w-[150px] t-bg-white "+(e.inputClass||""),e.helpClass="t-mt-2.5 t-text-center",v(e)),T=t=>(r(t),e({$formkit:"text",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required"},t)),D=e=>(e.wrapperClass="side-by-side t-items-center",T(e)),S=e=>(e.wrapperClass="t-flex t-justify-center",e.messagesClass="t-flex t-justify-center",e.inputClass="t-text-center",e.helpClass="t-mt-2.5 !t-text-sm t-text-center",T(e)),w=t=>(r(t),e({$formkit:"DatePicker",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required t-block t-mb-3 t-font-semibold t-text-base formkit-invalid:t-text-red-500",innerClass:"t-border t-border-gray-400 formkit-invalid:t-border-red-500 t-rounded t-mb-1 focus-within:t-border-blue-500"},t)),L=e=>(e.wrapperClass="side-by-side t-items-center",w(e)),A=e=>(e.wrapperClass="t-flex t-justify-center",e.inputClass="t-text-center",e.messagesClass="t-flex t-justify-center",w(e)),x=(e,t,a={})=>(t?S:D)({$formkit:"email",name:e?e+":Email":"Email",label:t?a.label:"Email Address:",placeholder:"email@domain.com",autocomplete:"email","data-tf-sensitive":"false",validation:"required|email",validationMessages:{required:"Email is required",email:"Invalid Email"},...a}),O=(e,t,a={})=>(t?S:D)({label:t?a.label:"First Name:",placeholder:"First Name",name:e?e+":First_Name":"First_Name",autocomplete:"given-name",validationMessages:{required:"First Name is required"},...a}),W=(e,t,a={})=>(t?S:D)({label:t?a.label:"Last Name:",placeholder:"Last Name",name:e?e+":Last_Name":"Last_Name",autocomplete:"family-name",validationMessages:{required:"Last Name is required"},...a}),$=(e,t,a={})=>(t?S:D)({$formkit:"tel",name:e?e+":Primary_Phone":"Primary_Phone",label:t?a.label:"Phone Number:",placeholder:a.placeholder||"###-###-####",maxlength:12,help:a.help||"10-digit phone number, hyphens optional",autocomplete:"tel-national","data-tf-sensitive":"false",validation:"required|matches:/^[0-9]{3}-?[0-9]{3}-?[0-9]{4}$/|valid_phone",validationMessages:{required:"Phone Number is required",matches:"Invalid Phone Format, use ###-###-####",valid_phone:"Invalid Phone Number"},helpClass:"t-mt-2.5 md:t-text-right md:t-mt-[-2px]",...a}),k=(t,a,n={})=>(a?S:D)(e({label:a?n.label:"Age of Applicant?",placeholder:"Age between 18 and 65",name:t?t+":Applicant_Age":"Applicant_Age",value:a?n.value??"50":null,maxlength:2,inputmode:"numeric",validation:"required|min:18,max:65",validationMessages:{required:"Applicant Age is required",min:"Invalid Age - must be between 18 and 65",max:"Invalid Age - must be between 18 and 65"},...n})),E=(t,a,n={})=>(a?_:b)(e({label:a?n.label:"Were You at Fault?",name:t?t+":At_Fault":"At_Fault"},n)),B=(t,a,n={})=>(a?P:I)(e({label:a?n.label:"Blood Alcohol Content Measured by Test:",name:t?t+":Blood_Alcohol_Content_Test":"Blood_Alcohol_Content_Test",options:["No Test","0.00% - 0.04%","0.05% - 0.08%","0.09% - 0.12%","0.13% - 0.16%","0.17% - 0.20%","More than 0.20%","Don't know"]},n)),M=(t,a,n={})=>(a?m:I)(e({label:a?n.label:"Cause of Injury:",name:t?t+":Cause_Of_Injury":"Cause_Of_Injury",options:["Traumatic Physical Injury (Accident)","Repeated Trauma Injury","Mental Injury","Occupational Disease","Not Sure"]},n)),j=(t,a,n={})=>(a?m:I)(e({label:a?n.label:"With Whom Do the Children Currently Live?",name:t?t+":Child_Home":"Child_Home",options:["Mother","Father","Grandparents","Other"]},n)),N=(t,a,n={})=>(a?g:I)(e({label:a?n.label:"Who is the Primary Caregiver?",name:t?t+":Child_Primary_Caregiver":"Child_Primary_Caregiver",options:["Mother","Father","Other"]},n)),F=(t,a,n={})=>(a?m:I)(e({label:a?n.label:"Your Relationship to Child(ren):",name:t?t+":Child_Relationship":"Child_Relationship",options:["Father","Mother","Grandparent","Aunt/Uncle","Other"]},n)),R=(t,a,n={})=>(a?m:I)(e({label:a?n.label:"Status of Claim:",name:t?t+":Claim_Status":"Claim_Status",options:["No action taken yet","Demand for compensation made","Lawsuit filed","Other"]},n)),H=(t,a,n)=>(t=>(r(t),e({$formkit:"textarea",rows:5,maxlength:500,validation:"required",validationMessages:{required:"Field is required"},innerClass:"t-max-w-xl",labelClass:"required"},t)))(e({name:t?t+":Comments":"Comments",label:"Please briefly describe your situation in a few words:",placeholder:'For Example: "I would like help with child support payments" or "I need help with visitation rights"'},n)),U=(t,a,n={})=>(a?m:I)(e({name:t?t+":Degree_Of_Interest":"Degree_Of_Interest",id:t?t+":Degree_Of_Interest":"Degree_Of_Interest",label:a?n.label:"How Likely Are You to Pay if Your Issue Could be Resolved?",help:a?n.help:"No payment necessary to speak with lawyers.",options:["Definitely","Probably","Maybe","Absolutely Can't Afford"]},n)),q=(t,a,n={})=>U(t,a,e(n,{help:"No payment necessary to speak with lawyers."})),Y=(t,a,n={})=>(a?_:b)(e({name:t?t+":Disability_Condition_Stop_Work":"Disability_Condition_Stop_Work",label:a?n.label:"Do You Expect To Be Out Of Work For At Least a Year Due To Your Health?"},n)),V=(t,a,n={})=>(a?_:b)(e({name:t?t+":Disability_Work_History":"Disability_Work_History",label:a?n.label:"Have You Had a Full-Time Job Within the Past 5 Years?"},n)),K=(t,a,n={})=>(a?_:b)(e({name:t?t+":Doctor_Treatment":"Doctor_Treatment",label:a?n.label:"Have You Recently Been Treated by a Doctor, Hospital or Clinic?"},n)),z=(t,a,n={})=>(a?m:I)(e({name:t?t+":Estate_Legal_Services_Needed":"Estate_Legal_Services_Needed",label:a?n.label:"Legal Services Needed for Your Estate:",options:["Charitable Giving","Contested Wills","Drafting Wills or Trust","Estate Administration","Asset Protection","Other"]},n)),G=["Adoption","Asbestos and Mesothelioma","Auto and Car Accidents","Bankruptcy","Birth Certificate and Name Change","Business Lawyers","Child Custody","Child Support","Civil Rights and Discrimination","Consumer Lawyers","Copyrights and Trademarks","Criminal and Felony","Debt and Collections","Defend a Lawsuit","Divorce and Separation","DUI and DWI","Elder Law","Employment and Workplace","Expungement","Family Issues","File a Lawsuit","Foreclosure","Guardianship","Harassment and Discrimination","Identity Theft","Immigration and Visas","Insurance","Landlord and Tenant","Lemon Law","Long Term Disability","Medical Malpractice","Non-Workplace Discrimination","Non-Workplace Harassment","Patents and Intellectual Property","Personal Injury","Power of Attorney","Probate and Estates","Product Liability","Property Damage","Real Estate","Sexual Harassment","Social Security Disability and Insurance","Tax and IRS","Traffic and Tickets","Unemployment","Victim of a Crime","Wills and Trusts","Workers Compensation","Workplace Discrimination","Workplace Harassment","Wrongful Death","Wrongful Termination","Not Sure or Other"],Q=(t,a,n={})=>(a?P:I)(e({label:a?n.label:"Type of Help Needed:",name:t?t+":Type_Of_Legal_Problem":"Type_Of_Legal_Problem",id:t?t+":Type_Of_Legal_Problem":"Type_Of_Legal_Problem",options:G},n)),Z=(t,a,n={})=>(a?_:b)(e({label:a?n.label:"Already Working with An Attorney?",name:t?t+":Have_Attorney":"Have_Attorney"},n)),J=(t,a,n={})=>(a?_:b)(e({name:t?t+":Have_Children":"Have_Children",label:a?n.label:"Do You Have Children?"},n)),X=(t,a,n={})=>(a?A:L)(e({label:a?n.label:"Date of Incident:",name:t?t+":Incident_Date":"Incident_Date"},n)),ee=(t,a,n={})=>(a?m:I)(e({label:a?n.label:"How Will You Pay for Legal Fees if You Hire a Lawyer?",help:a?n.help:"No payment necessary to start a consultation.",name:t?t+":Lawyer_Payment_Method":"Lawyer_Payment_Method",options:a?{Cash:"Cash","Credit Card":"Credit Card",Family:"Family or Friend",Other:"Other"}:["Cash","Check","Credit Card","Friend","Family","Other"],fieldsetClass:a?"$reset t-flex t-flex-col t-items-center":void 0},n)),te=(t,a,n={})=>(a?m:I)(e({label:a?n.label:"Marital Status:",name:t?t+":Marital_Status":"Marital_Status",options:["Unmarried, Living Together","Unmarried, Do Not Live Together","Married, Living Together","Separated","Divorced","Other"]},n)),ae=(t,a,n={})=>(a?_:b)(e({name:t?t+":Pending_Charges":"Pending_Charges",label:a?n.label:"Do you currently have any pending charges?"},n)),ne=(t,a,n={})=>(a?m:f)(e({label:a?n.label:"Primary Injury:",name:t?t+":Primary_Injury":"Primary_Injury",options:["Anxiety","Back or Neck Pain","Broken Bones","Cuts and Bruises","Headaches","Memory Loss","Loss of Limb","Not Sure or Other"]},n)),ie=(t,a,n={})=>(a?_:b)(e({name:t?t+":Prior_Alcohol_Offenses":"Prior_Alcohol_Offenses",label:a?n.label:"Any Prior Alcohol Related Offenses?"},n)),re=(t,a,n={})=>(a?_:b)(e({name:t?t+":Police_Report_Filed":"Police_Report_Filed",label:a?n.label:"Was a Police Report Filed?"},n)),se=(t,a,n={})=>(a?m:I)(e({label:a?n.label:"What is Your Role in this Matter?",name:t?t+":Role_In_Matter_Probate":"Role_In_Matter_Probate",options:["Preparing My Will","Executor","Heir","Other"]},n)),oe=(t,a,n={})=>(a?_:b)(e({name:t?t+":Social_Security_Disability_Receiving_Benefits":"Social_Security_Disability_Receiving_Benefits",label:a?n.label:"Are You Currently Receiving Social Security Disability Benefits?"},n)),le=(e,t={})=>({$formkit:"checkbox",label:"$meta.tcpaLanguage",__raw__sectionsSchema:{label:{attrs:{innerHTML:"$label"}}},name:e?e+":TCPA_Opt_In":"TCPA_Opt_In","data-tf-sensitive":"false",validation:"required|accepted",validationMessages:{required:"Consent is required",accepted:"Consent is required"},classes:{outer:t.outerClass?t.outerClass:"",wrapper:t.wrapperClass?t.wrapperClass:"",messages:t.messagesClass?t.messagesClass:"",label:"!t-text-[0.7rem] t-text-slate-500 t-font-normal !t-leading-[0.9rem]"+(t.labelClass?" "+t.labelClass:"")}}),ue=(t,a,n={})=>(a?m:I)(e({label:a?n.label:"Type of Alcohol Test Performed?",name:t?t+":Type_Of_Alcohol_Test":"Type_Of_Alcohol_Test",options:["No Test","Refused Test","Breath Test","Blood Test","Urine Test","Don't Know"]},n)),pe=(t,a,n={})=>(a?p:u)(e({label:a?n.label:"Type of Assets:",name:t?t+":Type_Of_Assets":"Type_Of_Assets",options:["Business Interests","Cash","Life Insurance Policies","Pensions/Retirement","Personal Possessions","Property","Stock/Bonds"]},n)),de=(t,a,n={})=>(a?m:I)(e({label:a?n.label:"Value of Your Assets?",name:t?t+":Value_Of_Assets":"Value_Of_Assets",options:["Less than 50K","50K to 100K","100K to 250K","250K to 500K","500K to 1M","More than 1M"]},n)),ce=(t,a)=>e({$cmp:"FormKit",props:{type:"group",key:t,id:t,name:t}},a),me="$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",ye="$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",fe=e=>"group"!==e.type&&"section"!==e.type&&"form"!==e.type&&"hidden"!==e.$formkit&&!e.children,he=e=>{if(fe(e))return e;for(var t=e.children.length-1;t>=0;t--){if("string"==typeof e.children)continue;const a=e.children[t];if(fe(a))return a;const n=he(a);if(n)return n}return null},be={$el:"div",if:"$activeStep === $lastStep()",attrs:{class:"t-flex t-justify-center t-items-center t-text-sm t-text-gray-500"},children:[{$el:"img",attrs:{loading:"lazy",alt:"",style:{border:0},width:"25",height:"25",src:"https://d27hmee62k45vz.cloudfront.net/lock_icon_1.jpeg"}},{$el:"span",children:"Secure & Encrypted",attrs:{class:"t-pl-2 t-pt-1 t-font-medium"}}]};function ge(t={}){return e(be,t)}function _e(e){return{$el:"h3",children:e.headline||"Tell Us About Your Situation",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-4 t-pt-0 t-px-1"}}}function Ce(e){return{$el:"h5",children:e.subheadline||"Tell us about your situation:",attrs:{class:"t-flex t-justify-center t-text-dark t-text-center !t-text-lg t-font-semibold t-pb-4 t-pt-0 t-px-3"}}}function ve(e){return{$el:"h3",children:e.headline||"Tell Us About Your Situation",attrs:{class:"t-flex t-justify-center t-text-center t-text-xl t-font-bold t-text-dark t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function Ie(e){return{$el:"h5",children:e.subheadline||"",attrs:{class:"t-flex t-justify-center t-text-center !t-text-lg t-font-normal t-text-dark t-pb-5 t-pt-0 t-px-1 "+(e.subheadlineClass||"")}}}function Pe(e){return function(e){return{$el:"h3",children:e.headline||"Additional Details",attrs:{class:"t-flex t-justify-center t-text-center t-text-lg sm:t-text-xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}({headline:e.headline||"Additional Case Details",headlineClass:e.headlineClass})}function Te(e){return{$el:"h3",children:e.headline||"Please Provide a Contact Name",attrs:{class:"t-flex t-justify-center t-text-center t-text-xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function De(e){return{$el:"h3",children:e.headline||"Do any of the following situations apply?",attrs:{class:"t-flex t-justify-center t-text-center t-text-xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function Se(e){return{$el:"h3",children:e.headline||a,attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-3 t-pt-4 t-px-1 "+(e.headlineClass||"")+" f-contact-info-headline"}}}function we(e){return{$el:"h5",children:e.subheadline||n,attrs:{class:"t-flex t-justify-center t-text-center !t-text-lg t-font-semibold t-pb-6 t-pt-0 t-px-3 "+(e.subheadlineClass||"")+" f-contact-info-subheadline"}}}const Le="(function() {\n  if (window.xxTrustedFormLoaded) {\n    return\n  }\n  var vid = '';\n  if (typeof window.zar !== 'undefined') {\n    vid = window.zar.getVID();\n  }\n  window.xxTrustedFormLoaded = true;\n  var sandbox = document.location.hostname.indexOf('localhost') > -1 ? 'true' : 'false'\n  var tf = document.createElement('script');\n  tf.type = 'text/javascript'; tf.async = true;\n  tf.src = (\"https:\" == document.location.protocol ? 'https' : 'http') + \"://api.trustedform.com/trustedform.js?field=xxTrustedFormCertUrl&identifier=\" + vid + \"&ping_field=xxTrustedFormPingUrl&provideReferrer=false&invert_field_sensitivity=true&sandbox=\" + sandbox + \"&l=\" + new Date().getTime() + Math.random();\n  var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(tf, s);\n})();";const Ae=(e,t)=>({$el:"section",if:'$stepEnabled("'+e+'")',attrs:{hidden:'$activeStep !== "'+e+'"',key:t||e}});function xe(t,a,n={}){const{nextOnEnter:i=!0,nextOnInput:r=!1,stepKey:s,nextStepMap:o,triggerRedirectMap:l,autoFocus:u}=n;if(a&&a.length&&(i||r)){const e=he(a[a.length-1]);e&&!0===i&&(e.onKeypress=me),e&&!0===r&&(e.onInput=ye)}return e(Ae(t,s),{children:[{$formkit:"group",id:t,name:t,nextStepMap:o,triggerRedirectMap:l,autoFocus:u,children:a}]})}function Oe(e,t,a,n={}){return void 0===n.nextOnInput&&(n.nextOnInput=!0),xe(e,[ve({headline:n.headline??a,headlineClass:n.headlineClass}),...Array.isArray(t)?t:[t]],n)}const We={type:"form",id:"form",config:{validationVisibility:"submit"},onSubmit:'$submit($submitUrl, $prepData, $handleRedirect, "text/plain; charset=UTF-8")',plugins:"$plugins",actions:!1,anchorElement:"form-anchor",useLocalStorage:!0,prepop:{fromURL:!0},errorCodes:{403:{message:"An Error Occurred",abort:!1},409:{abort:!1},429:"An Error Occurred",504:{message:"An Error Occurred",abort:!1}},formClass:"!t-max-w-[40rem]"};function $e(e,t){return Object.fromEntries(Object.entries(e).filter((([e])=>t.includes(e))))}const ke={};const Ee={$el:"div",children:[{$el:"div",attrs:{id:"form-anchor",class:"t-absolute",style:{top:"-30px",left:0}}}],attrs:{class:"t-relative"}};const Be={$el:"div",attrs:{class:"t-mt-7 t-mb-5 t-w-full t-flex t-flex-col t-justify-center t-items-center",style:{if:"$fns.eq($activeStep, $firstStep()) || $fns.eq($activeStep, $lastStep())",then:"display: none"}},children:[{$el:"div",attrs:{class:"t-flex t-justify-center"},children:[{$el:"span",attrs:{id:"progress-bar-text",class:"t-text-sm t-mb-1"},children:["0% Complete"]}]},{$el:"div",attrs:{class:"t-bg-gray-100 t-w-9/12 t-rounded"},children:[{$el:"div",attrs:{id:"progress-bar",class:"t-flex t-flex-col t-justify-center t-text-center t-whitespace-nowrap t-w-[10%] t-h-1.5 t-rounded t-text-white t-bg-[#007bff]",style:{transition:"width 0.5s ease"}}}]}]};const Me=[{$formkit:"hidden",name:"vertical",value:"Legal"},{$formkit:"hidden",name:"TCPA_Language",value:"$meta.tcpaLanguage"},{$formkit:"hidden",name:"gclid",value:null},{$formkit:"hidden",name:"campaignid",value:null},{$formkit:"hidden",name:"s",value:null}],je={"*":"https://listings.ziplawyer.com/api/v1/redirect?zone_id=4&vertical=Legal&category=${properties.Type_Of_Legal_Problem}&Degree_Of_Interest=${properties.Degree_Of_Interest}&zip_code=${properties.Zip}&sub_id=${properties.vid}"};const Ne={Civil_Defense:{Yes:{Type_Of_Legal_Problem:"Defend a Lawsuit"},No:{Type_Of_Legal_Problem:"File a Lawsuit"}},businessServicesOverrideMap:{Business_Services_Display:{"Business Formation":{Business_Services:"Business Formation"},Contracts:{Business_Services:"Contracts"},"Insurance and Liability":{Business_Services:"Insurance and Liability"},"Mergers and Acquisition":{Business_Services:"Mergers and Acquisition"},"Regulatory Compliance":{Business_Services:"Regulatory Compliance"},"Employee Dispute":{Business_Services:"Employee Dispute"},"Advice and Consulting":{Business_Services:"Other"},Other:{Business_Services:"Other"}}},Type_Of_Legal_Problem_Display:{Copyrights:{Type_Of_Legal_Problem:"Copyrights and Trademarks"},Trademarks:{Type_Of_Legal_Problem:"Copyrights and Trademarks"},Patents:{Type_Of_Legal_Problem:"Patents and Intellectual Property"},"Business Lawyers":{Type_Of_Legal_Problem:"Business Lawyers"},"Business Consulting":{Type_Of_Legal_Problem:"Business Lawyers"},"Not Sure or Other":{Type_Of_Legal_Problem:"Not Sure or Other"},"Auto Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Dog Bite":{Type_Of_Legal_Problem:"Personal Injury"},"Slip and Fall":{Type_Of_Legal_Problem:"Personal Injury"},"Workplace Injury":{Type_Of_Legal_Problem:"Workers Compensation"},"Trucking Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Motorcycle Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Other Accidents or Injuries":{Type_Of_Legal_Problem:"Personal Injury"},"Automobile Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Contract Disputes":{Type_Of_Legal_Problem:"Business Lawyers"},"Defamation and Slander":{Type_Of_Legal_Problem:"File a Lawsuit"},"Dog Bite":{Type_Of_Legal_Problem:"Personal Injury"},"Employment and Workplace":{Type_Of_Legal_Problem:"Employment and Workplace"},Fraud:{Type_Of_Legal_Problem:"Consumer Lawyers"},"Medical Malpractice":{Type_Of_Legal_Problem:"Medical Malpractice"},"Personal Injury":{Type_Of_Legal_Problem:"Personal Injury"},"Property Damage":{Type_Of_Legal_Problem:"Property Damage"},"Small Claims":{Type_Of_Legal_Problem:"File a Lawsuit"},"Real Estate":{Type_Of_Legal_Problem:"Real Estate"},"Other (describe on next page)":{Type_Of_Legal_Problem:"Not Sure or Other"},"Contract Creation":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Contract Enforcement":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Contract Cancellation":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Contract Fraud":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Breach of Contract":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Other Contract Issues":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Criminal Defense":{Type_Of_Legal_Problem:"Criminal and Felony"},"Victim of a Crime":{Type_Of_Legal_Problem:"Victim of a Crime"},"DUI and DWI":{Type_Of_Legal_Problem:"DUI and DWI"},Expungement:{Type_Of_Legal_Problem:"Expungement"},Harassment:{Type_Of_Legal_Problem:"Criminal and Felony"},"Not Sure or Other":{Type_Of_Legal_Problem:"Not Sure or Other"},"Workplace Harassment":{Type_Of_Legal_Problem:"Workplace Harassment"},"Workplace Discrimination":{Type_Of_Legal_Problem:"Workplace Discrimination"},"Wrongful Termination":{Type_Of_Legal_Problem:"Wrongful Termination"},"Payment Disputes":{Type_Of_Legal_Problem:"Employment and Workplace"},"Workers Compensation":{Type_Of_Legal_Problem:"Workers Compensation"},Unemployment:{Type_Of_Legal_Problem:"Unemployment"},"Other Workplace Issues":{Type_Of_Legal_Problem:"Employment and Workplace"},"Attorney Malpractice":{Type_Of_Legal_Problem:"File a Lawsuit"},"Other Malpractice Issues":{Type_Of_Legal_Problem:"File a Lawsuit"},"Vehicle Repossession":{Type_Of_Legal_Problem:"Bankruptcy"},"Property Repossession":{Type_Of_Legal_Problem:"Bankruptcy"},"Other Repossession Issues":{Type_Of_Legal_Problem:"Not Sure or Other"},"Contracts and Agreements":{Type_Of_Legal_Problem:"Real Estate"},"Deeds, Liens, and Titles":{Type_Of_Legal_Problem:"Real Estate"},Foreclosure:{Type_Of_Legal_Problem:"Foreclosure"},Insurance:{Type_Of_Legal_Problem:"Insurance"},"Landlord and Tenant":{Type_Of_Legal_Problem:"Landlord and Tenant"},"Loans and Mortgages":{Type_Of_Legal_Problem:"Real Estate"},"Wills, Trusts, and Estates":{Type_Of_Legal_Problem:"Wills and Trusts"},"Property Damage":{Type_Of_Legal_Problem:"Property Damage"},"Other Real Estate Issues":{Type_Of_Legal_Problem:"Real Estate"}}},Fe={Adoption:'Example: "I need help with adoption forms"',"Asbestos and Mesothelioma":'Example: "I was exposed to asbestos at work and would like to file a claim"',"Auto and Car Accidents":'Example: "A truck crashed into my car on the highway" or "I\'ve been involved in a hit and run accident"',Bankruptcy:'Example: "I need help filing for bankruptcy"',"Birth Certificate and Name Change":'Example: "Just married and would like to change my last name"',"Business Lawyers":'Example: "I need help incorporating a business" or "I would like a legal contract reviewed"',"Child Custody and Support":'Example: "Need help getting custody" or "Issues with child support payments"',"Child Custody":'Example: "Need help getting custody"',"Child Support":'Example: "Issues with child support payments"',"Civil Rights and Discrimination":'Example: "Police brutality" or "Coworker keeps harassing me"',"Civil Lawsuit":'Example: "A contractor took my money and never completed the job" or "I am being sued by a neighbor"',"File a Lawsuit":'Example: "A contractor took my money and never completed the job"',"Defend a Lawsuit":'Example: "I am being sued by a neighbor"',"Consumer Lawyers":'Example: "Someone committed fraud against me" or "A contractor took my money and never completed the job"',"Copyrights and Trademarks":'Example: "I would like to register a trademark or copyright a name"',"Criminal and Felony":'Example: "I was arrested for DUI and need legal defense" or "I am being charged with assault"',"Debt and Collections":'Example: "I would like to consolidate my debt" or "A collection agency is harassing me"',"Divorce and Separation":'Example: "I would like to file for an uncontested divorce"',"DUI and DWI":'Example: "I was arrested for DUI and need legal defense"',"Elder Law":'Example: "I would like help with Estate Planning" or "I need help with a guardianship"',"Employment and Workplace":'Example: "I was injured while on the job" or "My company is discriminating against me"',Expungement:'Example: "I would like to file for an expungement and clear my record"',"Family Issues":'Example: "I need help with guardianship" or "I need a simple will created"',Foreclosure:'Example: "I need help to avoid foreclosure on my house"',Guardianship:'Example: "I need help with guardianship documents"',"Harassment and Discrimination":'Example: "I am being discriminated at work" or "My neighbor is harassing me"',"Sexual Harassment":'Example: "I am being sexually harassed by a coworker"',"Workplace Harassment":'Example: "My coworker is being aggressive towards me"',"Non-Workplace Harassment":'Example: "My neighbor is harassing me"',"Workplace Discrimination":'Example: "I am being discriminated at work based on my age"',"Non-Workplace Discrimination":'Example: "I am being discriminated against by a local official"',"Identity Theft":'Example: "Someone stole my identity and I need help fixing the issue"',"Immigration and Visas":'Example: "I need help filing for a visa" or "Help with a green card"',Insurance:'Example: "I need help filing an insurance claim for damage to my house"',"Landlord and Tenant":'Example: "I need help to fight an eviction" or "I would like a lawyer to review a rental contract"',"Lemon Law":'Example: "I purchased a new vehicle that broke down already and seller will not assist"',"Long Term Disability":'Example: "I was injured on the job and would like to file for benefits" or "I need help filing for disability benefits"',"Medical Malpractice":'Example: "A doctor performed surgery on the wrong limb and I would like to file a lawsuit"',"Patents and Intellectual Property":'Example: "I would like to file for a patent" or "I need to copyright a name"',"Personal Injury":'Example: "I was bit by the neighbor\'s dog" or "I fell in the icy grocery store parking lot"',"Power of Attorney":'Example: "I need help with a limited or general power of attorney"',"Probate and Estates":'Example: "I need help with planning for my estate" or "A family member passed without a will in place"',"Product Liability":'Example: "My car battery caught on fire" or "I purchased a faulty product"',"Property Damage":'Example: "The neighbor\'s tree fell on my fence" or "My car was hit in the parking lot"',"Real Estate":'Example: "I need help with a quitclaim deed" or "I need a lawyer to review a purchase and sales agreement"',"Social Security Disability and Insurance":'Example: "I would like help filing for disability benefits" or "I\'ve been denied for SSDI and would like to appeal"',"Tax and IRS":'Example: "I need help fighting an IRS tax claim" or "I need audit defense"',"Traffic and Tickets":'Example: "I need help reinstating a supsended license" or "I would like to fight a traffic ticket"',Unemployment:'Example: "I need help filing for unemployment benefits"',"Victim of a Crime":'Example: "I was assaulted in the store" or "I am being discriminated against at work"',"Wills and Trusts":'Example: "I need a simple will created" or "I would like guidance on creating a trust fund"',"Workers Compensation":'Example: "I broke my arm at work and need help getting compensation"',"Wrongful Death":'Example: "A family member was killed on the job and we need legal representation"',"Wrongful Termination":'Example: "I was fired by my employer without cause"',"Not Sure or Other":'Example: "I was involved in a car accident" or "I need help setting up power of attorney"'},Re={Adoption:"Connect With Adoption Professionals Today","Auto and Car Accidents":"Connect With Accident Professionals Today",Bankruptcy:"Take Control of Your Financial Future","Birth Certificate and Name Change":"Start Your Change Today","Business Lawyers":"Connect With Business Professionals Today","Child Custody":"Connect With Custody Professionals Today","Child Support":"Connect With Child Support Professionals","Civil Rights and Discrimination":"Stand Up For Your Rights","Civil Lawsuit":"Connect With Lawsuit Professionals Today","Copyrights and Trademarks":"Protect Your Intellectual Property","Debt and Collections":"Connect With Debt Professionals Today","Divorce and Separation":"Connect With Divorce Professionals Today","DUI and DWI":"Defend Against DUI Charges","Elder Law":"Connect With Elder Law Professionals",Expungement:"Clear Your Record","Family Issues":"Connect With Family Legal Help",Foreclosure:"Fight to Keep Your Home",Guardianship:"Connect With Guardianship Professionals","Immigration and Visas":"Get Immigration Legal Help",Insurance:"Get Insurance Legal Help","Lemon Law":"Connect With Lemon Law Professionals","Long Term Disability":"Connect With Disability Professionals","Medical Malpractice":"Hold Negligent Providers Accountable","Patents and Intellectual Property":"Connect With IP Professionals Today","Personal Injury":"Maximize Your Injury Compensation","Probate and Estates":"Manage Probate with Expert Guidance","Product Liability":"Get Justice for Faulty Products","Real Estate":"Connect With Real Estate Professionals","Sexual Harassment":"Stand Up Against Sexual Harassment","Social Security Disability and Insurance":"Get the Benefits You Deserve","Tax and IRS":"Connect With Tax Legal Help","Traffic and Tickets":"Protect Your Record Today",Unemployment:"Connect With Unemployment Professionals","Victim of a Crime":"Seek Justice as a Crime Victim","Wills and Trusts":"Plan Your Estate with Confidence","Workers Compensation":"Maximize Your Workers' Comp Benefits","Wrongful Death":"Seek Justice for a Loved One","Wrongful Termination":"Fight Back Against Unfair Firing Today"},He={},Ue=["haveAttorney","degreeOfInterest","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],qe=["haveAttorney","degreeOfInterest","lawyerPaymentMethod","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],Ye=["haveAttorney","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],Ve={values:{Type_Of_Legal_Problem:{Adoption:["maritalStatus","haveChildren",...qe],"Asbestos and Mesothelioma":["incidentDate","doctorTreatment",...Ue],"Auto and Car Accidents":["incidentDate","atFault","primaryInjury","doctorTreatment","policeReportFiled",...Ye],Bankruptcy:["totalMonthlyIncome","totalDebt","ownRealEstate","valueOfAssets",...Ue],"Business Lawyers":["businessServices","businessType","numEmployeesOfBusiness",...Ue],"Child Custody":["childRelationship","childHome","childPrimaryCaregiver",...qe],"Child Support":["childRelationship","childHome","childPrimaryCaregiver",...qe],"Civil Rights and Discrimination":["civilRightsType",...Ue],"Civil Lawsuit":["civilDefense","lawsuitOtherParty",...Ue],"File a Lawsuit":["civilLawsuitTOLPDisplay","lawsuitOtherParty",...Ue],"Defend a Lawsuit":["lawsuitOtherParty",...Ue],"Consumer Lawyers":["consumerLawyerType","incidentDate","lawsuitOtherParty",...Ue],"Criminal and Felony":["criminalTOLPDisplay","crimeCommittedDate","roleInMatterCriminal","pendingCharges",...qe],"Debt and Collections":["totalMonthlyIncome","totalDebt","ownRealEstate","valueOfAssets",...Ue],"Divorce and Separation":["maritalStatus","haveChildren",...qe],"DUI and DWI":["incidentDate","priorAlcoholOffenses","typeOfAlcoholTest","bloodContentAlcoholTest","pendingCharges",...Ue],"Employment and Workplace":["employmentAndWorkplaceTOLPDisplay","numEmployeesOfBusiness","employerType","employeeAtCompany",...Ue],Expungement:["incidentDate","criminalChargeType",...qe],"Family Issues":["maritalStatus","haveChildren",...qe],Foreclosure:["ownRealEstate","typeOfProperty","amountPaymentsPastDue","loanAmount","defaultNotice",...Ue],Guardianship:["maritalStatus","haveChildren",...qe],"Immigration and Visas":["countryOfCitizenship","immigrationLocation","immigrationEntry","immigrationType","immigrationStatus","immigrationDetails",...Ue],"Landlord and Tenant":["landlordTenantIssue","landlordTenantParty",...Ue],"Lemon Law":["incidentDate","lawsuitOtherParty",...Ue],"Long Term Disability":["applicantOccupation","applicantAge","applicantLTDisabilityPolicy","applicantDisabilityHowObtain","applicantPreviouslyAppliedLtdBenefits","applicantReceivedDisabilityBenefits","applicantMonthlySalary",...Ye],"Medical Malpractice":["incidentDate","claimStatus","doctorTreatment","medicalMalpracticeInjuries",...Ue],"Patents and Intellectual Property":["patentAssistanceType","patentFor",...Ue],"Personal Injury":["incidentDate","claimStatus","atFault","primaryInjury","doctorTreatment",...Ye],"Probate and Estates":["valueOfAssets","typeOfAssets","roleInMatterProbate","estateLegalServicesNeeded",...Ue],"Property Damage":["realEstateArea","wouldLikeLawyerTo",...Ue],"Real Estate":["realEstateTOLPDisplay","realEstateArea","wouldLikeLawyerTo",...Ue],"Social Security Disability and Insurance":["applicantAge","disabilityConditionStopWork","disabilityWorkHistory","socialSecurityDisabilityReceivingBenefits","doctorTreatment",...Ye],"Tax and IRS":["totalDebt","taxProblemDetails","taxLevel","taxIssueType",...Ue],"Traffic and Tickets":["driversLicenseType","trafficViolations","haveCourtDate",...Ue],Unemployment:["numEmployeesOfBusiness","employerType","degreeOfInterest","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],"Victim of a Crime":["crimeCommittedDate","roleInMatterCriminal","pendingCharges",...qe],"Wills and Trusts":["valueOfAssets","typeOfAssets","roleInMatterProbate","estateLegalServicesNeeded",...Ue],"Workers Compensation":["incidentDate","claimStatus","primaryInjury","causeOfInjury","doctorTreatment",...Ye],"Workplace Harassment":["numEmployeesOfBusiness","employerType","employeeAtCompany",...Ue],"Workplace Discrimination":["numEmployeesOfBusiness","employerType","employeeAtCompany",...Ue],"Wrongful Death":["incidentDate","relationshipToVictim","criminalChargesFiled","causeOfDeath",...Ye],"Wrongful Termination":["numEmployeesOfBusiness","employerType",...Ue]},"*":Ue}},Ke=Ve.values.Type_Of_Legal_Problem;Ke["Child Custody"],Ke["Child Support"],Ve.values["*"],Ke["Family Issues"],Ke["Child Support"],Ke["Child Custody"],Ve.values["*"],Ke["Divorce and Separation"],Ke["Defend a Lawsuit"],Ke["File a Lawsuit"],Ke["Defend a Lawsuit"],Ke["File a Lawsuit"];const ze={values:{Type_Of_Legal_Problem_Display:{"Automobile Accident":Ke["Auto and Car Accidents"],"Contract Disputes":Ke["Business Lawyers"],"Dog Bite":Ke["Personal Injury"],"Employment and Workplace":Ke["Employment and Workplace"],Fraud:Ke["Consumer Lawyers"],"Medical Malpractice":Ke["Medical Malpractice"],"Personal Injury":Ke["Personal Injury"],"Property Damage":Ke["Property Damage"],"Real Estate":Ke["Real Estate"],"Not Sure or Other":Ve.values["*"]},"*":["lawsuitOtherParty",...Ue]}},Ge={values:{Type_Of_Legal_Problem_Display:{"Victim of a Crime":Ke["Victim of a Crime"],"DUI and DWI":Ke["DUI and DWI"],Expungement:Ke.Expungement,"Not Sure or Other":Ve.values["*"]},"*":["crimeCommittedDate","roleInMatterCriminal","pendingCharges",...qe]}},Qe={values:{Type_Of_Legal_Problem_Display:{"Wrongful Termination":Ke["Wrongful Termination"],"Workers Compensation":Ke["Workers Compensation"],"Personal Injury":Ke["Personal Injury"],Unemployment:Ke.Unemployment},"*":["numEmployeesOfBusiness","employerType","employeeAtCompany",...Ue]}};Ke["Patents and Intellectual Property"],Ke["Business Lawyers"],Ke["Business Lawyers"],Ve.values["*"];const Ze={values:{Type_Of_Legal_Problem_Display:{Foreclosure:Ke.Foreclosure,"Landlord and Tenant":Ke["Landlord and Tenant"],"Wills, Trusts, and Estates":Ke["Wills and Trusts"],"Property Damage":Ke["Property Damage"]},"*":["realEstateArea","wouldLikeLawyerTo",...Ue]}},Je=i,Xe=function(a=null){let n=Fe,i=Re,r=He;return a&&(n=$e(Fe,a),i=$e(Re,a),r=$e(He,a)),{type:"meta",data:e(ke,{tcpaLanguage:"By checking this box, I a) agree to the Terms of Use, and b) consent to be contacted by lawyers, lawyer networks, and partners of this website using live, autodialed, pre-recorded, or artificial voice calls, as well as text messages. Your consent is not required as a condition of purchasing any goods or services. To submit this request without this consent, call 878-213-4937.",defaultCommentsPlaceholder:t,commentsPlaceholders:n,defaultFinalHeadline:"Connect With The Legal Help You Deserve",finalHeadlines:i,defaultFinalSubHeadline:"Get a no-obligation consultation with a legal expert.",finalSubHeadlines:r})}}();Xe.data.dynamicSchema=[function(t={}){return Oe("amountPaymentsPastDue",((t,a,n={})=>(a?P:I)(e({label:a?n.label:"Total Amount of Payments that are Past Due:",name:t?t+":Amount_Payments_Past_Due":"Amount_Payments_Past_Due",options:["$0 - $499","$500 - $999","$1,000 - $2,499","$2,500 - $4,999","$5,000 - $9,999","$10,000 - $24,999","$25,000 - $49,999","$50,000 - $99,999","More than $100,000"]},n)))(t.scope,!0,t.input),"Total amount of payments past due:",t)}(),function(e={}){return Oe("applicantAge",k(e.scope,!0,e.input),"What is the applicant's age?",e)}(),function(t={}){return Oe("applicantDisabilityHowObtain",((t,a,n={})=>(a?g:I)(e({label:a?n.label:"How Did Applicant Obtain the Disability Policy?",name:t?t+":Applicant_Disability_How_Obtain":"Applicant_Disability_How_Obtain",options:["Employer","Self","Other"]},n)))(t.scope,!0,t.input),"How did the applicant obtain the disability policy?",t)}(),function(t={}){return Oe("applicantLTDisabilityPolicy",((t,a,n={})=>(a?_:b)(e({label:a?n.label:"Does Applicant have a Long Term Disability Policy?",name:t?t+":Applicant_Lt_Disability_Policy":"Applicant_Lt_Disability_Policy"},n)))(t.scope,!0,t.input),"Does the applicant have a disability policy?",t)}(),function(t={}){return Oe("applicantMonthlySalary",((t,a,n={})=>(a?P:I)(e({label:a?n.label:"Applicant's Monthly Salary/Pay When Last at Work:",name:t?t+":Applicant_Monthly_Salary":"Applicant_Monthly_Salary",options:["< $1,000","$1,000 - $2,000","$2,000 - $3,000","$3,000 - $4,000","$4,000 - $5,000","$5,000 - $6,000","$6,000 - $7,000","$7,000 - $8,000","$8,000 - $9,000","$9,000 - $10,000",">$10,000"]},n)))(t.scope,!0,t.input),"Applicant's monthly pay when last working:",t)}(),function(t={}){return Oe("applicantOccupation",((t,a,n={})=>(a?S:D)(e({label:a?n.label:"What is the Applicant's Occupation?",placeholder:"Occupation",name:t?t+":Applicant_Occupation":"Applicant_Occupation"},n)))(t.scope,!0,t.input),"What is the applicant's occupation?",t)}({nextOnInput:!1}),function(t={}){return Oe("applicantPreviouslyAppliedLtdBenefits",((t,a,n={})=>(a?C:y)(e({label:a?n.label:"Has Applicant Previously Applied for Long Term Disability Benefits?",name:t?t+":Applicant_Previously_Apply_Ltd_Benefits":"Applicant_Previously_Apply_Ltd_Benefits",options:["Yes, claim pending","Yes, claim denied","No"]},n)))(t.scope,!0,t.input),"Has the applicant previously applied for long-term disability benefits?",t)}(),function(t={}){return Oe("applicantReceivedDisabilityBenefits",((t,a,n={})=>(a?C:y)(e({label:a?n.label:"Has Applicant Ever Received Long Term Disability Benefits for this Claim?",name:t?t+":Applicant_Received_Disability_Benefits":"Applicant_Received_Disability_Benefits",options:["Yes, currently receiving","Yes, appealing a decision to stop payment of benefits","No"]},n)))(t.scope,!0,t.input),"Has the applicant received disability benefits for this claim?",t)}(),function(e={}){return Oe("atFault",E(e.scope,!0,e.input),"Were you at fault?",e)}(),function(e={}){return Oe("bloodContentAlcoholTest",B(e.scope,!0,e.input),"What was your blood alcohol content?",e)}(),function(t={}){return Oe("businessServices",((t,a,n={})=>(a?m:I)(e({label:a?n.label:"Legal Services Needed for Your Business:",name:t?t+":Business_Services":"Business_Services",options:["Business Formation","Contracts","Insurance and Liability","Mergers and Acquisition","Regulatory Compliance","Employee Dispute","Other"]},n)))(t.scope,!0,t.input),"What legal services do you need?",t)}(),function(t={}){return Oe("businessType",((t,a,n={})=>(a?g:f)(e({label:a?n.label:"Is the Business Public or Private?",name:t?t+":Business_Type":"Business_Type",options:["Public","Private"]},n)))(t.scope,!0,t.input),"Is the business public or private?",t)}(),function(t={}){return Oe("causeOfDeath",((t,a,n={})=>(a?m:I)(e({label:a?n.label:"What was the Cause of the Victim's Death?",name:t?t+":Cause_Of_Death":"Cause_Of_Death",options:["Vehicle Accident","Negligent/Careless Act","Reckless Act","Other"]},n)))(t.scope,!0,t.input),"What was the cause of death?",t)}(),function(e={}){return Oe("causeOfInjury",M(e.scope,!0,e.input),"What was the cause of the injury?",e)}(),function(e={}){return Oe("childHome",j(e.scope,!0,e.input),"Who do the children currently live with?",e)}(),function(e={}){return Oe("childPrimaryCaregiver",N(e.scope,!0,e.input),"Who is the primary caregiver?",e)}(),function(e={}){return Oe("childRelationship",F(e.scope,!0,e.input),"Your relationship to the children:",e)}(),function(t={}){return Oe("civilLawsuitTOLPDisplay",((t,a,n={})=>(a?m:c)(e({label:a?n.label:"Select The Type of Lawsuit You Would Like to File:",if:a?null:'$get(Type_Of_Legal_Problem).value == "Civil Lawsuit" && $get(Civil_Defense).value == "File a Lawsuit"',name:t?t+":Type_Of_Legal_Problem_Display":"Type_Of_Legal_Problem_Display",options:["Automobile Accident","Contract Disputes","Defamation and Slander","Dog Bite","Employment and Workplace","Fraud","Medical Malpractice","Personal Injury","Property Damage","Small Claims","Real Estate","Not Sure or Other"]},n)))(t.scope,!0,t.input),"What type of lawsuit would you like to file?",t)}({nextStepMap:ze}),function(t={}){return Oe("civilRightsType",((t,a,n={})=>(a?m:I)(e({label:a?n.label:"On what basis were your rights violated?",name:t?t+":Civil_Rights_Type":"Civil_Rights_Type",options:["Age","Disability","Gender","Race","Religion","Other"]},n)))(t.scope,!0,t.input),"How were your rights violated?",t)}(),function(e={}){return Oe("claimStatus",R(e.scope,!0,e.input),"What is the status of the claim?",e)}(),function(t={}){return Oe("consumerLawyerType",((t,a,n={})=>(a?P:I)(e({label:a?n.label:"What best describes your issue?",name:t?t+":Consumer_Lawyer_Type":"Consumer_Lawyer_Type",options:["Unsafe Environment","Unsafe Products","Auto Fraud","Credit Reporting Issues","Debt Collection Abuse","Identity Theft","Lemon Law","Military Consumer Rights","Predatory Lending","Student Loans","Other"]},n)))(t.scope,!0,t.input),"What best describes your issue?",t)}(),function(t={}){return Oe("countryOfCitizenship",((t,a,n={})=>(a?P:I)(e({label:a?n.label:"What is Your Current Country of Citizenship?",name:t?t+":Country_Of_Citizenship":"Country_Of_Citizenship",options:["Afghanistan","Albania","Algeria","Andorra","Angola","Antigua and Barbuda","Argentina","Armenia","Australia","Austria","Azerbaijan","Bahamas","The Bahrain","Bangladesh","Barbados","Belarus","Belgium","Belize","Benin","Bhutan","Bolivia","Bosnia and Herzegovina","Botswana","Brazil","Brunei","Bulgaria","Burkina Faso","Burundi","Cambodia","Cameroon","Canada","Cape Verde","Central African Republic","Chad","Chile","China","Colombia","Comoros","Congo (Congoâ Kinshasa)","Congo (Congoâ Brazzaville)","Costa Rica","Coted'Ivoire (Ivory Coast)","Croatia","Cuba","Cyprus","Czech Republic","Denmark","Djibouti","Dominica","Dominican Republic","Ecuador","Egypt","El Salvador","Equatorial Guinea","Eritrea","Estonia","Ethiopia","Fiji","Finland","France","Gabon","Gambia","Georgia","Germany","Ghana","Greece","Grenada","Guatemala","Guinea","Guinea-Bissau","Guyana","Haiti","Honduras","Hungary","Iceland","India","Indonesia","Iran","Iraq","Ireland","Israel","Italy","Jamaica","Japan","Jordan","Kazakhstan","Kenya","Kiribati","Korea (North Korea)","Korea (South Korea)","Kuwait","Kyrgyzstan","Laos","Latvia","Lebanon","Lesotho","Liberia","Libya","Liechtenstein","Lithuania","Luxembourg","Macedonia","Madagascar","Malawi","Malaysia","Maldives","Mali","Malta","Marshall Islands","Mauritania","Mauritius","Mexico","Micronesia","Moldova","Monaco","Mongolia","Montenegro","Morocco","Mozambique","Myanmar (Burma)","Namibia","Nauru","Nepal","Netherlands","New Zealand","Nicaragua","Niger","Nigeria","Norway","Oman","Pakistan","Palau","Panama","Papua New Guinea","Paraguay","Peru","Philippines","Poland","Portugal","Qatar","Romania","Russia","Rwanda","Saint Kitts and Nevis","SaintLucia","Saint Vincent and the Grenadines","Samoa","San Marino","Sao Tome and Principe","Saudi Arabia","Senegal","Serbia","Seychelles","Sierra Leone","Singapore","Slovakia","Slovenia","Solomon Islands","Somalia","South Africa","Spain","SriLanka","Sudan","Suriname","Swaziland","Sweden","Switzerland","Syria","Tajikistan","Tanzania","Thailand","Timor-Leste (East Timor)","Togo","Tonga","Trinidad and Tobago","Tunisia","Turkey","Turkmenistan","Tuvalu","Uganda","Ukraine","United Arab Emirates","United Kingdom","United States","Uruguay","Uzbekistan","Vanuatu","Vatican City","Venezuela","Vietnam","Yemen","Zambia","Zimbabwe"]},n)))(t.scope,!0,t.input),"What is your current country of citizenship?",t)}(),function(t={}){return Oe("crimeCommittedDate",((t,a,n={})=>(a?A:L)(e({label:a?n.label:"When was the Alleged Crime?",name:t?t+":Crime_Committed_Date":"Crime_Committed_Date"},n)))(t.scope,!0,t.input),"When was the alleged crime?",t)}({nextOnInput:!1}),function(t={}){return Oe("criminalChargeType",((t,a,n={})=>(a?m:I)(e({label:a?n.label:"What Type of Charge?",name:t?t+":Criminal_Charge_Type":"Criminal_Charge_Type",options:["Felony","Misdemeanor","Juvenile","Other"]},n)))(t.scope,!0,t.input),"What type of criminal charge?",t)}(),function(t={}){return Oe("criminalChargesFiled",((t,a,n={})=>(a?C:y)(e({label:a?n.label:"Were Criminal Charges Filed?",name:t?t+":Criminal_Charges_Filed":"Criminal_Charges_Filed",options:["Yes","No","Not Sure"]},n)))(t.scope,!0,t.input),"Have criminal charges been filed?",t)}(),function(t={}){return Oe("criminalTOLPDisplay",((t,a,n={})=>(a?m:c)(e({label:a?n.label:"Select The Criminal Issue:",if:a?n.if:'$get(Type_Of_Legal_Problem).value == "Criminal and Felony"',name:t?t+":Type_Of_Legal_Problem_Display":"Type_Of_Legal_Problem_Display",options:["Criminal Defense","Victim of a Crime","DUI and DWI","Expungement","Harassment","Not Sure or Other"]},n)))(t.scope,!0,t.input),"Which type of criminal issue?",t)}({nextStepMap:Ge}),function(t={}){return Oe("defaultNotice",((t,a,n={})=>(a?_:b)(e({name:t?t+":Default_Notice":"Default_Notice",label:a?n.label:"Have You Received a Notice of Loan Default?"},n)))(t.scope,!0,t.input),"Have you received a loan default notice?",t)}(),function(e={}){return Oe("degreeOfInterest",U(e.scope,!0,e.input),"Could you pay if your issue could be resolved?",e)}(),function(e={}){return Oe("disabilityConditionStopWork",Y(e.scope,!0,e.input),"Do you expect to be out of work for at least a year?",e)}(),function(e={}){return Oe("disabilityWorkHistory",V(e.scope,!0,e.input),"Have you had a full-time job in the past 5 years?",e)}(),function(e={}){return Oe("doctorTreatment",K(e.scope,!0,e.input),"Have you seen a doctor about this?",e)}(),function(t={}){return Oe("driversLicenseType",((t,a,n={})=>(a?g:h)(e({name:t?t+":Drivers_License_Type":"Drivers_License_Type",label:a?n.label:"Type of Driver's License:",options:["Private","Commercial"]},n)))(t.scope,!0,t.input),"What type of license do you have?",t)}(),function(e={}){return Oe("estateLegalServicesNeeded",z(e.scope,!0,e.input),"What legal services are needed?",e)}(),function(t={}){return Oe("employerType",((t,a,n={})=>(a?m:I)(e({label:a?n.label:"The Employer Is a:",name:t?t+":Employer_Type":"Employer_Type",options:["Sole proprietorship (mom and pop)","Partnership","Franchise","Privately held company","Public corporation","Government Agency","Don't know"]},n)))(t.scope,!0,t.input),"What type of employer is it?",t)}(),function(t={}){return Oe("employeeAtCompany",((t,a,n={})=>(a?_:b)(e({name:t?t+":Employee_At_Company":"Employee_At_Company",label:a?n.label:"Do You Still Work at the Company?"},n)))(t.scope,!0,t.input),"Do you/they still work at the company?",t)}(),function(t={}){return Oe("employmentAndWorkplaceTOLPDisplay",((t,a,n={})=>(a?m:c)(e({label:a?n.label:"Select The Workplace Issue:",name:t?t+":Type_Of_Legal_Problem_Display":"Type_Of_Legal_Problem_Display",options:["Workplace Harassment","Workplace Discrimination","Wrongful Termination","Payment Disputes","Workers Compensation","Personal Injury","Unemployment","Other Workplace Issues"]},n)))(t.scope,!0,t.input),"What type of workplace issue?",t)}({nextStepMap:Qe}),function(e={}){return Oe("haveAttorney",Z(e.scope,!0,e.input),"Already working with an attorney?",e)}(),function(e={}){return Oe("haveChildren",J(e.scope,!0,e.input),"Do you have children?",e)}(),function(t={}){return Oe("haveCourtDate",((t,a,n={})=>(a?_:b)(e({name:t?t+":Have_Court_Date":"Have_Court_Date",label:a?n.label:"Do You Have a Court Date?"},n)))(t.scope,!0,t.input),"Do you have a court date?",t)}(),function(t={}){return Oe("immigrationDetails",((t,a,n={})=>(a?P:I)(e({label:a?n.label:"Where is the Person Seeking Immigration Located?",name:t?t+":Immigration_Details":"Immigration_Details",options:["In the USA with proper documentation","In the USA without proper documentation","Not in the USA","In Deportation/Removal Proceedings","Currently Detained (friend or family submitting this request)","Out on Bond","None Apply"]},n)))(t.scope,!0,t.input),"Where is the person seeking immigration located?",t)}(),function(t={}){return Oe("immigrationEntry",((t,a,n={})=>(a?P:I)(e({label:a?n.label:"How are you Trying to Enter the Country?",name:t?t+":Immigration_Entry":"Immigration_Entry",options:["With Proper Documents/Visa and Inspection through Customs Border Patrol","Illegally","No Entry","Other"]},n)))(t.scope,!0,t.input),"How are you trying to enter the country?",t)}(),function(t={}){return Oe("immigrationLocation",((t,a,n={})=>(a?m:I)(e({label:a?n.label:"Where Are You Migrating To?",name:t?t+":Immigration_Location":"Immigration_Location",options:["In the USA","Outside the USA"]},n)))(t.scope,!0,t.input),"Where are you migrating to?",t)}(),function(t={}){return Oe("immigrationStatus",((t,a,n={})=>(a?P:I)(e({label:a?n.label:"What is the Current Status of the Immigration Case?",name:t?t+":Immigration_Status":"Immigration_Status",options:["Out of Status (overstayed my visa)","Current Visa Holder (in status)","Lawful Permanent Resident (green card)","Not Applicable (outside the USA)","Other"]},n)))(t.scope,!0,t.input),"Current statue of the immigration case:",t)}(),function(t={}){return Oe("immigrationType",((t,a,n={})=>(a?P:I)(e({label:a?n.label:"What Type of Immigration Issue?",name:t?t+":Immigration_Type":"Immigration_Type",options:["Citizenship (for current green card holders)","Permanent Visa Family Based (green cards)","Permanent Visa Business Based (green cards)","Temporary Business Visa","Temporary Tourist Visa","Investor","Asylum","Self Petition (violence & abuse victims)","Removal/Deportation Proceeding","Other"]},n)))(t.scope,!0,t.input),"What type of immigration issue?",t)}(),function(e={}){return Oe("incidentDate",X(e.scope,!0,e.input),"When did the incident occur?",e)}({nextOnInput:!1}),function(t={}){return Oe("landlordTenantIssue",((t,a,n={})=>(a?m:c)(e({label:a?n.label:"What is the Landlord / Tenant Issue?",if:a?n.if:'$get(Type_Of_Legal_Problem).value == "Landlord and Tenant"',id:t?t+":Landlord_Tenant_Issue":"Landlord_Tenant_Issue",name:t?t+":Landlord_Tenant_Issue":"Landlord_Tenant_Issue",options:["Eviction","Repairs and Maintenance","Lease and Rental Agreements","Discrimination","Right of Entry and Privacy","Screening and Applications","Environmental Hazards","Other Dispute"]},n)))(t.scope,!0,t.input),"What is the landlord / tenant issue?",t)}(),function(t={}){return Oe("landlordTenantParty",((t,a,n={})=>(a?g:I)(e({label:a?n.label:"I am the:",name:t?t+":Landlord_Tenant_Party":"Landlord_Tenant_Party",options:["Landlord","Tenant","Other"]},n)))(t.scope,!0,t.input),"I am the:",t)}(),function(t={}){return Oe("lawsuitOtherParty",((t,a,n={})=>(a?m:I)(e({label:a?n.label:"The Other Party is a:",name:t?t+":Lawsuit_Other_Party":"Lawsuit_Other_Party",options:["Individual","Small Business","Large Corporation","Government Entity"]},n)))(t.scope,!0,t.input),"What describes the other party in the lawsuit?",t)}(),function(e={}){return Oe("lawyerPaymentMethod",ee(e.scope,!0,e.input),"How would you pay if a solution required it?",e)}(),function(t={}){return Oe("loanAmount",((t,a,n={})=>(a?P:I)(e({label:a?n.label:"Total Amount of Loan?",name:t?t+":Loan_Amount":"Loan_Amount",options:["Less than $10,000","$10,000 - $24,999","$25,000 - $49,999","$50,000 - $99,999","$100,000 - $199,999","$200,000 - $299,999","$300,000 - $399,999","$400,000 - $499,999","$500,000 - $599,999","More than $600,000"]},n)))(t.scope,!0,t.input),"Total amount of the loan:",t)}(),function(e={}){return Oe("maritalStatus",te(e.scope,!0,e.input),"What is your marital status?",e)}(),function(t={}){return Oe("medicalMalpracticeInjuries",((t,a,n={})=>(a?P:I)(e({label:a?n.label:"Injuries from Medical Malpractice:",name:t?t+":Medical_Malpractice_Injuries":"Medical_Malpractice_Injuries",options:["No Injury","Minor Injury","Disfigurement or cosmetic injury","Short term loss of physical ability","Long term loss of physical injury","Possibility of future harm","Death of Patient"]},n)))(t.scope,!0,t.input),"What injuries did you suffer?",t)}(),function(t={}){return Oe("numEmployeesOfBusiness",((t,a,n={})=>(a?m:I)(e({label:a?n.label:"Total Employees of Business? (estimated)",name:t?t+":Num_Employees_Of_Business":"Num_Employees_Of_Business",options:["1-5","6-20","21-50","51-100","101-500","501-1,000","More than 1,000"]},n)))(t.scope,!0,t.input),"How many employees does the business have?",t)}(),function(t={}){return Oe("ownRealEstate",((t,a,n={})=>(a?_:b)(e({name:t?t+":Own_Real_Estate":"Own_Real_Estate",label:a?n.label:"Do You Own Real Estate?"},n)))(t.scope,!0,t.input),"Do you own real estate?",t)}(),function(t={}){return Oe("patentAssistanceType",((t,a,n={})=>(a?P:I)(e({label:a?n.label:"Legal Assistance Needed:",name:t?t+":Patent_Assistance_Type":"Patent_Assistance_Type",options:["Obtaining a Patent","Avoiding Patent Infringement","Suing for Patent Infringement","Defending Against a Claim of Patent Infringement","Other"]},n)))(t.scope,!0,t.input),"What type of assistance do you need?",t)}(),function(t={}){return Oe("patentFor",((t,a,n={})=>(a?m:I)(e({label:a?n.label:"The Patent is for a:",name:t?t+":Patent_For":"Patent_For",options:["Product or Machine","Process","Computer Software","Living Organism or Plant","Ornamental Design","Other"]},n)))(t.scope,!0,t.input),"What is the patent for?",t)}(),function(e={}){return Oe("pendingCharges",ae(e.scope,!0,e.input),"Do you have any pending charges?",e)}(),function(e={}){return Oe("policeReportFiled",re(e.scope,!0,e.input),"Was a police report filed?",e)}(),function(e={}){return Oe("primaryInjury",ne(e.scope,!0,e.input),"What was the primary injury?",e)}(),function(e={}){return Oe("priorAlcoholOffenses",ie(e.scope,!0,e.input),"Do you have prior alcohol offenses?",e)}(),function(t={}){return Oe("realEstateArea",((t,a,n={})=>(a?m:I)(e({label:a?n.label:"Area of Real Estate:",name:t?t+":Real_Estate_Area":"Real_Estate_Area",options:["Condos and Coops","Construction Disputes","Purchase/Sale Contract","Refinancing Agreement","Title and Boundary Disputes","Zoning, Planning and Land Use","Property Deeds and Transfers","Liens","Other"]},n)))(t.scope,!0,t.input),"What area of real estate?",t)}(),function(t={}){return Oe("realEstateTOLPDisplay",((t,a,n={})=>(a?m:c)(e({label:a?n.label:"Select The Real Estate Issue:",if:a?n.if:'$get(Type_Of_Legal_Problem).value == "Real Estate"',name:t?t+":Type_Of_Legal_Problem_Display":"Type_Of_Legal_Problem_Display",options:["Contracts and Agreements","Deeds, Liens, and Titles","Foreclosure","Insurance","Landlord and Tenant","Loans and Mortgages","Wills, Trusts, and Estates","Property Damage","Not Sure or Other"]},n)))(t.scope,!0,t.input),"What type of real estate issue?",t)}({nextStepMap:Ze}),function(t={}){return Oe("relationshipToVictim",((t,a,n={})=>(a?m:I)(e({label:a?n.label:"Relationship to the Victim:",name:t?t+":Relationship_To_Victim":"Relationship_To_Victim",options:["Parent","Spouse","Sibling","Friend","Other"]},n)))(t.scope,!0,t.input),"What is your relationship to the victim?",t)}(),function(t={}){return Oe("roleInMatterCriminal",((t,a,n={})=>(a?C:y)(e({label:a?n.label:"What is Your Role in this Matter?",name:t?t+":Role_In_Matter_Criminal":"Role_In_Matter_Criminal",options:["I have been accused","I am acting on behalf of someone who has been accused","Other"]},n)))(t.scope,!0,t.input),"What is your role in this matter?",t)}(),function(e={}){return Oe("roleInMatterProbate",se(e.scope,!0,e.input),"What is your role in this matter?",e)}(),function(e={}){return Oe("socialSecurityDisabilityReceivingBenefits",oe(e.scope,!0,e.input),"Are you receiving Social Security Disability benefits?",e)}(),function(t={}){return Oe("taxIssueType",((t,a,n={})=>(a?m:I)(e({label:a?n.label:"Type of Tax Issue:",name:t?t+":Tax_Issue_Type":"Tax_Issue_Type",options:["Income","Property","Corporate"]},n)))(t.scope,!0,t.input),"What type of tax issue?",t)}(),function(t={}){return Oe("taxLevel",((t,a,n={})=>(a?m:I)(e({label:a?n.label:"Which Level of Tax Issue?",name:t?t+":Tax_Level":"Tax_Level",options:["Federal","State","Local"]},n)))(t.scope,!0,t.input),"What level of tax issue?",t)}(),function(t={}){return Oe("taxProblemDetails",((t,a,n={})=>(a?P:I)(e({label:a?n.label:"Details of Tax Problem:",name:t?t+":Tax_Problem_Details":"Tax_Problem_Details",options:["Assets Seized","Bank Account Levied","Cannot Pay Taxes","Innocent Spouse","Lien Filed","Received Audit Notice","Unpaid Interest","Wage Garnishment","Other"]},n)))(t.scope,!0,t.input),"Details of the tax problem:",t)}(),function(t={}){return Oe("totalDebt",((t,a,n={})=>(a?m:I)(e({label:a?n.label:"Total Debt?",name:t?t+":Total_Debt":"Total_Debt",options:["Less than 5K","5K to 10K","10K to 20K","20K to 50K","More than 50K"]},n)))(t.scope,!0,t.input),"What is your total debt?",t)}(),function(t={}){return Oe("totalMonthlyIncome",((t,a,n={})=>(a?P:I)(e({label:a?n.label:"Total Monthly Income?",name:t?t+":Total_Monthly_Income":"Total_Monthly_Income",options:["Less than 1K","1K to 2K","2K to 3K","3K to 4K","4K to 5K","5K to 7K","7K to 10K","10K to 15K","More than 15K"]},n)))(t.scope,!0,t.input),"What is your total monthly income?",t)}(),function(t={}){return Oe("trafficViolations",((t,a,n={})=>(a?P:I)(e({label:a?n.label:"Which Type of Violation?",name:t?t+":Traffic_Violations":"Traffic_Violations",options:["Disregarding a Red Light","Disregarding a Stop Sign","DMV Letter About License","DUI/DWI","Failure to Appear in Court","License Suspended/Revoked","Minor in Possession of Alcohol","No Child Safety Seat","No Liability Insurance","No Seat Belt","Open Container of Alcohol","Parking Ticket","Racing","Speeding","Unpaid Traffic Tickets","Warrant Issue for Arrest","Other Violation"]},n)))(t.scope,!0,t.input),"What type of traffic violation?",t)}(),function(e={}){return Oe("typeOfAlcoholTest",ue(e.scope,!0,e.input),"What type of alcohol test was performed?",e)}(),function(e={}){return void 0===e.nextOnInput&&(e.nextOnInput=!1),Oe("typeOfAssets",pe(e.scope,!0,e.input),"What type of assets are involved?",e)}(),function(t={}){return Oe("typeOfProperty",((t,a,n={})=>(a?m:I)(e({label:a?n.label:"Type of Property:",name:t?t+":Type_Of_Property":"Type_Of_Property",options:["Residential","Commercial","Industrial","Agricultural","Recreational","Other"]},n)))(t.scope,!0,t.input),"What type of property is involved?",t)}(),function(e={}){return Oe("valueOfAssets",de(e.scope,!0,e.input),"What is the value of your assets?",e)}(),function(t={}){return Oe("veteransDisabilityApplied",((t,a,n={})=>(a?P:I)(e({label:a?n.label:"Has the Applicant Applied for VA Disability Compensation?",name:t?t+":Veterans_Disability_Applied":"Veterans_Disability_Applied",options:["Yes, Claim filed and awaiting decision","Yes, Claim denied","Yes, Claim on appeal","Yes, Claim approved","Yes, Benefits awarded","No, Claim has not been filed"]},n)))(t.scope,!0,t.input),"Has the applicant applied for VA disability benefits?",t)}(),function(t={}){return Oe("veteransDisabilityConditions",((t,a,n={})=>(a?o:l)(e({label:a?n.label:"What Service Connected Conditions Does the Applicant Have?",name:t?t+":Veterans_Disability_Conditions":"Veterans_Disability_Conditions",options:["Traumatic Physical Injury (broken bones, loss of limb)","Mental Injury","Occupational Disease","Repeated Trauma Injury","Other"]},n)))(t.scope,!0,t.input),"What conditions or injuries are applicable?",t)}(),function(t={}){return Oe("veteransDisabilityInjured",((t,a,n={})=>(a?_:b)(e({name:t?t+":Veterans_Disability_Injured":"Veterans_Disability_Injured",label:a?n.label:"Was the Applicant Hurt While on Duty or is the Condition Related to Military Service?"},n)))(t.scope,!0,t.input),"Is the condition or injury related to military service?",t)}(),function(t={}){return Oe("veteransDisabilityRelationship",((t,a,n={})=>(a?P:I)(e({label:a?n.label:"What is Your Relationship to the Applicant?",name:t?t+":Veterans_Disability_Relationship":"Veterans_Disability_Relationship",options:["Self, Active Duty","Self, Active Reserve","Self, Discharged from Active Duty","Self, Discharged as Reservist","Surviving Family Member","Other"]},n)))(t.scope,!0,t.input),"What is your relationship to the applicant?",t)}(),function(t={}){return Oe("wouldLikeLawyerTo",((t,a,n={})=>(a?C:y)(e({label:a?n.label:"I Would Like a Lawyer to:",name:t?t+":Would_Like_Lawyer_To":"Would_Like_Lawyer_To",options:["Give me general advice to protect my interests","Act as my agent in the transaction","Assist me in the remaining stages of the transaction","Bring a lawsuit against another party","Defend against a lawsuit filed by another party","Other"]},n)))(t.scope,!0,t.input),"I would like the lawyer to:",t)}(),function(e={}){return Oe("zipcode",((e,t,a={})=>(t?S:D)({label:t?a.label:"Zip Code:",help:t?a.help??"We try to match you with local help":null,placeholder:"#####",name:e?e+":Zip":"Zip",maxlength:5,inputmode:"numeric",autocomplete:"postal-code",validation:"required|matches:/^[0-9]{5}$/",validationMessages:{required:"Zip Code is required",matches:"Invalid Zip Code"},...a}))(e.scope,!0,e.input),"Please verify your Zip Code",e)}(),function(e={}){return xe("commentsWithBankruptcy",[Pe(e),H(e.scope,0,{label:void 0===e.label?"Please briefly describe your legal issue in a few words:":e.label,placeholder:e.placeholder||t,inputClass:void 0===e.inputClass?"!t-h-32":e.inputClass}),l({label:"I'd also like a consult for bankruptcy or debt elimination (optional)",help:"Note: you will be contacted separately by a bankruptcy/debt expert",name:a?a+":CrossSell_Bankruptcy":"CrossSell_Bankruptcy",id:a?a+":CrossSell_Bankruptcy":"CrossSell_Bankruptcy",if:'$getVal($get(form), "Type_Of_Legal_Problem") != "Bankruptcy" && ($getVal($get(form), "Degree_Of_Interest") == "Absolutely Can\'t Afford" || $getVal($get(form), "Degree_Of_Interest") == "Maybe" || $getVal($get(form), "Degree_Of_Interest") == "Probably")',validation:null,helpClass:"!t-text-sm"}),{$el:"div",if:"$get(CrossSell_Bankruptcy).value == true",children:[H("CrossSell:Bankruptcy",0,{label:"Bankruptcy or debt details:",placeholder:"Please describe your bankrtupcy or debt situation in a few words...",inputClass:"!t-h-16"})]}],{nextOnEnter:!1});var a}({label:null,headline:"Please briefly describe your situation:",headlineClass:"!t-text-dark"}),function(e={}){return e.nextOnInput=!1,e.stepKey="$get(Type_Of_Legal_Problem).value",xe("legalCrossSells",[De(e),u({id:"Legal_CrossSells",name:"Legal_CrossSells",help:'Just hit "Next" if none apply',helpClass:"t-text-center !t-text-sm",validation:null,options:'$getCrossSellOptions($get(form), $getVal($get(form), "Type_Of_Legal_Problem"))'})],e)}({headlineClass:"!t-text-dark",nextStepMap:{values:{Legal_CrossSells:{"Auto and Car Accidents":["autoAndCarAccidentCrossSellQuestions"],"Personal Injury":["personalInjuryCrossSellQuestions"],"Workers Compensation":["workersCompensationCrossSellQuestions"],"DUI and DWI":["duiAndDWICrossSellQuestions"],"Long Term Disability":["longTermDisabilityCrossSellQuestions"],"Social Security Disability and Insurance":["ssdiCrossSellQuestions"],Bankruptcy:["bankruptcyCrossSellQuestions"],"Power of Attorney":["powerOfAttorneyCrossSellQuestions"],"Wills and Trusts":["willsAndTrustsCrossSellQuestions"],"Divorce and Separation":["divorceAndSeparationCrossSellQuestions"],"Child Custody":["childCustodyCrossSellQuestions"]},"*":["firstAndLast","contactInfo"]},appendSteps:["firstAndLast","contactInfo"],matchesAllowed:1}}),function(e={}){return xe("autoAndCarAccidentCrossSellQuestions",[_e({headline:"You May Be Entitled To Compensation"}),Ce({subheadline:"Tell us about your accident:"}),(t="true",a="CrossSell:Auto_and_Car_Accidents",ce("AutoAndCarAccidentsQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Auto and Car Accidents"',children:[Z(a),X(a),E(a),ne(a),K(a),re(a)]})),H("CrossSell:Auto_and_Car_Accidents",0,{label:"Accident Description:",placeholder:"Please describe your accident in a few words...",inputClass:"!t-h-16"})],e);var t,a}(),function(e={}){return xe("personalInjuryCrossSellQuestions",[_e({headline:"You May Be Entitled To Compensation"}),Ce({subheadline:"Tell us about your injury:"}),(t="true",a="CrossSell:Personal_Injury",ce("PersonalInjuryQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Personal Injury"',children:[Z(a),X(a),R(a),E(a),ne(a),K(a)]})),H("CrossSell:Personal_Injury",0,{label:"Injury Description:",placeholder:"Please describe your injury in a few words...",inputClass:"!t-h-16"})],e);var t,a}(),function(e={}){return xe("workersCompensationCrossSellQuestions",[_e({headline:"You May Be Entitled To Benefits"}),Ce({subheadline:"Tell us about your injury:"}),(t="true",a="CrossSell:Workers_Compensation",ce("WorkersCompensationQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Workers Compensation"',children:[Z(a),X(a),R(a),ne(a),M(a),K(a)]})),H("CrossSell:Workers_Compensation",0,{label:"Injury Description:",placeholder:"Please describe your injury in a few words...",inputClass:"!t-h-16"})],e);var t,a}(),function(e={}){return xe("duiAndDWICrossSellQuestions",[_e({headline:"About Your DUI/DWI"}),(t="true",a="CrossSell:DUI_and_DWI",ce("DUIAndDWIQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "DUI and DWI"',children:[Z(a),X(a),ie(a),ue(a),B(a),ae(a),q(a)]})),H("CrossSell:DUI_and_DWI",0,{label:"Incident Description:",placeholder:"Please describe your incident in a few words...",inputClass:"!t-h-16"})],e);var t,a}(),function(e={}){return xe("ssdiCrossSellQuestions",[_e({headline:"You May Be Entitled To Benefits"}),Ce({subheadline:"Tell us about your disability:"}),(t="true",a="CrossSell:Social_Security_Disability_and_Insurance",ce("SocialSecurityDisabilityAndInsuranceQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Social Security Disability and Insurance"',children:[Z(a),k(a),Y(a),V(a),oe(a),K(a)]})),H("CrossSell:Social_Security_Disability_and_Insurance",0,{label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"})],e);var t,a}(),function(e={}){return xe("powerOfAttorneyCrossSellQuestions",[_e({headline:"Power of Attorney Information"}),(t="true",a="CrossSell:Power_of_Attorney",ce("PowerofAttorneyQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Power of Attorney"',children:[Z(a),q(a)]})),H("CrossSell:Power_of_Attorney",0,{label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"})],e);var t,a}(),function(e={}){return xe("willsAndTrustsCrossSellQuestions",[_e({headline:"Will or Trust Information"}),(t="true",a="CrossSell:Wills_and_Trusts",ce("WillsAndTrustsQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Wills and Trusts"',children:[Z(a),de(a),pe(a),se(a),z(a),q(a)]})),H("CrossSell:Wills_and_Trusts",0,{label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"})],e);var t,a}(),function(e={}){return xe("divorceAndSeparationCrossSellQuestions",[_e({headline:"Divorce or Separation Information"}),(t="true",a="CrossSell:Divorce_and_Separation",ce("DivorceQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Divorce and Separation"',children:[Z(a),te(a),J(a),U(a),ee(a)]})),H("CrossSell:Divorce_and_Separation",0,{label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"})],e);var t,a}(),function(e={}){return xe("childCustodyCrossSellQuestions",[_e({headline:"Child Custody Information"}),(t="true",a="CrossSell:Child_Custody",ce("ChildCustodyQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Child Custody"',children:[Z(a),F(a),j(a),N(a),U(a),ee(a)]})),H("CrossSell:Child_Custody",0,{label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"})],e);var t,a}(),function(e={}){return xe("firstAndLast",[Te({headline:e.headline??"Who is looking for help?",headlineClass:e.headlineClass}),Ie({subheadline:e.subheadline??"We never share info without consent",subheadlineClass:"!t-text-sm !t-text-gray-500"}),O(e.scope),W(e.scope)],e)}({headlineClass:"!t-text-dark"})];const et=[Xe,e(Ee,tt),{$cmp:"FormKit",props:function(t){const a=e(We,t);return a.formId&&!a.name&&(a.name=a.formId),a}({formId:"generalLegalSingle",redirectMap:function(t){return e(je,t)}(),valueOverrideMap:Ne,crossSellOptionMap:Je}),children:[function(t){return e(Be,t)}(),function(t={}){return e(function(e={}){return{$el:"h1",attrs:{class:"t-flex t-justify-center t-text-center t-text-[2rem] t-font-semibold t-pt-5 t-px-7 md:t-px-3 "+(e.headlineClass||"")+" f-first-headline"}}}(t),t)}({children:'$urlParam("hl", "Need Legal Help? Start Here!")',if:"$activeStep === $firstStep()"}),function(t={}){return e(function(e={}){return{$el:"h3",attrs:{class:"t-flex t-justify-center t-text-center t-text-[1.1rem] md:t-text-[1.2rem] t-font-medium t-text-blue-500 t-px-10 t-pb-3 "+(e.subheadlineClass||"")+" f-first-subheadline"}}}(t),t)}({children:'$urlParam("shl", "Our Service is Fast and Free!")',if:"$activeStep === $firstStep()"}),...Me,{$el:"div",attrs:{class:"form-body"},children:[function(e={}){return xe("generalTOLP",[Q(e.scope,!0,e.input)],e)}({nextOnInput:!1,nextStepMap:Ve,headlineClass:"t-text-lg",input:{placeholder:"Select a Category",innerClass:"!t-max-w-[275px] md:!t-max-w-xl"}}),function(e="Type_Of_Legal_Problem"){return{$cmp:"FormKitSchema",if:"$get("+e+").value",props:{schema:"$meta.dynamicSchema",data:"$buildData($meta)"}}}(),function(e={}){return xe("contactInfo",[Se(e),we(e),{$el:"script",if:"$activeStep === $lastStep()",children:Le},x(e.scope),$(e.scope),le(e.scope),ge()],{nextOnEnter:!1})}(),((e={})=>({$el:"div",attrs:{class:{if:"$activeStep === $firstStep()",then:"step-nav "+(e.firstStepButtonClass||"!t-justify-center sm:!t-justify-between"),else:"step-nav !t-justify-between"}},children:[{$formkit:"button",name:"back_button",onClick:"$setPreviousStep($prevStepFunc($get(form)))",children:"Back",outerClass:{if:"$activeStep === $firstStep()",then:"t-hidden sm:t-block",else:""},style:{if:"$activeStep === $firstStep()",then:"display: none;"},classes:{input:(e.inputClass||"")+" f-navigation-input"}},{$formkit:"button",name:"next_button",onClick:"$setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form)))",children:{if:"$activeStep === $firstStep()",then:e.startText||"Start",else:"Next"},outerClass:{if:"$activeStep === $lastStep()",then:"t-hidden",else:""},style:{if:"$activeStep === $lastStep()",then:"display: none;"},classes:{input:(e.inputClass||"")+" f-navigation-input"}},{$formkit:"submit",name:"submit_button",label:e.submitLabel||"Submit",if:"$activeStep === $lastStep()",style:{if:"$activeStep !== $lastStep()",then:"display: none;"},classes:{input:(e.inputClass||"")+" !t-ml-2 sm:!t-ml-auto f-navigation-input"}}]}))(),{$el:"pre",if:'$urlParam("fdbg", "") == 1',children:[{$el:"pre",children:"$stringify( $get(form).value )",attrs:{class:"t-text-xs",style:"overflow: scroll"}},{$el:"pre",children:["activeStep: ","$activeStep"],attrs:{class:"t-text-xs",style:"overflow: scroll"}},{$el:"pre",children:["stepHistory: ","$stepHistory"],attrs:{class:"t-text-xs",style:"overflow: scroll"}},{$el:"pre",children:["stepQueue: ","$stepQueue"],attrs:{class:"t-text-xs",style:"overflow: scroll"}},{$el:"pre",children:["steps: ","$stepKeys()"],attrs:{class:"t-text-xs",style:"overflow: scroll"}}]}]}]}];var tt;const at=et.find((e=>"FormKit"===e.$cmp));return at.props.name="generalLegalPopUnderSingle",at.props.formId="generalLegalPopUnderSingle",at.props.popUnderMap={"*":"/thank-you"},et}();