bhl-forms 0.6.4 → 0.6.5

package/dist/forms/generalLegalPopUnder.es.js

@@ -2940,12 +2940,7 @@ function commentsWithBankruptcyV2(updates = {}) {
         ],
       }
     ],
-    // TODO: UGLY: use named params!
     updates.nextOnEnter,
-    false,
-    undefined,
-    undefined,
-    false
   )
 }
 

package/dist/forms/generalLegalPopUnder.iife.js

@@ -1 +1 @@
-var generalLegalPopUnder=function(){"use strict";function e(){return Object.assign({},...arguments)}const a='$getKey($meta, "commentsPlaceholders." + $get(Type_Of_Legal_Problem).value, $meta.defaultCommentsPlaceholder)',t='$getKey($meta, "finalHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalHeadline)',i='$getKey($meta, "finalSubHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalSubHeadline)',n={type:"form",id:"form",config:{validationVisibility:"submit"},onSubmit:'$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 r={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 o={$el:"div",children:[{$el:"div",attrs:{id:"form-anchor",class:"t-absolute",style:{top:"-30px",left:0}}}],attrs:{class:"t-relative"}};const l={$el:"div",if:"$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"}},{$el:"span",children:"Secure & Encrypted",attrs:{class:"t-pl-2 t-pt-1 t-font-medium"}}]};function s(a){return e(l,a)}const d=[{$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},{$formkit:"hidden",name:"s",value:null}],u={"*":"https://listings.ziplawyer.com/api/v1/redirect?zone_id=4&vertical=Legal&category=${properties.Type_Of_Legal_Problem}&Degree_Of_Interest=${properties.Degree_Of_Interest}&zip_code=${properties.Zip}&sub_id=${properties.vid}"};const m=a=>(a.name&&!a.id&&(a.id=a.name),e({$formkit:"checkbox",validation:"required",validationMessages:{required:"Field is required"}},a)),p=e=>(e&&e.legendClass||(e.legendClass="required"),e.fieldsetClass="$reset",e.optionsClass="t-pl-8 md:t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",m(e)),c=a=>(a.name&&!a.id&&(a.id=a.name),e({$formkit:"radio",validation:"required",validationMessages:{required:"Field is required"},optionsClass:"t-pt-3 t-pl-1",legendClass:"required"},a)),f=e=>(e.legendClass="required",e.fieldsetClass="$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="$reset t-flex t-cursor-pointer t-mb-3",c(e)),y=e=>(e.legendClass="legend-left required",e.fieldsetClass="$reset side-by-side",e.optionsClass="t-pl-1",e.innerClass="t-flex t-items-center",e.wrapperClass="t-mb-3",c(e)),_=e=>(e.legendClass="legend-left-flex md:t-max-w-[40%] required",e.fieldsetClass="$reset side-by-side-flex",e.optionsClass="md:t-ml-4 md:t-mt-2 t-grid t-grid-cols-1 md:t-grid-cols-2-125",e.innerClass="t-flex t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",c(e)),h=e=>(e.legendClass="legend-left t-pb-1 required",e.fieldsetClass="$reset side-by-side t-items-center",e.optionsClass="t-mt-1 t-grid t-grid-cols-1 md:t-grid-cols-2-125 t-items-center",e.innerClass="t-flex t-items-center",e.optionClass="t-pr-1",c(e)),g=e=>(e.options=["Yes","No"],h(e)),b=a=>(a.labelClass="required",a.wrapperClass="side-by-side t-items-center",a.innerClass="select-height-content",a.helpClass="t-mt-2.5 md:t-text-right md:t-mt-[-5px]",(a=>(a.name&&!a.id&&(a.id=a.name),e({$formkit:"select",placeholder:"Please Select",validation:"required",validationMessages:{required:"Field is required"},inputClass:"t-bg-white",labelClass:"required"},a)))(a)),C=a=>(a.wrapperClass="side-by-side t-items-center",(a=>(a.name&&!a.id&&(a.id=a.name),e({$formkit:"text",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required"},a)))(a)),P=a=>(a.wrapperClass="side-by-side t-items-center",(a=>(a.name&&!a.id&&(a.id=a.name),e({$formkit:"DatePicker",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required t-block t-mb-3 t-font-semibold t-text-base formkit-invalid:t-text-red-500",innerClass:"t-border t-border-gray-400 formkit-invalid:t-border-red-500 t-rounded t-mb-1 focus-within:t-border-blue-500"},a)))(a)),v=e=>C({name:e?e+":Applicant_Occupation":"Applicant_Occupation",label:"What is the Applicant's Occupation?",placeholder:"Occupation"}),T=e=>C({name:e?e+":Applicant_Age":"Applicant_Age",label:"Age of Applicant?",placeholder:"Age between 18 and 65",maxlength:2,inputmode:"numeric",validation:"required|min:18,max:65",validationMessages:{required:"Applicant Age is required",min:"Invalid Age - must be between 18 and 65",max:"Invalid Age - must be between 18 and 65"}}),L=e=>b({name:e?e+":Applicant_Disability_How_Obtain":"Applicant_Disability_How_Obtain",label:"How Did Applicant Obtain the Disability Policy?",options:["Employer","Self","Other"]}),I=e=>y({name:e?e+":Applicant_Previously_Apply_Ltd_Benefits":"Applicant_Previously_Apply_Ltd_Benefits",label:"Has Applicant Previously Applied for Long Term Disability Benefits?",options:["Yes, claim pending","Yes, claim denied","No"]}),w=e=>b({name:e?e+":Applicant_Monthly_Salary":"Applicant_Monthly_Salary",label:"Applicant's Monthly Salary/Pay When Last at Work:",options:["< $1,000","$1,000 - $2,000","$2,000 - $3,000","$3,000 - $4,000","$4,000 - $5,000","$5,000 - $6,000","$6,000 - $7,000","$7,000 - $8,000","$8,000 - $9,000","$9,000 - $10,000",">$10,000"]}),$=e=>y({name:e?e+":Applicant_Received_Disability_Benefits":"Applicant_Received_Disability_Benefits",label:"Has Applicant Ever Received Long Term Disability Benefits for this Claim?",options:["Yes, currently receiving","Yes, appealing a decision to stop payment of benefits","No"]}),O=e=>g({name:e?e+":Applicant_Lt_Disability_Policy":"Applicant_Lt_Disability_Policy",label:"Does Applicant have a Long Term Disability Policy?"}),D=e=>g({name:e?e+":At_Fault":"At_Fault",label:"Were You at Fault?"}),S=()=>{return(e={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")',validation:null,helpClass:"!t-text-sm"}).legendClass="legend-left required",e.fieldsetClass="$reset side-by-side",e.optionsClass="t-pl-1",e.innerClass="t-flex t-items-center",e.wrapperClass="t-mb-3",m(e);var e},A=e=>b({name:e?e+":Blood_Alcohol_Content_Test":"Blood_Alcohol_Content_Test",label:"Blood Alcohol Content Measured by Test:",options:["No Test","0.00% - 0.04%","0.05% - 0.08%","0.09% - 0.12%","0.13% - 0.16%","0.17% - 0.20%","More than 0.20%","Don't know"]}),x=e=>b({name:e?e+":Cause_Of_Injury":"Cause_Of_Injury",label:"Cause of Injury:",options:["Traumatic Physical Injury (Accident)","Repeated Trauma Injury","Mental Injury","Occupational Disease","Not Sure"]}),k=a=>h(e({name:"Civil_Defense",id:"Civil_Defense",if:'$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"}},a)),E=a=>f(e({name:"Type_Of_Legal_Problem_Display",if:'$get(Type_Of_Legal_Problem).value == "Civil Lawsuit" && $get(Civil_Defense).value == "No"',label:"Select The Type of Lawsuit You Would Like to File:",options:["Automobile Accident","Contract Disputes","Defamation and Slander","Dog Bite","Employment and Workplace","Fraud","Medical Malpractice","Personal Injury","Property Damage","Small Claims","Real Estate","Other (describe on next page)"]},a)),W=e=>b({name:e?e+":Child_Home":"Child_Home",label:"With Whom Do the Children Currently Live?",options:["Mother","Father","Grandparents","Other"]}),M=e=>b({name:e?e+":Child_Primary_Caregiver":"Child_Primary_Caregiver",label:"Who is the Primary Caregiver?",options:["Mother","Father","Other"]}),B=e=>b({name:e?e+":Child_Relationship":"Child_Relationship",label:"Your Relationship to Child(ren):",options:["Father","Mother","Grandparent","Aunt/Uncle","Other"]}),N=e=>b({name:e?e+":Claim_Status":"Claim_Status",label:"Status of Claim:",options:["No action taken yet","Demand for compensation made","Lawsuit filed","Other"]}),F=(a,t)=>(a=>(a.name&&!a.id&&(a.id=a.name),e({$formkit:"textarea",rows:5,maxlength:500,validation:"required",validationMessages:{required:"Field is required"},innerClass:"t-max-w-xl",labelClass:"required"},a)))(e({name:t?t+":Comments":"Comments",label:"Please briefly describe your situation in a few words:",placeholder:'For Example: "I would like help with child support payments" or "I need help with visitation rights"'},a)),R=e=>b({name:e?e+":Country_Of_Citizenship":"Country_Of_Citizenship",label:"What is Your Current Country of Citizenship?",options:["Afghanistan","Albania","Algeria","Andorra","Angola","Antigua and Barbuda","Argentina","Armenia","Australia","Austria","Azerbaijan","Bahamas","The Bahrain","Bangladesh","Barbados","Belarus","Belgium","Belize","Benin","Bhutan","Bolivia","Bosnia and Herzegovina","Botswana","Brazil","Brunei","Bulgaria","Burkina Faso","Burundi","Cambodia","Cameroon","Canada","Cape Verde","Central African Republic","Chad","Chile","China","Colombia","Comoros","Congo (Congoâ Kinshasa)","Congo (Congoâ Brazzaville)","Costa Rica","Coted'Ivoire (Ivory Coast)","Croatia","Cuba","Cyprus","Czech Republic","Denmark","Djibouti","Dominica","Dominican Republic","Ecuador","Egypt","El Salvador","Equatorial Guinea","Eritrea","Estonia","Ethiopia","Fiji","Finland","France","Gabon","Gambia","Georgia","Germany","Ghana","Greece","Grenada","Guatemala","Guinea","Guinea-Bissau","Guyana","Haiti","Honduras","Hungary","Iceland","India","Indonesia","Iran","Iraq","Ireland","Israel","Italy","Jamaica","Japan","Jordan","Kazakhstan","Kenya","Kiribati","Korea (North Korea)","Korea (South Korea)","Kuwait","Kyrgyzstan","Laos","Latvia","Lebanon","Lesotho","Liberia","Libya","Liechtenstein","Lithuania","Luxembourg","Macedonia","Madagascar","Malawi","Malaysia","Maldives","Mali","Malta","Marshall Islands","Mauritania","Mauritius","Mexico","Micronesia","Moldova","Monaco","Mongolia","Montenegro","Morocco","Mozambique","Myanmar (Burma)","Namibia","Nauru","Nepal","Netherlands","New Zealand","Nicaragua","Niger","Nigeria","Norway","Oman","Pakistan","Palau","Panama","Papua New Guinea","Paraguay","Peru","Philippines","Poland","Portugal","Qatar","Romania","Russia","Rwanda","Saint Kitts and Nevis","SaintLucia","Saint Vincent and the Grenadines","Samoa","San Marino","Sao Tome and Principe","Saudi Arabia","Senegal","Serbia","Seychelles","Sierra Leone","Singapore","Slovakia","Slovenia","Solomon Islands","Somalia","South Africa","Spain","SriLanka","Sudan","Suriname","Swaziland","Sweden","Switzerland","Syria","Tajikistan","Tanzania","Thailand","Timor-Leste (East Timor)","Togo","Tonga","Trinidad and Tobago","Tunisia","Turkey","Turkmenistan","Tuvalu","Uganda","Ukraine","United Arab Emirates","United Kingdom","United States","Uruguay","Uzbekistan","Vanuatu","Vatican City","Venezuela","Vietnam","Yemen","Zambia","Zimbabwe"]}),j=()=>P({label:"When was the Alleged Crime?",name:"Crime_Committed_Date"}),U=(e,a)=>b({name:e?e+":Degree_Of_Interest":"Degree_Of_Interest",id:e?e+":Degree_Of_Interest":"Degree_Of_Interest",label:"How Likely Are You to Pay if Your Issue Could be Resolved?",help:a,options:["Definitely","Probably","Maybe","Absolutely Can't Afford"]}),H=e=>U(e,"No payment necessary to speak with lawyers."),Q=e=>g({name:e?e+":Disability_Condition_Stop_Work":"Disability_Condition_Stop_Work",label:"Do You Expect To Be Out Of Work For At Least a Year Due To Your Health?"}),Y=e=>g({name:e?e+":Disability_Work_History":"Disability_Work_History",label:"Have You Had a Full-Time Job Within the Past 5 Years?"}),q=e=>g({name:e?e+":Doctor_Treatment":"Doctor_Treatment",label:"Have You Recently Been Treated by a Doctor, Hospital or Clinic?"}),K=()=>b({label:"The Employer Is a:",name:"Employer_Type",options:["Sole proprietorship (mom and pop)","Partnership","Franchise","Privately held company","Public corporation","Government Agency","Don't know"]}),V=a=>f(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"]},a)),z=e=>b({name:e?e+":Estate_Legal_Services_Needed":"Estate_Legal_Services_Needed",label:"Legal Services Needed for Your Estate:",options:["Charitable Giving","Contested Wills","Drafting Wills or Trust","Estate Administration","Asset Protection","Other"]}),G=["Adoption","Asbestos and Mesothelioma","Auto and Car Accidents","Bankruptcy","Birth Certificate and Name Change","Business Lawyers","Child Custody","Child Support","Civil Rights and Discrimination","Consumer Lawyers","Copyrights and Trademarks","Criminal and Felony","Debt and Collections","Defend a Lawsuit","Divorce and Separation","DUI and DWI","Elder Law","Employment and Workplace","Expungement","Family Issues","File a Lawsuit","Foreclosure","Guardianship","Harassment and Discrimination","Identity Theft","Immigration and Visas","Insurance","Landlord and Tenant","Lemon Law","Long Term Disability","Medical Malpractice","Non-Workplace Discrimination","Non-Workplace Harassment","Patents and Intellectual Property","Personal Injury","Power of Attorney","Probate and Estates","Product Liability","Property Damage","Real Estate","Sexual Harassment","Social Security Disability and Insurance","Tax and IRS","Traffic and Tickets","Unemployment","Victim of a Crime","Wills and Trusts","Workers Compensation","Workplace Discrimination","Workplace Harassment","Wrongful Death","Wrongful Termination","Not Sure or Other"],Z=a=>b(e({label:"Type of Help Needed:",name:"Type_Of_Legal_Problem",id:"Type_Of_Legal_Problem",options:G},a)),J=e=>g({name:e?e+":Have_Attorney":"Have_Attorney",label:"Already Working with An Attorney?"}),X=e=>g({name:e?e+":Have_Children":"Have_Children",label:"Do You Have Children?"}),ee=e=>b({name:e?e+":Immigration_Details":"Immigration_Details",label:"Where is the Person Seeking Immigration Located?",options:["In the USA with proper documentation","In the USA without proper documentation","Not in the USA","In Deportation/Removal Proceedings","Currently Detained (friend or family submitting this request)","Out on Bond","None Apply"]}),ae=e=>b({name:e?e+":Immigration_Entry":"Immigration_Entry",label:"How are you Trying to Enter the Country?",options:["With Proper Documents/Visa and Inspection through Customs Border Patrol","Illegally","No Entry","Other"]}),te=e=>b({name:e?e+":Immigration_Location":"Immigration_Location",label:"Where Are You Migrating To?",options:["In the USA","Outside the USA"]}),ie=e=>b({name:e?e+":Immigration_Type":"Immigration_Type",label:"What Type of Immigration Issue?",options:["Citizenship (for current green card holders)","Permanent Visa Family Based (green cards)","Permanent Visa Business Based (green cards)","Temporary Business Visa","Temporary Tourist Visa","Investor","Asylum","Self Petition (violence & abuse victims)","Removal/Deportation Proceeding","Other"]}),ne=e=>b({name:e?e+":Immigration_Status":"Immigration_Status",label:"What is the Current Status of the Immigration Case?",options:["Out of Status (overstayed my visa)","Current Visa Holder (in status)","Lawful Permanent Resident (green card)","Not Applicable (outside the USA)","Other"]}),re=e=>P({name:e?e+":Incident_Date":"Incident_Date",label:"Date of Incident:"}),oe=()=>b({label:"The Other Party is a:",name:"Lawsuit_Other_Party",options:["Individual","Small Business","Large Corporation","Government Entity"]}),le=e=>b({name:e?e+":Lawyer_Payment_Method":"Lawyer_Payment_Method",label:"How Will You Pay for Legal Fees if You Hire a Lawyer?",help:"No payment necessary to speak with lawyers.",options:["Cash","Check","Credit Card","Friend","Family","Other"]}),se=e=>b({name:e?e+":Marital_Status":"Marital_Status",label:"Marital Status:",options:["Unmarried, Living Together","Unmarried, Do Not Live Together","Married, Living Together","Separated","Divorced","Other"]}),de=()=>b({label:"Total Employees of Business? (estimated)",name:"Num_Employees_Of_Business",options:["1-5","6-20","21-50","51-100","101-500","501-1,000","More than 1,000"]}),ue=()=>g({name:"Own_Real_Estate",label:"Do You Own Real Estate?"}),me=e=>g({name:e?e+":Pending_Charges":"Pending_Charges",label:"Do you currently have any pending charges?"}),pe=e=>_({name:e?e+":Primary_Injury":"Primary_Injury",label:"Primary Injury:",options:["Anxiety","Back or Neck Pain","Broken Bones","Cuts and Bruises","Headaches","Memory Loss","Loss of Limb","Other (describe on next page)"]}),ce=e=>g({name:e?e+":Prior_Alcohol_Offenses":"Prior_Alcohol_Offenses",label:"Any Prior Alcohol Related Offenses?"}),fe=e=>g({name:e?e+":Police_Report_Filed":"Police_Report_Filed",label:"Was a Police Report Filed?"}),ye=()=>b({label:"Area of Real Estate:",name:"Real_Estate_Area",options:["Condos and Coops","Construction Disputes","Purchase/Sale Contract","Refinancing Agreement","Title and Boundary Disputes","Zoning, Planning and Land Use","Property Deeds and Transfers","Liens","Other"]}),_e=a=>f(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","Other Real Estate Issues"]},a)),he=()=>y({label:"What is Your Role in this Matter?",name:"Role_In_Matter_Criminal",options:["I have been accused","I am acting on behalf of someone who has been accused","Other"]}),ge=e=>b({name:e?e+":Role_In_Matter_Probate":"Role_In_Matter_Probate",label:"What Is Your Role in this Matter?",options:["Preparing My Will","Executor","Heir","Other"]}),be=e=>g({name:e?e+":Social_Security_Disability_Receiving_Benefits":"Social_Security_Disability_Receiving_Benefits",label:"Are You Currently Receiving Social Security Disability Benefits?"}),Ce=()=>b({label:"Total Debt?",name:"Total_Debt",options:["Less than 5K","5K to 10K","10K to 20K","20K to 50K","More than 50K"]}),Pe=()=>b({label:"Total Monthly Income?",name:"Total_Monthly_Income",options:["Less than 1K","1K to 2K","2K to 3K","3K to 4K","4K to 5K","5K to 7K","7K to 10K","10K to 15K","More than 15K"]}),ve=e=>b({name:e?e+":Type_Of_Alcohol_Test":"Type_Of_Alcohol_Test",label:"Type of Alcohol Test Performed?",options:["No Test","Refused Test","Breath Test","Blood Test","Urine Test","Don't Know"]}),Te=e=>p({name:e?e+":Type_Of_Assets":"Type_Of_Assets",label:"Type of Assets:",options:["Business Interests","Cash","Life Insurance Policies","Pensions/Retirement","Personal Possessions","Property","Stock/Bonds"]}),Le=e=>b({name:e?e+":Value_Of_Assets":"Value_Of_Assets",label:"Value of Your Assets?",options:["Less than 50K","50K to 100K","100K to 250K","250K to 500K","500K to 1M","More than 1M"]}),Ie=()=>y({label:"I Would Like a Lawyer to:",name:"Would_Like_Lawyer_To",options:["Give me general advice to protect my interests","Act as my agent in the transaction","Assist me in the remaining stages of the transaction","Bring a lawsuit against another party","Defend against a lawsuit filed by another party","Other"]}),we=(a,t)=>e({$cmp:"FormKit",props:{type:"group",key:a,id:a,name:a}},t),$e=()=>[J(),H()],Oe=(e,a)=>we("AutoAndCarAccidentsQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Auto and Car Accidents"',children:[J(a),re(a),D(a),pe(a),q(a),fe(a)]}),De=(e,a)=>we("ChildCustodyAndSupportQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Child Custody and Support"',children:[J(a),B(a),W(a),M(a),U(a),le(a)]}),Se=(e,a)=>we("ChildCustodyQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Child Custody"',children:[J(a),B(a),W(a),M(a),U(a),le(a)]}),Ae=a=>f(e({name:"Type_Of_Legal_Problem_Display",if:'$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"]},a)),xe=(e,a)=>we("DivorceQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Divorce and Separation"',children:[J(a),se(a),X(a),U(a),le(a)]}),ke=(e,a)=>we("DUIAndDWIQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "DUI and DWI"',children:[J(a),re(a),ce(a),ve(a),A(a),me(a),H(a)]}),Ee=(e,a)=>we("ImmigrationAndVisasQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Immigration and Visas"',children:[J(a),R(a),te(a),ae(a),ie(a),ne(a),ee(a),H(a)]}),We=(e,a)=>we("LongTermDisabilityQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Long Term Disability"',children:[J(a),v(a),T(a),O(a),L(a),I(a),$(a),w(a)]}),Me=(e,a)=>we("PersonalInjuryQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Personal Injury"',children:[J(a),re(a),N(a),D(a),pe(a),q(a)]}),Be=(e,a)=>we("PowerofAttorneyQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Power of Attorney"',children:[J(a),H(a)]}),Ne=(e,a)=>we("SocialSecurityDisabilityAndInsuranceQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Social Security Disability and Insurance"',children:[J(a),T(a),Q(a),Y(a),be(a),q(a)]}),Fe=(e,a)=>we("WillsAndTrustsQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Wills and Trusts"',children:[J(a),Le(a),Te(a),ge(a),z(a),H(a)]}),Re=(e,a)=>we("WorkersCompensationQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Workers Compensation"',children:[J(a),re(a),N(a),pe(a),x(a),q(a)]}),je="$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",Ue="$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",He=e=>"group"!==e.type&&"section"!==e.type&&"form"!==e.type&&"hidden"!==e.$formkit&&!e.children,Qe=e=>{if(He(e))return e;for(var a=e.children.length-1;a>=0;a--){if("string"==typeof e.children)continue;const t=e.children[a];if(He(t))return t;const i=Qe(t);if(i)return i}return null};function Ye(e){return{$el:"h3",children:e.headline||"Tell Us About Your Situation",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1"}}}function qe(e){return{$el:"h5",children:e.subheadline||"Tell us about your situation:",attrs:{class:"t-flex t-justify-center t-text-dark t-text-center !t-text-lg t-font-semibold t-pb-4 t-pt-0 t-px-3"}}}function Ke(e){return{$el:"h3",children:e.headline||"Additional Case Details",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function Ve(e){return{$el:"h3",children:e.headline||"Please Provide a Contact Name",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function ze(e){return{$el:"h3",children:e.headline||"Do any of the following situations apply?",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function Ge(e){return{$el:"h3",children:e.headline||t,attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-3 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function Ze(e){return{$el:"h5",children:e.subheadline||i,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 Je="(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 Xe=(e,a)=>({$el:"section",if:'$stepEnabled("'+e+'")',attrs:{hidden:'$activeStep !== "'+e+'"',key:a||e}});function ea(a,t,i=!0,n=!1,r=void 0,o=void 0,l=void 0){if(void 0===i&&(i=!0),t&&t.length&&(i||n)){const e=Qe(t[t.length-1]);e&&!0===i&&(e.onKeypress=je),e&&!0===n&&(e.onInput=Ue)}return e(Xe(a,r),{children:[{$formkit:"group",id:a,name:a,nextStepMap:o,autoFocus:l,children:t}]})}const aa=[{type:"meta",data:e(r,{defaultCommentsPlaceholder:a,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."}})},e(o,ta),{$cmp:"FormKit",props:function(a){const t=e(n,a);return t.formId&&!t.name&&(t.name=t.formId),t}({formId:"generalLegalPopUnder",redirectMap:function(a){return e(u,a)}(),popUnderMap:{"*":"/thank-you"},valueOverrideMap:{Civil_Defense:{Yes:{Type_Of_Legal_Problem:"Defend a Lawsuit"},No:{Type_Of_Legal_Problem:"File a Lawsuit"}},Type_Of_Legal_Problem_Display:{"Auto Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Dog Bite":{Type_Of_Legal_Problem:"Personal Injury"},"Slip and Fall":{Type_Of_Legal_Problem:"Personal Injury"},"Workplace Injury":{Type_Of_Legal_Problem:"Workers Compensation"},"Trucking Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Motorcycle Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Other Accidents or Injuries":{Type_Of_Legal_Problem:"Personal Injury"},"Automobile Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Contract Disputes":{Type_Of_Legal_Problem:"Business Lawyers"},"Defamation and Slander":{Type_Of_Legal_Problem:"File a Lawsuit"},"Dog Bite":{Type_Of_Legal_Problem:"Personal Injury"},"Employment and Workplace":{Type_Of_Legal_Problem:"Employment and Workplace"},Fraud:{Type_Of_Legal_Problem:"Consumer Lawyers"},"Medical Malpractice":{Type_Of_Legal_Problem:"Medical Malpractice"},"Personal Injury":{Type_Of_Legal_Problem:"Personal Injury"},"Property Damage":{Type_Of_Legal_Problem:"Property Damage"},"Small Claims":{Type_Of_Legal_Problem:"File a Lawsuit"},"Real Estate":{Type_Of_Legal_Problem:"Real Estate"},"Other (describe on next page)":{Type_Of_Legal_Problem:"Not Sure or Other"},"Contract Creation":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Contract Enforcement":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Contract Cancellation":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Contract Fraud":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Breach of Contract":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Other Contract Issues":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Criminal Defense":{Type_Of_Legal_Problem:"Criminal and Felony"},"Victim of a Crime":{Type_Of_Legal_Problem:"Victim of a Crime"},"DUI and DWI":{Type_Of_Legal_Problem:"DUI and DWI"},Expungement:{Type_Of_Legal_Problem:"Expungement"},Harassment:{Type_Of_Legal_Problem:"Criminal and Felony"},"Not Sure or Other":{Type_Of_Legal_Problem:"Not Sure or Other"},"Workplace Harassment":{Type_Of_Legal_Problem:"Workplace Harassment"},"Workplace Discrimination":{Type_Of_Legal_Problem:"Workplace Discrimination"},"Wrongful Termination":{Type_Of_Legal_Problem:"Wrongful Termination"},"Payment Disputes":{Type_Of_Legal_Problem:"Employment and Workplace"},"Workers Compensation":{Type_Of_Legal_Problem:"Workers Compensation"},Unemployment:{Type_Of_Legal_Problem:"Unemployment"},"Other Workplace Issues":{Type_Of_Legal_Problem:"Employment and Workplace"},"Attorney Malpractice":{Type_Of_Legal_Problem:"Civil Lawsuit"},"Other Malpractice Issues":{Type_Of_Legal_Problem:"Not Sure or Other"},"Vehicle Repossession":{Type_Of_Legal_Problem:"Bankruptcy"},"Property Repossession":{Type_Of_Legal_Problem:"Bankruptcy"},"Other Repossession Issues":{Type_Of_Legal_Problem:"Not Sure or Other"},"Contracts and Agreements":{Type_Of_Legal_Problem:"Real Estate"},"Deeds, Liens, and Titles":{Type_Of_Legal_Problem:"Real Estate"},Foreclosure:{Type_Of_Legal_Problem:"Foreclosure"},Insurance:{Type_Of_Legal_Problem:"Insurance"},"Landlord and Tenant":{Type_Of_Legal_Problem:"Landlord and Tenant"},"Loans and Mortgages":{Type_Of_Legal_Problem:"Real Estate"},"Wills, Trusts, and Estates":{Type_Of_Legal_Problem:"Wills and Trusts"},"Property Damage":{Type_Of_Legal_Problem:"Property Damage"},"Other Real Estate Issues":{Type_Of_Legal_Problem:"Real Estate"}}}}),children:[function(a={}){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||"")}}}(a),a)}({children:'$urlParam("hl", "Need Legal Help? Start Here!")',if:"$activeStep === $firstStep()"}),function(a={}){return e(function(e={}){return{$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||"")}}}(a),a)}({children:'$urlParam("shl", "Our Service is Fast and Free!")',if:"$activeStep === $firstStep()"}),...d,{$el:"div",attrs:{class:"form-body"},children:[function(e={}){return ea("generalLegalTOLPAndZip",[Z(),k(),E(),Ae(),V(),f({label:"What is the Landlord / Tenant Issue?",if:'$get(Type_Of_Legal_Problem).value == "Landlord and Tenant"',id:"Landlord_Tenant_Issue",name:"Landlord_Tenant_Issue",options:["Eviction","Repairs and Maintenance","Lease and Rental Agreements","Discrimination","Right of Entry and Privacy","Screening and Applications","Environmental Hazards","Other Dispute"]}),_e(),C({label:"Zip Code:",placeholder:"#####",name:"Zip",maxlength:5,inputmode:"numeric",autocomplete:"postal-code",validation:"required|matches:/^[0-9]{5}$/",validationMessages:{required:"Zip Code is required",matches:"Invalid Zip Code"}})],e.nextOnEnter)}(),function(e={}){var a,t,i=[we("AdoptionQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Adoption"',children:[J(),se(),X(),U(),le()]}),we("AsbestosAndMesotheliomaQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Asbestos and Mesothelioma"',children:[J(),re(),q(),H()]}),Oe(),we("BankruptcyQuestions",{if:a||'$get(Type_Of_Legal_Problem).value == "Bankruptcy"',children:[J(t),Pe(),Ce(),ue(),Le(t),H(t)]}),we("BirthCertificateAndNameChangeQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Birth Certificate and Name Change"',children:[J(),H()]}),we("BusinessLawyersQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Business Lawyers"',children:[J(),b({label:"Legal Services Needed for Your Business:",id:"Business_Services",name:"Business_Services",options:["Business Formation","Contracts","Insurance and Liability","Mergers and Acquisition","Regulatory Compliance","Employee Dispute","Other"]}),_({label:"Is the Business Public or Private?",name:"Business_Type",options:["Public","Private"]}),de(),H()]}),De(),Se(),we("ChildSupportQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Child Support"',children:[J(),B(),W(),M(),U(),le()]}),we("CivilRightsAndDiscriminationQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Civil Rights and Discrimination"',children:[b({label:"On what basis were your rights violated?",name:"Civil_Rights_Type",options:["Age","Disability","Gender","Race","Religion","Other"]}),J(),H()]}),we("CivilLawsuitQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Civil Lawsuit"',children:[J(),oe(),H()]}),we("FileLawsuitQuestions",{if:'$get(Type_Of_Legal_Problem).value == "File a Lawsuit"',children:[J(),oe(),H()]}),we("DefendLawsuitQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Defend a Lawsuit"',children:[J(),oe(),H()]}),we("ConsumerLawyersQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Consumer Lawyers"',children:[b({label:"What best describes your issue?",name:"Consumer_Lawyer_Type",options:["Unsafe Environment","Unsafe Products","Auto Fraud","Credit Reporting Issues","Debt Collection Abuse","Identity Theft","Lemon Law","Military Consumer Rights","Predatory Lending","Student Loans","Other"]}),re(),J(),oe(),H()]}),we("CopyrightsAndTrademarksQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Copyrights and Trademarks"',children:[J(),H()]}),we("CriminalAndFelonyQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Criminal and Felony"',children:[J(),j(),he(),me(),U(),le()]}),we("DebtAndCollectionsQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Debt and Collections"',children:[J(),Pe(),Ce(),ue(),Le(),H()]}),xe(),ke(),we("ElderLawQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Elder Law"',children:[J(),H()]}),we("EmploymentAndWorkplaceQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Employment and Workplace"',children:[J(),de(),K(),H()]}),we("ExpungementQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Expungement"',children:[J(),re(),b({label:"What Type of Charge?",name:"Criminal_Charge_Type",options:["Felony","Misdemeanor","Juvenile","Other"]}),U(),le()]}),we("FamilyIssuesQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Family Issues"',children:[J(),se(),X(),U(),le()]}),we("ForeclosureQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Foreclosure"',children:[J(),ue(),b({label:"Type of Property:",name:"Type_Of_Property",options:["Residential","Commercial","Industrial","Agricultural","Recreational","Other"]}),b({label:"Total Amount of Payments that are Past Due:",name:"Amount_Payments_Past_Due",options:["$0 - $499","$500 - $999","$1,000 - $2,499","$2,500 - $4,999","$5,000 - $9,999","$10,000 - $24,999","$25,000 - $49,999","$50,000 - $99,999","More than $100,000"]}),b({label:"Total Amount of Loan?",name:"Loan_Amount",options:["Less than $10,000","$10,000 - $24,999","$25,000 - $49,999","$50,000 - $99,999","$100,000 - $199,999","$200,000 - $299,999","$300,000 - $399,999","$400,000 - $499,999","$500,000 - $599,999","More than $600,000"]}),g({name:"Default_Notice",label:"Have You Received a Notice of Default from the Lender?"}),H()]}),we("GuardianshipQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Guardianship"',children:[J(),se(),X(),U(),le()]}),we("HarassmentAndDiscriminationQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Harassment and Discrimination"',children:$e()}),we("SexualHarassmentQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Sexual Harassment"',children:$e()}),we("WorkplaceHarassmentQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Workplace Harassment"',children:$e()}),we("NonWorkplaceHarassmentQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Non-Workplace Harassment"',children:$e()}),we("WorkplaceDiscriminationQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Workplace Discrimination"',children:$e()}),we("NonWorkplaceDiscriminationQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Non-Workplace Discrimination"',children:$e()}),we("IdentityTheftQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Identity Theft"',children:[J(),H()]}),Ee(),we("InsuranceQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Insurance"',children:[J(),H()]}),we("LandlordAndTenantQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Landlord and Tenant"',children:[J(),b({label:"I am the:",name:"Landlord_Tenant_Party",options:["Landlord","Tenant","Other"]}),H()]}),we("LemonLawQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Lemon Law"',children:[J(),re(),oe(),H()]}),We(),we("MedicalMalpracticeQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Medical Malpractice"',children:[J(),re(),N(),q(),b({label:"Injuries from Medical Malpractice:",name:"Medical_Malpractice_Injuries",options:["No Injury","Minor Injury","Disfigurement or cosmetic injury","Short term loss of physical ability","Long term loss of physical injury","Possibility of future harm","Death of Patient"]}),H()]}),we("PatentsAndIntellectualPropertyQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Patents and Intellectual Property"',children:[J(),b({label:"Legal Assistance Needed:",name:"Patent_Assistance_Type",options:["Obtaining a Patent","Avoiding Patent Infringement","Suing for Patent Infringement","Defending Against a Claim of Patent Infringement","Other"]}),b({label:"The Patent is for a:",name:"Patent_For",options:["Product or Machine","Process","Computer Software","Living Organism or Plant","Ornamental Design","Other"]}),H()]}),Me(),Be(),we("ProbateAndEstatesQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Probate and Estates"',children:[J(),Le(),Te(),ge(),z(),H()]}),we("ProductLiabilityQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Product Liability"',children:[J(),H()]}),we("PropertyDamageQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Property Damage"',children:[J(),ye(),Ie(),H()]}),we("RealEstateQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Real Estate"',children:[J(),ye(),Ie(),H()]}),Ne(),we("TaxAndIRSQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Tax and IRS"',children:[J(),Ce(),b({label:"Details of Tax Problem:",name:"Tax_Problem_Details",options:["Assets Seized","Bank Account Levied","Cannot Pay Taxes","Innocent Spouse","Lien Filed","Received Audit Notice","Unpaid Interest","Wage Garnishment","Other"]}),b({label:"Which Level of Tax Issue?",name:"Tax_Level",options:["Federal","State","Local"]}),b({label:"Type of Tax Issue:",name:"Tax_Issue_Type",options:["Income","Property","Corporate"]}),H()]}),we("TrafficAndTicketsQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Traffic and Tickets"',children:[J(),h({name:"Drivers_License_Type",label:"Type of Driver's License:",options:["Private","Commercial"]}),b({label:"Which Type of Violation?",name:"Traffic_Violations",options:["Disregarding a Red Light","Disregarding a Stop Sign","DMV Letter About License","DUI/DWI","Failure to Appear in Court","License Suspended/Revoked","Minor in Possession of Alcohol","No Child Safety Seat","No Liability Insurance","No Seat Belt","Open Container of Alcohol","Parking Ticket","Racing","Speeding","Unpaid Traffic Tickets","Warrant Issue for Arrest","Other Violation"]}),g({name:"Have_Court_Date",label:"Do You Have a Court Date?"}),H()]}),we("UnemploymentQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Unemployment"',children:[de(),K(),H()]}),we("VictimOfACrimeQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Victim of a Crime"',children:[J(),j(),he(),me(),U(),le()]}),Fe(),Re(),we("WrongfulDeathQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Wrongful Death"',children:[J(),re(),b({label:"Relationship to the Victim:",name:"Relationship_To_Victim",options:["Parent","Spouse","Sibling","Friend","Other"]}),y({name:"Criminal_Charges_Filed",label:"Were Criminal Charges Filed?",options:["Yes","No","Not Sure"]}),b({label:"What was the Cause of the Victim's Death?",name:"Cause_Of_Death",options:["Vehicle Accident","Negligent/Careless Act","Reckless Act","Other"]})]}),we("WrongfulTerminationQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Wrongful Termination"',children:[J(),de(),K(),H()]}),we("NotSureOrOtherQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Not Sure or Other"',children:[J(),H()]})];return i.unshift(function(e){return{$el:"h3",children:e.headline||"Tell Us About Your Situation",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1"}}}(e)),ea("TOLPQuestions",i,e.nextOnEnter)}(),function(e={}){return ea("commentsWithBankruptcy",[Ke(e),F({label:void 0===e.label?"Please briefly describe your legal issue in a few words:":e.label,placeholder:e.placeholder||a,inputClass:void 0===e.inputClass?"!t-h-40":e.inputClass}),S(),{$el:"div",if:"$get(CrossSell_Bankruptcy).value == true",children:[F({label:"Bankruptcy or debt details:",placeholder:"Please describe your bankrtupcy or debt situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Bankruptcy")]}],e.nextOnEnter,!1,void 0,void 0,!1)}({nextOnEnter:!1}),function(e={}){return ea("legalCrossSells",[ze(e),p({id:"Legal_CrossSells",name:"Legal_CrossSells",help:'Just hit "Next" if none apply',helpClass:"t-text-center !t-text-sm",validation:null,options:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "Auto and Car Accidents"',then:{"Social Security Disability and Insurance":"Interest in Disability Benefits","Wills and Trusts":"Need a Will or Trust","Workers Compensation":"Workplace Injury","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "Personal Injury" || $getVal($get(form), "Type_Of_Legal_Problem") === "Workers Compensation"',then:{"DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "DUI and DWI"',then:{"Personal Injury":"Personal or Workplace Injury","Wills and Trusts":"Need a Will or Trust","Social Security Disability and Insurance":"Interest in Disability Benefits","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "Wills and Trusts" || $getVal($get(form), "Type_Of_Legal_Problem") === "Probate and Estates" || $getVal($get(form), "Type_Of_Legal_Problem") === "Power of Attorney"',then:{"Auto and Car Accidents":"Injured in a Car Accident","Personal Injury":"Personal or Workplace Injury","DUI and DWI":"Involved in a DUI/DWI","Social Security Disability and Insurance":"Interest in Disability Benefits","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "Long Term Disability" || $getVal($get(form), "Type_Of_Legal_Problem") === "Social Security Disability and Insurance"',then:{"Auto and Car Accidents":"Injured in a Car Accident","DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{"Auto and Car Accidents":"Injured in a Car Accident","Personal Injury":"Personal or Workplace Injury","DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Social Security Disability and Insurance":"Interest in Disability Benefits"}}}}}}})],e.nextOnEnter,!1,"$get(Type_Of_Legal_Problem).value")}(),function(e={}){return ea("autoAndCarAccidentCrossSellQuestions",[Ye({headline:"You May Be Entitled To Compensation"}),qe({subheadline:"Tell us about your accident:"}),Oe("true","CrossSell:Auto_and_Car_Accidents"),F({label:"Accident Description:",placeholder:"Please describe your accident in a few words...",inputClass:"!t-h-16"},"CrossSell:Auto_and_Car_Accidents")],e.nextOnEnter)}(),function(e={}){return ea("personalInjuryCrossSellQuestions",[Ye({headline:"You May Be Entitled To Compensation"}),qe({subheadline:"Tell us about your injury:"}),Me("true","CrossSell:Personal_Injury"),F({label:"Injury Description:",placeholder:"Please describe your injury in a few words...",inputClass:"!t-h-16"},"CrossSell:Personal_Injury")],e.nextOnEnter)}(),function(e={}){return ea("workersCompensationCrossSellQuestions",[Ye({headline:"You May Be Entitled To Benefits"}),qe({subheadline:"Tell us about your injury:"}),Re("true","CrossSell:Workers_Compensation"),F({label:"Injury Description:",placeholder:"Please describe your injury in a few words...",inputClass:"!t-h-16"},"CrossSell:Workers_Compensation")],e.nextOnEnter)}(),function(e={}){return ea("duiAndDWICrossSellQuestions",[Ye({headline:"About Your DUI/DWI"}),ke("true","CrossSell:DUI_and_DWI"),F({label:"Incident Description:",placeholder:"Please describe your incident in a few words...",inputClass:"!t-h-16"},"CrossSell:DUI_and_DWI")],e.nextOnEnter)}(),function(e={}){return ea("ssdiCrossSellQuestions",[Ye({headline:"You May Be Entitled To Benefits"}),qe({subheadline:"Tell us about your disability:"}),Ne("true","CrossSell:Social_Security_Disability_and_Insurance"),F({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Social_Security_Disability_and_Insurance")],e.nextOnEnter)}(),function(e={}){return ea("powerOfAttorneyCrossSellQuestions",[Ye({headline:"Power of Attorney Information"}),Be("true","CrossSell:Power_of_Attorney"),F({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Power_of_Attorney")],e.nextOnEnter)}(),function(e={}){return ea("willsAndTrustsCrossSellQuestions",[Ye({headline:"Will or Trust Information"}),Fe("true","CrossSell:Wills_and_Trusts"),F({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Wills_and_Trusts")],e.nextOnEnter)}(),function(e={}){return ea("divorceAndSeparationCrossSellQuestions",[Ye({headline:"Divorce or Separation Information"}),xe("true","CrossSell:Divorce_and_Separation"),F({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Divorce_and_Separation")],e.nextOnEnter)}(),function(e={}){return ea("childCustodyCrossSellQuestions",[Ye({headline:"Child Custody Information"}),Se("true","CrossSell:Child_Custody"),F({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Child_Custody")],e.nextOnEnter)}(),function(e={}){return ea("firstAndLast",[Ve(e),C({$formkit:"text",label:"First Name:",placeholder:"First",name:"First_Name",autocomplete:"given-name",validationMessages:{required:"First Name is required"}}),C({$formkit:"text",label:"Last Name:",placeholder:"Last",name:"Last_Name",autocomplete:"family-name",validationMessages:{required:"Last Name is required"}})],e.nextOnEnter)}(),function(e={}){return ea("contactInfo",[Ge(e),Ze(e),{$el:"script",if:"$activeStep === $lastStep()",children:Je},C({$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"}}),C({$formkit:"tel",name:"Primary_Phone",label:"Phone Number:",placeholder:"###-###-####",maxlength:12,help:"10-digit phone number, hyphens optional",autocomplete:"tel-national","data-tf-sensitive":"false",validation:"required|matches:/^[0-9]{3}-?[0-9]{3}-?[0-9]{4}$/|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"}},s()],e.nextOnEnter)}({nextOnEnter:!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: ","$stepKeys()"],attrs:{class:"t-text-xs",style:"overflow: scroll"}}]}]}]}];var ta;return aa}();
+var generalLegalPopUnder=function(){"use strict";function e(){return Object.assign({},...arguments)}const a='$getKey($meta, "commentsPlaceholders." + $get(Type_Of_Legal_Problem).value, $meta.defaultCommentsPlaceholder)',t='$getKey($meta, "finalHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalHeadline)',i='$getKey($meta, "finalSubHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalSubHeadline)',n={type:"form",id:"form",config:{validationVisibility:"submit"},onSubmit:'$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 r={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 o={$el:"div",children:[{$el:"div",attrs:{id:"form-anchor",class:"t-absolute",style:{top:"-30px",left:0}}}],attrs:{class:"t-relative"}};const l={$el:"div",if:"$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"}},{$el:"span",children:"Secure & Encrypted",attrs:{class:"t-pl-2 t-pt-1 t-font-medium"}}]};function s(a){return e(l,a)}const d=[{$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},{$formkit:"hidden",name:"s",value:null}],u={"*":"https://listings.ziplawyer.com/api/v1/redirect?zone_id=4&vertical=Legal&category=${properties.Type_Of_Legal_Problem}&Degree_Of_Interest=${properties.Degree_Of_Interest}&zip_code=${properties.Zip}&sub_id=${properties.vid}"};const m=a=>(a.name&&!a.id&&(a.id=a.name),e({$formkit:"checkbox",validation:"required",validationMessages:{required:"Field is required"}},a)),p=e=>(e&&e.legendClass||(e.legendClass="required"),e.fieldsetClass="$reset",e.optionsClass="t-pl-8 md:t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",m(e)),c=a=>(a.name&&!a.id&&(a.id=a.name),e({$formkit:"radio",validation:"required",validationMessages:{required:"Field is required"},optionsClass:"t-pt-3 t-pl-1",legendClass:"required"},a)),f=e=>(e.legendClass="required",e.fieldsetClass="$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="$reset t-flex t-cursor-pointer t-mb-3",c(e)),y=e=>(e.legendClass="legend-left required",e.fieldsetClass="$reset side-by-side",e.optionsClass="t-pl-1",e.innerClass="t-flex t-items-center",e.wrapperClass="t-mb-3",c(e)),_=e=>(e.legendClass="legend-left-flex md:t-max-w-[40%] required",e.fieldsetClass="$reset side-by-side-flex",e.optionsClass="md:t-ml-4 md:t-mt-2 t-grid t-grid-cols-1 md:t-grid-cols-2-125",e.innerClass="t-flex t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",c(e)),h=e=>(e.legendClass="legend-left t-pb-1 required",e.fieldsetClass="$reset side-by-side t-items-center",e.optionsClass="t-mt-1 t-grid t-grid-cols-1 md:t-grid-cols-2-125 t-items-center",e.innerClass="t-flex t-items-center",e.optionClass="t-pr-1",c(e)),g=e=>(e.options=["Yes","No"],h(e)),b=a=>(a.labelClass="required",a.wrapperClass="side-by-side t-items-center",a.innerClass="select-height-content",a.helpClass="t-mt-2.5 md:t-text-right md:t-mt-[-5px]",(a=>(a.name&&!a.id&&(a.id=a.name),e({$formkit:"select",placeholder:"Please Select",validation:"required",validationMessages:{required:"Field is required"},inputClass:"t-bg-white",labelClass:"required"},a)))(a)),C=a=>(a.wrapperClass="side-by-side t-items-center",(a=>(a.name&&!a.id&&(a.id=a.name),e({$formkit:"text",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required"},a)))(a)),P=a=>(a.wrapperClass="side-by-side t-items-center",(a=>(a.name&&!a.id&&(a.id=a.name),e({$formkit:"DatePicker",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required t-block t-mb-3 t-font-semibold t-text-base formkit-invalid:t-text-red-500",innerClass:"t-border t-border-gray-400 formkit-invalid:t-border-red-500 t-rounded t-mb-1 focus-within:t-border-blue-500"},a)))(a)),v=e=>C({name:e?e+":Applicant_Occupation":"Applicant_Occupation",label:"What is the Applicant's Occupation?",placeholder:"Occupation"}),T=e=>C({name:e?e+":Applicant_Age":"Applicant_Age",label:"Age of Applicant?",placeholder:"Age between 18 and 65",maxlength:2,inputmode:"numeric",validation:"required|min:18,max:65",validationMessages:{required:"Applicant Age is required",min:"Invalid Age - must be between 18 and 65",max:"Invalid Age - must be between 18 and 65"}}),L=e=>b({name:e?e+":Applicant_Disability_How_Obtain":"Applicant_Disability_How_Obtain",label:"How Did Applicant Obtain the Disability Policy?",options:["Employer","Self","Other"]}),I=e=>y({name:e?e+":Applicant_Previously_Apply_Ltd_Benefits":"Applicant_Previously_Apply_Ltd_Benefits",label:"Has Applicant Previously Applied for Long Term Disability Benefits?",options:["Yes, claim pending","Yes, claim denied","No"]}),w=e=>b({name:e?e+":Applicant_Monthly_Salary":"Applicant_Monthly_Salary",label:"Applicant's Monthly Salary/Pay When Last at Work:",options:["< $1,000","$1,000 - $2,000","$2,000 - $3,000","$3,000 - $4,000","$4,000 - $5,000","$5,000 - $6,000","$6,000 - $7,000","$7,000 - $8,000","$8,000 - $9,000","$9,000 - $10,000",">$10,000"]}),$=e=>y({name:e?e+":Applicant_Received_Disability_Benefits":"Applicant_Received_Disability_Benefits",label:"Has Applicant Ever Received Long Term Disability Benefits for this Claim?",options:["Yes, currently receiving","Yes, appealing a decision to stop payment of benefits","No"]}),O=e=>g({name:e?e+":Applicant_Lt_Disability_Policy":"Applicant_Lt_Disability_Policy",label:"Does Applicant have a Long Term Disability Policy?"}),D=e=>g({name:e?e+":At_Fault":"At_Fault",label:"Were You at Fault?"}),S=()=>{return(e={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")',validation:null,helpClass:"!t-text-sm"}).legendClass="legend-left required",e.fieldsetClass="$reset side-by-side",e.optionsClass="t-pl-1",e.innerClass="t-flex t-items-center",e.wrapperClass="t-mb-3",m(e);var e},A=e=>b({name:e?e+":Blood_Alcohol_Content_Test":"Blood_Alcohol_Content_Test",label:"Blood Alcohol Content Measured by Test:",options:["No Test","0.00% - 0.04%","0.05% - 0.08%","0.09% - 0.12%","0.13% - 0.16%","0.17% - 0.20%","More than 0.20%","Don't know"]}),x=e=>b({name:e?e+":Cause_Of_Injury":"Cause_Of_Injury",label:"Cause of Injury:",options:["Traumatic Physical Injury (Accident)","Repeated Trauma Injury","Mental Injury","Occupational Disease","Not Sure"]}),k=a=>h(e({name:"Civil_Defense",id:"Civil_Defense",if:'$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"}},a)),E=a=>f(e({name:"Type_Of_Legal_Problem_Display",if:'$get(Type_Of_Legal_Problem).value == "Civil Lawsuit" && $get(Civil_Defense).value == "No"',label:"Select The Type of Lawsuit You Would Like to File:",options:["Automobile Accident","Contract Disputes","Defamation and Slander","Dog Bite","Employment and Workplace","Fraud","Medical Malpractice","Personal Injury","Property Damage","Small Claims","Real Estate","Other (describe on next page)"]},a)),W=e=>b({name:e?e+":Child_Home":"Child_Home",label:"With Whom Do the Children Currently Live?",options:["Mother","Father","Grandparents","Other"]}),M=e=>b({name:e?e+":Child_Primary_Caregiver":"Child_Primary_Caregiver",label:"Who is the Primary Caregiver?",options:["Mother","Father","Other"]}),B=e=>b({name:e?e+":Child_Relationship":"Child_Relationship",label:"Your Relationship to Child(ren):",options:["Father","Mother","Grandparent","Aunt/Uncle","Other"]}),N=e=>b({name:e?e+":Claim_Status":"Claim_Status",label:"Status of Claim:",options:["No action taken yet","Demand for compensation made","Lawsuit filed","Other"]}),F=(a,t)=>(a=>(a.name&&!a.id&&(a.id=a.name),e({$formkit:"textarea",rows:5,maxlength:500,validation:"required",validationMessages:{required:"Field is required"},innerClass:"t-max-w-xl",labelClass:"required"},a)))(e({name:t?t+":Comments":"Comments",label:"Please briefly describe your situation in a few words:",placeholder:'For Example: "I would like help with child support payments" or "I need help with visitation rights"'},a)),R=e=>b({name:e?e+":Country_Of_Citizenship":"Country_Of_Citizenship",label:"What is Your Current Country of Citizenship?",options:["Afghanistan","Albania","Algeria","Andorra","Angola","Antigua and Barbuda","Argentina","Armenia","Australia","Austria","Azerbaijan","Bahamas","The Bahrain","Bangladesh","Barbados","Belarus","Belgium","Belize","Benin","Bhutan","Bolivia","Bosnia and Herzegovina","Botswana","Brazil","Brunei","Bulgaria","Burkina Faso","Burundi","Cambodia","Cameroon","Canada","Cape Verde","Central African Republic","Chad","Chile","China","Colombia","Comoros","Congo (Congoâ Kinshasa)","Congo (Congoâ Brazzaville)","Costa Rica","Coted'Ivoire (Ivory Coast)","Croatia","Cuba","Cyprus","Czech Republic","Denmark","Djibouti","Dominica","Dominican Republic","Ecuador","Egypt","El Salvador","Equatorial Guinea","Eritrea","Estonia","Ethiopia","Fiji","Finland","France","Gabon","Gambia","Georgia","Germany","Ghana","Greece","Grenada","Guatemala","Guinea","Guinea-Bissau","Guyana","Haiti","Honduras","Hungary","Iceland","India","Indonesia","Iran","Iraq","Ireland","Israel","Italy","Jamaica","Japan","Jordan","Kazakhstan","Kenya","Kiribati","Korea (North Korea)","Korea (South Korea)","Kuwait","Kyrgyzstan","Laos","Latvia","Lebanon","Lesotho","Liberia","Libya","Liechtenstein","Lithuania","Luxembourg","Macedonia","Madagascar","Malawi","Malaysia","Maldives","Mali","Malta","Marshall Islands","Mauritania","Mauritius","Mexico","Micronesia","Moldova","Monaco","Mongolia","Montenegro","Morocco","Mozambique","Myanmar (Burma)","Namibia","Nauru","Nepal","Netherlands","New Zealand","Nicaragua","Niger","Nigeria","Norway","Oman","Pakistan","Palau","Panama","Papua New Guinea","Paraguay","Peru","Philippines","Poland","Portugal","Qatar","Romania","Russia","Rwanda","Saint Kitts and Nevis","SaintLucia","Saint Vincent and the Grenadines","Samoa","San Marino","Sao Tome and Principe","Saudi Arabia","Senegal","Serbia","Seychelles","Sierra Leone","Singapore","Slovakia","Slovenia","Solomon Islands","Somalia","South Africa","Spain","SriLanka","Sudan","Suriname","Swaziland","Sweden","Switzerland","Syria","Tajikistan","Tanzania","Thailand","Timor-Leste (East Timor)","Togo","Tonga","Trinidad and Tobago","Tunisia","Turkey","Turkmenistan","Tuvalu","Uganda","Ukraine","United Arab Emirates","United Kingdom","United States","Uruguay","Uzbekistan","Vanuatu","Vatican City","Venezuela","Vietnam","Yemen","Zambia","Zimbabwe"]}),j=()=>P({label:"When was the Alleged Crime?",name:"Crime_Committed_Date"}),U=(e,a)=>b({name:e?e+":Degree_Of_Interest":"Degree_Of_Interest",id:e?e+":Degree_Of_Interest":"Degree_Of_Interest",label:"How Likely Are You to Pay if Your Issue Could be Resolved?",help:a,options:["Definitely","Probably","Maybe","Absolutely Can't Afford"]}),H=e=>U(e,"No payment necessary to speak with lawyers."),Q=e=>g({name:e?e+":Disability_Condition_Stop_Work":"Disability_Condition_Stop_Work",label:"Do You Expect To Be Out Of Work For At Least a Year Due To Your Health?"}),Y=e=>g({name:e?e+":Disability_Work_History":"Disability_Work_History",label:"Have You Had a Full-Time Job Within the Past 5 Years?"}),q=e=>g({name:e?e+":Doctor_Treatment":"Doctor_Treatment",label:"Have You Recently Been Treated by a Doctor, Hospital or Clinic?"}),K=()=>b({label:"The Employer Is a:",name:"Employer_Type",options:["Sole proprietorship (mom and pop)","Partnership","Franchise","Privately held company","Public corporation","Government Agency","Don't know"]}),V=a=>f(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"]},a)),z=e=>b({name:e?e+":Estate_Legal_Services_Needed":"Estate_Legal_Services_Needed",label:"Legal Services Needed for Your Estate:",options:["Charitable Giving","Contested Wills","Drafting Wills or Trust","Estate Administration","Asset Protection","Other"]}),G=["Adoption","Asbestos and Mesothelioma","Auto and Car Accidents","Bankruptcy","Birth Certificate and Name Change","Business Lawyers","Child Custody","Child Support","Civil Rights and Discrimination","Consumer Lawyers","Copyrights and Trademarks","Criminal and Felony","Debt and Collections","Defend a Lawsuit","Divorce and Separation","DUI and DWI","Elder Law","Employment and Workplace","Expungement","Family Issues","File a Lawsuit","Foreclosure","Guardianship","Harassment and Discrimination","Identity Theft","Immigration and Visas","Insurance","Landlord and Tenant","Lemon Law","Long Term Disability","Medical Malpractice","Non-Workplace Discrimination","Non-Workplace Harassment","Patents and Intellectual Property","Personal Injury","Power of Attorney","Probate and Estates","Product Liability","Property Damage","Real Estate","Sexual Harassment","Social Security Disability and Insurance","Tax and IRS","Traffic and Tickets","Unemployment","Victim of a Crime","Wills and Trusts","Workers Compensation","Workplace Discrimination","Workplace Harassment","Wrongful Death","Wrongful Termination","Not Sure or Other"],Z=a=>b(e({label:"Type of Help Needed:",name:"Type_Of_Legal_Problem",id:"Type_Of_Legal_Problem",options:G},a)),J=e=>g({name:e?e+":Have_Attorney":"Have_Attorney",label:"Already Working with An Attorney?"}),X=e=>g({name:e?e+":Have_Children":"Have_Children",label:"Do You Have Children?"}),ee=e=>b({name:e?e+":Immigration_Details":"Immigration_Details",label:"Where is the Person Seeking Immigration Located?",options:["In the USA with proper documentation","In the USA without proper documentation","Not in the USA","In Deportation/Removal Proceedings","Currently Detained (friend or family submitting this request)","Out on Bond","None Apply"]}),ae=e=>b({name:e?e+":Immigration_Entry":"Immigration_Entry",label:"How are you Trying to Enter the Country?",options:["With Proper Documents/Visa and Inspection through Customs Border Patrol","Illegally","No Entry","Other"]}),te=e=>b({name:e?e+":Immigration_Location":"Immigration_Location",label:"Where Are You Migrating To?",options:["In the USA","Outside the USA"]}),ie=e=>b({name:e?e+":Immigration_Type":"Immigration_Type",label:"What Type of Immigration Issue?",options:["Citizenship (for current green card holders)","Permanent Visa Family Based (green cards)","Permanent Visa Business Based (green cards)","Temporary Business Visa","Temporary Tourist Visa","Investor","Asylum","Self Petition (violence & abuse victims)","Removal/Deportation Proceeding","Other"]}),ne=e=>b({name:e?e+":Immigration_Status":"Immigration_Status",label:"What is the Current Status of the Immigration Case?",options:["Out of Status (overstayed my visa)","Current Visa Holder (in status)","Lawful Permanent Resident (green card)","Not Applicable (outside the USA)","Other"]}),re=e=>P({name:e?e+":Incident_Date":"Incident_Date",label:"Date of Incident:"}),oe=()=>b({label:"The Other Party is a:",name:"Lawsuit_Other_Party",options:["Individual","Small Business","Large Corporation","Government Entity"]}),le=e=>b({name:e?e+":Lawyer_Payment_Method":"Lawyer_Payment_Method",label:"How Will You Pay for Legal Fees if You Hire a Lawyer?",help:"No payment necessary to speak with lawyers.",options:["Cash","Check","Credit Card","Friend","Family","Other"]}),se=e=>b({name:e?e+":Marital_Status":"Marital_Status",label:"Marital Status:",options:["Unmarried, Living Together","Unmarried, Do Not Live Together","Married, Living Together","Separated","Divorced","Other"]}),de=()=>b({label:"Total Employees of Business? (estimated)",name:"Num_Employees_Of_Business",options:["1-5","6-20","21-50","51-100","101-500","501-1,000","More than 1,000"]}),ue=()=>g({name:"Own_Real_Estate",label:"Do You Own Real Estate?"}),me=e=>g({name:e?e+":Pending_Charges":"Pending_Charges",label:"Do you currently have any pending charges?"}),pe=e=>_({name:e?e+":Primary_Injury":"Primary_Injury",label:"Primary Injury:",options:["Anxiety","Back or Neck Pain","Broken Bones","Cuts and Bruises","Headaches","Memory Loss","Loss of Limb","Other (describe on next page)"]}),ce=e=>g({name:e?e+":Prior_Alcohol_Offenses":"Prior_Alcohol_Offenses",label:"Any Prior Alcohol Related Offenses?"}),fe=e=>g({name:e?e+":Police_Report_Filed":"Police_Report_Filed",label:"Was a Police Report Filed?"}),ye=()=>b({label:"Area of Real Estate:",name:"Real_Estate_Area",options:["Condos and Coops","Construction Disputes","Purchase/Sale Contract","Refinancing Agreement","Title and Boundary Disputes","Zoning, Planning and Land Use","Property Deeds and Transfers","Liens","Other"]}),_e=a=>f(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","Other Real Estate Issues"]},a)),he=()=>y({label:"What is Your Role in this Matter?",name:"Role_In_Matter_Criminal",options:["I have been accused","I am acting on behalf of someone who has been accused","Other"]}),ge=e=>b({name:e?e+":Role_In_Matter_Probate":"Role_In_Matter_Probate",label:"What Is Your Role in this Matter?",options:["Preparing My Will","Executor","Heir","Other"]}),be=e=>g({name:e?e+":Social_Security_Disability_Receiving_Benefits":"Social_Security_Disability_Receiving_Benefits",label:"Are You Currently Receiving Social Security Disability Benefits?"}),Ce=()=>b({label:"Total Debt?",name:"Total_Debt",options:["Less than 5K","5K to 10K","10K to 20K","20K to 50K","More than 50K"]}),Pe=()=>b({label:"Total Monthly Income?",name:"Total_Monthly_Income",options:["Less than 1K","1K to 2K","2K to 3K","3K to 4K","4K to 5K","5K to 7K","7K to 10K","10K to 15K","More than 15K"]}),ve=e=>b({name:e?e+":Type_Of_Alcohol_Test":"Type_Of_Alcohol_Test",label:"Type of Alcohol Test Performed?",options:["No Test","Refused Test","Breath Test","Blood Test","Urine Test","Don't Know"]}),Te=e=>p({name:e?e+":Type_Of_Assets":"Type_Of_Assets",label:"Type of Assets:",options:["Business Interests","Cash","Life Insurance Policies","Pensions/Retirement","Personal Possessions","Property","Stock/Bonds"]}),Le=e=>b({name:e?e+":Value_Of_Assets":"Value_Of_Assets",label:"Value of Your Assets?",options:["Less than 50K","50K to 100K","100K to 250K","250K to 500K","500K to 1M","More than 1M"]}),Ie=()=>y({label:"I Would Like a Lawyer to:",name:"Would_Like_Lawyer_To",options:["Give me general advice to protect my interests","Act as my agent in the transaction","Assist me in the remaining stages of the transaction","Bring a lawsuit against another party","Defend against a lawsuit filed by another party","Other"]}),we=(a,t)=>e({$cmp:"FormKit",props:{type:"group",key:a,id:a,name:a}},t),$e=()=>[J(),H()],Oe=(e,a)=>we("AutoAndCarAccidentsQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Auto and Car Accidents"',children:[J(a),re(a),D(a),pe(a),q(a),fe(a)]}),De=(e,a)=>we("ChildCustodyAndSupportQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Child Custody and Support"',children:[J(a),B(a),W(a),M(a),U(a),le(a)]}),Se=(e,a)=>we("ChildCustodyQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Child Custody"',children:[J(a),B(a),W(a),M(a),U(a),le(a)]}),Ae=a=>f(e({name:"Type_Of_Legal_Problem_Display",if:'$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"]},a)),xe=(e,a)=>we("DivorceQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Divorce and Separation"',children:[J(a),se(a),X(a),U(a),le(a)]}),ke=(e,a)=>we("DUIAndDWIQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "DUI and DWI"',children:[J(a),re(a),ce(a),ve(a),A(a),me(a),H(a)]}),Ee=(e,a)=>we("ImmigrationAndVisasQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Immigration and Visas"',children:[J(a),R(a),te(a),ae(a),ie(a),ne(a),ee(a),H(a)]}),We=(e,a)=>we("LongTermDisabilityQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Long Term Disability"',children:[J(a),v(a),T(a),O(a),L(a),I(a),$(a),w(a)]}),Me=(e,a)=>we("PersonalInjuryQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Personal Injury"',children:[J(a),re(a),N(a),D(a),pe(a),q(a)]}),Be=(e,a)=>we("PowerofAttorneyQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Power of Attorney"',children:[J(a),H(a)]}),Ne=(e,a)=>we("SocialSecurityDisabilityAndInsuranceQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Social Security Disability and Insurance"',children:[J(a),T(a),Q(a),Y(a),be(a),q(a)]}),Fe=(e,a)=>we("WillsAndTrustsQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Wills and Trusts"',children:[J(a),Le(a),Te(a),ge(a),z(a),H(a)]}),Re=(e,a)=>we("WorkersCompensationQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Workers Compensation"',children:[J(a),re(a),N(a),pe(a),x(a),q(a)]}),je="$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",Ue="$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",He=e=>"group"!==e.type&&"section"!==e.type&&"form"!==e.type&&"hidden"!==e.$formkit&&!e.children,Qe=e=>{if(He(e))return e;for(var a=e.children.length-1;a>=0;a--){if("string"==typeof e.children)continue;const t=e.children[a];if(He(t))return t;const i=Qe(t);if(i)return i}return null};function Ye(e){return{$el:"h3",children:e.headline||"Tell Us About Your Situation",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1"}}}function qe(e){return{$el:"h5",children:e.subheadline||"Tell us about your situation:",attrs:{class:"t-flex t-justify-center t-text-dark t-text-center !t-text-lg t-font-semibold t-pb-4 t-pt-0 t-px-3"}}}function Ke(e){return{$el:"h3",children:e.headline||"Additional Case Details",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function Ve(e){return{$el:"h3",children:e.headline||"Please Provide a Contact Name",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function ze(e){return{$el:"h3",children:e.headline||"Do any of the following situations apply?",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function Ge(e){return{$el:"h3",children:e.headline||t,attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-3 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function Ze(e){return{$el:"h5",children:e.subheadline||i,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 Je="(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 Xe=(e,a)=>({$el:"section",if:'$stepEnabled("'+e+'")',attrs:{hidden:'$activeStep !== "'+e+'"',key:a||e}});function ea(a,t,i=!0,n=!1,r=void 0,o=void 0,l=void 0){if(void 0===i&&(i=!0),t&&t.length&&(i||n)){const e=Qe(t[t.length-1]);e&&!0===i&&(e.onKeypress=je),e&&!0===n&&(e.onInput=Ue)}return e(Xe(a,r),{children:[{$formkit:"group",id:a,name:a,nextStepMap:o,autoFocus:l,children:t}]})}const aa=[{type:"meta",data:e(r,{defaultCommentsPlaceholder:a,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."}})},e(o,ta),{$cmp:"FormKit",props:function(a){const t=e(n,a);return t.formId&&!t.name&&(t.name=t.formId),t}({formId:"generalLegalPopUnder",redirectMap:function(a){return e(u,a)}(),popUnderMap:{"*":"/thank-you"},valueOverrideMap:{Civil_Defense:{Yes:{Type_Of_Legal_Problem:"Defend a Lawsuit"},No:{Type_Of_Legal_Problem:"File a Lawsuit"}},Type_Of_Legal_Problem_Display:{"Auto Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Dog Bite":{Type_Of_Legal_Problem:"Personal Injury"},"Slip and Fall":{Type_Of_Legal_Problem:"Personal Injury"},"Workplace Injury":{Type_Of_Legal_Problem:"Workers Compensation"},"Trucking Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Motorcycle Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Other Accidents or Injuries":{Type_Of_Legal_Problem:"Personal Injury"},"Automobile Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Contract Disputes":{Type_Of_Legal_Problem:"Business Lawyers"},"Defamation and Slander":{Type_Of_Legal_Problem:"File a Lawsuit"},"Dog Bite":{Type_Of_Legal_Problem:"Personal Injury"},"Employment and Workplace":{Type_Of_Legal_Problem:"Employment and Workplace"},Fraud:{Type_Of_Legal_Problem:"Consumer Lawyers"},"Medical Malpractice":{Type_Of_Legal_Problem:"Medical Malpractice"},"Personal Injury":{Type_Of_Legal_Problem:"Personal Injury"},"Property Damage":{Type_Of_Legal_Problem:"Property Damage"},"Small Claims":{Type_Of_Legal_Problem:"File a Lawsuit"},"Real Estate":{Type_Of_Legal_Problem:"Real Estate"},"Other (describe on next page)":{Type_Of_Legal_Problem:"Not Sure or Other"},"Contract Creation":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Contract Enforcement":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Contract Cancellation":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Contract Fraud":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Breach of Contract":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Other Contract Issues":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Criminal Defense":{Type_Of_Legal_Problem:"Criminal and Felony"},"Victim of a Crime":{Type_Of_Legal_Problem:"Victim of a Crime"},"DUI and DWI":{Type_Of_Legal_Problem:"DUI and DWI"},Expungement:{Type_Of_Legal_Problem:"Expungement"},Harassment:{Type_Of_Legal_Problem:"Criminal and Felony"},"Not Sure or Other":{Type_Of_Legal_Problem:"Not Sure or Other"},"Workplace Harassment":{Type_Of_Legal_Problem:"Workplace Harassment"},"Workplace Discrimination":{Type_Of_Legal_Problem:"Workplace Discrimination"},"Wrongful Termination":{Type_Of_Legal_Problem:"Wrongful Termination"},"Payment Disputes":{Type_Of_Legal_Problem:"Employment and Workplace"},"Workers Compensation":{Type_Of_Legal_Problem:"Workers Compensation"},Unemployment:{Type_Of_Legal_Problem:"Unemployment"},"Other Workplace Issues":{Type_Of_Legal_Problem:"Employment and Workplace"},"Attorney Malpractice":{Type_Of_Legal_Problem:"Civil Lawsuit"},"Other Malpractice Issues":{Type_Of_Legal_Problem:"Not Sure or Other"},"Vehicle Repossession":{Type_Of_Legal_Problem:"Bankruptcy"},"Property Repossession":{Type_Of_Legal_Problem:"Bankruptcy"},"Other Repossession Issues":{Type_Of_Legal_Problem:"Not Sure or Other"},"Contracts and Agreements":{Type_Of_Legal_Problem:"Real Estate"},"Deeds, Liens, and Titles":{Type_Of_Legal_Problem:"Real Estate"},Foreclosure:{Type_Of_Legal_Problem:"Foreclosure"},Insurance:{Type_Of_Legal_Problem:"Insurance"},"Landlord and Tenant":{Type_Of_Legal_Problem:"Landlord and Tenant"},"Loans and Mortgages":{Type_Of_Legal_Problem:"Real Estate"},"Wills, Trusts, and Estates":{Type_Of_Legal_Problem:"Wills and Trusts"},"Property Damage":{Type_Of_Legal_Problem:"Property Damage"},"Other Real Estate Issues":{Type_Of_Legal_Problem:"Real Estate"}}}}),children:[function(a={}){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||"")}}}(a),a)}({children:'$urlParam("hl", "Need Legal Help? Start Here!")',if:"$activeStep === $firstStep()"}),function(a={}){return e(function(e={}){return{$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||"")}}}(a),a)}({children:'$urlParam("shl", "Our Service is Fast and Free!")',if:"$activeStep === $firstStep()"}),...d,{$el:"div",attrs:{class:"form-body"},children:[function(e={}){return ea("generalLegalTOLPAndZip",[Z(),k(),E(),Ae(),V(),f({label:"What is the Landlord / Tenant Issue?",if:'$get(Type_Of_Legal_Problem).value == "Landlord and Tenant"',id:"Landlord_Tenant_Issue",name:"Landlord_Tenant_Issue",options:["Eviction","Repairs and Maintenance","Lease and Rental Agreements","Discrimination","Right of Entry and Privacy","Screening and Applications","Environmental Hazards","Other Dispute"]}),_e(),C({label:"Zip Code:",placeholder:"#####",name:"Zip",maxlength:5,inputmode:"numeric",autocomplete:"postal-code",validation:"required|matches:/^[0-9]{5}$/",validationMessages:{required:"Zip Code is required",matches:"Invalid Zip Code"}})],e.nextOnEnter)}(),function(e={}){var a,t,i=[we("AdoptionQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Adoption"',children:[J(),se(),X(),U(),le()]}),we("AsbestosAndMesotheliomaQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Asbestos and Mesothelioma"',children:[J(),re(),q(),H()]}),Oe(),we("BankruptcyQuestions",{if:a||'$get(Type_Of_Legal_Problem).value == "Bankruptcy"',children:[J(t),Pe(),Ce(),ue(),Le(t),H(t)]}),we("BirthCertificateAndNameChangeQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Birth Certificate and Name Change"',children:[J(),H()]}),we("BusinessLawyersQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Business Lawyers"',children:[J(),b({label:"Legal Services Needed for Your Business:",id:"Business_Services",name:"Business_Services",options:["Business Formation","Contracts","Insurance and Liability","Mergers and Acquisition","Regulatory Compliance","Employee Dispute","Other"]}),_({label:"Is the Business Public or Private?",name:"Business_Type",options:["Public","Private"]}),de(),H()]}),De(),Se(),we("ChildSupportQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Child Support"',children:[J(),B(),W(),M(),U(),le()]}),we("CivilRightsAndDiscriminationQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Civil Rights and Discrimination"',children:[b({label:"On what basis were your rights violated?",name:"Civil_Rights_Type",options:["Age","Disability","Gender","Race","Religion","Other"]}),J(),H()]}),we("CivilLawsuitQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Civil Lawsuit"',children:[J(),oe(),H()]}),we("FileLawsuitQuestions",{if:'$get(Type_Of_Legal_Problem).value == "File a Lawsuit"',children:[J(),oe(),H()]}),we("DefendLawsuitQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Defend a Lawsuit"',children:[J(),oe(),H()]}),we("ConsumerLawyersQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Consumer Lawyers"',children:[b({label:"What best describes your issue?",name:"Consumer_Lawyer_Type",options:["Unsafe Environment","Unsafe Products","Auto Fraud","Credit Reporting Issues","Debt Collection Abuse","Identity Theft","Lemon Law","Military Consumer Rights","Predatory Lending","Student Loans","Other"]}),re(),J(),oe(),H()]}),we("CopyrightsAndTrademarksQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Copyrights and Trademarks"',children:[J(),H()]}),we("CriminalAndFelonyQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Criminal and Felony"',children:[J(),j(),he(),me(),U(),le()]}),we("DebtAndCollectionsQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Debt and Collections"',children:[J(),Pe(),Ce(),ue(),Le(),H()]}),xe(),ke(),we("ElderLawQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Elder Law"',children:[J(),H()]}),we("EmploymentAndWorkplaceQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Employment and Workplace"',children:[J(),de(),K(),H()]}),we("ExpungementQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Expungement"',children:[J(),re(),b({label:"What Type of Charge?",name:"Criminal_Charge_Type",options:["Felony","Misdemeanor","Juvenile","Other"]}),U(),le()]}),we("FamilyIssuesQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Family Issues"',children:[J(),se(),X(),U(),le()]}),we("ForeclosureQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Foreclosure"',children:[J(),ue(),b({label:"Type of Property:",name:"Type_Of_Property",options:["Residential","Commercial","Industrial","Agricultural","Recreational","Other"]}),b({label:"Total Amount of Payments that are Past Due:",name:"Amount_Payments_Past_Due",options:["$0 - $499","$500 - $999","$1,000 - $2,499","$2,500 - $4,999","$5,000 - $9,999","$10,000 - $24,999","$25,000 - $49,999","$50,000 - $99,999","More than $100,000"]}),b({label:"Total Amount of Loan?",name:"Loan_Amount",options:["Less than $10,000","$10,000 - $24,999","$25,000 - $49,999","$50,000 - $99,999","$100,000 - $199,999","$200,000 - $299,999","$300,000 - $399,999","$400,000 - $499,999","$500,000 - $599,999","More than $600,000"]}),g({name:"Default_Notice",label:"Have You Received a Notice of Default from the Lender?"}),H()]}),we("GuardianshipQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Guardianship"',children:[J(),se(),X(),U(),le()]}),we("HarassmentAndDiscriminationQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Harassment and Discrimination"',children:$e()}),we("SexualHarassmentQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Sexual Harassment"',children:$e()}),we("WorkplaceHarassmentQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Workplace Harassment"',children:$e()}),we("NonWorkplaceHarassmentQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Non-Workplace Harassment"',children:$e()}),we("WorkplaceDiscriminationQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Workplace Discrimination"',children:$e()}),we("NonWorkplaceDiscriminationQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Non-Workplace Discrimination"',children:$e()}),we("IdentityTheftQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Identity Theft"',children:[J(),H()]}),Ee(),we("InsuranceQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Insurance"',children:[J(),H()]}),we("LandlordAndTenantQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Landlord and Tenant"',children:[J(),b({label:"I am the:",name:"Landlord_Tenant_Party",options:["Landlord","Tenant","Other"]}),H()]}),we("LemonLawQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Lemon Law"',children:[J(),re(),oe(),H()]}),We(),we("MedicalMalpracticeQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Medical Malpractice"',children:[J(),re(),N(),q(),b({label:"Injuries from Medical Malpractice:",name:"Medical_Malpractice_Injuries",options:["No Injury","Minor Injury","Disfigurement or cosmetic injury","Short term loss of physical ability","Long term loss of physical injury","Possibility of future harm","Death of Patient"]}),H()]}),we("PatentsAndIntellectualPropertyQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Patents and Intellectual Property"',children:[J(),b({label:"Legal Assistance Needed:",name:"Patent_Assistance_Type",options:["Obtaining a Patent","Avoiding Patent Infringement","Suing for Patent Infringement","Defending Against a Claim of Patent Infringement","Other"]}),b({label:"The Patent is for a:",name:"Patent_For",options:["Product or Machine","Process","Computer Software","Living Organism or Plant","Ornamental Design","Other"]}),H()]}),Me(),Be(),we("ProbateAndEstatesQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Probate and Estates"',children:[J(),Le(),Te(),ge(),z(),H()]}),we("ProductLiabilityQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Product Liability"',children:[J(),H()]}),we("PropertyDamageQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Property Damage"',children:[J(),ye(),Ie(),H()]}),we("RealEstateQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Real Estate"',children:[J(),ye(),Ie(),H()]}),Ne(),we("TaxAndIRSQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Tax and IRS"',children:[J(),Ce(),b({label:"Details of Tax Problem:",name:"Tax_Problem_Details",options:["Assets Seized","Bank Account Levied","Cannot Pay Taxes","Innocent Spouse","Lien Filed","Received Audit Notice","Unpaid Interest","Wage Garnishment","Other"]}),b({label:"Which Level of Tax Issue?",name:"Tax_Level",options:["Federal","State","Local"]}),b({label:"Type of Tax Issue:",name:"Tax_Issue_Type",options:["Income","Property","Corporate"]}),H()]}),we("TrafficAndTicketsQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Traffic and Tickets"',children:[J(),h({name:"Drivers_License_Type",label:"Type of Driver's License:",options:["Private","Commercial"]}),b({label:"Which Type of Violation?",name:"Traffic_Violations",options:["Disregarding a Red Light","Disregarding a Stop Sign","DMV Letter About License","DUI/DWI","Failure to Appear in Court","License Suspended/Revoked","Minor in Possession of Alcohol","No Child Safety Seat","No Liability Insurance","No Seat Belt","Open Container of Alcohol","Parking Ticket","Racing","Speeding","Unpaid Traffic Tickets","Warrant Issue for Arrest","Other Violation"]}),g({name:"Have_Court_Date",label:"Do You Have a Court Date?"}),H()]}),we("UnemploymentQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Unemployment"',children:[de(),K(),H()]}),we("VictimOfACrimeQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Victim of a Crime"',children:[J(),j(),he(),me(),U(),le()]}),Fe(),Re(),we("WrongfulDeathQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Wrongful Death"',children:[J(),re(),b({label:"Relationship to the Victim:",name:"Relationship_To_Victim",options:["Parent","Spouse","Sibling","Friend","Other"]}),y({name:"Criminal_Charges_Filed",label:"Were Criminal Charges Filed?",options:["Yes","No","Not Sure"]}),b({label:"What was the Cause of the Victim's Death?",name:"Cause_Of_Death",options:["Vehicle Accident","Negligent/Careless Act","Reckless Act","Other"]})]}),we("WrongfulTerminationQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Wrongful Termination"',children:[J(),de(),K(),H()]}),we("NotSureOrOtherQuestions",{if:'$get(Type_Of_Legal_Problem).value == "Not Sure or Other"',children:[J(),H()]})];return i.unshift(function(e){return{$el:"h3",children:e.headline||"Tell Us About Your Situation",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1"}}}(e)),ea("TOLPQuestions",i,e.nextOnEnter)}(),function(e={}){return ea("commentsWithBankruptcy",[Ke(e),F({label:void 0===e.label?"Please briefly describe your legal issue in a few words:":e.label,placeholder:e.placeholder||a,inputClass:void 0===e.inputClass?"!t-h-40":e.inputClass}),S(),{$el:"div",if:"$get(CrossSell_Bankruptcy).value == true",children:[F({label:"Bankruptcy or debt details:",placeholder:"Please describe your bankrtupcy or debt situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Bankruptcy")]}],e.nextOnEnter)}({nextOnEnter:!1}),function(e={}){return ea("legalCrossSells",[ze(e),p({id:"Legal_CrossSells",name:"Legal_CrossSells",help:'Just hit "Next" if none apply',helpClass:"t-text-center !t-text-sm",validation:null,options:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "Auto and Car Accidents"',then:{"Social Security Disability and Insurance":"Interest in Disability Benefits","Wills and Trusts":"Need a Will or Trust","Workers Compensation":"Workplace Injury","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "Personal Injury" || $getVal($get(form), "Type_Of_Legal_Problem") === "Workers Compensation"',then:{"DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "DUI and DWI"',then:{"Personal Injury":"Personal or Workplace Injury","Wills and Trusts":"Need a Will or Trust","Social Security Disability and Insurance":"Interest in Disability Benefits","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "Wills and Trusts" || $getVal($get(form), "Type_Of_Legal_Problem") === "Probate and Estates" || $getVal($get(form), "Type_Of_Legal_Problem") === "Power of Attorney"',then:{"Auto and Car Accidents":"Injured in a Car Accident","Personal Injury":"Personal or Workplace Injury","DUI and DWI":"Involved in a DUI/DWI","Social Security Disability and Insurance":"Interest in Disability Benefits","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "Long Term Disability" || $getVal($get(form), "Type_Of_Legal_Problem") === "Social Security Disability and Insurance"',then:{"Auto and Car Accidents":"Injured in a Car Accident","DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{"Auto and Car Accidents":"Injured in a Car Accident","Personal Injury":"Personal or Workplace Injury","DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Social Security Disability and Insurance":"Interest in Disability Benefits"}}}}}}})],e.nextOnEnter,!1,"$get(Type_Of_Legal_Problem).value")}(),function(e={}){return ea("autoAndCarAccidentCrossSellQuestions",[Ye({headline:"You May Be Entitled To Compensation"}),qe({subheadline:"Tell us about your accident:"}),Oe("true","CrossSell:Auto_and_Car_Accidents"),F({label:"Accident Description:",placeholder:"Please describe your accident in a few words...",inputClass:"!t-h-16"},"CrossSell:Auto_and_Car_Accidents")],e.nextOnEnter)}(),function(e={}){return ea("personalInjuryCrossSellQuestions",[Ye({headline:"You May Be Entitled To Compensation"}),qe({subheadline:"Tell us about your injury:"}),Me("true","CrossSell:Personal_Injury"),F({label:"Injury Description:",placeholder:"Please describe your injury in a few words...",inputClass:"!t-h-16"},"CrossSell:Personal_Injury")],e.nextOnEnter)}(),function(e={}){return ea("workersCompensationCrossSellQuestions",[Ye({headline:"You May Be Entitled To Benefits"}),qe({subheadline:"Tell us about your injury:"}),Re("true","CrossSell:Workers_Compensation"),F({label:"Injury Description:",placeholder:"Please describe your injury in a few words...",inputClass:"!t-h-16"},"CrossSell:Workers_Compensation")],e.nextOnEnter)}(),function(e={}){return ea("duiAndDWICrossSellQuestions",[Ye({headline:"About Your DUI/DWI"}),ke("true","CrossSell:DUI_and_DWI"),F({label:"Incident Description:",placeholder:"Please describe your incident in a few words...",inputClass:"!t-h-16"},"CrossSell:DUI_and_DWI")],e.nextOnEnter)}(),function(e={}){return ea("ssdiCrossSellQuestions",[Ye({headline:"You May Be Entitled To Benefits"}),qe({subheadline:"Tell us about your disability:"}),Ne("true","CrossSell:Social_Security_Disability_and_Insurance"),F({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Social_Security_Disability_and_Insurance")],e.nextOnEnter)}(),function(e={}){return ea("powerOfAttorneyCrossSellQuestions",[Ye({headline:"Power of Attorney Information"}),Be("true","CrossSell:Power_of_Attorney"),F({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Power_of_Attorney")],e.nextOnEnter)}(),function(e={}){return ea("willsAndTrustsCrossSellQuestions",[Ye({headline:"Will or Trust Information"}),Fe("true","CrossSell:Wills_and_Trusts"),F({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Wills_and_Trusts")],e.nextOnEnter)}(),function(e={}){return ea("divorceAndSeparationCrossSellQuestions",[Ye({headline:"Divorce or Separation Information"}),xe("true","CrossSell:Divorce_and_Separation"),F({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Divorce_and_Separation")],e.nextOnEnter)}(),function(e={}){return ea("childCustodyCrossSellQuestions",[Ye({headline:"Child Custody Information"}),Se("true","CrossSell:Child_Custody"),F({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Child_Custody")],e.nextOnEnter)}(),function(e={}){return ea("firstAndLast",[Ve(e),C({$formkit:"text",label:"First Name:",placeholder:"First",name:"First_Name",autocomplete:"given-name",validationMessages:{required:"First Name is required"}}),C({$formkit:"text",label:"Last Name:",placeholder:"Last",name:"Last_Name",autocomplete:"family-name",validationMessages:{required:"Last Name is required"}})],e.nextOnEnter)}(),function(e={}){return ea("contactInfo",[Ge(e),Ze(e),{$el:"script",if:"$activeStep === $lastStep()",children:Je},C({$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"}}),C({$formkit:"tel",name:"Primary_Phone",label:"Phone Number:",placeholder:"###-###-####",maxlength:12,help:"10-digit phone number, hyphens optional",autocomplete:"tel-national","data-tf-sensitive":"false",validation:"required|matches:/^[0-9]{3}-?[0-9]{3}-?[0-9]{4}$/|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"}},s()],e.nextOnEnter)}({nextOnEnter:!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 ta;return aa}();