bhl-forms 0.6.10 → 0.6.12

This diff represents the content of publicly available package versions that have been released to one of the supported registries. The information contained in this diff is provided for informational purposes only and reflects changes between package versions as they appear in their respective public registries.
Files changed (69) hide show
  1. package/dist/bhl-forms.iife.js +1 -1
  2. package/dist/bhl-forms.modern.iife.js +7 -7
  3. package/dist/bhl-forms.modern.umd.js +1 -1
  4. package/dist/bhl-forms.umd.js +1 -1
  5. package/dist/forms/accidentsAndInjuries.es.js +29 -28
  6. package/dist/forms/accidentsAndInjuries.iife.js +1 -1
  7. package/dist/forms/business.es.js +38 -36
  8. package/dist/forms/business.iife.js +1 -1
  9. package/dist/forms/business.json +1 -1
  10. package/dist/forms/childAndFamily.es.js +29 -28
  11. package/dist/forms/childAndFamily.iife.js +1 -1
  12. package/dist/forms/childAndFamilySingle.es.js +38 -36
  13. package/dist/forms/childAndFamilySingle.iife.js +1 -1
  14. package/dist/forms/childAndFamilySingle.json +1 -1
  15. package/dist/forms/civilLawsuit.es.js +45 -43
  16. package/dist/forms/civilLawsuit.iife.js +1 -1
  17. package/dist/forms/civilLawsuit.json +1 -1
  18. package/dist/forms/contracts.es.js +29 -28
  19. package/dist/forms/contracts.iife.js +1 -1
  20. package/dist/forms/criminal.es.js +39 -37
  21. package/dist/forms/criminal.iife.js +1 -1
  22. package/dist/forms/criminal.json +1 -1
  23. package/dist/forms/divorce.es.js +38 -36
  24. package/dist/forms/divorce.iife.js +1 -1
  25. package/dist/forms/divorce.json +1 -1
  26. package/dist/forms/employmentAndWorkplace.es.js +44 -42
  27. package/dist/forms/employmentAndWorkplace.iife.js +1 -1
  28. package/dist/forms/employmentAndWorkplace.json +1 -1
  29. package/dist/forms/generalLegal.es.js +29 -28
  30. package/dist/forms/generalLegal.iife.js +1 -1
  31. package/dist/forms/generalLegalPopUnder.es.js +29 -28
  32. package/dist/forms/generalLegalPopUnder.iife.js +1 -1
  33. package/dist/forms/generalLegalPopUnderSingle.es.js +45 -43
  34. package/dist/forms/generalLegalPopUnderSingle.iife.js +1 -1
  35. package/dist/forms/generalLegalPopUnderSingle.json +1 -1
  36. package/dist/forms/generalLegalSingle.es.js +45 -43
  37. package/dist/forms/generalLegalSingle.iife.js +1 -1
  38. package/dist/forms/generalLegalSingle.json +1 -1
  39. package/dist/forms/generalLegalThankYou.es.js +19 -20
  40. package/dist/forms/generalLegalThankYou.iife.js +1 -1
  41. package/dist/forms/harassmentAndDiscrimination.es.js +29 -28
  42. package/dist/forms/harassmentAndDiscrimination.iife.js +1 -1
  43. package/dist/forms/landlordTenant.es.js +38 -36
  44. package/dist/forms/landlordTenant.iife.js +1 -1
  45. package/dist/forms/landlordTenant.json +1 -1
  46. package/dist/forms/malpractice.es.js +29 -28
  47. package/dist/forms/malpractice.iife.js +1 -1
  48. package/dist/forms/mechanics.es.js +824 -34
  49. package/dist/forms/mechanics.iife.js +1 -1
  50. package/dist/forms/mechanics.json +1 -1
  51. package/dist/forms/patentsAndIP.es.js +38 -36
  52. package/dist/forms/patentsAndIP.iife.js +1 -1
  53. package/dist/forms/patentsAndIP.json +1 -1
  54. package/dist/forms/realEstate.es.js +29 -28
  55. package/dist/forms/realEstate.iife.js +1 -1
  56. package/dist/forms/repossession.es.js +29 -28
  57. package/dist/forms/repossession.iife.js +1 -1
  58. package/dist/forms/ssdi.es.js +25 -25
  59. package/dist/forms/ssdi.iife.js +1 -1
  60. package/dist/forms/ssdi.json +1 -1
  61. package/dist/forms/testForm.es.js +18 -19
  62. package/dist/forms/testForm.iife.js +1 -1
  63. package/dist/forms/testRedirects.es.js +8 -2
  64. package/dist/forms/testRedirects.iife.js +1 -1
  65. package/dist/forms/testRedirects.json +1 -1
  66. package/dist/forms/willsAndTrusts.es.js +29 -28
  67. package/dist/forms/willsAndTrusts.iife.js +1 -1
  68. package/dist/main.css +1 -1
  69. package/package.json +1 -1
@@ -1 +1 @@
1
- [{"type":"meta","data":{"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":"$getKey($meta, \"commentsPlaceholders.\" + $get(Type_Of_Legal_Problem).value, $meta.defaultCommentsPlaceholder)","commentsPlaceholders":{"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 was injured at work and would like to file for workers compensation benefits\"","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\""},"defaultFinalHeadline":"Submit Your Case","finalHeadlines":{},"defaultFinalSubHeadline":"You may benefit from speaking with a legal professional. Please verify your contact information.","finalSubHeadlines":{"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."}}},{"$el":"div","children":[{"$el":"div","attrs":{"id":"form-anchor","class":"t-absolute","style":{"top":"-30px","left":0}}}],"attrs":{"class":"t-relative"}},{"$cmp":"FormKit","props":{"type":"form","id":"form","config":{"validationVisibility":"submit"},"onSubmit":"$submit($submitUrl, $prepData, $handleRedirect, \"text/plain; charset=UTF-8\")","plugins":"$plugins","actions":false,"anchorElement":"form-anchor","useLocalStorage":true,"prepop":{"fromURL":true},"errorCodes":{"403":{"message":"An Error Occurred","abort":false},"409":{"abort":false},"429":"An Error Occurred","504":{"message":"An Error Occurred","abort":false}},"formClass":"!t-max-w-[40rem]","formId":"ssdi","redirectMap":{"*":"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}"},"name":"ssdi"},"children":[{"$el":"div","attrs":{"class":"t-mt-7 t-mb-5 t-w-full t-flex t-flex-col t-justify-center t-items-center","style":{"if":"$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":[{"$el":"div","attrs":{"id":"progress-bar","class":"t-flex t-flex-col t-justify-center t-text-center t-whitespace-nowrap t-w-[10%] t-h-1.5 t-rounded t-text-white t-bg-[#007bff]","style":{"transition":"width 0.5s ease"}}}]}]},{"$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 !t-text-dark"},"children":"$urlParam(\"hl\", \"Start Your FREE Case Evaluation\")","if":"$activeStep === $firstStep()","headlineClass":"!t-text-dark"},{"$el":"h3","attrs":{"class":"t-flex t-justify-center t-text-center !t-text-[1.2rem] t-font-medium t-text-blue-500 t-px-10 !t-text-[#00428A]"},"children":"$urlParam(\"shl\", \"You Could Receive up to $3,148 Per Month!\")","if":"$activeStep === $firstStep()","subheadlineClass":"!t-text-[#00428A]"},{"$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},{"$formkit":"hidden","name":"s","value":null},{"$el":"div","attrs":{"class":"form-body"},"children":[{"$el":"section","if":"$stepEnabled(\"ssdiTOLPAndZip\")","attrs":{"hidden":"$activeStep !== \"ssdiTOLPAndZip\"","key":"ssdiTOLPAndZip"},"children":[{"$formkit":"group","id":"ssdiTOLPAndZip","name":"ssdiTOLPAndZip","children":[{"$formkit":"hidden","name":"Type_Of_Legal_Problem","id":"Type_Of_Legal_Problem","value":"Social Security Disability and Insurance"},{"$formkit":"text","validation":"required|matches:/^[0-9]{5}$/","validationMessages":{"required":"Zip Code is required","matches":"Invalid Zip Code"},"labelClass":"required","placeholder":"#####","help":"We try to match you with local legal help","name":"Zip","maxlength":5,"inputmode":"numeric","autocomplete":"postal-code","wrapperClass":"t-flex t-justify-center","messagesClass":"t-flex t-justify-center","inputClass":"t-text-center","helpClass":"t-mt-2.5 !t-text-sm t-text-center","id":"Zip","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"section","if":"$stepEnabled(\"ssdiApplicantAge\")","attrs":{"hidden":"$activeStep !== \"ssdiApplicantAge\"","key":"ssdiApplicantAge"},"children":[{"$formkit":"group","id":"ssdiApplicantAge","name":"ssdiApplicantAge","children":[{"$el":"h3","children":"What is the Age of the Applicant?","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-dark t-pb-5 t-pt-0 t-px-1 "}},{"$formkit":"text","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"},"labelClass":"required","name":"Applicant_Age","value":"50","placeholder":"Age between 18 and 65","maxlength":2,"inputmode":"numeric","wrapperClass":"t-flex t-justify-center","messagesClass":"t-flex t-justify-center","inputClass":"t-text-center","id":"Applicant_Age","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))","onInput":"$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"section","if":"$stepEnabled(\"ssdiDisabilityConditionStopWork\")","attrs":{"hidden":"$activeStep !== \"ssdiDisabilityConditionStopWork\"","key":"ssdiDisabilityConditionStopWork"},"children":[{"$formkit":"group","id":"ssdiDisabilityConditionStopWork","name":"ssdiDisabilityConditionStopWork","children":[{"$el":"h3","children":"Do You Expect To Be Out Of Work For At Least a Year Due To Your Health?","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-dark t-pb-5 t-pt-0 t-px-1 "}},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-flex t-justify-center t-my-3","legendClass":"legend-left","name":"Disability_Condition_Stop_Work","options":["Yes","No"],"fieldsetClass":"$reset t-flex t-justify-center t-items-center","optionClass":"radiobtn t-my-2 sm:t-my-0 t-mx-2 md:t-mx-5","wrapperClass":"$reset formkit-wrapper t-mb-0 t-flex t-items-center t-h-[100%]","labelClass":"t-font-semibold t-text-[#1e448f] t-w-[100%]","decoratorIcon":false,"messagesClass":"t-flex t-justify-center","id":"Disability_Condition_Stop_Work","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))","onInput":"$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"section","if":"$stepEnabled(\"ssdiDisabilityWorkHistory\")","attrs":{"hidden":"$activeStep !== \"ssdiDisabilityWorkHistory\"","key":"ssdiDisabilityWorkHistory"},"children":[{"$formkit":"group","id":"ssdiDisabilityWorkHistory","name":"ssdiDisabilityWorkHistory","children":[{"$el":"h3","children":"Have You Had a Full-Time Job Within the Past 5 Years?","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-dark t-pb-5 t-pt-0 t-px-1 "}},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-flex t-justify-center t-my-3","legendClass":"legend-left","name":"Disability_Work_History","options":["Yes","No"],"fieldsetClass":"$reset t-flex t-justify-center t-items-center","optionClass":"radiobtn t-my-2 sm:t-my-0 t-mx-2 md:t-mx-5","wrapperClass":"$reset formkit-wrapper t-mb-0 t-flex t-items-center t-h-[100%]","labelClass":"t-font-semibold t-text-[#1e448f] t-w-[100%]","decoratorIcon":false,"messagesClass":"t-flex t-justify-center","id":"Disability_Work_History","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))","onInput":"$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"section","if":"$stepEnabled(\"ssdiSocialSecurityDisabilityReceivingBenefits\")","attrs":{"hidden":"$activeStep !== \"ssdiSocialSecurityDisabilityReceivingBenefits\"","key":"ssdiSocialSecurityDisabilityReceivingBenefits"},"children":[{"$formkit":"group","id":"ssdiSocialSecurityDisabilityReceivingBenefits","name":"ssdiSocialSecurityDisabilityReceivingBenefits","children":[{"$el":"h3","children":"Are You Currently Receiving Social Security Disability Benefits?","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-dark t-pb-5 t-pt-0 t-px-1 "}},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-flex t-justify-center t-my-3","legendClass":"legend-left","name":"Social_Security_Disability_Receiving_Benefits","options":["Yes","No"],"fieldsetClass":"$reset t-flex t-justify-center t-items-center","optionClass":"radiobtn t-my-2 sm:t-my-0 t-mx-2 md:t-mx-5","wrapperClass":"$reset formkit-wrapper t-mb-0 t-flex t-items-center t-h-[100%]","labelClass":"t-font-semibold t-text-[#1e448f] t-w-[100%]","decoratorIcon":false,"messagesClass":"t-flex t-justify-center","id":"Social_Security_Disability_Receiving_Benefits","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))","onInput":"$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"section","if":"$stepEnabled(\"ssdiDoctorTreatment\")","attrs":{"hidden":"$activeStep !== \"ssdiDoctorTreatment\"","key":"ssdiDoctorTreatment"},"children":[{"$formkit":"group","id":"ssdiDoctorTreatment","name":"ssdiDoctorTreatment","children":[{"$el":"h3","children":"Have You Recently Been Treated by a Doctor, Hospital or Clinic?","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-dark t-pb-5 t-pt-0 t-px-1 "}},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-flex t-justify-center t-my-3","legendClass":"legend-left","name":"Doctor_Treatment","options":["Yes","No"],"fieldsetClass":"$reset t-flex t-justify-center t-items-center","optionClass":"radiobtn t-my-2 sm:t-my-0 t-mx-2 md:t-mx-5","wrapperClass":"$reset formkit-wrapper t-mb-0 t-flex t-items-center t-h-[100%]","labelClass":"t-font-semibold t-text-[#1e448f] t-w-[100%]","decoratorIcon":false,"messagesClass":"t-flex t-justify-center","id":"Doctor_Treatment","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))","onInput":"$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"section","if":"$stepEnabled(\"ssdiHaveAttorney\")","attrs":{"hidden":"$activeStep !== \"ssdiHaveAttorney\"","key":"ssdiHaveAttorney"},"children":[{"$formkit":"group","id":"ssdiHaveAttorney","name":"ssdiHaveAttorney","children":[{"$el":"h3","children":"Already Working with An Attorney?","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-dark t-pb-5 t-pt-0 t-px-1 "}},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-flex t-justify-center t-my-3","legendClass":"legend-left","name":"Have_Attorney","options":["Yes","No"],"fieldsetClass":"$reset t-flex t-justify-center t-items-center","optionClass":"radiobtn t-my-2 sm:t-my-0 t-mx-2 md:t-mx-5","wrapperClass":"$reset formkit-wrapper t-mb-0 t-flex t-items-center t-h-[100%]","labelClass":"t-font-semibold t-text-[#1e448f] t-w-[100%]","decoratorIcon":false,"messagesClass":"t-flex t-justify-center","id":"Have_Attorney","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))","onInput":"$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"section","if":"$stepEnabled(\"commentsWithBankruptcy\")","attrs":{"hidden":"$activeStep !== \"commentsWithBankruptcy\"","key":"commentsWithBankruptcy"},"children":[{"$formkit":"group","id":"commentsWithBankruptcy","name":"commentsWithBankruptcy","children":[{"$el":"h3","children":"Please briefly describe your situation:","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 !t-text-dark"}},{"$formkit":"textarea","rows":5,"maxlength":500,"validation":"required","validationMessages":{"required":"Field is required"},"innerClass":"t-max-w-xl","labelClass":"required","name":"Comments","label":null,"placeholder":"$getKey($meta, \"commentsPlaceholders.\" + $get(Type_Of_Legal_Problem).value, $meta.defaultCommentsPlaceholder)","inputClass":"!t-h-32","id":"Comments"},{"$formkit":"checkbox","validation":null,"validationMessages":{"required":"Field is required"},"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":"CrossSell_Bankruptcy","id":"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\")","helpClass":"!t-text-sm","legendClass":"legend-left required","fieldsetClass":"$reset side-by-side","optionsClass":"t-pl-1","innerClass":"t-flex t-items-center","wrapperClass":"t-mb-3"},{"$el":"div","if":"$get(CrossSell_Bankruptcy).value == true","children":[{"$formkit":"textarea","rows":5,"maxlength":500,"validation":"required","validationMessages":{"required":"Field is required"},"innerClass":"t-max-w-xl","labelClass":"required","name":"CrossSell:Bankruptcy:Comments","label":"Bankruptcy or debt details:","placeholder":"Please describe your bankrtupcy or debt situation in a few words...","inputClass":"!t-h-16","id":"CrossSell:Bankruptcy:Comments"}]}]}]},{"$el":"section","if":"$stepEnabled(\"firstAndLast\")","attrs":{"hidden":"$activeStep !== \"firstAndLast\"","key":"firstAndLast"},"children":[{"$formkit":"group","id":"firstAndLast","name":"firstAndLast","children":[{"$el":"h3","children":"Please Provide a Contact Name","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 !t-text-dark"}},{"$formkit":"text","validation":"required","validationMessages":{"required":"First Name is required"},"labelClass":"required","label":"First Name:","placeholder":"First","name":"First_Name","autocomplete":"given-name","wrapperClass":"side-by-side t-items-center","id":"First_Name"},{"$formkit":"text","validation":"required","validationMessages":{"required":"Last Name is required"},"labelClass":"required","label":"Last Name:","placeholder":"Last","name":"Last_Name","autocomplete":"family-name","wrapperClass":"side-by-side t-items-center","id":"Last_Name","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"section","if":"$stepEnabled(\"contactInfo\")","attrs":{"hidden":"$activeStep !== \"contactInfo\"","key":"contactInfo"},"children":[{"$formkit":"group","id":"contactInfo","name":"contactInfo","children":[{"$el":"h3","children":"Submit Your Free Application","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-3 t-pt-0 t-px-1 !t-text-[#00428A]"}},{"$el":"h5","children":"Based on your input you may qualify for SSDI benefits. Please verify your contact information.","attrs":{"class":"t-flex t-justify-center t-text-center !t-text-lg t-font-semibold t-pb-7 t-pt-0 t-px-3 "}},{"$el":"script","if":"$activeStep === $lastStep()","children":"(function() {\n if (window.xxTrustedFormLoaded) {\n return\n }\n var vid = '';\n if (typeof window.zar !== 'undefined') {\n vid = window.zar.getVID();\n }\n window.xxTrustedFormLoaded = true;\n var sandbox = document.location.hostname.indexOf('localhost') > -1 ? 'true' : 'false'\n var tf = document.createElement('script');\n tf.type = 'text/javascript'; tf.async = true;\n tf.src = (\"https:\" == document.location.protocol ? 'https' : 'http') + \"://api.trustedform.com/trustedform.js?field=xxTrustedFormCertUrl&identifier=\" + vid + \"&ping_field=xxTrustedFormPingUrl&provideReferrer=false&invert_field_sensitivity=true&sandbox=\" + sandbox + \"&l=\" + new Date().getTime() + Math.random();\n var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(tf, s);\n})();"},{"$formkit":"email","validation":"required|email","validationMessages":{"required":"Email is required","email":"Invalid Email"},"labelClass":"required","name":"Email","label":"Email Address:","placeholder":"email@domain.com","autocomplete":"email","data-tf-sensitive":"false","wrapperClass":"side-by-side t-items-center","id":"Email"},{"$formkit":"tel","validation":"required|matches:/^[0-9]{3}-?[0-9]{3}-?[0-9]{4}$/|valid_phone","validationMessages":{"required":"Field is required","matches":"Invalid Phone Format, use ###-###-####","valid_phone":"Invalid Phone Number"},"labelClass":"required","name":"Primary_Phone","label":"Phone Number:","placeholder":"###-###-####","maxlength":12,"help":"10-digit phone number, hyphens optional","autocomplete":"tel-national","data-tf-sensitive":"false","helpClass":"t-mt-2.5 md:t-text-right md:t-mt-[-2px]","wrapperClass":"side-by-side t-items-center","id":"Primary_Phone"},{"$formkit":"checkbox","label":"$meta.tcpaLanguage","name":"TCPA_Opt_In","data-tf-sensitive":"false","validation":"required|accepted","validationMessages":{"required":"Consent is required","accepted":"Consent is required"},"classes":{"label":"t-text-xs t-text-slate-500 t-font-normal"}},{"$el":"div","if":"$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"}},{"$el":"span","children":"Secure & Encrypted","attrs":{"class":"t-pl-2 t-pt-1 t-font-medium"}}]}]}]},{"$el":"div","attrs":{"class":"step-nav"},"children":[{"$formkit":"button","name":"back_button","onClick":"$setPreviousStep($prevStepFunc($get(form)))","children":"Back","style":{"if":"$activeStep === $firstStep()","then":"visibility: hidden;"}},{"$formkit":"button","name":"next_button","onClick":"$setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form)))","children":{"if":"$activeStep === $firstStep()","then":"Start","else":"Next"},"outerClass":{"if":"$activeStep === $lastStep()","then":"t-hidden","else":""},"style":{"if":"$activeStep === $lastStep()","then":"display: none;"}},{"$formkit":"submit","name":"submit_button","label":"Submit","if":"$activeStep === $lastStep()","style":{"if":"$activeStep !== $lastStep()","then":"display: none;"}}]},{"$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: ","$stepKeys()"],"attrs":{"class":"t-text-xs","style":"overflow: scroll"}}]}]}]}]
1
+ [{"type":"meta","data":{"tcpaLanguage":"By checking this box, I a) agree to the Terms of Use, and b) consent to be contacted by lawyers, lawyer networks, and partners of this website using live, autodialed, pre-recorded, or artificial voice calls, as well as text messages. Your consent is not required as a condition of purchasing any goods or services. To submit this request without this consent, call 878-213-4937.","defaultCommentsPlaceholder":"$getKey($meta, \"commentsPlaceholders.\" + $get(Type_Of_Legal_Problem).value, $meta.defaultCommentsPlaceholder)","commentsPlaceholders":{"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 was injured at work and would like to file for workers compensation benefits\"","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\""},"defaultFinalHeadline":"Submit Your Case","finalHeadlines":{},"defaultFinalSubHeadline":"You may benefit from speaking with a legal professional. Please verify your contact information.","finalSubHeadlines":{"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."}}},{"$el":"div","children":[{"$el":"div","attrs":{"id":"form-anchor","class":"t-absolute","style":{"top":"-30px","left":0}}}],"attrs":{"class":"t-relative"}},{"$cmp":"FormKit","props":{"type":"form","id":"form","config":{"validationVisibility":"submit"},"onSubmit":"$submit($submitUrl, $prepData, $handleRedirect, \"text/plain; charset=UTF-8\")","plugins":"$plugins","actions":false,"anchorElement":"form-anchor","useLocalStorage":true,"prepop":{"fromURL":true},"errorCodes":{"403":{"message":"An Error Occurred","abort":false},"409":{"abort":false},"429":"An Error Occurred","504":{"message":"An Error Occurred","abort":false}},"formClass":"!t-max-w-[40rem]","formId":"ssdi","redirectMap":{"*":"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}"},"name":"ssdi"},"children":[{"$el":"div","attrs":{"class":"t-mt-7 t-mb-5 t-w-full t-flex t-flex-col t-justify-center t-items-center","style":{"if":"$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":[{"$el":"div","attrs":{"id":"progress-bar","class":"t-flex t-flex-col t-justify-center t-text-center t-whitespace-nowrap t-w-[10%] t-h-1.5 t-rounded t-text-white t-bg-[#007bff]","style":{"transition":"width 0.5s ease"}}}]}]},{"$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 !t-text-dark"},"children":"$urlParam(\"hl\", \"Start Your FREE Case Evaluation\")","if":"$activeStep === $firstStep()","headlineClass":"!t-text-dark"},{"$el":"h3","attrs":{"class":"t-flex t-justify-center t-text-center !t-text-[1.2rem] t-font-medium t-text-blue-500 t-px-10 !t-text-[#00428A]"},"children":"$urlParam(\"shl\", \"You Could Receive up to $3,148 Per Month!\")","if":"$activeStep === $firstStep()","subheadlineClass":"!t-text-[#00428A]"},{"$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},{"$formkit":"hidden","name":"s","value":null},{"$el":"div","attrs":{"class":"form-body"},"children":[{"$el":"section","if":"$stepEnabled(\"ssdiTOLPAndZip\")","attrs":{"hidden":"$activeStep !== \"ssdiTOLPAndZip\"","key":"ssdiTOLPAndZip"},"children":[{"$formkit":"group","id":"ssdiTOLPAndZip","name":"ssdiTOLPAndZip","children":[{"$formkit":"hidden","name":"Type_Of_Legal_Problem","id":"Type_Of_Legal_Problem","value":"Social Security Disability and Insurance"},{"$formkit":"text","validation":"required|matches:/^[0-9]{5}$/","validationMessages":{"required":"Zip Code is required","matches":"Invalid Zip Code"},"labelClass":"required","placeholder":"#####","help":"We try to match you with local legal help","name":"Zip","maxlength":5,"inputmode":"numeric","autocomplete":"postal-code","wrapperClass":"t-flex t-justify-center","messagesClass":"t-flex t-justify-center","inputClass":"t-text-center","helpClass":"t-mt-2.5 !t-text-sm t-text-center","id":"Zip","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"section","if":"$stepEnabled(\"ssdiApplicantAge\")","attrs":{"hidden":"$activeStep !== \"ssdiApplicantAge\"","key":"ssdiApplicantAge"},"children":[{"$formkit":"group","id":"ssdiApplicantAge","name":"ssdiApplicantAge","children":[{"$el":"h3","children":"What is the Age of the Applicant?","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-dark t-pb-5 t-pt-0 t-px-1 "}},{"$formkit":"text","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"},"labelClass":"required","name":"Applicant_Age","value":"50","placeholder":"Age between 18 and 65","maxlength":2,"inputmode":"numeric","wrapperClass":"t-flex t-justify-center","messagesClass":"t-flex t-justify-center","inputClass":"t-text-center","id":"Applicant_Age","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))","onInput":"$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"section","if":"$stepEnabled(\"ssdiDisabilityConditionStopWork\")","attrs":{"hidden":"$activeStep !== \"ssdiDisabilityConditionStopWork\"","key":"ssdiDisabilityConditionStopWork"},"children":[{"$formkit":"group","id":"ssdiDisabilityConditionStopWork","name":"ssdiDisabilityConditionStopWork","children":[{"$el":"h3","children":"Do You Expect To Be Out Of Work For At Least a Year Due To Your Health?","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-dark t-pb-5 t-pt-0 t-px-1 "}},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-flex t-justify-center t-my-3","legendClass":"legend-left","name":"Disability_Condition_Stop_Work","options":["Yes","No"],"fieldsetClass":"$reset t-flex t-justify-center t-flex-col-reverse t-items-center","optionClass":"radiobtn t-my-2 sm:t-my-0 t-mx-2 md:t-mx-5","wrapperClass":"$reset formkit-wrapper t-mb-0 t-flex t-items-center t-h-[100%]","labelClass":"t-font-semibold t-text-[#1e448f] t-w-[100%]","decoratorIcon":false,"messagesClass":"t-flex t-justify-center","helpClass":"t-mt-2.5 !t-text-sm t-text-center","id":"Disability_Condition_Stop_Work","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))","onInput":"$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"section","if":"$stepEnabled(\"ssdiDisabilityWorkHistory\")","attrs":{"hidden":"$activeStep !== \"ssdiDisabilityWorkHistory\"","key":"ssdiDisabilityWorkHistory"},"children":[{"$formkit":"group","id":"ssdiDisabilityWorkHistory","name":"ssdiDisabilityWorkHistory","children":[{"$el":"h3","children":"Have You Had a Full-Time Job Within the Past 5 Years?","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-dark t-pb-5 t-pt-0 t-px-1 "}},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-flex t-justify-center t-my-3","legendClass":"legend-left","name":"Disability_Work_History","options":["Yes","No"],"fieldsetClass":"$reset t-flex t-justify-center t-flex-col-reverse t-items-center","optionClass":"radiobtn t-my-2 sm:t-my-0 t-mx-2 md:t-mx-5","wrapperClass":"$reset formkit-wrapper t-mb-0 t-flex t-items-center t-h-[100%]","labelClass":"t-font-semibold t-text-[#1e448f] t-w-[100%]","decoratorIcon":false,"messagesClass":"t-flex t-justify-center","helpClass":"t-mt-2.5 !t-text-sm t-text-center","id":"Disability_Work_History","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))","onInput":"$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"section","if":"$stepEnabled(\"ssdiSocialSecurityDisabilityReceivingBenefits\")","attrs":{"hidden":"$activeStep !== \"ssdiSocialSecurityDisabilityReceivingBenefits\"","key":"ssdiSocialSecurityDisabilityReceivingBenefits"},"children":[{"$formkit":"group","id":"ssdiSocialSecurityDisabilityReceivingBenefits","name":"ssdiSocialSecurityDisabilityReceivingBenefits","children":[{"$el":"h3","children":"Are You Currently Receiving Social Security Disability Benefits?","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-dark t-pb-5 t-pt-0 t-px-1 "}},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-flex t-justify-center t-my-3","legendClass":"legend-left","name":"Social_Security_Disability_Receiving_Benefits","options":["Yes","No"],"fieldsetClass":"$reset t-flex t-justify-center t-flex-col-reverse t-items-center","optionClass":"radiobtn t-my-2 sm:t-my-0 t-mx-2 md:t-mx-5","wrapperClass":"$reset formkit-wrapper t-mb-0 t-flex t-items-center t-h-[100%]","labelClass":"t-font-semibold t-text-[#1e448f] t-w-[100%]","decoratorIcon":false,"messagesClass":"t-flex t-justify-center","helpClass":"t-mt-2.5 !t-text-sm t-text-center","id":"Social_Security_Disability_Receiving_Benefits","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))","onInput":"$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"section","if":"$stepEnabled(\"ssdiDoctorTreatment\")","attrs":{"hidden":"$activeStep !== \"ssdiDoctorTreatment\"","key":"ssdiDoctorTreatment"},"children":[{"$formkit":"group","id":"ssdiDoctorTreatment","name":"ssdiDoctorTreatment","children":[{"$el":"h3","children":"Have You Recently Been Treated by a Doctor, Hospital or Clinic?","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-dark t-pb-5 t-pt-0 t-px-1 "}},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-flex t-justify-center t-my-3","legendClass":"legend-left","name":"Doctor_Treatment","options":["Yes","No"],"fieldsetClass":"$reset t-flex t-justify-center t-flex-col-reverse t-items-center","optionClass":"radiobtn t-my-2 sm:t-my-0 t-mx-2 md:t-mx-5","wrapperClass":"$reset formkit-wrapper t-mb-0 t-flex t-items-center t-h-[100%]","labelClass":"t-font-semibold t-text-[#1e448f] t-w-[100%]","decoratorIcon":false,"messagesClass":"t-flex t-justify-center","helpClass":"t-mt-2.5 !t-text-sm t-text-center","id":"Doctor_Treatment","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))","onInput":"$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"section","if":"$stepEnabled(\"ssdiHaveAttorney\")","attrs":{"hidden":"$activeStep !== \"ssdiHaveAttorney\"","key":"ssdiHaveAttorney"},"children":[{"$formkit":"group","id":"ssdiHaveAttorney","name":"ssdiHaveAttorney","children":[{"$el":"h3","children":"Already Working with An Attorney?","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-dark t-pb-5 t-pt-0 t-px-1 "}},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-flex t-justify-center t-my-3","legendClass":"legend-left","name":"Have_Attorney","options":["Yes","No"],"fieldsetClass":"$reset t-flex t-justify-center t-flex-col-reverse t-items-center","optionClass":"radiobtn t-my-2 sm:t-my-0 t-mx-2 md:t-mx-5","wrapperClass":"$reset formkit-wrapper t-mb-0 t-flex t-items-center t-h-[100%]","labelClass":"t-font-semibold t-text-[#1e448f] t-w-[100%]","decoratorIcon":false,"messagesClass":"t-flex t-justify-center","helpClass":"t-mt-2.5 !t-text-sm t-text-center","id":"Have_Attorney","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))","onInput":"$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"section","if":"$stepEnabled(\"commentsWithBankruptcy\")","attrs":{"hidden":"$activeStep !== \"commentsWithBankruptcy\"","key":"commentsWithBankruptcy"},"children":[{"$formkit":"group","id":"commentsWithBankruptcy","name":"commentsWithBankruptcy","children":[{"$el":"h3","children":"Please briefly describe your situation:","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 !t-text-dark"}},{"$formkit":"textarea","rows":5,"maxlength":500,"validation":"required","validationMessages":{"required":"Field is required"},"innerClass":"t-max-w-xl","labelClass":"required","name":"Comments","label":null,"placeholder":"$getKey($meta, \"commentsPlaceholders.\" + $get(Type_Of_Legal_Problem).value, $meta.defaultCommentsPlaceholder)","inputClass":"!t-h-32","id":"Comments"},{"$formkit":"checkbox","validation":null,"validationMessages":{"required":"Field is required"},"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":"CrossSell_Bankruptcy","id":"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\")","helpClass":"!t-text-sm","legendClass":"legend-left required","fieldsetClass":"$reset side-by-side","optionsClass":"t-pl-1","innerClass":"t-flex t-items-center","wrapperClass":"t-mb-3"},{"$el":"div","if":"$get(CrossSell_Bankruptcy).value == true","children":[{"$formkit":"textarea","rows":5,"maxlength":500,"validation":"required","validationMessages":{"required":"Field is required"},"innerClass":"t-max-w-xl","labelClass":"required","name":"CrossSell:Bankruptcy:Comments","label":"Bankruptcy or debt details:","placeholder":"Please describe your bankrtupcy or debt situation in a few words...","inputClass":"!t-h-16","id":"CrossSell:Bankruptcy:Comments"}]}]}]},{"$el":"section","if":"$stepEnabled(\"firstAndLast\")","attrs":{"hidden":"$activeStep !== \"firstAndLast\"","key":"firstAndLast"},"children":[{"$formkit":"group","id":"firstAndLast","name":"firstAndLast","children":[{"$el":"h3","children":"Please Provide a Contact Name","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 !t-text-dark"}},{"$formkit":"text","validation":"required","validationMessages":{"required":"First Name is required"},"labelClass":"required","label":"First Name:","placeholder":"First","name":"First_Name","autocomplete":"given-name","wrapperClass":"side-by-side t-items-center","id":"First_Name"},{"$formkit":"text","validation":"required","validationMessages":{"required":"Last Name is required"},"labelClass":"required","label":"Last Name:","placeholder":"Last","name":"Last_Name","autocomplete":"family-name","wrapperClass":"side-by-side t-items-center","id":"Last_Name","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"section","if":"$stepEnabled(\"contactInfo\")","attrs":{"hidden":"$activeStep !== \"contactInfo\"","key":"contactInfo"},"children":[{"$formkit":"group","id":"contactInfo","name":"contactInfo","children":[{"$el":"h3","children":"Submit Your Free Application","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-3 t-pt-0 t-px-1 !t-text-[#00428A]"}},{"$el":"h5","children":"Based on your input you may qualify for SSDI benefits. Please verify your contact information.","attrs":{"class":"t-flex t-justify-center t-text-center !t-text-lg t-font-semibold t-pb-7 t-pt-0 t-px-3 "}},{"$el":"script","if":"$activeStep === $lastStep()","children":"(function() {\n if (window.xxTrustedFormLoaded) {\n return\n }\n var vid = '';\n if (typeof window.zar !== 'undefined') {\n vid = window.zar.getVID();\n }\n window.xxTrustedFormLoaded = true;\n var sandbox = document.location.hostname.indexOf('localhost') > -1 ? 'true' : 'false'\n var tf = document.createElement('script');\n tf.type = 'text/javascript'; tf.async = true;\n tf.src = (\"https:\" == document.location.protocol ? 'https' : 'http') + \"://api.trustedform.com/trustedform.js?field=xxTrustedFormCertUrl&identifier=\" + vid + \"&ping_field=xxTrustedFormPingUrl&provideReferrer=false&invert_field_sensitivity=true&sandbox=\" + sandbox + \"&l=\" + new Date().getTime() + Math.random();\n var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(tf, s);\n})();"},{"$formkit":"email","validation":"required|email","validationMessages":{"required":"Email is required","email":"Invalid Email"},"labelClass":"required","name":"Email","label":"Email Address:","placeholder":"email@domain.com","autocomplete":"email","data-tf-sensitive":"false","wrapperClass":"side-by-side t-items-center","id":"Email"},{"$formkit":"tel","validation":"required|matches:/^[0-9]{3}-?[0-9]{3}-?[0-9]{4}$/|valid_phone","validationMessages":{"required":"Field is required","matches":"Invalid Phone Format, use ###-###-####","valid_phone":"Invalid Phone Number"},"labelClass":"required","name":"Primary_Phone","label":"Phone Number:","placeholder":"###-###-####","maxlength":12,"help":"10-digit phone number, hyphens optional","autocomplete":"tel-national","data-tf-sensitive":"false","helpClass":"t-mt-2.5 md:t-text-right md:t-mt-[-2px]","wrapperClass":"side-by-side t-items-center","id":"Primary_Phone"},{"$formkit":"checkbox","label":"$meta.tcpaLanguage","name":"TCPA_Opt_In","data-tf-sensitive":"false","validation":"required|accepted","validationMessages":{"required":"Consent is required","accepted":"Consent is required"},"classes":{"label":"t-text-xs t-text-slate-500 t-font-normal"}},{"$el":"div","if":"$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"}},{"$el":"span","children":"Secure & Encrypted","attrs":{"class":"t-pl-2 t-pt-1 t-font-medium"}}]}]}]},{"$el":"div","attrs":{"class":"step-nav"},"children":[{"$formkit":"button","name":"back_button","onClick":"$setPreviousStep($prevStepFunc($get(form)))","children":"Back","style":{"if":"$activeStep === $firstStep()","then":"visibility: hidden;"}},{"$formkit":"button","name":"next_button","onClick":"$setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form)))","children":{"if":"$activeStep === $firstStep()","then":"Start","else":"Next"},"outerClass":{"if":"$activeStep === $lastStep()","then":"t-hidden","else":""},"style":{"if":"$activeStep === $lastStep()","then":"display: none;"}},{"$formkit":"submit","name":"submit_button","label":"Submit","if":"$activeStep === $lastStep()","style":{"if":"$activeStep !== $lastStep()","then":"display: none;"}}]},{"$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"}}]}]}]}]
@@ -63,9 +63,9 @@ const category = () => sbsSelect({
63
63
  ]
64
64
  });
65
65
 
66
- const email = () => sbsText({
66
+ const email = (scope) => sbsText({
67
67
  $formkit: 'email',
68
- name: 'Email',
68
+ name: scope ? scope + ':' + 'Email' : 'Email',
69
69
  label: 'Email Address:',
70
70
  placeholder: 'email@domain.com',
71
71
  autocomplete: 'email',
@@ -77,31 +77,31 @@ const email = () => sbsText({
77
77
  }
78
78
  });
79
79
 
80
- const firstName = () => sbsText({
80
+ const firstName = (scope) => sbsText({
81
81
  $formkit: 'text',
82
82
  label: 'First Name:',
83
83
  placeholder: 'First',
84
- name: 'First_Name',
84
+ name: scope ? scope + ':' + 'First_Name' : 'First_Name',
85
85
  autocomplete: "given-name",
86
86
  validationMessages: {
87
87
  required: 'First Name is required'
88
88
  }
89
89
  });
90
90
 
91
- const lastName = () => sbsText({
91
+ const lastName = (scope) => sbsText({
92
92
  $formkit: 'text',
93
93
  label: 'Last Name:',
94
94
  placeholder: 'Last',
95
- name: 'Last_Name',
95
+ name: scope ? scope + ':' + 'Last_Name' : 'Last_Name',
96
96
  autocomplete: "family-name",
97
97
  validationMessages: {
98
98
  required: 'Last Name is required'
99
99
  }
100
100
  });
101
101
 
102
- const phone = () => sbsText({
102
+ const phone = (scope) => sbsText({
103
103
  $formkit: 'tel',
104
- name: 'Primary_Phone',
104
+ name: scope ? scope + ':' + 'Primary_Phone' : 'Primary_Phone',
105
105
  label: 'Phone Number:',
106
106
  placeholder: '###-###-####',
107
107
  maxlength: 12,
@@ -117,10 +117,10 @@ const phone = () => sbsText({
117
117
  helpClass: "t-mt-2.5 md:t-text-right md:t-mt-[-2px]"
118
118
  });
119
119
 
120
- const TCPAConsent = () => ({
120
+ const TCPAConsent = (scope) => ({
121
121
  $formkit: 'checkbox',
122
122
  label: '$meta.tcpaLanguage',
123
- name: 'TCPA_Opt_In',
123
+ name: scope ? scope + ':' + 'TCPA_Opt_In' : 'TCPA_Opt_In',
124
124
  'data-tf-sensitive': 'false',
125
125
  validation: 'required|accepted',
126
126
  validationMessages: {
@@ -132,10 +132,10 @@ const TCPAConsent = () => ({
132
132
  }
133
133
  });
134
134
 
135
- const zipcode = () => sbsText({
135
+ const zipcode = (scope) => sbsText({
136
136
  label: 'Zip Code:',
137
137
  placeholder: '#####',
138
- name: 'Zip',
138
+ name: scope ? scope + ':' + 'Zip' : 'Zip',
139
139
  maxlength: 5,
140
140
  inputmode: "numeric",
141
141
  autocomplete: 'postal-code',
@@ -292,6 +292,7 @@ function step(name, inputs, nextOnEnter = true, nextOnInput = false, stepKey = u
292
292
  )
293
293
  }
294
294
 
295
+
295
296
  function categoryAndZip(updates = {}) {
296
297
  return step(
297
298
  'categoryAndZip',
@@ -310,9 +311,9 @@ function contactInfo(updates = {}) {
310
311
  contactStepHeadline(updates),
311
312
  contactStepSubHeadline(updates),
312
313
  trustedFormScript(),
313
- email(),
314
- phone(),
315
- TCPAConsent(),
314
+ email(updates.scope),
315
+ phone(updates.scope),
316
+ TCPAConsent(updates.scope),
316
317
  secureIcon()
317
318
  ],
318
319
  false, // nextOnEnter
@@ -330,9 +331,7 @@ function firstAndLast(updates = {}) {
330
331
  )
331
332
  }
332
333
 
333
- // ------ Common
334
-
335
- const formNavigation = () => ({
334
+ const formNavigation = (updates = {}) => ({
336
335
  $el: 'div',
337
336
  attrs: {
338
337
  class: 'step-nav'
@@ -370,7 +369,7 @@ const formNavigation = () => ({
370
369
  {
371
370
  $formkit: 'submit',
372
371
  name: 'submit_button',
373
- label: 'Submit',
372
+ label: updates.submitLabel || 'Submit',
374
373
  if: '$activeStep === $lastStep()',
375
374
  style: {
376
375
  if: '$activeStep !== $lastStep()',
@@ -1 +1 @@
1
- var testForm=function(){"use strict";function e(){return Object.assign({},...arguments)}const t='$getKey($meta, "finalHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalHeadline)',a='$getKey($meta, "finalSubHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalSubHeadline)',i=t=>(t.labelClass="required",t.wrapperClass="side-by-side t-items-center",t.innerClass="select-height-content",t.helpClass="t-mt-2.5 md:t-text-right md:t-mt-[-5px]",(t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"select",placeholder:"Please Select",validation:"required",validationMessages:{required:"Field is required"},inputClass:"t-bg-white",labelClass:"required"},t)))(t)),n=t=>(t.wrapperClass="side-by-side t-items-center",(t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"text",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required"},t)))(t)),r="$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",o="$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",l=e=>"group"!==e.type&&"section"!==e.type&&"form"!==e.type&&"hidden"!==e.$formkit&&!e.children,s=e=>{if(l(e))return e;for(var t=e.children.length-1;t>=0;t--){if("string"==typeof e.children)continue;const a=e.children[t];if(l(a))return a;const i=s(a);if(i)return i}return null},d={$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"}},{$el:"span",children:"Secure & Encrypted",attrs:{class:"t-pl-2 t-pt-1 t-font-medium"}}]};function m(t){return e(d,t)}function c(e){return{$el:"h3",children:e.headline||t,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||"")}}}function p(e){return{$el:"h5",children:e.subheadline||a,attrs:{class:"t-flex t-justify-center t-text-center !t-text-lg t-font-semibold t-pb-7 t-pt-0 t-px-3 "+(e.subheadlineClass||"")}}}const u="(function() {\n if (window.xxTrustedFormLoaded) {\n return\n }\n var vid = '';\n if (typeof window.zar !== 'undefined') {\n vid = window.zar.getVID();\n }\n window.xxTrustedFormLoaded = true;\n var sandbox = document.location.hostname.indexOf('localhost') > -1 ? 'true' : 'false'\n var tf = document.createElement('script');\n tf.type = 'text/javascript'; tf.async = true;\n tf.src = (\"https:\" == document.location.protocol ? 'https' : 'http') + \"://api.trustedform.com/trustedform.js?field=xxTrustedFormCertUrl&identifier=\" + vid + \"&ping_field=xxTrustedFormPingUrl&provideReferrer=false&invert_field_sensitivity=true&sandbox=\" + sandbox + \"&l=\" + new Date().getTime() + Math.random();\n var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(tf, s);\n})();";const f=(e,t)=>({$el:"section",if:'$stepEnabled("'+e+'")',attrs:{hidden:'$activeStep !== "'+e+'"',key:t||e}});function h(t,a,i=!0,n=!1,l=void 0,d=void 0,m=void 0){if(void 0===i&&(i=!0),a&&a.length&&(i||n)){const e=s(a[a.length-1]);e&&!0===i&&(e.onKeypress=r),e&&!0===n&&(e.onInput=o)}return e(f(t,l),{children:[{$formkit:"group",id:t,name:t,nextStepMap:d,autoFocus:m,children:a}]})}const y={type:"form",id:"form",config:{validationVisibility:"submit"},onSubmit:'$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 g(e,t){return Object.fromEntries(Object.entries(e).filter((([e])=>t.includes(e))))}const b={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."};const x={$el:"div",children:[{$el:"div",attrs:{id:"form-anchor",class:"t-absolute",style:{top:"-30px",left:0}}}],attrs:{class:"t-relative"}};const v=[{$formkit:"hidden",name:"vertical",value:"Legal"},{$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}],w={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 was injured at work and would like to file for workers compensation benefits"',"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"'},$={},k={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."},I=[function(t=null){let a=w,i=$,n=k;return t&&(a=g(w,t),i=g($,t),n=g(k,t)),{type:"meta",data:e(b,{defaultCommentsPlaceholder:'$getKey($meta, "commentsPlaceholders." + $get(Type_Of_Legal_Problem).value, $meta.defaultCommentsPlaceholder)',commentsPlaceholders:a,defaultFinalHeadline:"Submit Your Case",finalHeadlines:i,defaultFinalSubHeadline:"You may benefit from speaking with a legal professional. Please verify your contact information.",finalSubHeadlines:n})}}(),e(x,E),{$cmp:"FormKit",props:function(t){const a=e(y,t);return a.formId&&!a.name&&(a.name=a.formId),a}({formId:"testForm"}),children:[function(t={}){return e(function(e={}){return{$el:"h1",attrs:{class:"t-flex t-justify-center t-text-center !t-text-[2rem] t-font-semibold t-pt-5 t-px-7 md:t-px-3 "+(e.headlineClass||"")}}}(t),t)}({children:'$urlParam("hl", "Start Here For a Free Consultation")',if:"$activeStep === $firstStep()"}),function(t={}){return e(function(e={}){return{$el:"h3",attrs:{class:"t-flex t-justify-center t-text-center !t-text-[1.2rem] t-font-medium t-text-blue-500 t-px-10 "+(e.subheadlineClass||"")}}}(t),t)}({children:'$urlParam("shl", "Our Service is Fast and Free!")',if:"$activeStep === $firstStep()"}),...v,{$el:"div",attrs:{class:"form-body"},children:[function(e={}){return h("categoryAndZip",[n({label:"Zip Code:",placeholder:"#####",name:"Zip",maxlength:5,inputmode:"numeric",autocomplete:"postal-code",validation:"required|matches:/^[0-9]{5}$/",validationMessages:{required:"Zip Code is required",matches:"Invalid Zip Code"}}),i({label:"Category:",name:"category",id:"category",options:["Fruits","Vegetables"]})],e.nextOnEnter)}(),function(e={}){return h("firstAndLast",[n({$formkit:"text",label:"First Name:",placeholder:"First",name:"First_Name",autocomplete:"given-name",validationMessages:{required:"First Name is required"}}),n({$formkit:"text",label:"Last Name:",placeholder:"Last",name:"Last_Name",autocomplete:"family-name",validationMessages:{required:"Last Name is required"}})],e.nextOnEnter)}(),function(e={}){return h("contactInfo",[c(e),p(e),{$el:"script",if:"$activeStep === $lastStep()",children:u},n({$formkit:"email",name:"Email",label:"Email Address:",placeholder:"email@domain.com",autocomplete:"email","data-tf-sensitive":"false",validation:"required|email",validationMessages:{required:"Email is required",email:"Invalid Email"}}),n({$formkit:"tel",name:"Primary_Phone",label:"Phone Number:",placeholder:"###-###-####",maxlength:12,help:"10-digit phone number, hyphens optional",autocomplete:"tel-national","data-tf-sensitive":"false",validation:"required|matches:/^[0-9]{3}-?[0-9]{3}-?[0-9]{4}$/|valid_phone",validationMessages:{required:"Field 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]"}),{$formkit:"checkbox",label:"$meta.tcpaLanguage",name:"TCPA_Opt_In","data-tf-sensitive":"false",validation:"required|accepted",validationMessages:{required:"Consent is required",accepted:"Consent is required"},classes:{label:"t-text-xs t-text-slate-500 t-font-normal"}},m()],!1)}(),{$el:"div",attrs:{class:"step-nav"},children:[{$formkit:"button",name:"back_button",onClick:"$setPreviousStep($prevStepFunc($get(form)))",children:"Back",style:{if:"$activeStep === $firstStep()",then:"visibility: hidden;"}},{$formkit:"button",name:"next_button",onClick:"$setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form)))",children:{if:"$activeStep === $firstStep()",then:"Start",else:"Next"},outerClass:{if:"$activeStep === $lastStep()",then:"t-hidden",else:""},style:{if:"$activeStep === $lastStep()",then:"display: none;"}},{$formkit:"submit",name:"submit_button",label:"Submit",if:"$activeStep === $lastStep()",style:{if:"$activeStep !== $lastStep()",then:"display: none;"}}]},{$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: ","$stepKeys()"],attrs:{class:"t-text-xs",style:"overflow: scroll"}}]}]}]}];var E;return I}();
1
+ var testForm=function(){"use strict";function e(){return Object.assign({},...arguments)}const t='$getKey($meta, "finalHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalHeadline)',a='$getKey($meta, "finalSubHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalSubHeadline)',i=t=>(t.labelClass="required",t.wrapperClass="side-by-side t-items-center",t.innerClass="select-height-content",t.helpClass="t-mt-2.5 md:t-text-right md:t-mt-[-5px]",(t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"select",placeholder:"Please Select",validation:"required",validationMessages:{required:"Field is required"},inputClass:"t-bg-white",labelClass:"required"},t)))(t)),n=t=>(t.wrapperClass="side-by-side t-items-center",(t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"text",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required"},t)))(t)),r=e=>n({$formkit:"text",label:"Last Name:",placeholder:"Last",name:e?e+":Last_Name":"Last_Name",autocomplete:"family-name",validationMessages:{required:"Last Name is required"}}),o=e=>n({$formkit:"tel",name:e?e+":Primary_Phone":"Primary_Phone",label:"Phone Number:",placeholder:"###-###-####",maxlength:12,help:"10-digit phone number, hyphens optional",autocomplete:"tel-national","data-tf-sensitive":"false",validation:"required|matches:/^[0-9]{3}-?[0-9]{3}-?[0-9]{4}$/|valid_phone",validationMessages:{required:"Field 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]"}),l=e=>({$formkit:"checkbox",label:"$meta.tcpaLanguage",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:{label:"t-text-xs t-text-slate-500 t-font-normal"}}),s="$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",d="$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",m=e=>"group"!==e.type&&"section"!==e.type&&"form"!==e.type&&"hidden"!==e.$formkit&&!e.children,c=e=>{if(m(e))return e;for(var t=e.children.length-1;t>=0;t--){if("string"==typeof e.children)continue;const a=e.children[t];if(m(a))return a;const i=c(a);if(i)return i}return null},p={$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"}},{$el:"span",children:"Secure & Encrypted",attrs:{class:"t-pl-2 t-pt-1 t-font-medium"}}]};function u(t){return e(p,t)}function f(e){return{$el:"h3",children:e.headline||t,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||"")}}}function h(e){return{$el:"h5",children:e.subheadline||a,attrs:{class:"t-flex t-justify-center t-text-center !t-text-lg t-font-semibold t-pb-7 t-pt-0 t-px-3 "+(e.subheadlineClass||"")}}}const y="(function() {\n if (window.xxTrustedFormLoaded) {\n return\n }\n var vid = '';\n if (typeof window.zar !== 'undefined') {\n vid = window.zar.getVID();\n }\n window.xxTrustedFormLoaded = true;\n var sandbox = document.location.hostname.indexOf('localhost') > -1 ? 'true' : 'false'\n var tf = document.createElement('script');\n tf.type = 'text/javascript'; tf.async = true;\n tf.src = (\"https:\" == document.location.protocol ? 'https' : 'http') + \"://api.trustedform.com/trustedform.js?field=xxTrustedFormCertUrl&identifier=\" + vid + \"&ping_field=xxTrustedFormPingUrl&provideReferrer=false&invert_field_sensitivity=true&sandbox=\" + sandbox + \"&l=\" + new Date().getTime() + Math.random();\n var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(tf, s);\n})();";const g=(e,t)=>({$el:"section",if:'$stepEnabled("'+e+'")',attrs:{hidden:'$activeStep !== "'+e+'"',key:t||e}});function b(t,a,i=!0,n=!1,r=void 0,o=void 0,l=void 0){if(void 0===i&&(i=!0),a&&a.length&&(i||n)){const e=c(a[a.length-1]);e&&!0===i&&(e.onKeypress=s),e&&!0===n&&(e.onInput=d)}return e(g(t,r),{children:[{$formkit:"group",id:t,name:t,nextStepMap:o,autoFocus:l,children:a}]})}const v={type:"form",id:"form",config:{validationVisibility:"submit"},onSubmit:'$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 x(e,t){return Object.fromEntries(Object.entries(e).filter((([e])=>t.includes(e))))}const w={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."};const $={$el:"div",children:[{$el:"div",attrs:{id:"form-anchor",class:"t-absolute",style:{top:"-30px",left:0}}}],attrs:{class:"t-relative"}};const k=[{$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}],I={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 was injured at work and would like to file for workers compensation benefits"',"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"'},E={},S={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."},P=[function(t=null){let a=I,i=E,n=S;return t&&(a=x(I,t),i=x(E,t),n=x(S,t)),{type:"meta",data:e(w,{defaultCommentsPlaceholder:'$getKey($meta, "commentsPlaceholders." + $get(Type_Of_Legal_Problem).value, $meta.defaultCommentsPlaceholder)',commentsPlaceholders:a,defaultFinalHeadline:"Submit Your Case",finalHeadlines:i,defaultFinalSubHeadline:"You may benefit from speaking with a legal professional. Please verify your contact information.",finalSubHeadlines:n})}}(),e($,C),{$cmp:"FormKit",props:function(t){const a=e(v,t);return a.formId&&!a.name&&(a.name=a.formId),a}({formId:"testForm"}),children:[function(t={}){return e(function(e={}){return{$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||"")}}}(t),t)}({children:'$urlParam("hl", "Start Here For a Free Consultation")',if:"$activeStep === $firstStep()"}),function(t={}){return e(function(e={}){return{$el:"h3",attrs:{class:"t-flex t-justify-center t-text-center !t-text-[1.2rem] t-font-medium t-text-blue-500 t-px-10 "+(e.subheadlineClass||"")}}}(t),t)}({children:'$urlParam("shl", "Our Service is Fast and Free!")',if:"$activeStep === $firstStep()"}),...k,{$el:"div",attrs:{class:"form-body"},children:[function(e={}){return b("categoryAndZip",[n({label:"Zip Code:",placeholder:"#####",name:t?t+":Zip":"Zip",maxlength:5,inputmode:"numeric",autocomplete:"postal-code",validation:"required|matches:/^[0-9]{5}$/",validationMessages:{required:"Zip Code is required",matches:"Invalid Zip Code"}}),i({label:"Category:",name:"category",id:"category",options:["Fruits","Vegetables"]})],e.nextOnEnter);var t}(),function(e={}){return b("firstAndLast",[n({$formkit:"text",label:"First Name:",placeholder:"First",name:t?t+":First_Name":"First_Name",autocomplete:"given-name",validationMessages:{required:"First Name is required"}}),r()],e.nextOnEnter);var t}(),function(e={}){return b("contactInfo",[f(e),h(e),{$el:"script",if:"$activeStep === $lastStep()",children:y},(t=e.scope,n({$formkit:"email",name:t?t+":Email":"Email",label:"Email Address:",placeholder:"email@domain.com",autocomplete:"email","data-tf-sensitive":"false",validation:"required|email",validationMessages:{required:"Email is required",email:"Invalid Email"}})),o(e.scope),l(e.scope),u()],!1);var t}(),((e={})=>({$el:"div",attrs:{class:"step-nav"},children:[{$formkit:"button",name:"back_button",onClick:"$setPreviousStep($prevStepFunc($get(form)))",children:"Back",style:{if:"$activeStep === $firstStep()",then:"visibility: hidden;"}},{$formkit:"button",name:"next_button",onClick:"$setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form)))",children:{if:"$activeStep === $firstStep()",then:"Start",else:"Next"},outerClass:{if:"$activeStep === $lastStep()",then:"t-hidden",else:""},style:{if:"$activeStep === $lastStep()",then:"display: none;"}},{$formkit:"submit",name:"submit_button",label:e.submitLabel||"Submit",if:"$activeStep === $lastStep()",style:{if:"$activeStep !== $lastStep()",then:"display: none;"}}]}))(),{$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 C;return P}();
@@ -226,10 +226,10 @@ const realEstateTOLPDisplay = (updates) => col2Radio(merge({
226
226
  ]
227
227
  }, updates));
228
228
 
229
- const zipcode = () => sbsText({
229
+ const zipcode = (scope) => sbsText({
230
230
  label: 'Zip Code:',
231
231
  placeholder: '#####',
232
- name: 'Zip',
232
+ name: scope ? scope + ':' + 'Zip' : 'Zip',
233
233
  maxlength: 5,
234
234
  inputmode: "numeric",
235
235
  autocomplete: 'postal-code',
@@ -513,6 +513,12 @@ const hiddenInputsMechanics = [
513
513
  name: "vertical",
514
514
  value: "AutoRepair"
515
515
  },
516
+ {
517
+ $formkit: 'hidden',
518
+ name: "Category",
519
+ id: "Category",
520
+ value: "Mechanics"
521
+ },
516
522
  ...hiddenInputsBase
517
523
  ];
518
524
 
@@ -1 +1 @@
1
- var testRedirects=function(){"use strict";function e(){return Object.assign({},...arguments)}const t=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"radio",validation:"required",validationMessages:{required:"Field is required"},optionsClass:"t-pt-3 t-pl-1",legendClass:"required"},t)),r=e=>(e.legendClass="required",e.fieldsetClass="$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="$reset t-flex t-cursor-pointer t-mb-3",t(e)),a=t=>(t.labelClass="required",t.wrapperClass="side-by-side t-items-center",t.innerClass="select-height-content",t.helpClass="t-mt-2.5 md:t-text-right md:t-mt-[-5px]",(t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"select",placeholder:"Please Select",validation:"required",validationMessages:{required:"Field is required"},inputClass:"t-bg-white",labelClass:"required"},t)))(t)),i=t=>(t.wrapperClass="side-by-side t-items-center",(t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"text",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required"},t)))(t)),n=r=>(e=>(e.legendClass="legend-left t-pb-1 required",e.fieldsetClass="$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",t(e)))(e({name:"Civil_Defense",id:"Civil_Defense",if:'$get(Type_Of_Legal_Problem).value == "Civil Lawsuit"',label:"Do You Need Representation to File a Lawsuit or Defend One?",options:{Yes:"Defend a Lawsuit",No:"File a Lawsuit"}},r)),s=t=>r(e({name:"Type_Of_Legal_Problem_Display",if:'$get(Type_Of_Legal_Problem).value == "Civil Lawsuit" && $get(Civil_Defense).value == "No"',label:"Select The Type of Lawsuit You Would Like to File:",options:["Automobile Accident","Contract Disputes","Defamation and Slander","Dog Bite","Employment and Workplace","Fraud","Medical Malpractice","Personal Injury","Property Damage","Small Claims","Real Estate","Not Sure or Other"]},t)),l=t=>r(e({name:"Type_Of_Legal_Problem_Display",if:'$get(Type_Of_Legal_Problem).value == "Employment and Workplace"',label:"Select The Workplace Issue:",options:["Workplace Harassment","Workplace Discrimination","Wrongful Termination","Payment Disputes","Workers Compensation","Personal Injury","Unemployment","Other Workplace Issues"]},t)),o=["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"],d=t=>a(e({label:"Type of Help Needed:",name:"Type_Of_Legal_Problem",id:"Type_Of_Legal_Problem",options:o},t)),p=t=>r(e({name:"Type_Of_Legal_Problem_Display",if:'$get(Type_Of_Legal_Problem).value == "Real Estate"',label:"Select The Type of Real Estate Issue:",options:["Contracts and Agreements","Deeds, Liens, and Titles","Foreclosure","Insurance","Landlord and Tenant","Loans and Mortgages","Wills, Trusts, and Estates","Property Damage","Not Sure or Other"]},t)),c=t=>r(e({name:"Type_Of_Legal_Problem_Display",if:'$get(Type_Of_Legal_Problem).value == "Criminal and Felony"',label:"Which Type of Criminal Issue?",options:["Criminal Defense","Victim of a Crime","DUI and DWI","Expungement","Harassment","Not Sure or Other"]},t)),m="$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",u="$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",f=e=>"group"!==e.type&&"section"!==e.type&&"form"!==e.type&&"hidden"!==e.$formkit&&!e.children,g=e=>{if(f(e))return e;for(var t=e.children.length-1;t>=0;t--){if("string"==typeof e.children)continue;const r=e.children[t];if(f(r))return r;const a=g(r);if(a)return a}return null},y=(e,t)=>({$el:"section",if:'$stepEnabled("'+e+'")',attrs:{hidden:'$activeStep !== "'+e+'"',key:t||e}});const h={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]"};const $=[{$formkit:"hidden",name:"vertical",value:"AutoRepair"},{$formkit:"hidden",name:"gclid",value:null},{$formkit:"hidden",name:"campaignid",value:null},{$formkit:"hidden",name:"s",value:null}],b=[e({$el:"div",children:[{$el:"div",attrs:{id:"form-anchor",class:"t-absolute",style:{top:"-30px",left:0}}}],attrs:{class:"t-relative"}},v),{$cmp:"FormKit",props:function(t){const r=e(h,t);return r.formId&&!r.name&&(r.name=r.formId),r}({formId:"testRedirects",redirectMap:{"*":"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}"},formClass:"!t-max-w-[36rem]"}),children:[function(t={}){return e(function(e={}){return{$el:"h1",attrs:{class:"t-flex t-justify-center t-text-center !t-text-[2rem] t-font-semibold t-pt-5 t-px-7 md:t-px-3 "+(e.headlineClass||"")}}}(t),t)}({children:'$urlParam("hl", "Have Questions for a Lawyer?")',if:"$activeStep === $firstStep()"}),...$,{$el:"div",attrs:{class:"form-body"},children:[function(t={}){return function(t,r,a=!0,i=!1,n,s,l){if(void 0===a&&(a=!0),r&&r.length&&(a||i)){const e=g(r[r.length-1]);e&&!0===a&&(e.onKeypress=m),e&&!0===i&&(e.onInput=u)}return e(y(t,n),{children:[{$formkit:"group",id:t,name:t,nextStepMap:s,autoFocus:l,children:r}]})}("generalLegalTOLPAndZip",[d(),n(),s(),c(),l(),r({label:"What is the Landlord / Tenant Issue?",if:'$get(Type_Of_Legal_Problem).value == "Landlord and Tenant"',id:"Landlord_Tenant_Issue",name:"Landlord_Tenant_Issue",options:["Eviction","Repairs and Maintenance","Lease and Rental Agreements","Discrimination","Right of Entry and Privacy","Screening and Applications","Environmental Hazards","Other Dispute"]}),p(),i({label:"Zip Code:",placeholder:"#####",name:"Zip",maxlength:5,inputmode:"numeric",autocomplete:"postal-code",validation:"required|matches:/^[0-9]{5}$/",validationMessages:{required:"Zip Code is required",matches:"Invalid Zip Code"}})],t.nextOnEnter,t.nextOnInput,t.stepKey,t.nextStepMap)}(),function(e={}){return{$el:"div",attrs:{class:"step-nav"},children:[{$formkit:"button",name:"hidden_button",children:"Hidden",style:{if:"$activeStep === $firstStep()",then:"visibility: hidden;"}},{$formkit:"submit",name:"submit_button",label:e.submitLabel||"Chat Now"}]}}(),{$el:"pre",if:'$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: ","$stepKeys()"],attrs:{class:"t-text-xs",style:"overflow: scroll"}}]}]}]}];var v;return b}();
1
+ var testRedirects=function(){"use strict";function e(){return Object.assign({},...arguments)}const t=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"radio",validation:"required",validationMessages:{required:"Field is required"},optionsClass:"t-pt-3 t-pl-1",legendClass:"required"},t)),r=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",t(e)),a=t=>(t.labelClass="required",t.wrapperClass="side-by-side t-items-center",t.innerClass="select-height-content",t.helpClass="t-mt-2.5 md:t-text-right md:t-mt-[-5px]",(t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"select",placeholder:"Please Select",validation:"required",validationMessages:{required:"Field is required"},inputClass:"t-bg-white",labelClass:"required"},t)))(t)),i=t=>(t.wrapperClass="side-by-side t-items-center",(t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"text",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required"},t)))(t)),n=r=>(e=>(e.legendClass="legend-left t-pb-1 required",e.fieldsetClass="$reset side-by-side t-items-center",e.optionsClass="t-mt-1 t-grid t-grid-cols-1 md:t-grid-cols-2-125 t-items-center",e.innerClass="t-flex t-items-center",e.optionClass="t-pr-1",t(e)))(e({name:"Civil_Defense",id:"Civil_Defense",if:'$get(Type_Of_Legal_Problem).value == "Civil Lawsuit"',label:"Do You Need Representation to File a Lawsuit or Defend One?",options:{Yes:"Defend a Lawsuit",No:"File a Lawsuit"}},r)),s=t=>r(e({name:"Type_Of_Legal_Problem_Display",if:'$get(Type_Of_Legal_Problem).value == "Civil Lawsuit" && $get(Civil_Defense).value == "No"',label:"Select The Type of Lawsuit You Would Like to File:",options:["Automobile Accident","Contract Disputes","Defamation and Slander","Dog Bite","Employment and Workplace","Fraud","Medical Malpractice","Personal Injury","Property Damage","Small Claims","Real Estate","Not Sure or Other"]},t)),l=t=>r(e({name:"Type_Of_Legal_Problem_Display",if:'$get(Type_Of_Legal_Problem).value == "Employment and Workplace"',label:"Select The Workplace Issue:",options:["Workplace Harassment","Workplace Discrimination","Wrongful Termination","Payment Disputes","Workers Compensation","Personal Injury","Unemployment","Other Workplace Issues"]},t)),o=["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"],d=t=>a(e({label:"Type of Help Needed:",name:"Type_Of_Legal_Problem",id:"Type_Of_Legal_Problem",options:o},t)),p=t=>r(e({name:"Type_Of_Legal_Problem_Display",if:'$get(Type_Of_Legal_Problem).value == "Real Estate"',label:"Select The Type of Real Estate Issue:",options:["Contracts and Agreements","Deeds, Liens, and Titles","Foreclosure","Insurance","Landlord and Tenant","Loans and Mortgages","Wills, Trusts, and Estates","Property Damage","Not Sure or Other"]},t)),c=t=>r(e({name:"Type_Of_Legal_Problem_Display",if:'$get(Type_Of_Legal_Problem).value == "Criminal and Felony"',label:"Which Type of Criminal Issue?",options:["Criminal Defense","Victim of a Crime","DUI and DWI","Expungement","Harassment","Not Sure or Other"]},t)),m="$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",u="$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",f=e=>"group"!==e.type&&"section"!==e.type&&"form"!==e.type&&"hidden"!==e.$formkit&&!e.children,g=e=>{if(f(e))return e;for(var t=e.children.length-1;t>=0;t--){if("string"==typeof e.children)continue;const r=e.children[t];if(f(r))return r;const a=g(r);if(a)return a}return null},y=(e,t)=>({$el:"section",if:'$stepEnabled("'+e+'")',attrs:{hidden:'$activeStep !== "'+e+'"',key:t||e}});const h={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]"};const $=[{$formkit:"hidden",name:"vertical",value:"AutoRepair"},{$formkit:"hidden",name:"Category",id:"Category",value:"Mechanics"},{$formkit:"hidden",name:"gclid",value:null},{$formkit:"hidden",name:"campaignid",value:null},{$formkit:"hidden",name:"s",value:null}],v=[e({$el:"div",children:[{$el:"div",attrs:{id:"form-anchor",class:"t-absolute",style:{top:"-30px",left:0}}}],attrs:{class:"t-relative"}},b),{$cmp:"FormKit",props:function(t){const r=e(h,t);return r.formId&&!r.name&&(r.name=r.formId),r}({formId:"testRedirects",redirectMap:{"*":"https://listings.ziplawyer.com/api/v1/redirect?zone_id=4&vertical=Legal&category=${properties.Type_Of_Legal_Problem}&Degree_Of_Interest=${properties.Degree_Of_Interest}&zip_code=${properties.Zip}&sub_id=${properties.vid}"},formClass:"!t-max-w-[36rem]"}),children:[function(t={}){return e(function(e={}){return{$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||"")}}}(t),t)}({children:'$urlParam("hl", "Have Questions for a Lawyer?")',if:"$activeStep === $firstStep()"}),...$,{$el:"div",attrs:{class:"form-body"},children:[function(t={}){return function(t,r,a=!0,i=!1,n,s,l){if(void 0===a&&(a=!0),r&&r.length&&(a||i)){const e=g(r[r.length-1]);e&&!0===a&&(e.onKeypress=m),e&&!0===i&&(e.onInput=u)}return e(y(t,n),{children:[{$formkit:"group",id:t,name:t,nextStepMap:s,autoFocus:l,children:r}]})}("generalLegalTOLPAndZip",[d(),n(),s(),c(),l(),r({label:"What is the Landlord / Tenant Issue?",if:'$get(Type_Of_Legal_Problem).value == "Landlord and Tenant"',id:"Landlord_Tenant_Issue",name:"Landlord_Tenant_Issue",options:["Eviction","Repairs and Maintenance","Lease and Rental Agreements","Discrimination","Right of Entry and Privacy","Screening and Applications","Environmental Hazards","Other Dispute"]}),p(),i({label:"Zip Code:",placeholder:"#####",name:a?a+":Zip":"Zip",maxlength:5,inputmode:"numeric",autocomplete:"postal-code",validation:"required|matches:/^[0-9]{5}$/",validationMessages:{required:"Zip Code is required",matches:"Invalid Zip Code"}})],t.nextOnEnter,t.nextOnInput,t.stepKey,t.nextStepMap);var a}(),function(e={}){return{$el:"div",attrs:{class:"step-nav"},children:[{$formkit:"button",name:"hidden_button",children:"Hidden",style:{if:"$activeStep === $firstStep()",then:"visibility: hidden;"}},{$formkit:"submit",name:"submit_button",label:e.submitLabel||"Chat Now"}]}}(),{$el:"pre",if:'$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: ","$stepKeys()"],attrs:{class:"t-text-xs",style:"overflow: scroll"}}]}]}]}];var b;return v}();
@@ -1 +1 @@
1
- [{"$el":"div","children":[{"$el":"div","attrs":{"id":"form-anchor","class":"t-absolute","style":{"top":"-30px","left":0}}}],"attrs":{"class":"t-relative"}},{"$cmp":"FormKit","props":{"type":"form","id":"form","config":{"validationVisibility":"submit"},"onSubmit":"$submit($submitUrl, $prepData, $handleRedirect, \"text/plain; charset=UTF-8\")","plugins":"$plugins","actions":false,"anchorElement":"form-anchor","useLocalStorage":true,"prepop":{"fromURL":true},"errorCodes":{"403":{"message":"An Error Occurred","abort":false},"409":{"abort":false},"429":"An Error Occurred","504":{"message":"An Error Occurred","abort":false}},"formClass":"!t-max-w-[36rem]","formId":"testRedirects","redirectMap":{"*":"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}"},"name":"testRedirects"},"children":[{"$el":"h1","attrs":{"class":"t-flex t-justify-center t-text-center !t-text-[2rem] t-font-semibold t-pt-5 t-px-7 md:t-px-3 "},"children":"$urlParam(\"hl\", \"Have Questions for a Lawyer?\")","if":"$activeStep === $firstStep()"},{"$formkit":"hidden","name":"vertical","value":"AutoRepair"},{"$formkit":"hidden","name":"gclid","value":null},{"$formkit":"hidden","name":"campaignid","value":null},{"$formkit":"hidden","name":"s","value":null},{"$el":"div","attrs":{"class":"form-body"},"children":[{"$el":"section","if":"$stepEnabled(\"generalLegalTOLPAndZip\")","attrs":{"hidden":"$activeStep !== \"generalLegalTOLPAndZip\"","key":"generalLegalTOLPAndZip"},"children":[{"$formkit":"group","id":"generalLegalTOLPAndZip","name":"generalLegalTOLPAndZip","children":[{"$formkit":"select","placeholder":"Please Select","validation":"required","validationMessages":{"required":"Field is required"},"inputClass":"t-bg-white","labelClass":"required","label":"Type of Help Needed:","name":"Type_Of_Legal_Problem","id":"Type_Of_Legal_Problem","options":["Adoption","Asbestos and Mesothelioma","Auto and Car Accidents","Bankruptcy","Birth Certificate and Name Change","Business Lawyers","Child Custody","Child Support","Civil Rights and Discrimination","Consumer Lawyers","Copyrights and Trademarks","Criminal and Felony","Debt and Collections","Defend a Lawsuit","Divorce and Separation","DUI and DWI","Elder Law","Employment and Workplace","Expungement","Family Issues","File a Lawsuit","Foreclosure","Guardianship","Harassment and Discrimination","Identity Theft","Immigration and Visas","Insurance","Landlord and Tenant","Lemon Law","Long Term Disability","Medical Malpractice","Non-Workplace Discrimination","Non-Workplace Harassment","Patents and Intellectual Property","Personal Injury","Power of Attorney","Probate and Estates","Product Liability","Property Damage","Real Estate","Sexual Harassment","Social Security Disability and Insurance","Tax and IRS","Traffic and Tickets","Unemployment","Victim of a Crime","Wills and Trusts","Workers Compensation","Workplace Discrimination","Workplace Harassment","Wrongful Death","Wrongful Termination","Not Sure or Other"],"wrapperClass":"side-by-side t-items-center","innerClass":"select-height-content","helpClass":"t-mt-2.5 md:t-text-right md:t-mt-[-5px]"},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-mt-1 t-grid t-grid-cols-1 md:t-grid-cols-2-125 t-items-center","legendClass":"legend-left t-pb-1 required","name":"Civil_Defense","id":"Civil_Defense","if":"$get(Type_Of_Legal_Problem).value == \"Civil Lawsuit\"","label":"Do You Need Representation to File a Lawsuit or Defend One?","options":{"Yes":"Defend a Lawsuit","No":"File a Lawsuit"},"fieldsetClass":"$reset side-by-side t-items-center","innerClass":"t-flex t-items-center","optionClass":"t-pr-1"},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2","legendClass":"required","name":"Type_Of_Legal_Problem_Display","if":"$get(Type_Of_Legal_Problem).value == \"Civil Lawsuit\" && $get(Civil_Defense).value == \"No\"","label":"Select The Type of Lawsuit You Would Like to File:","options":["Automobile Accident","Contract Disputes","Defamation and Slander","Dog Bite","Employment and Workplace","Fraud","Medical Malpractice","Personal Injury","Property Damage","Small Claims","Real Estate","Not Sure or Other"],"fieldsetClass":"$reset","innerClass":"t-items-start","wrapperClass":"$reset t-flex t-cursor-pointer t-mb-3","id":"Type_Of_Legal_Problem_Display"},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2","legendClass":"required","name":"Type_Of_Legal_Problem_Display","if":"$get(Type_Of_Legal_Problem).value == \"Criminal and Felony\"","label":"Which Type of Criminal Issue?","options":["Criminal Defense","Victim of a Crime","DUI and DWI","Expungement","Harassment","Not Sure or Other"],"fieldsetClass":"$reset","innerClass":"t-items-start","wrapperClass":"$reset t-flex t-cursor-pointer t-mb-3","id":"Type_Of_Legal_Problem_Display"},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2","legendClass":"required","name":"Type_Of_Legal_Problem_Display","if":"$get(Type_Of_Legal_Problem).value == \"Employment and Workplace\"","label":"Select The Workplace Issue:","options":["Workplace Harassment","Workplace Discrimination","Wrongful Termination","Payment Disputes","Workers Compensation","Personal Injury","Unemployment","Other Workplace Issues"],"fieldsetClass":"$reset","innerClass":"t-items-start","wrapperClass":"$reset t-flex t-cursor-pointer t-mb-3","id":"Type_Of_Legal_Problem_Display"},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2","legendClass":"required","label":"What is the Landlord / Tenant Issue?","if":"$get(Type_Of_Legal_Problem).value == \"Landlord and Tenant\"","id":"Landlord_Tenant_Issue","name":"Landlord_Tenant_Issue","options":["Eviction","Repairs and Maintenance","Lease and Rental Agreements","Discrimination","Right of Entry and Privacy","Screening and Applications","Environmental Hazards","Other Dispute"],"fieldsetClass":"$reset","innerClass":"t-items-start","wrapperClass":"$reset t-flex t-cursor-pointer t-mb-3"},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2","legendClass":"required","name":"Type_Of_Legal_Problem_Display","if":"$get(Type_Of_Legal_Problem).value == \"Real Estate\"","label":"Select The Type of Real Estate Issue:","options":["Contracts and Agreements","Deeds, Liens, and Titles","Foreclosure","Insurance","Landlord and Tenant","Loans and Mortgages","Wills, Trusts, and Estates","Property Damage","Not Sure or Other"],"fieldsetClass":"$reset","innerClass":"t-items-start","wrapperClass":"$reset t-flex t-cursor-pointer t-mb-3","id":"Type_Of_Legal_Problem_Display"},{"$formkit":"text","validation":"required|matches:/^[0-9]{5}$/","validationMessages":{"required":"Zip Code is required","matches":"Invalid Zip Code"},"labelClass":"required","label":"Zip Code:","placeholder":"#####","name":"Zip","maxlength":5,"inputmode":"numeric","autocomplete":"postal-code","wrapperClass":"side-by-side t-items-center","id":"Zip","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"div","attrs":{"class":"step-nav"},"children":[{"$formkit":"button","name":"hidden_button","children":"Hidden","style":{"if":"$activeStep === $firstStep()","then":"visibility: hidden;"}},{"$formkit":"submit","name":"submit_button","label":"Chat Now"}]},{"$el":"pre","if":"$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: ","$stepKeys()"],"attrs":{"class":"t-text-xs","style":"overflow: scroll"}}]}]}]}]
1
+ [{"$el":"div","children":[{"$el":"div","attrs":{"id":"form-anchor","class":"t-absolute","style":{"top":"-30px","left":0}}}],"attrs":{"class":"t-relative"}},{"$cmp":"FormKit","props":{"type":"form","id":"form","config":{"validationVisibility":"submit"},"onSubmit":"$submit($submitUrl, $prepData, $handleRedirect, \"text/plain; charset=UTF-8\")","plugins":"$plugins","actions":false,"anchorElement":"form-anchor","useLocalStorage":true,"prepop":{"fromURL":true},"errorCodes":{"403":{"message":"An Error Occurred","abort":false},"409":{"abort":false},"429":"An Error Occurred","504":{"message":"An Error Occurred","abort":false}},"formClass":"!t-max-w-[36rem]","formId":"testRedirects","redirectMap":{"*":"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}"},"name":"testRedirects"},"children":[{"$el":"h1","attrs":{"class":"t-flex t-justify-center t-text-center !t-text-[2rem] t-font-semibold t-pt-5 t-px-7 md:t-px-3 "},"children":"$urlParam(\"hl\", \"Have Questions for a Lawyer?\")","if":"$activeStep === $firstStep()"},{"$formkit":"hidden","name":"vertical","value":"AutoRepair"},{"$formkit":"hidden","name":"Category","id":"Category","value":"Mechanics"},{"$formkit":"hidden","name":"gclid","value":null},{"$formkit":"hidden","name":"campaignid","value":null},{"$formkit":"hidden","name":"s","value":null},{"$el":"div","attrs":{"class":"form-body"},"children":[{"$el":"section","if":"$stepEnabled(\"generalLegalTOLPAndZip\")","attrs":{"hidden":"$activeStep !== \"generalLegalTOLPAndZip\"","key":"generalLegalTOLPAndZip"},"children":[{"$formkit":"group","id":"generalLegalTOLPAndZip","name":"generalLegalTOLPAndZip","children":[{"$formkit":"select","placeholder":"Please Select","validation":"required","validationMessages":{"required":"Field is required"},"inputClass":"t-bg-white","labelClass":"required","label":"Type of Help Needed:","name":"Type_Of_Legal_Problem","id":"Type_Of_Legal_Problem","options":["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"],"wrapperClass":"side-by-side t-items-center","innerClass":"select-height-content","helpClass":"t-mt-2.5 md:t-text-right md:t-mt-[-5px]"},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-mt-1 t-grid t-grid-cols-1 md:t-grid-cols-2-125 t-items-center","legendClass":"legend-left t-pb-1 required","name":"Civil_Defense","id":"Civil_Defense","if":"$get(Type_Of_Legal_Problem).value == \"Civil Lawsuit\"","label":"Do You Need Representation to File a Lawsuit or Defend One?","options":{"Yes":"Defend a Lawsuit","No":"File a Lawsuit"},"fieldsetClass":"$reset side-by-side t-items-center","innerClass":"t-flex t-items-center","optionClass":"t-pr-1"},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2","legendClass":"required","name":"Type_Of_Legal_Problem_Display","if":"$get(Type_Of_Legal_Problem).value == \"Civil Lawsuit\" && $get(Civil_Defense).value == \"No\"","label":"Select The Type of Lawsuit You Would Like to File:","options":["Automobile Accident","Contract Disputes","Defamation and Slander","Dog Bite","Employment and Workplace","Fraud","Medical Malpractice","Personal Injury","Property Damage","Small Claims","Real Estate","Not Sure or Other"],"fieldsetClass":"$reset","innerClass":"t-items-start","wrapperClass":"$reset t-flex t-cursor-pointer t-mb-3","id":"Type_Of_Legal_Problem_Display"},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2","legendClass":"required","name":"Type_Of_Legal_Problem_Display","if":"$get(Type_Of_Legal_Problem).value == \"Criminal and Felony\"","label":"Which Type of Criminal Issue?","options":["Criminal Defense","Victim of a Crime","DUI and DWI","Expungement","Harassment","Not Sure or Other"],"fieldsetClass":"$reset","innerClass":"t-items-start","wrapperClass":"$reset t-flex t-cursor-pointer t-mb-3","id":"Type_Of_Legal_Problem_Display"},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2","legendClass":"required","name":"Type_Of_Legal_Problem_Display","if":"$get(Type_Of_Legal_Problem).value == \"Employment and Workplace\"","label":"Select The Workplace Issue:","options":["Workplace Harassment","Workplace Discrimination","Wrongful Termination","Payment Disputes","Workers Compensation","Personal Injury","Unemployment","Other Workplace Issues"],"fieldsetClass":"$reset","innerClass":"t-items-start","wrapperClass":"$reset t-flex t-cursor-pointer t-mb-3","id":"Type_Of_Legal_Problem_Display"},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2","legendClass":"required","label":"What is the Landlord / Tenant Issue?","if":"$get(Type_Of_Legal_Problem).value == \"Landlord and Tenant\"","id":"Landlord_Tenant_Issue","name":"Landlord_Tenant_Issue","options":["Eviction","Repairs and Maintenance","Lease and Rental Agreements","Discrimination","Right of Entry and Privacy","Screening and Applications","Environmental Hazards","Other Dispute"],"fieldsetClass":"$reset","innerClass":"t-items-start","wrapperClass":"$reset t-flex t-cursor-pointer t-mb-3"},{"$formkit":"radio","validation":"required","validationMessages":{"required":"Field is required"},"optionsClass":"t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2","legendClass":"required","name":"Type_Of_Legal_Problem_Display","if":"$get(Type_Of_Legal_Problem).value == \"Real Estate\"","label":"Select The Type of Real Estate Issue:","options":["Contracts and Agreements","Deeds, Liens, and Titles","Foreclosure","Insurance","Landlord and Tenant","Loans and Mortgages","Wills, Trusts, and Estates","Property Damage","Not Sure or Other"],"fieldsetClass":"$reset","innerClass":"t-items-start","wrapperClass":"$reset t-flex t-cursor-pointer t-mb-3","id":"Type_Of_Legal_Problem_Display"},{"$formkit":"text","validation":"required|matches:/^[0-9]{5}$/","validationMessages":{"required":"Zip Code is required","matches":"Invalid Zip Code"},"labelClass":"required","label":"Zip Code:","placeholder":"#####","name":"Zip","maxlength":5,"inputmode":"numeric","autocomplete":"postal-code","wrapperClass":"side-by-side t-items-center","id":"Zip","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"div","attrs":{"class":"step-nav"},"children":[{"$formkit":"button","name":"hidden_button","children":"Hidden","style":{"if":"$activeStep === $firstStep()","then":"visibility: hidden;"}},{"$formkit":"submit","name":"submit_button","label":"Chat Now"}]},{"$el":"pre","if":"$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"}}]}]}]}]