bhl-forms 0.6.8 → 0.6.9

package/dist/forms/generalLegalPopUnderSingle.es.js

@@ -3279,6 +3279,18 @@ const formPropDefaults = {
   formClass: '!t-max-w-[40rem]'
 };
 
+function filterMapByKey(obj, keyList) {
+  return Object.fromEntries(
+    Object.entries(obj).filter(([key]) => keyList.includes(key))
+  );
+}
+
+// export function filteredNextStepsMapLegal(keyList) {
+//   const res = { Type_Of_Legal_Problem: filterMapByKey(nextStepsMapGeneralLegal["Type_Of_Legal_Problem"], keyList) }
+//   res["*"] = nextStepsMapGeneralLegal["*"]
+//   return res
+// }
+
 function formProps(updates) {
   const props = merge(
     formPropDefaults,
@@ -3305,14 +3317,22 @@ function metaProps(updates) {
   }
 }
 
-function defaultMetaProps() {
+function defaultMetaProps(tolps = null) {
+  let commentsPlaceholders = TOLPCommentsPlaceholders;
+  let finalHeadlines = TOLPFinalHeadlines;
+  let finalSubHeadlines = TOLPFinalSubHeadlines;
+  if (tolps) {
+    commentsPlaceholders = filterMapByKey(TOLPCommentsPlaceholders, tolps);
+    finalHeadlines = filterMapByKey(TOLPFinalHeadlines, tolps);
+    finalSubHeadlines = filterMapByKey(TOLPFinalSubHeadlines, tolps);
+  }
   return metaProps({
     defaultCommentsPlaceholder: DEFAULT_COMMENTS_PLACEHOLDER_DYNAMIC,
-    commentsPlaceholders: TOLPCommentsPlaceholders,
+    commentsPlaceholders: commentsPlaceholders,
     defaultFinalHeadline: DEFAULT_FINAL_HEADLINE,
-    finalHeadlines: TOLPFinalHeadlines,
+    finalHeadlines: finalHeadlines,
     defaultFinalSubHeadline: DEFAULT_FINAL_SUBHEADLINE,
-    finalSubHeadlines: TOLPFinalSubHeadlines,
+    finalSubHeadlines: finalSubHeadlines,
   })
 }
 
@@ -3488,15 +3508,7 @@ function legalRedirectMap(updates) {
   )
 }
 
-const legalAllValueOverrideMap = {
-  'Civil_Defense': {
-    'Yes': {
-      'Type_Of_Legal_Problem': 'Defend a Lawsuit'
-    },
-    'No': {
-      'Type_Of_Legal_Problem': 'File a Lawsuit'
-    }
-  },
+const businessServicesOverrideMap = {
   'Business_Services_Display': {
     "Business Formation": {
       'Business_Services': 'Business Formation'
@@ -3523,7 +3535,43 @@ const legalAllValueOverrideMap = {
       'Business_Services': 'Other'
     }
   },
+};
+
+const patentsAndIPTOLPDisplayOverrideMap = {
   'Type_Of_Legal_Problem_Display': {
+    'Copyrights': {
+      'Type_Of_Legal_Problem': 'Copyrights and Trademarks'
+    },
+    'Trademarks': {
+      'Type_Of_Legal_Problem': 'Copyrights and Trademarks'
+    },
+    'Patents': {
+      'Type_Of_Legal_Problem': 'Patents and Intellectual Property'
+    },
+    'Business Lawyers': {
+      'Type_Of_Legal_Problem': 'Business Lawyers'
+    },
+    'Business Consulting': {
+      'Type_Of_Legal_Problem': 'Business Lawyers'
+    },
+    'Not Sure or Other': {
+      'Type_Of_Legal_Problem': 'Not Sure or Other'
+    },
+  }
+};
+
+const legalAllValueOverrideMap = {
+  'Civil_Defense': {
+    'Yes': {
+      'Type_Of_Legal_Problem': 'Defend a Lawsuit'
+    },
+    'No': {
+      'Type_Of_Legal_Problem': 'File a Lawsuit'
+    }
+  },
+  businessServicesOverrideMap,
+  'Type_Of_Legal_Problem_Display': {
+    ...patentsAndIPTOLPDisplayOverrideMap,
     // Accidents and PI
     'Auto Accident': {
       'Type_Of_Legal_Problem': 'Auto and Car Accidents'
@@ -4120,18 +4168,6 @@ const nextStepsMapGeneralLegal = {
   '*': nextStepsLegalDefault
 };
 
-// function filterMapByKey(obj, keyList) {
-//   return Object.fromEntries(
-//     Object.entries(obj).filter(([key]) => keyList.includes(key))
-//   );
-// }
-
-// export function filteredNextStepsMapLegal(keyList) {
-//   const res = { Type_Of_Legal_Problem: filterMapByKey(nextStepsMapGeneralLegal["Type_Of_Legal_Problem"], keyList) }
-//   res["*"] = nextStepsMapGeneralLegal["*"]
-//   return res
-// }
-
 const TOLPNextSteps = nextStepsMapGeneralLegal["Type_Of_Legal_Problem"];
 
 ({
@@ -4214,6 +4250,15 @@ const nextStepsMapEmploymentAndWorkplaceTOLPDisplay = {
   ]
 };
 
+({
+  'Type_Of_Legal_Problem_Display': {
+    'Patents': TOLPNextSteps["Patents and Intellectual Property"],
+    'Business Lawyers': TOLPNextSteps["Business Lawyers"],
+    'Business Consulting': TOLPNextSteps["Business Lawyers"],
+  },
+  '*': nextStepsMapGeneralLegal["*"],
+});
+
 const nextStepsMapRealEstateTOLPDisplay = {
   'Type_Of_Legal_Problem_Display': {
     'Foreclosure': TOLPNextSteps["Foreclosure"],

package/dist/forms/generalLegalPopUnderSingle.iife.js

@@ -1 +1 @@
-var generalLegalPopUnderSingle=function(){"use strict";function e(){return Object.assign({},...arguments)}const t='$getKey($meta, "commentsPlaceholders." + $get(Type_Of_Legal_Problem).value, $meta.defaultCommentsPlaceholder)',a='$getKey($meta, "finalHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalHeadline)',n='$getKey($meta, "finalSubHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalSubHeadline)',i=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"checkbox",validation:"required",validationMessages:{required:"Field is required"}},t)),r=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",i(e)),o=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"radio",validation:"required",validationMessages:{required:"Field is required"},optionsClass:"t-pt-3 t-pl-1",legendClass:"required"},t)),s=e=>(e.legendClass="required t-w-[100%] t-text-center",void 0===e.fieldsetClass&&(e.fieldsetClass="$reset t-flex t-justify-center"),e.optionsClass="t-pl-4 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",e.optionClass="t-pl-4 md:t-pl-8 md:t-min-w-[200px]",e.messagesClass="t-flex t-justify-center",e.helpClass="t-mt-0 t-mb-4 !t-text-sm t-text-center",o(e)),l=e=>(e.options=["Yes","No"],(e=>(e.legendClass="legend-left t-pb-1 required",e.fieldsetClass="$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",o(e)))(e)),d=e=>(e.legendClass="legend-left",e.fieldsetClass="$reset t-flex t-justify-center t-items-center",void 0===e.optionsClass&&(e.optionsClass="t-flex t-flex-col sm:t-flex-row t-justify-center t-my-3"),e.optionClass="radiobtn t-my-2 sm:t-my-0 t-mx-2 md:t-mx-5",e.wrapperClass="$reset formkit-wrapper t-mb-0 t-flex t-items-center t-h-[100%]",e.labelClass="t-font-semibold t-text-[#1e448f] t-w-[100%]",e.decoratorIcon=!1,e.messagesClass="t-flex t-justify-center",o(e)),u=e=>(e.options=["Yes","No"],e.optionsClass="t-flex t-justify-center t-my-3",d(e)),c=e=>(e.legendClass="required",e.fieldsetClass="$reset t-flex t-justify-center",e.optionsClass="t-pl-2 t-pt-3",e.innerClass="t-items-center",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",e.optionClass="t-pl-4 md:t-pl-12",e.messagesClass="t-flex t-justify-center",o(e)),p=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"select",placeholder:"Please Select",validation:"required",validationMessages:{required:"Field is required"},inputClass:"t-bg-white",labelClass:"required"},t)),m=e=>(e.labelClass="required",e.wrapperClass="side-by-side t-items-center",e.innerClass="select-height-content",e.helpClass="t-mt-2.5 md:t-text-right md:t-mt-[-5px]",p(e)),y=e=>(e.labelClass="required",e.wrapperClass="t-flex t-justify-center",e.messagesClass="t-flex t-justify-center",e.inputClass="t-min-w-[150px] t-bg-white",e.helpClass="t-mt-2.5 t-text-center",p(e)),f=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"text",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required"},t)),h=e=>(e.wrapperClass="side-by-side t-items-center",f(e)),g=e=>(e.wrapperClass="t-flex t-justify-center",e.messagesClass="t-flex t-justify-center",e.inputClass="t-text-center",f(e)),_=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"DatePicker",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required t-block t-mb-3 t-font-semibold t-text-base formkit-invalid:t-text-red-500",innerClass:"t-border t-border-gray-400 formkit-invalid:t-border-red-500 t-rounded t-mb-1 focus-within:t-border-blue-500"},t)),b=e=>(e.wrapperClass="t-flex t-justify-center",e.inputClass="t-text-center",e.messagesClass="t-flex t-justify-center",_(e)),C=e=>h({name:e?e+":Applicant_Age":"Applicant_Age",label:"Age of Applicant?",placeholder:"Age between 18 and 65",maxlength:2,inputmode:"numeric",validation:"required|min:18,max:65",validationMessages:{required:"Applicant Age is required",min:"Invalid Age - must be between 18 and 65",max:"Invalid Age - must be between 18 and 65"}}),v=e=>l({name:e?e+":At_Fault":"At_Fault",label:"Were You at Fault?"}),P=()=>{return(e={label:"I'd also like a consult for bankruptcy or debt elimination (optional)",help:"Note: you will be contacted separately by a bankruptcy/debt expert",name:"CrossSell_Bankruptcy",id:"CrossSell_Bankruptcy",if:'$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="$reset side-by-side",e.optionsClass="t-pl-1",e.innerClass="t-flex t-items-center",e.wrapperClass="t-mb-3",i(e);var e},I=e=>m({name:e?e+":Blood_Alcohol_Content_Test":"Blood_Alcohol_Content_Test",label:"Blood Alcohol Content Measured by Test:",options:["No Test","0.00% - 0.04%","0.05% - 0.08%","0.09% - 0.12%","0.13% - 0.16%","0.17% - 0.20%","More than 0.20%","Don't know"]}),w=e=>m({name:e?e+":Cause_Of_Injury":"Cause_Of_Injury",label:"Cause of Injury:",options:["Traumatic Physical Injury (Accident)","Repeated Trauma Injury","Mental Injury","Occupational Disease","Not Sure"]}),D=e=>m({name:e?e+":Child_Home":"Child_Home",label:"With Whom Do the Children Currently Live?",options:["Mother","Father","Grandparents","Other"]}),T=e=>m({name:e?e+":Child_Primary_Caregiver":"Child_Primary_Caregiver",label:"Who is the Primary Caregiver?",options:["Mother","Father","Other"]}),S=e=>m({name:e?e+":Child_Relationship":"Child_Relationship",label:"Your Relationship to Child(ren):",options:["Father","Mother","Grandparent","Aunt/Uncle","Other"]}),x=e=>m({name:e?e+":Claim_Status":"Claim_Status",label:"Status of Claim:",options:["No action taken yet","Demand for compensation made","Lawsuit filed","Other"]}),A=(t,a)=>(t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"textarea",rows:5,maxlength:500,validation:"required",validationMessages:{required:"Field is required"},innerClass:"t-max-w-xl",labelClass:"required"},t)))(e({name:a?a+":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"'},t)),L=(e,t)=>m({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:t,options:["Definitely","Probably","Maybe","Absolutely Can't Afford"]}),O=e=>L(e,"No payment necessary to speak with lawyers."),k=e=>l({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?"}),$=e=>l({name:e?e+":Disability_Work_History":"Disability_Work_History",label:"Have You Had a Full-Time Job Within the Past 5 Years?"}),W=e=>l({name:e?e+":Doctor_Treatment":"Doctor_Treatment",label:"Have You Recently Been Treated by a Doctor, Hospital or Clinic?"}),E=e=>m({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"]}),M=["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"],B=t=>y(e({name:"Type_Of_Legal_Problem",id:"Type_Of_Legal_Problem",options:M},t)),j=e=>l({name:e?e+":Have_Attorney":"Have_Attorney",label:"Already Working with An Attorney?"}),F=e=>l({name:e?e+":Have_Children":"Have_Children",label:"Do You Have Children?"}),N=e=>{return(t={name:e?e+":Incident_Date":"Incident_Date",label:"Date of Incident:"}).wrapperClass="side-by-side t-items-center",_(t);var t},R=e=>m({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"]}),H=e=>m({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"]}),U=e=>l({name:e?e+":Pending_Charges":"Pending_Charges",label:"Do you currently have any pending charges?"}),q=e=>{return(t={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","Not Sure or Other"]}).legendClass="legend-left-flex md:t-max-w-[40%] required",t.fieldsetClass="$reset side-by-side-flex",t.optionsClass="md:t-ml-4 md:t-mt-2 t-grid t-grid-cols-1 md:t-grid-cols-2-125",t.innerClass="t-flex t-items-start",t.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",o(t);var t},K=e=>l({name:e?e+":Prior_Alcohol_Offenses":"Prior_Alcohol_Offenses",label:"Any Prior Alcohol Related Offenses?"}),Y=e=>l({name:e?e+":Police_Report_Filed":"Police_Report_Filed",label:"Was a Police Report Filed?"}),V=e=>m({name:e?e+":Role_In_Matter_Probate":"Role_In_Matter_Probate",label:"What Is Your Role in this Matter?",options:["Preparing My Will","Executor","Heir","Other"]}),z=e=>l({name:e?e+":Social_Security_Disability_Receiving_Benefits":"Social_Security_Disability_Receiving_Benefits",label:"Are You Currently Receiving Social Security Disability Benefits?"}),G=e=>m({name:e?e+":Type_Of_Alcohol_Test":"Type_Of_Alcohol_Test",label:"Type of Alcohol Test Performed?",options:["No Test","Refused Test","Breath Test","Blood Test","Urine Test","Don't Know"]}),Q=e=>r({name:e?e+":Type_Of_Assets":"Type_Of_Assets",label:"Type of Assets:",options:["Business Interests","Cash","Life Insurance Policies","Pensions/Retirement","Personal Possessions","Property","Stock/Bonds"]}),Z=e=>{return(t={name:e?e+":Type_Of_Assets":"Type_Of_Assets",options:["Business Interests","Cash","Life Insurance Policies","Pensions/Retirement","Personal Possessions","Property","Stock/Bonds"]})&&t.legendClass||(t.legendClass="required"),t.fieldsetClass="$reset t-flex t-justify-center",t.optionClass="t-mx-5",t.optionsClass="t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",t.innerClass="t-items-center",t.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",t.messagesClass="t-flex t-justify-center",i(t);var t},J=e=>m({name:e?e+":Value_Of_Assets":"Value_Of_Assets",label:"Value of Your Assets?",options:["Less than 50K","50K to 100K","100K to 250K","250K to 500K","500K to 1M","More than 1M"]}),X=()=>{return(e={label:"What Service Connected Conditions Does the Applicant Have? (select all that apply)",name:"Veterans_Disability_Conditions",options:["Traumatic Physical Injury (broken bones, loss of limb)","Mental Injury","Occupational Disease","Repeated Trauma Injury","Other"]})&&e.legendClass||(e.legendClass="required"),e.fieldsetClass="$reset",e.optionsClass="t-pl-2 t-pt-3",e.innerClass="t-items-center",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",i(e);var e},ee=(t,a)=>e({$cmp:"FormKit",props:{type:"group",key:t,id:t,name:t}},a),te="$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",ae="$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",ne=e=>"group"!==e.type&&"section"!==e.type&&"form"!==e.type&&"hidden"!==e.$formkit&&!e.children,ie=e=>{if(ne(e))return e;for(var t=e.children.length-1;t>=0;t--){if("string"==typeof e.children)continue;const a=e.children[t];if(ne(a))return a;const n=ie(a);if(n)return n}return null},re={$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"}},{$el:"span",children:"Secure & Encrypted",attrs:{class:"t-pl-2 t-pt-1 t-font-medium"}}]};function oe(t){return e(re,t)}function se(e){return{$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 le(e){return{$el:"h5",children:e.subheadline||"Tell us about your situation:",attrs:{class:"t-flex t-justify-center t-text-dark t-text-center !t-text-lg t-font-semibold t-pb-4 t-pt-0 t-px-3"}}}function de(e){return{$el:"h3",children:e.headline||"Tell Us About Your Situation",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-dark t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function ue(e){return{$el:"h5",children:e.subheadline||"",attrs:{class:"t-flex t-justify-center t-text-center !t-text-lg t-font-normal t-text-dark t-pb-5 t-pt-0 t-px-1 "+(e.subheadlineClass||"")}}}function ce(e){return{$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 pe(e){return{$el:"h3",children:e.headline||"Please Provide a Contact Name",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function me(e){return{$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 ye(e){return{$el:"h3",children:e.headline||a,attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-3 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function fe(e){return{$el:"h5",children:e.subheadline||n,attrs:{class:"t-flex t-justify-center t-text-center !t-text-lg t-font-semibold t-pb-7 t-pt-0 t-px-3 "+(e.subheadlineClass||"")}}}const he="(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 ge=(e,t)=>({$el:"section",if:'$stepEnabled("'+e+'")',attrs:{hidden:'$activeStep !== "'+e+'"',key:t||e}});function _e(t,a,n=!0,i=!1,r=void 0,o=void 0,s=void 0){if(void 0===n&&(n=!0),a&&a.length&&(n||i)){const e=ie(a[a.length-1]);e&&!0===n&&(e.onKeypress=te),e&&!0===i&&(e.onInput=ae)}return e(ge(t,r),{children:[{$formkit:"group",id:t,name:t,nextStepMap:o,autoFocus:s,children:a}]})}function be(e,t,a,n={}){return _e(e,[de({headline:n.headline??a,headlineClass:n.headlineClass}),...Array.isArray(t)?t:[t]],n.nextOnEnter,void 0===n.nextOnInput||n.nextOnInput,n.stepKey,n.nextStepMap)}const Ce={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 ve={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 Pe={$el:"div",children:[{$el:"div",attrs:{id:"form-anchor",class:"t-absolute",style:{top:"-30px",left:0}}}],attrs:{class:"t-relative"}};const Ie={$el:"div",attrs:{class:"t-mt-7 t-mb-5 t-w-full t-flex t-flex-col t-justify-center t-items-center",style:{if:"$fns.eq($activeStep, $firstStep()) || $fns.eq($activeStep, $lastStep())",then:"display: none"}},children:[{$el:"div",attrs:{class:"t-flex t-justify-center"},children:[{$el:"span",attrs:{id:"progress-bar-text",class:"t-text-sm t-mb-1"},children:["0% Complete"]}]},{$el:"div",attrs:{class:"t-bg-gray-100 t-w-9/12 t-rounded"},children:[{$el:"div",attrs:{id:"progress-bar",class:"t-flex t-flex-col t-justify-center t-text-center t-whitespace-nowrap t-w-[10%] t-h-1.5 t-rounded t-text-white t-bg-[#007bff]",style:{transition:"width 0.5s ease"}}}]}]};const we=[{$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},{$formkit:"hidden",name:"s",value:null}],De={"*":"https://listings.ziplawyer.com/api/v1/redirect?zone_id=4&vertical=Legal&category=${properties.Type_Of_Legal_Problem}&Degree_Of_Interest=${properties.Degree_Of_Interest}&zip_code=${properties.Zip}&sub_id=${properties.vid}"};const Te={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"'},Se={},xe={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."},Ae=["haveAttorney","degreeOfInterest","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],Le=["haveAttorney","degreeOfInterest","lawyerPaymentMethod","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],Oe=["haveAttorney","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],ke={Type_Of_Legal_Problem:{Adoption:["maritalStatus","haveChildren",...Le],"Asbestos and Mesothelioma":["incidentDate","doctorTreatment",...Ae],"Auto and Car Accidents":["incidentDate","atFault","primaryInjury","doctorTreatment","policeReportFiled",...Oe],Bankruptcy:["totalMonthlyIncome","totalDebt","ownRealEstate","valueOfAssets",...Ae],"Business Lawyers":["businessServices","businessType","numEmployeesOfBusiness",...Ae],"Child Custody":["childRelationship","childHome","childPrimaryCaregiver",...Le],"Child Support":["childRelationship","childHome","childPrimaryCaregiver",...Le],"Civil Rights and Discrimination":["civilRightsType",...Ae],"Civil Lawsuit":["civilDefense","lawsuitOtherParty",...Ae],"File a Lawsuit":["civilLawsuitTOLPDisplay","lawsuitOtherParty",...Ae],"Defend a Lawsuit":["lawsuitOtherParty",...Ae],"Consumer Lawyers":["consumerLawyerType","incidentDate","lawsuitOtherParty",...Ae],"Criminal and Felony":["criminalTOLPDisplay","crimeCommittedDate","roleInMatterCriminal","pendingCharges",...Le],"Debt and Collections":["totalMonthlyIncome","totalDebt","ownRealEstate","valueOfAssets",...Ae],"Divorce and Separation":["maritalStatus","haveChildren",...Le],"DUI and DWI":["incidentDate","priorAlcoholOffenses","typeOfAlcoholTest","bloodContentAlcoholTest","pendingCharges",...Ae],"Employment and Workplace":["employmentAndWorkplaceTOLPDisplay","numEmployeesOfBusiness","employerType","employeeAtCompany",...Ae],Expungement:["incidentDate","criminalChargeType",...Le],"Family Issues":["maritalStatus","haveChildren",...Le],Foreclosure:["ownRealEstate","typeOfProperty","amountPaymentsPastDue","loanAmount","defaultNotice",...Ae],Guardianship:["maritalStatus","haveChildren",...Le],"Immigration and Visas":["countryOfCitizenship","immigrationLocation","immigrationEntry","immigrationType","immigrationStatus","immigrationDetails",...Ae],"Landlord and Tenant":["landlordTenantIssue","landlordTenantParty",...Ae],"Lemon Law":["incidentDate","lawsuitOtherParty",...Ae],"Long Term Disability":["applicantOccupation","applicantAge","applicantLTDisabilityPolicy","applicantDisabilityHowObtain","applicantPreviouslyAppliedLtdBenefits","applicantReceivedDisabilityBenefits","applicantMonthlySalary",...Oe],"Medical Malpractice":["incidentDate","claimStatus","doctorTreatment","medicalMalpracticeInjuries",...Ae],"Patents and Intellectual Property":["patentAssistanceType","patentFor",...Ae],"Personal Injury":["incidentDate","claimStatus","atFault","primaryInjury","doctorTreatment",...Oe],"Probate and Estates":["valueOfAssets","typeOfAssets","roleInMatterProbate","estateLegalServicesNeeded",...Ae],"Property Damage":["realEstateArea","wouldLikeLawyerTo",...Ae],"Real Estate":["realEstateTOLPDisplay","realEstateArea","wouldLikeLawyerTo",...Ae],"Social Security Disability and Insurance":["applicantAge","disabilityConditionStopWork","disabilityWorkHistory","socialSecurityDisabilityReceivingBenefits","doctorTreatment",...Oe],"Tax and IRS":["totalDebt","taxProblemDetails","taxLevel","taxIssueType",...Ae],"Traffic and Tickets":["driversLicenseType","trafficViolations","haveCourtDate",...Ae],Unemployment:["numEmployeesOfBusiness","employerType","degreeOfInterest","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],"Victim of a Crime":["crimeCommittedDate","roleInMatterCriminal","pendingCharges",...Le],"Wills and Trusts":["valueOfAssets","typeOfAssets","roleInMatterProbate","estateLegalServicesNeeded",...Ae],"Workers Compensation":["incidentDate","claimStatus","primaryInjury","causeOfInjury","doctorTreatment",...Oe],"Workplace Harassment":["numEmployeesOfBusiness","employerType","employeeAtCompany",...Ae],"Workplace Discrimination":["numEmployeesOfBusiness","employerType","employeeAtCompany",...Ae],"Wrongful Death":["incidentDate","relationshipToVictim","criminalChargesFiled","causeOfDeath",...Oe],"Wrongful Termination":["numEmployeesOfBusiness","employerType",...Ae]},"*":Ae},$e=ke.Type_Of_Legal_Problem;$e["Child Custody"],$e["Child Support"],$e["Family Issues"],$e["Defend a Lawsuit"],$e["File a Lawsuit"],$e["Defend a Lawsuit"],$e["File a Lawsuit"];const We={Type_Of_Legal_Problem_Display:{"Automobile Accident":$e["Auto and Car Accidents"],"Contract Disputes":$e["Business Lawyers"],"Dog Bite":$e["Personal Injury"],"Employment and Workplace":$e["Employment and Workplace"],Fraud:$e["Consumer Lawyers"],"Medical Malpractice":$e["Medical Malpractice"],"Personal Injury":$e["Personal Injury"],"Property Damage":$e["Property Damage"],"Real Estate":$e["Real Estate"],"Not Sure or Other":ke["*"]},"*":["lawsuitOtherParty",...Ae]},Ee={Type_Of_Legal_Problem_Display:{"Victim of a Crime":$e["Victim of a Crime"],"DUI and DWI":$e["DUI and DWI"],Expungement:$e.Expungement,"Not Sure or Other":ke["*"]},"*":["crimeCommittedDate","roleInMatterCriminal","pendingCharges",...Le]},Me={Type_Of_Legal_Problem_Display:{"Wrongful Termination":$e["Wrongful Termination"],"Workers Compensation":$e["Workers Compensation"],"Personal Injury":$e["Personal Injury"],Unemployment:$e.Unemployment},"*":["numEmployeesOfBusiness","employerType","employeeAtCompany",...Ae]},Be={Type_Of_Legal_Problem_Display:{Foreclosure:$e.Foreclosure,"Landlord and Tenant":$e["Landlord and Tenant"],"Wills, Trusts, and Estates":$e["Wills and Trusts"],"Property Damage":$e["Property Damage"]},"*":["realEstateArea","wouldLikeLawyerTo",...Ae]},je={type:"meta",data:e(ve,{defaultCommentsPlaceholder:t,commentsPlaceholders:Te,defaultFinalHeadline:"Submit Your Case",finalHeadlines:Se,defaultFinalSubHeadline:"You may benefit from speaking with a legal professional. Please verify your contact information.",finalSubHeadlines:xe})};je.data.dynamicSchema=[function(e={}){return be("amountPaymentsPastDue",y({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"]}),"Total amount of payments past due:",e)}(),function(e={}){return be("applicantAge",g({name:t?t+":Applicant_Age":"Applicant_Age",value:"50",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"}}),"What is the applicant's age?",e);var t}(),function(e={}){return be("applicantDisabilityHowObtain",d({name:t?t+":Applicant_Disability_How_Obtain":"Applicant_Disability_How_Obtain",options:["Employer","Self","Other"]}),"How did the applicant obtain the disability policy?",e);var t}(),function(e={}){return be("applicantLTDisabilityPolicy",u({name:t?t+":Applicant_Lt_Disability_Policy":"Applicant_Lt_Disability_Policy"}),"Does the applicant have a disability policy?",e);var t}(),function(e={}){return be("applicantMonthlySalary",y({name:t?t+":Applicant_Monthly_Salary":"Applicant_Monthly_Salary",options:["< $1,000","$1,000 - $2,000","$2,000 - $3,000","$3,000 - $4,000","$4,000 - $5,000","$5,000 - $6,000","$6,000 - $7,000","$7,000 - $8,000","$8,000 - $9,000","$9,000 - $10,000",">$10,000"]}),"Applicant's monthly pay when last working:",e);var t}(),function(e={}){return be("applicantOccupation",g({name:t?t+":Applicant_Occupation":"Applicant_Occupation",placeholder:"Occupation"}),"What is the applicant's occupation?",e);var t}({nextOnInput:!1}),function(e={}){return be("applicantPreviouslyAppliedLtdBenefits",c({name:t?t+":Applicant_Previously_Apply_Ltd_Benefits":"Applicant_Previously_Apply_Ltd_Benefits",options:["Yes, claim pending","Yes, claim denied","No"]}),"Has the applicant previously applied for long-term disability benefits?",e);var t}(),function(e={}){return be("applicantReceivedDisabilityBenefits",c({name:t?t+":Applicant_Received_Disability_Benefits":"Applicant_Received_Disability_Benefits",options:["Yes, currently receiving","Yes, appealing a decision to stop payment of benefits","No"]}),"Has the applicant received disability benefits for this claim?",e);var t}(),function(e={}){return be("atFault",u({name:t?t+":At_Fault":"At_Fault"}),"Were you at fault?",e);var t}(),function(e={}){return be("bloodContentAlcoholTest",y({name:t?t+":Blood_Alcohol_Content_Test":"Blood_Alcohol_Content_Test",options:["No Test","0.00% - 0.04%","0.05% - 0.08%","0.09% - 0.12%","0.13% - 0.16%","0.17% - 0.20%","More than 0.20%","Don't know"]}),"What was your blood alcohol content?",e);var t}(),function(e={}){return be("businessServices",s({id:"Business_Services",name:"Business_Services",options:["Business Formation","Contracts","Insurance and Liability","Mergers and Acquisition","Regulatory Compliance","Employee Dispute","Other"]}),"What legal services do you need?",e)}(),function(e={}){return be("businessType",d({name:"Business_Type",options:["Public","Private"]}),"Is the business public or private?",e)}(),function(e={}){return be("causeOfDeath",s({name:"Cause_Of_Death",options:["Vehicle Accident","Negligent/Careless Act","Reckless Act","Other"]}),"What was the cause of death?",e)}(),function(e={}){return be("causeOfInjury",s({name:t?t+":Cause_Of_Injury":"Cause_Of_Injury",options:["Traumatic Physical Injury (Accident)","Repeated Trauma Injury","Mental Injury","Occupational Disease","Not Sure"]}),"What was the cause of the injury?",e);var t}(),function(e={}){return be("childHome",s({name:t?t+":Child_Home":"Child_Home",options:["Mother","Father","Grandparents","Other"]}),"Who do the children currently live with?",e);var t}(),function(e={}){return be("childPrimaryCaregiver",d({name:t?t+":Child_Primary_Caregiver":"Child_Primary_Caregiver",options:["Mother","Father","Other"]}),"Who is the primary caregiver?",e);var t}(),function(e={}){return be("childRelationship",s({name:t?t+":Child_Relationship":"Child_Relationship",options:["Father","Mother","Grandparent","Aunt/Uncle","Other"]}),"Your relationship to the children:",e);var t}(),function(t={}){return be("civilLawsuitTOLPDisplay",(t=>s(e({name:"Type_Of_Legal_Problem_Display",options:["Automobile Accident","Contract Disputes","Defamation and Slander","Dog Bite","Employment and Workplace","Fraud","Medical Malpractice","Personal Injury","Property Damage","Small Claims","Real Estate","Not Sure or Other"]},t)))(),"What type of lawsuit would you like to file?",t)}({nextStepMap:We}),function(e={}){return be("civilRightsType",s({name:"Civil_Rights_Type",options:["Age","Disability","Gender","Race","Religion","Other"]}),"How were your rights violated?",e)}(),function(e={}){return be("claimStatus",s({name:t?t+":Claim_Status":"Claim_Status",options:["No action taken yet","Demand for compensation made","Lawsuit filed","Other"]}),"What is the status of the claim?",e);var t}(),function(e={}){return be("consumerLawyerType",y({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"]}),"What best describes your issue?",e)}(),function(e={}){return be("countryOfCitizenship",y({name:t?t+":Country_Of_Citizenship":"Country_Of_Citizenship",options:["Afghanistan","Albania","Algeria","Andorra","Angola","Antigua and Barbuda","Argentina","Armenia","Australia","Austria","Azerbaijan","Bahamas","The Bahrain","Bangladesh","Barbados","Belarus","Belgium","Belize","Benin","Bhutan","Bolivia","Bosnia and Herzegovina","Botswana","Brazil","Brunei","Bulgaria","Burkina Faso","Burundi","Cambodia","Cameroon","Canada","Cape Verde","Central African Republic","Chad","Chile","China","Colombia","Comoros","Congo (Congoâ Kinshasa)","Congo (Congoâ Brazzaville)","Costa Rica","Coted'Ivoire (Ivory Coast)","Croatia","Cuba","Cyprus","Czech Republic","Denmark","Djibouti","Dominica","Dominican Republic","Ecuador","Egypt","El Salvador","Equatorial Guinea","Eritrea","Estonia","Ethiopia","Fiji","Finland","France","Gabon","Gambia","Georgia","Germany","Ghana","Greece","Grenada","Guatemala","Guinea","Guinea-Bissau","Guyana","Haiti","Honduras","Hungary","Iceland","India","Indonesia","Iran","Iraq","Ireland","Israel","Italy","Jamaica","Japan","Jordan","Kazakhstan","Kenya","Kiribati","Korea (North Korea)","Korea (South Korea)","Kuwait","Kyrgyzstan","Laos","Latvia","Lebanon","Lesotho","Liberia","Libya","Liechtenstein","Lithuania","Luxembourg","Macedonia","Madagascar","Malawi","Malaysia","Maldives","Mali","Malta","Marshall Islands","Mauritania","Mauritius","Mexico","Micronesia","Moldova","Monaco","Mongolia","Montenegro","Morocco","Mozambique","Myanmar (Burma)","Namibia","Nauru","Nepal","Netherlands","New Zealand","Nicaragua","Niger","Nigeria","Norway","Oman","Pakistan","Palau","Panama","Papua New Guinea","Paraguay","Peru","Philippines","Poland","Portugal","Qatar","Romania","Russia","Rwanda","Saint Kitts and Nevis","SaintLucia","Saint Vincent and the Grenadines","Samoa","San Marino","Sao Tome and Principe","Saudi Arabia","Senegal","Serbia","Seychelles","Sierra Leone","Singapore","Slovakia","Slovenia","Solomon Islands","Somalia","South Africa","Spain","SriLanka","Sudan","Suriname","Swaziland","Sweden","Switzerland","Syria","Tajikistan","Tanzania","Thailand","Timor-Leste (East Timor)","Togo","Tonga","Trinidad and Tobago","Tunisia","Turkey","Turkmenistan","Tuvalu","Uganda","Ukraine","United Arab Emirates","United Kingdom","United States","Uruguay","Uzbekistan","Vanuatu","Vatican City","Venezuela","Vietnam","Yemen","Zambia","Zimbabwe"]}),"What is your current country of citizenship?",e);var t}(),function(e={}){return be("crimeCommittedDate",b({name:"Crime_Committed_Date"}),"When was the alleged crime?",e)}({nextOnInput:!1}),function(e={}){return be("criminalChargeType",s({name:"Criminal_Charge_Type",options:["Felony","Misdemeanor","Juvenile","Other"]}),"What type of criminal charge?",e)}(),function(e={}){return be("criminalChargesFiled",c({name:"Criminal_Charges_Filed",options:["Yes","No","Not Sure"]}),"Have criminal charges been filed?",e)}(),function(t={}){return be("criminalTOLPDisplay",(t=>s(e({name:"Type_Of_Legal_Problem_Display",options:["Criminal Defense","Victim of a Crime","DUI and DWI","Expungement","Harassment","Not Sure or Other"]},t)))(),"Which type of criminal issue?",t)}({nextStepMap:Ee}),function(e={}){return be("defaultNotice",u({name:"Default_Notice"}),"Have you received a default notice from the lender?",e)}(),function(e={}){return be("degreeOfInterest",s({name:t?t+":Degree_Of_Interest":"Degree_Of_Interest",id:t?t+":Degree_Of_Interest":"Degree_Of_Interest",help:a,options:["Definitely","Probably","Maybe","Absolutely Can't Afford"]}),"Could you pay if your issue could be resolved?",e);var t,a}(),function(e={}){return be("disabilityConditionStopWork",u({name:t?t+":Disability_Condition_Stop_Work":"Disability_Condition_Stop_Work"}),"Do you expect to be out of work for at least a year?",e);var t}(),function(e={}){return be("disabilityWorkHistory",u({name:t?t+":Disability_Work_History":"Disability_Work_History"}),"Have you had a full-time job in the past 5 years?",e);var t}(),function(e={}){return be("doctorTreatment",u({name:"Doctor_Treatment"}),"Have you seen a doctor about this?",e)}(),function(e={}){return be("driversLicenseType",d({name:"Drivers_License_Type",options:["Private","Commercial"]}),"What type of license do you have?",e)}(),function(e={}){return be("estateLegalServicesNeeded",s({name:t?t+":Estate_Legal_Services_Needed":"Estate_Legal_Services_Needed",options:["Charitable Giving","Contested Wills","Drafting Wills or Trust","Estate Administration","Asset Protection","Other"]}),"What legal services are needed?",e);var t}(),function(e={}){return be("employerType",s({name:"Employer_Type",options:["Sole proprietorship (mom and pop)","Partnership","Franchise","Privately held company","Public corporation","Government Agency","Don't know"]}),"What type of employer is it?",e)}(),function(e={}){return be("employeeAtCompany",u({name:t?t+":Employee_At_Company":"Employee_At_Company"}),"Do you/they still work at the company?",e);var t}(),function(t={}){return be("employmentAndWorkplaceTOLPDisplay",(t=>s(e({name:"Type_Of_Legal_Problem_Display",options:["Workplace Harassment","Workplace Discrimination","Wrongful Termination","Payment Disputes","Workers Compensation","Personal Injury","Unemployment","Other Workplace Issues"]},t)))(),"What type of workplace issue?",t)}({nextStepMap:Me}),function(e={}){return be("haveAttorney",u({name:"Have_Attorney"}),"Already working with an attorney?",e)}(),function(e={}){return be("haveChildren",u({name:t?t+":Have_Children":"Have_Children"}),"Do you have children?",e);var t}(),function(e={}){return be("haveCourtDate",u({name:"Have_Court_Date"}),"Do you have a court date?",e)}(),function(e={}){return be("immigrationDetails",y({name:t?t+":Immigration_Details":"Immigration_Details",options:["In the USA with proper documentation","In the USA without proper documentation","Not in the USA","In Deportation/Removal Proceedings","Currently Detained (friend or family submitting this request)","Out on Bond","None Apply"]}),"Where is the person seeking immigration located?",e);var t}(),function(e={}){return be("immigrationEntry",y({name:t?t+":Immigration_Entry":"Immigration_Entry",options:["With Proper Documents/Visa and Inspection through Customs Border Patrol","Illegally","No Entry","Other"]}),"How are you trying to enter the country?",e);var t}(),function(e={}){return be("immigrationLocation",s({name:t?t+":Immigration_Location":"Immigration_Location",options:["In the USA","Outside the USA"]}),"Where are you migrating to?",e);var t}(),function(e={}){return be("immigrationStatus",y({name:t?t+":Immigration_Status":"Immigration_Status",options:["Out of Status (overstayed my visa)","Current Visa Holder (in status)","Lawful Permanent Resident (green card)","Not Applicable (outside the USA)","Other"]}),"Current statue of the immigration case:",e);var t}(),function(e={}){return be("immigrationType",y({name:t?t+":Immigration_Type":"Immigration_Type",options:["Citizenship (for current green card holders)","Permanent Visa Family Based (green cards)","Permanent Visa Business Based (green cards)","Temporary Business Visa","Temporary Tourist Visa","Investor","Asylum","Self Petition (violence & abuse victims)","Removal/Deportation Proceeding","Other"]}),"What type of immigration issue?",e);var t}(),function(e={}){return be("incidentDate",b({name:t?t+":Incident_Date":"Incident_Date"}),"When did the incident occur?",e);var t}({nextOnInput:!1}),function(e={}){return be("landlordTenantIssue",s({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"]}),"What is the landlord / tenant issue?",e)}(),function(e={}){return be("landlordTenantParty",d({name:"Landlord_Tenant_Party",options:["Landlord","Tenant","Other"]}),"I am the:",e)}(),function(e={}){return be("lawsuitOtherParty",s({name:"Lawsuit_Other_Party",options:["Individual","Small Business","Large Corporation","Government Entity"]}),"What describes the other party in the lawsuit?",e)}(),function(e={}){return be("lawyerPaymentMethod",s({name:t?t+":Lawyer_Payment_Method":"Lawyer_Payment_Method",help:"No payment necessary to start a consultation.",options:{Cash:"Cash","Credit Card":"Credit Card",Family:"Family or Friend",Other:"Other"},fieldsetClass:"$reset t-flex t-flex-col t-items-center"}),"How would you pay if a solution required it?",e);var t}(),function(e={}){return be("loanAmount",y({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"]}),"Total amount of the loan:",e)}(),function(e={}){return be("maritalStatus",s({name:t?t+":Marital_Status":"Marital_Status",options:["Unmarried, Living Together","Unmarried, Do Not Live Together","Married, Living Together","Separated","Divorced","Other"]}),"What is your marital status?",e);var t}(),function(e={}){return be("medicalMalpracticeInjuries",y({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"]}),"What injuries did you suffer?",e)}(),function(e={}){return be("numEmployeesOfBusiness",s({name:"Num_Employees_Of_Business",options:["1-5","6-20","21-50","51-100","101-500","501-1,000","More than 1,000"]}),"How many employees does the business have?",e)}(),function(e={}){return be("ownRealEstate",u({name:"Own_Real_Estate"}),"Do you own real estate?",e)}(),function(e={}){return be("patentAssistanceType",y({name:"Patent_Assistance_Type",options:["Obtaining a Patent","Avoiding Patent Infringement","Suing for Patent Infringement","Defending Against a Claim of Patent Infringement","Other"]}),"What type of assistance do you need?",e)}(),function(e={}){return be("patentFor",s({name:"Patent_For",options:["Product or Machine","Process","Computer Software","Living Organism or Plant","Ornamental Design","Other"]}),"What is the patent for?",e)}(),function(e={}){return be("pendingCharges",u({name:t?t+":Pending_Charges":"Pending_Charges"}),"Do you have any pending charges?",e);var t}(),function(e={}){return be("policeReportFiled",u({name:t?t+":Police_Report_Filed":"Police_Report_Filed"}),"Was a police report filed?",e);var t}(),function(e={}){return be("primaryInjury",s({name:t?t+":Primary_Injury":"Primary_Injury",options:["Anxiety","Back or Neck Pain","Broken Bones","Cuts and Bruises","Headaches","Memory Loss","Loss of Limb","Not Sure or Other"]}),"What was the primary injury?",e);var t}(),function(e={}){return be("priorAlcoholOffenses",u({name:t?t+":Prior_Alcohol_Offenses":"Prior_Alcohol_Offenses"}),"Do you have prior alcohol offenses?",e);var t}(),function(e={}){return be("realEstateArea",s({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"]}),"What area of real estate?",e)}(),function(t={}){return be("realEstateTOLPDisplay",(t=>s(e({name:"Type_Of_Legal_Problem_Display",options:["Contracts and Agreements","Deeds, Liens, and Titles","Foreclosure","Insurance","Landlord and Tenant","Loans and Mortgages","Wills, Trusts, and Estates","Property Damage","Not Sure or Other"]},t)))(),"What type of real estate issue?",t)}({nextStepMap:Be}),function(e={}){return be("relationshipToVictim",s({name:"Relationship_To_Victim",options:["Parent","Spouse","Sibling","Friend","Other"]}),"What is your relationship to the victim?",e)}(),function(e={}){return be("roleInMatterCriminal",c({name:"Role_In_Matter_Criminal",options:["I have been accused","I am acting on behalf of someone who has been accused","Other"]}),"What is your role in this matter?",e)}(),function(e={}){return be("roleInMatterProbate",s({name:t?t+":Role_In_Matter_Probate":"Role_In_Matter_Probate",options:["Preparing My Will","Executor","Heir","Other"]}),"What is your role in this matter?",e);var t}(),function(e={}){return be("socialSecurityDisabilityReceivingBenefits",u({name:t?t+":Social_Security_Disability_Receiving_Benefits":"Social_Security_Disability_Receiving_Benefits"}),"Are you receiving Social Security Disability benefits?",e);var t}(),function(e={}){return be("taxIssueType",s({name:"Tax_Issue_Type",options:["Income","Property","Corporate"]}),"What type of tax issue?",e)}(),function(e={}){return be("taxLevel",s({name:"Tax_Level",options:["Federal","State","Local"]}),"What level of tax issue?",e)}(),function(e={}){return be("taxProblemDetails",y({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"]}),"Details of the tax problem:",e)}(),function(e={}){return be("totalDebt",s({name:"Total_Debt",options:["Less than 5K","5K to 10K","10K to 20K","20K to 50K","More than 50K"]}),"What is your total debt?",e)}(),function(e={}){return be("totalMonthlyIncome",y({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"]}),"What is your total monthly income?",e)}(),function(e={}){return be("trafficViolations",y({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"]}),"What type of traffic violation?",e)}(),function(e={}){return be("typeOfAlcoholTest",s({name:t?t+":Type_Of_Alcohol_Test":"Type_Of_Alcohol_Test",options:["No Test","Refused Test","Breath Test","Blood Test","Urine Test","Don't Know"]}),"What type of alcohol test was performed?",e);var t}(),function(e={}){return void 0===e.nextOnInput&&(e.nextOnInput=!1),be("typeOfAssets",Z(),"What type of assets are involved?",e)}(),function(e={}){return be("typeOfProperty",s({name:"Type_Of_Property",options:["Residential","Commercial","Industrial","Agricultural","Recreational","Other"]}),"What type of property is involved?",e)}(),function(e={}){return be("valueOfAssets",s({name:t?t+":Value_Of_Assets":"Value_Of_Assets",options:["Less than 50K","50K to 100K","100K to 250K","250K to 500K","500K to 1M","More than 1M"]}),"What is the value of your assets?",e);var t}(),function(e={}){return be("veteransDisabilityApplied",y({name:"Veterans_Disability_Applied",options:["Yes, Claim filed and awaiting decision","Yes, Claim denied","Yes, Claim on appeal","Yes, Claim approved","Yes, Benefits awarded","No, Claim has not been filed"]}),"Has the applicant applied for VA disability benefits?",e)}(),function(e={}){return be("veteransDisabilityConditions",X(),"What conditions or injuries are applicable?",e)}(),function(e={}){return be("veteransDisabilityInjured",u({name:"Veterans_Disability_Injured"}),"Is the condition or injury related to military service?",e)}(),function(e={}){return be("veteransDisabilityRelationship",y({name:"Veterans_Disability_Relationship",options:["Self, Active Duty","Self, Active Reserve","Self, Discharged from Active Duty","Self, Discharged as Reservist","Surviving Family Member","Other"]}),"What is your relationship to the applicant?",e)}(),function(e={}){return be("wouldLikeLawyerTo",c({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"]}),"I would like the lawyer to:",e)}(),function(e={}){return be("zipcode",((e={})=>f({placeholder:"#####",help:e.help??"We try to match you with local legal help",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"},wrapperClass:"t-flex t-justify-center",messagesClass:"t-flex t-justify-center",inputClass:"t-text-center",helpClass:"t-mt-2.5 !t-text-sm t-text-center"}))(e),"Please verify your Zip Code",e)}(),function(e={}){return _e("commentsWithBankruptcy",[ce(e),A({label:void 0===e.label?"Please briefly describe your legal issue in a few words:":e.label,placeholder:e.placeholder||t,inputClass:void 0===e.inputClass?"!t-h-32":e.inputClass}),P(),{$el:"div",if:"$get(CrossSell_Bankruptcy).value == true",children:[A({label:"Bankruptcy or debt details:",placeholder:"Please describe your bankrtupcy or debt situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Bankruptcy")]}],!1)}({label:null,headline:"Please briefly describe your situation:",headlineClass:"!t-text-dark"}),function(e={}){return _e("legalCrossSells",[me(e),r({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,"$get(Type_Of_Legal_Problem).value")}({headlineClass:"!t-text-dark"}),function(e={}){return _e("autoAndCarAccidentCrossSellQuestions",[se({headline:"You May Be Entitled To Compensation"}),le({subheadline:"Tell us about your accident:"}),(t="true",a="CrossSell:Auto_and_Car_Accidents",ee("AutoAndCarAccidentsQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Auto and Car Accidents"',children:[j(a),N(a),v(a),q(a),W(a),Y(a)]})),A({label:"Accident Description:",placeholder:"Please describe your accident in a few words...",inputClass:"!t-h-16"},"CrossSell:Auto_and_Car_Accidents")],e.nextOnEnter);var t,a}(),function(e={}){return _e("personalInjuryCrossSellQuestions",[se({headline:"You May Be Entitled To Compensation"}),le({subheadline:"Tell us about your injury:"}),(t="true",a="CrossSell:Personal_Injury",ee("PersonalInjuryQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Personal Injury"',children:[j(a),N(a),x(a),v(a),q(a),W(a)]})),A({label:"Injury Description:",placeholder:"Please describe your injury in a few words...",inputClass:"!t-h-16"},"CrossSell:Personal_Injury")],e.nextOnEnter);var t,a}(),function(e={}){return _e("workersCompensationCrossSellQuestions",[se({headline:"You May Be Entitled To Benefits"}),le({subheadline:"Tell us about your injury:"}),(t="true",a="CrossSell:Workers_Compensation",ee("WorkersCompensationQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Workers Compensation"',children:[j(a),N(a),x(a),q(a),w(a),W(a)]})),A({label:"Injury Description:",placeholder:"Please describe your injury in a few words...",inputClass:"!t-h-16"},"CrossSell:Workers_Compensation")],e.nextOnEnter);var t,a}(),function(e={}){return _e("duiAndDWICrossSellQuestions",[se({headline:"About Your DUI/DWI"}),(t="true",a="CrossSell:DUI_and_DWI",ee("DUIAndDWIQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "DUI and DWI"',children:[j(a),N(a),K(a),G(a),I(a),U(a),O(a)]})),A({label:"Incident Description:",placeholder:"Please describe your incident in a few words...",inputClass:"!t-h-16"},"CrossSell:DUI_and_DWI")],e.nextOnEnter);var t,a}(),function(e={}){return _e("ssdiCrossSellQuestions",[se({headline:"You May Be Entitled To Benefits"}),le({subheadline:"Tell us about your disability:"}),(t="true",a="CrossSell:Social_Security_Disability_and_Insurance",ee("SocialSecurityDisabilityAndInsuranceQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Social Security Disability and Insurance"',children:[j(a),C(a),k(a),$(a),z(a),W(a)]})),A({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Social_Security_Disability_and_Insurance")],e.nextOnEnter);var t,a}(),function(e={}){return _e("powerOfAttorneyCrossSellQuestions",[se({headline:"Power of Attorney Information"}),(t="true",a="CrossSell:Power_of_Attorney",ee("PowerofAttorneyQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Power of Attorney"',children:[j(a),O(a)]})),A({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Power_of_Attorney")],e.nextOnEnter);var t,a}(),function(e={}){return _e("willsAndTrustsCrossSellQuestions",[se({headline:"Will or Trust Information"}),(t="true",a="CrossSell:Wills_and_Trusts",ee("WillsAndTrustsQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Wills and Trusts"',children:[j(a),J(a),Q(a),V(a),E(a),O(a)]})),A({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Wills_and_Trusts")],e.nextOnEnter);var t,a}(),function(e={}){return _e("divorceAndSeparationCrossSellQuestions",[se({headline:"Divorce or Separation Information"}),(t="true",a="CrossSell:Divorce_and_Separation",ee("DivorceQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Divorce and Separation"',children:[j(a),H(a),F(a),L(a),R(a)]})),A({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Divorce_and_Separation")],e.nextOnEnter);var t,a}(),function(e={}){return _e("childCustodyCrossSellQuestions",[se({headline:"Child Custody Information"}),(t="true",a="CrossSell:Child_Custody",ee("ChildCustodyQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Child Custody"',children:[j(a),S(a),D(a),T(a),L(a),R(a)]})),A({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Child_Custody")],e.nextOnEnter);var t,a}(),function(e={}){return _e("firstAndLast",[pe({headline:e.headline??"Who is looking for help?",headlineClass:e.headlineClass}),ue({subheadline:e.subheadline??"Note: we never share info without consent",subheadlineClass:"!t-text-sm !t-text-gray-500"}),h({$formkit:"text",label:"First Name:",placeholder:"First",name:"First_Name",autocomplete:"given-name",validationMessages:{required:"First Name is required"}}),h({$formkit:"text",label:"Last Name:",placeholder:"Last",name:"Last_Name",autocomplete:"family-name",validationMessages:{required:"Last Name is required"}})],e.nextOnEnter)}({headlineClass:"!t-text-dark"})];const Fe=[je,e(Pe,Ne),{$cmp:"FormKit",props:function(t){const a=e(Ce,t);return a.formId&&!a.name&&(a.name=a.formId),a}({formId:"generalLegalSingle",redirectMap:function(t){return e(De,t)}(),valueOverrideMap:{Civil_Defense:{Yes:{Type_Of_Legal_Problem:"Defend a Lawsuit"},No:{Type_Of_Legal_Problem:"File a Lawsuit"}},Business_Services_Display:{"Business Formation":{Business_Services:"Business Formation"},Contracts:{Business_Services:"Contracts"},"Insurance and Liability":{Business_Services:"Insurance and Liability"},"Mergers and Acquisition":{Business_Services:"Mergers and Acquisition"},"Regulatory Compliance":{Business_Services:"Regulatory Compliance"},"Employee Dispute":{Business_Services:"Employee Dispute"},"Advice and Consulting":{Business_Services:"Other"},Other:{Business_Services:"Other"}},Type_Of_Legal_Problem_Display:{"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(t){return e(Ie,t)}(),function(t={}){return e(function(e={}){return{$el:"h1",attrs:{class:"t-flex t-justify-center t-text-center !t-text-[2rem] t-font-semibold t-pt-5 t-px-7 md:t-px-3 "+(e.headlineClass||"")}}}(t),t)}({children:'$urlParam("hl", "Need Legal Help? Start Here!")',if:"$activeStep === $firstStep()"}),function(t={}){return e(function(e={}){return{$el:"h3",attrs:{class:"t-flex t-justify-center t-text-center !t-text-[1.2rem] t-font-medium t-text-blue-500 t-px-10 "+(e.subheadlineClass||"")}}}(t),t)}({children:'$urlParam("shl", "Our Service is Fast and Free!")',if:"$activeStep === $firstStep()"}),...we,{$el:"div",attrs:{class:"form-body"},children:[function(e={}){return _e("generalTOLP",[B(e.input)],e.nextOnEnter,e.nextOnInput,e.stepKey,e.nextStepMap)}({nextOnInput:!1,nextStepMap:ke,headlineClass:"t-text-lg",input:{placeholder:"Select a Category",innerClass:"!t-max-w-[275px] md:!t-max-w-xl"}}),{$cmp:"FormKitSchema",if:"$get(Type_Of_Legal_Problem).value",props:{schema:"$meta.dynamicSchema",data:"$buildData($meta)"}},function(e={}){return _e("contactInfo",[ye(e),fe(e),{$el:"script",if:"$activeStep === $lastStep()",children:he},h({$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"}}),h({$formkit:"tel",name:"Primary_Phone",label:"Phone Number:",placeholder:"###-###-####",maxlength:12,help:"10-digit phone number, hyphens optional",autocomplete:"tel-national","data-tf-sensitive":"false",validation:"required|matches:/^[0-9]{3}-?[0-9]{3}-?[0-9]{4}$/|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"}},oe()],!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: ","$stepKeys()"],attrs:{class:"t-text-xs",style:"overflow: scroll"}}]}]}]}];var Ne;const Re=Fe.find((e=>"FormKit"===e.$cmp));return Re.props.name="generalLegalPopUnderSingle",Re.props.formId="generalLegalPopUnderSingle",Re.props.popUnderMap={"*":"/thank-you"},Fe}();
+var generalLegalPopUnderSingle=function(){"use strict";function e(){return Object.assign({},...arguments)}const t='$getKey($meta, "commentsPlaceholders." + $get(Type_Of_Legal_Problem).value, $meta.defaultCommentsPlaceholder)',a='$getKey($meta, "finalHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalHeadline)',n='$getKey($meta, "finalSubHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalSubHeadline)',i=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"checkbox",validation:"required",validationMessages:{required:"Field is required"}},t)),r=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",i(e)),o=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"radio",validation:"required",validationMessages:{required:"Field is required"},optionsClass:"t-pt-3 t-pl-1",legendClass:"required"},t)),s=e=>(e.legendClass="required t-w-[100%] t-text-center",void 0===e.fieldsetClass&&(e.fieldsetClass="$reset t-flex t-justify-center"),e.optionsClass="t-pl-4 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",e.optionClass="t-pl-4 md:t-pl-8 md:t-min-w-[200px]",e.messagesClass="t-flex t-justify-center",e.helpClass="t-mt-0 t-mb-4 !t-text-sm t-text-center",o(e)),l=e=>(e.options=["Yes","No"],(e=>(e.legendClass="legend-left t-pb-1 required",e.fieldsetClass="$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",o(e)))(e)),u=e=>(e.legendClass="legend-left",e.fieldsetClass="$reset t-flex t-justify-center t-items-center",void 0===e.optionsClass&&(e.optionsClass="t-flex t-flex-col sm:t-flex-row t-justify-center t-my-3"),e.optionClass="radiobtn t-my-2 sm:t-my-0 t-mx-2 md:t-mx-5",e.wrapperClass="$reset formkit-wrapper t-mb-0 t-flex t-items-center t-h-[100%]",e.labelClass="t-font-semibold t-text-[#1e448f] t-w-[100%]",e.decoratorIcon=!1,e.messagesClass="t-flex t-justify-center",o(e)),d=e=>(e.options=["Yes","No"],e.optionsClass="t-flex t-justify-center t-my-3",u(e)),c=e=>(e.legendClass="required",e.fieldsetClass="$reset t-flex t-justify-center",e.optionsClass="t-pl-2 t-pt-3",e.innerClass="t-items-center",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",e.optionClass="t-pl-4 md:t-pl-12",e.messagesClass="t-flex t-justify-center",o(e)),p=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"select",placeholder:"Please Select",validation:"required",validationMessages:{required:"Field is required"},inputClass:"t-bg-white",labelClass:"required"},t)),m=e=>(e.labelClass="required",e.wrapperClass="side-by-side t-items-center",e.innerClass="select-height-content",e.helpClass="t-mt-2.5 md:t-text-right md:t-mt-[-5px]",p(e)),y=e=>(e.labelClass="required",e.wrapperClass="t-flex t-justify-center",e.messagesClass="t-flex t-justify-center",e.inputClass="t-min-w-[150px] t-bg-white",e.helpClass="t-mt-2.5 t-text-center",p(e)),f=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"text",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required"},t)),h=e=>(e.wrapperClass="side-by-side t-items-center",f(e)),g=e=>(e.wrapperClass="t-flex t-justify-center",e.messagesClass="t-flex t-justify-center",e.inputClass="t-text-center",f(e)),_=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"DatePicker",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required t-block t-mb-3 t-font-semibold t-text-base formkit-invalid:t-text-red-500",innerClass:"t-border t-border-gray-400 formkit-invalid:t-border-red-500 t-rounded t-mb-1 focus-within:t-border-blue-500"},t)),b=e=>(e.wrapperClass="t-flex t-justify-center",e.inputClass="t-text-center",e.messagesClass="t-flex t-justify-center",_(e)),C=e=>h({name:e?e+":Applicant_Age":"Applicant_Age",label:"Age of Applicant?",placeholder:"Age between 18 and 65",maxlength:2,inputmode:"numeric",validation:"required|min:18,max:65",validationMessages:{required:"Applicant Age is required",min:"Invalid Age - must be between 18 and 65",max:"Invalid Age - must be between 18 and 65"}}),v=e=>l({name:e?e+":At_Fault":"At_Fault",label:"Were You at Fault?"}),P=()=>{return(e={label:"I'd also like a consult for bankruptcy or debt elimination (optional)",help:"Note: you will be contacted separately by a bankruptcy/debt expert",name:"CrossSell_Bankruptcy",id:"CrossSell_Bankruptcy",if:'$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="$reset side-by-side",e.optionsClass="t-pl-1",e.innerClass="t-flex t-items-center",e.wrapperClass="t-mb-3",i(e);var e},I=e=>m({name:e?e+":Blood_Alcohol_Content_Test":"Blood_Alcohol_Content_Test",label:"Blood Alcohol Content Measured by Test:",options:["No Test","0.00% - 0.04%","0.05% - 0.08%","0.09% - 0.12%","0.13% - 0.16%","0.17% - 0.20%","More than 0.20%","Don't know"]}),w=e=>m({name:e?e+":Cause_Of_Injury":"Cause_Of_Injury",label:"Cause of Injury:",options:["Traumatic Physical Injury (Accident)","Repeated Trauma Injury","Mental Injury","Occupational Disease","Not Sure"]}),T=e=>m({name:e?e+":Child_Home":"Child_Home",label:"With Whom Do the Children Currently Live?",options:["Mother","Father","Grandparents","Other"]}),D=e=>m({name:e?e+":Child_Primary_Caregiver":"Child_Primary_Caregiver",label:"Who is the Primary Caregiver?",options:["Mother","Father","Other"]}),S=e=>m({name:e?e+":Child_Relationship":"Child_Relationship",label:"Your Relationship to Child(ren):",options:["Father","Mother","Grandparent","Aunt/Uncle","Other"]}),x=e=>m({name:e?e+":Claim_Status":"Claim_Status",label:"Status of Claim:",options:["No action taken yet","Demand for compensation made","Lawsuit filed","Other"]}),L=(t,a)=>(t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"textarea",rows:5,maxlength:500,validation:"required",validationMessages:{required:"Field is required"},innerClass:"t-max-w-xl",labelClass:"required"},t)))(e({name:a?a+":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"'},t)),O=(e,t)=>m({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:t,options:["Definitely","Probably","Maybe","Absolutely Can't Afford"]}),A=e=>O(e,"No payment necessary to speak with lawyers."),k=e=>l({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?"}),$=e=>l({name:e?e+":Disability_Work_History":"Disability_Work_History",label:"Have You Had a Full-Time Job Within the Past 5 Years?"}),W=e=>l({name:e?e+":Doctor_Treatment":"Doctor_Treatment",label:"Have You Recently Been Treated by a Doctor, Hospital or Clinic?"}),E=e=>m({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"]}),M=["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"],B=t=>y(e({name:"Type_Of_Legal_Problem",id:"Type_Of_Legal_Problem",options:M},t)),j=e=>l({name:e?e+":Have_Attorney":"Have_Attorney",label:"Already Working with An Attorney?"}),F=e=>l({name:e?e+":Have_Children":"Have_Children",label:"Do You Have Children?"}),N=e=>{return(t={name:e?e+":Incident_Date":"Incident_Date",label:"Date of Incident:"}).wrapperClass="side-by-side t-items-center",_(t);var t},R=e=>m({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"]}),H=e=>m({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"]}),U=e=>l({name:e?e+":Pending_Charges":"Pending_Charges",label:"Do you currently have any pending charges?"}),q=e=>{return(t={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","Not Sure or Other"]}).legendClass="legend-left-flex md:t-max-w-[40%] required",t.fieldsetClass="$reset side-by-side-flex",t.optionsClass="md:t-ml-4 md:t-mt-2 t-grid t-grid-cols-1 md:t-grid-cols-2-125",t.innerClass="t-flex t-items-start",t.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",o(t);var t},K=e=>l({name:e?e+":Prior_Alcohol_Offenses":"Prior_Alcohol_Offenses",label:"Any Prior Alcohol Related Offenses?"}),Y=e=>l({name:e?e+":Police_Report_Filed":"Police_Report_Filed",label:"Was a Police Report Filed?"}),V=e=>m({name:e?e+":Role_In_Matter_Probate":"Role_In_Matter_Probate",label:"What Is Your Role in this Matter?",options:["Preparing My Will","Executor","Heir","Other"]}),z=e=>l({name:e?e+":Social_Security_Disability_Receiving_Benefits":"Social_Security_Disability_Receiving_Benefits",label:"Are You Currently Receiving Social Security Disability Benefits?"}),G=e=>m({name:e?e+":Type_Of_Alcohol_Test":"Type_Of_Alcohol_Test",label:"Type of Alcohol Test Performed?",options:["No Test","Refused Test","Breath Test","Blood Test","Urine Test","Don't Know"]}),Q=e=>r({name:e?e+":Type_Of_Assets":"Type_Of_Assets",label:"Type of Assets:",options:["Business Interests","Cash","Life Insurance Policies","Pensions/Retirement","Personal Possessions","Property","Stock/Bonds"]}),Z=e=>{return(t={name:e?e+":Type_Of_Assets":"Type_Of_Assets",options:["Business Interests","Cash","Life Insurance Policies","Pensions/Retirement","Personal Possessions","Property","Stock/Bonds"]})&&t.legendClass||(t.legendClass="required"),t.fieldsetClass="$reset t-flex t-justify-center",t.optionClass="t-mx-5",t.optionsClass="t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",t.innerClass="t-items-center",t.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",t.messagesClass="t-flex t-justify-center",i(t);var t},J=e=>m({name:e?e+":Value_Of_Assets":"Value_Of_Assets",label:"Value of Your Assets?",options:["Less than 50K","50K to 100K","100K to 250K","250K to 500K","500K to 1M","More than 1M"]}),X=()=>{return(e={label:"What Service Connected Conditions Does the Applicant Have? (select all that apply)",name:"Veterans_Disability_Conditions",options:["Traumatic Physical Injury (broken bones, loss of limb)","Mental Injury","Occupational Disease","Repeated Trauma Injury","Other"]})&&e.legendClass||(e.legendClass="required"),e.fieldsetClass="$reset",e.optionsClass="t-pl-2 t-pt-3",e.innerClass="t-items-center",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",i(e);var e},ee=(t,a)=>e({$cmp:"FormKit",props:{type:"group",key:t,id:t,name:t}},a),te="$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",ae="$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",ne=e=>"group"!==e.type&&"section"!==e.type&&"form"!==e.type&&"hidden"!==e.$formkit&&!e.children,ie=e=>{if(ne(e))return e;for(var t=e.children.length-1;t>=0;t--){if("string"==typeof e.children)continue;const a=e.children[t];if(ne(a))return a;const n=ie(a);if(n)return n}return null},re={$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"}},{$el:"span",children:"Secure & Encrypted",attrs:{class:"t-pl-2 t-pt-1 t-font-medium"}}]};function oe(t){return e(re,t)}function se(e){return{$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 le(e){return{$el:"h5",children:e.subheadline||"Tell us about your situation:",attrs:{class:"t-flex t-justify-center t-text-dark t-text-center !t-text-lg t-font-semibold t-pb-4 t-pt-0 t-px-3"}}}function ue(e){return{$el:"h3",children:e.headline||"Tell Us About Your Situation",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-dark t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function de(e){return{$el:"h5",children:e.subheadline||"",attrs:{class:"t-flex t-justify-center t-text-center !t-text-lg t-font-normal t-text-dark t-pb-5 t-pt-0 t-px-1 "+(e.subheadlineClass||"")}}}function ce(e){return{$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 pe(e){return{$el:"h3",children:e.headline||"Please Provide a Contact Name",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function me(e){return{$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 ye(e){return{$el:"h3",children:e.headline||a,attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-3 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function fe(e){return{$el:"h5",children:e.subheadline||n,attrs:{class:"t-flex t-justify-center t-text-center !t-text-lg t-font-semibold t-pb-7 t-pt-0 t-px-3 "+(e.subheadlineClass||"")}}}const he="(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 ge=(e,t)=>({$el:"section",if:'$stepEnabled("'+e+'")',attrs:{hidden:'$activeStep !== "'+e+'"',key:t||e}});function _e(t,a,n=!0,i=!1,r=void 0,o=void 0,s=void 0){if(void 0===n&&(n=!0),a&&a.length&&(n||i)){const e=ie(a[a.length-1]);e&&!0===n&&(e.onKeypress=te),e&&!0===i&&(e.onInput=ae)}return e(ge(t,r),{children:[{$formkit:"group",id:t,name:t,nextStepMap:o,autoFocus:s,children:a}]})}function be(e,t,a,n={}){return _e(e,[ue({headline:n.headline??a,headlineClass:n.headlineClass}),...Array.isArray(t)?t:[t]],n.nextOnEnter,void 0===n.nextOnInput||n.nextOnInput,n.stepKey,n.nextStepMap)}const Ce={type:"form",id:"form",config:{validationVisibility:"submit"},onSubmit:'$submit($submitUrl, $prepData, $handleRedirect, "text/plain; charset=UTF-8")',plugins:"$plugins",actions:!1,anchorElement:"form-anchor",useLocalStorage:!0,prepop:{fromURL:!0},errorCodes:{403:{message:"An Error Occurred",abort:!1},409:{abort:!1},429:"An Error Occurred",504:{message:"An Error Occurred",abort:!1}},formClass:"!t-max-w-[40rem]"};function ve(e,t){return Object.fromEntries(Object.entries(e).filter((([e])=>t.includes(e))))}const Pe={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 Ie={$el:"div",children:[{$el:"div",attrs:{id:"form-anchor",class:"t-absolute",style:{top:"-30px",left:0}}}],attrs:{class:"t-relative"}};const we={$el:"div",attrs:{class:"t-mt-7 t-mb-5 t-w-full t-flex t-flex-col t-justify-center t-items-center",style:{if:"$fns.eq($activeStep, $firstStep()) || $fns.eq($activeStep, $lastStep())",then:"display: none"}},children:[{$el:"div",attrs:{class:"t-flex t-justify-center"},children:[{$el:"span",attrs:{id:"progress-bar-text",class:"t-text-sm t-mb-1"},children:["0% Complete"]}]},{$el:"div",attrs:{class:"t-bg-gray-100 t-w-9/12 t-rounded"},children:[{$el:"div",attrs:{id:"progress-bar",class:"t-flex t-flex-col t-justify-center t-text-center t-whitespace-nowrap t-w-[10%] t-h-1.5 t-rounded t-text-white t-bg-[#007bff]",style:{transition:"width 0.5s ease"}}}]}]};const Te=[{$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},{$formkit:"hidden",name:"s",value:null}],De={"*":"https://listings.ziplawyer.com/api/v1/redirect?zone_id=4&vertical=Legal&category=${properties.Type_Of_Legal_Problem}&Degree_Of_Interest=${properties.Degree_Of_Interest}&zip_code=${properties.Zip}&sub_id=${properties.vid}"};const Se={Civil_Defense:{Yes:{Type_Of_Legal_Problem:"Defend a Lawsuit"},No:{Type_Of_Legal_Problem:"File a Lawsuit"}},businessServicesOverrideMap:{Business_Services_Display:{"Business Formation":{Business_Services:"Business Formation"},Contracts:{Business_Services:"Contracts"},"Insurance and Liability":{Business_Services:"Insurance and Liability"},"Mergers and Acquisition":{Business_Services:"Mergers and Acquisition"},"Regulatory Compliance":{Business_Services:"Regulatory Compliance"},"Employee Dispute":{Business_Services:"Employee Dispute"},"Advice and Consulting":{Business_Services:"Other"},Other:{Business_Services:"Other"}}},Type_Of_Legal_Problem_Display:{Type_Of_Legal_Problem_Display:{Copyrights:{Type_Of_Legal_Problem:"Copyrights and Trademarks"},Trademarks:{Type_Of_Legal_Problem:"Copyrights and Trademarks"},Patents:{Type_Of_Legal_Problem:"Patents and Intellectual Property"},"Business Lawyers":{Type_Of_Legal_Problem:"Business Lawyers"},"Business Consulting":{Type_Of_Legal_Problem:"Business Lawyers"},"Not Sure or Other":{Type_Of_Legal_Problem:"Not Sure or Other"}},"Auto Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Dog Bite":{Type_Of_Legal_Problem:"Personal Injury"},"Slip and Fall":{Type_Of_Legal_Problem:"Personal Injury"},"Workplace Injury":{Type_Of_Legal_Problem:"Workers Compensation"},"Trucking Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Motorcycle Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Other Accidents or Injuries":{Type_Of_Legal_Problem:"Personal Injury"},"Automobile Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Contract Disputes":{Type_Of_Legal_Problem:"Business Lawyers"},"Defamation and Slander":{Type_Of_Legal_Problem:"File a Lawsuit"},"Dog Bite":{Type_Of_Legal_Problem:"Personal Injury"},"Employment and Workplace":{Type_Of_Legal_Problem:"Employment and Workplace"},Fraud:{Type_Of_Legal_Problem:"Consumer Lawyers"},"Medical Malpractice":{Type_Of_Legal_Problem:"Medical Malpractice"},"Personal Injury":{Type_Of_Legal_Problem:"Personal Injury"},"Property Damage":{Type_Of_Legal_Problem:"Property Damage"},"Small Claims":{Type_Of_Legal_Problem:"File a Lawsuit"},"Real Estate":{Type_Of_Legal_Problem:"Real Estate"},"Other (describe on next page)":{Type_Of_Legal_Problem:"Not Sure or Other"},"Contract Creation":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Contract Enforcement":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Contract Cancellation":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Contract Fraud":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Breach of Contract":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Other Contract Issues":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Criminal Defense":{Type_Of_Legal_Problem:"Criminal and Felony"},"Victim of a Crime":{Type_Of_Legal_Problem:"Victim of a Crime"},"DUI and DWI":{Type_Of_Legal_Problem:"DUI and DWI"},Expungement:{Type_Of_Legal_Problem:"Expungement"},Harassment:{Type_Of_Legal_Problem:"Criminal and Felony"},"Not Sure or Other":{Type_Of_Legal_Problem:"Not Sure or Other"},"Workplace Harassment":{Type_Of_Legal_Problem:"Workplace Harassment"},"Workplace Discrimination":{Type_Of_Legal_Problem:"Workplace Discrimination"},"Wrongful Termination":{Type_Of_Legal_Problem:"Wrongful Termination"},"Payment Disputes":{Type_Of_Legal_Problem:"Employment and Workplace"},"Workers Compensation":{Type_Of_Legal_Problem:"Workers Compensation"},Unemployment:{Type_Of_Legal_Problem:"Unemployment"},"Other Workplace Issues":{Type_Of_Legal_Problem:"Employment and Workplace"},"Attorney Malpractice":{Type_Of_Legal_Problem:"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"}}},xe={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"'},Le={},Oe={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."},Ae=["haveAttorney","degreeOfInterest","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],ke=["haveAttorney","degreeOfInterest","lawyerPaymentMethod","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],$e=["haveAttorney","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],We={Type_Of_Legal_Problem:{Adoption:["maritalStatus","haveChildren",...ke],"Asbestos and Mesothelioma":["incidentDate","doctorTreatment",...Ae],"Auto and Car Accidents":["incidentDate","atFault","primaryInjury","doctorTreatment","policeReportFiled",...$e],Bankruptcy:["totalMonthlyIncome","totalDebt","ownRealEstate","valueOfAssets",...Ae],"Business Lawyers":["businessServices","businessType","numEmployeesOfBusiness",...Ae],"Child Custody":["childRelationship","childHome","childPrimaryCaregiver",...ke],"Child Support":["childRelationship","childHome","childPrimaryCaregiver",...ke],"Civil Rights and Discrimination":["civilRightsType",...Ae],"Civil Lawsuit":["civilDefense","lawsuitOtherParty",...Ae],"File a Lawsuit":["civilLawsuitTOLPDisplay","lawsuitOtherParty",...Ae],"Defend a Lawsuit":["lawsuitOtherParty",...Ae],"Consumer Lawyers":["consumerLawyerType","incidentDate","lawsuitOtherParty",...Ae],"Criminal and Felony":["criminalTOLPDisplay","crimeCommittedDate","roleInMatterCriminal","pendingCharges",...ke],"Debt and Collections":["totalMonthlyIncome","totalDebt","ownRealEstate","valueOfAssets",...Ae],"Divorce and Separation":["maritalStatus","haveChildren",...ke],"DUI and DWI":["incidentDate","priorAlcoholOffenses","typeOfAlcoholTest","bloodContentAlcoholTest","pendingCharges",...Ae],"Employment and Workplace":["employmentAndWorkplaceTOLPDisplay","numEmployeesOfBusiness","employerType","employeeAtCompany",...Ae],Expungement:["incidentDate","criminalChargeType",...ke],"Family Issues":["maritalStatus","haveChildren",...ke],Foreclosure:["ownRealEstate","typeOfProperty","amountPaymentsPastDue","loanAmount","defaultNotice",...Ae],Guardianship:["maritalStatus","haveChildren",...ke],"Immigration and Visas":["countryOfCitizenship","immigrationLocation","immigrationEntry","immigrationType","immigrationStatus","immigrationDetails",...Ae],"Landlord and Tenant":["landlordTenantIssue","landlordTenantParty",...Ae],"Lemon Law":["incidentDate","lawsuitOtherParty",...Ae],"Long Term Disability":["applicantOccupation","applicantAge","applicantLTDisabilityPolicy","applicantDisabilityHowObtain","applicantPreviouslyAppliedLtdBenefits","applicantReceivedDisabilityBenefits","applicantMonthlySalary",...$e],"Medical Malpractice":["incidentDate","claimStatus","doctorTreatment","medicalMalpracticeInjuries",...Ae],"Patents and Intellectual Property":["patentAssistanceType","patentFor",...Ae],"Personal Injury":["incidentDate","claimStatus","atFault","primaryInjury","doctorTreatment",...$e],"Probate and Estates":["valueOfAssets","typeOfAssets","roleInMatterProbate","estateLegalServicesNeeded",...Ae],"Property Damage":["realEstateArea","wouldLikeLawyerTo",...Ae],"Real Estate":["realEstateTOLPDisplay","realEstateArea","wouldLikeLawyerTo",...Ae],"Social Security Disability and Insurance":["applicantAge","disabilityConditionStopWork","disabilityWorkHistory","socialSecurityDisabilityReceivingBenefits","doctorTreatment",...$e],"Tax and IRS":["totalDebt","taxProblemDetails","taxLevel","taxIssueType",...Ae],"Traffic and Tickets":["driversLicenseType","trafficViolations","haveCourtDate",...Ae],Unemployment:["numEmployeesOfBusiness","employerType","degreeOfInterest","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],"Victim of a Crime":["crimeCommittedDate","roleInMatterCriminal","pendingCharges",...ke],"Wills and Trusts":["valueOfAssets","typeOfAssets","roleInMatterProbate","estateLegalServicesNeeded",...Ae],"Workers Compensation":["incidentDate","claimStatus","primaryInjury","causeOfInjury","doctorTreatment",...$e],"Workplace Harassment":["numEmployeesOfBusiness","employerType","employeeAtCompany",...Ae],"Workplace Discrimination":["numEmployeesOfBusiness","employerType","employeeAtCompany",...Ae],"Wrongful Death":["incidentDate","relationshipToVictim","criminalChargesFiled","causeOfDeath",...$e],"Wrongful Termination":["numEmployeesOfBusiness","employerType",...Ae]},"*":Ae},Ee=We.Type_Of_Legal_Problem;Ee["Child Custody"],Ee["Child Support"],Ee["Family Issues"],Ee["Defend a Lawsuit"],Ee["File a Lawsuit"],Ee["Defend a Lawsuit"],Ee["File a Lawsuit"];const Me={Type_Of_Legal_Problem_Display:{"Automobile Accident":Ee["Auto and Car Accidents"],"Contract Disputes":Ee["Business Lawyers"],"Dog Bite":Ee["Personal Injury"],"Employment and Workplace":Ee["Employment and Workplace"],Fraud:Ee["Consumer Lawyers"],"Medical Malpractice":Ee["Medical Malpractice"],"Personal Injury":Ee["Personal Injury"],"Property Damage":Ee["Property Damage"],"Real Estate":Ee["Real Estate"],"Not Sure or Other":We["*"]},"*":["lawsuitOtherParty",...Ae]},Be={Type_Of_Legal_Problem_Display:{"Victim of a Crime":Ee["Victim of a Crime"],"DUI and DWI":Ee["DUI and DWI"],Expungement:Ee.Expungement,"Not Sure or Other":We["*"]},"*":["crimeCommittedDate","roleInMatterCriminal","pendingCharges",...ke]},je={Type_Of_Legal_Problem_Display:{"Wrongful Termination":Ee["Wrongful Termination"],"Workers Compensation":Ee["Workers Compensation"],"Personal Injury":Ee["Personal Injury"],Unemployment:Ee.Unemployment},"*":["numEmployeesOfBusiness","employerType","employeeAtCompany",...Ae]};Ee["Patents and Intellectual Property"],Ee["Business Lawyers"],Ee["Business Lawyers"];const Fe={Type_Of_Legal_Problem_Display:{Foreclosure:Ee.Foreclosure,"Landlord and Tenant":Ee["Landlord and Tenant"],"Wills, Trusts, and Estates":Ee["Wills and Trusts"],"Property Damage":Ee["Property Damage"]},"*":["realEstateArea","wouldLikeLawyerTo",...Ae]},Ne=function(a=null){let n=xe,i=Le,r=Oe;return a&&(n=ve(xe,a),i=ve(Le,a),r=ve(Oe,a)),{type:"meta",data:e(Pe,{defaultCommentsPlaceholder:t,commentsPlaceholders:n,defaultFinalHeadline:"Submit Your Case",finalHeadlines:i,defaultFinalSubHeadline:"You may benefit from speaking with a legal professional. Please verify your contact information.",finalSubHeadlines:r})}}();Ne.data.dynamicSchema=[function(e={}){return be("amountPaymentsPastDue",y({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"]}),"Total amount of payments past due:",e)}(),function(e={}){return be("applicantAge",g({name:t?t+":Applicant_Age":"Applicant_Age",value:"50",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"}}),"What is the applicant's age?",e);var t}(),function(e={}){return be("applicantDisabilityHowObtain",u({name:t?t+":Applicant_Disability_How_Obtain":"Applicant_Disability_How_Obtain",options:["Employer","Self","Other"]}),"How did the applicant obtain the disability policy?",e);var t}(),function(e={}){return be("applicantLTDisabilityPolicy",d({name:t?t+":Applicant_Lt_Disability_Policy":"Applicant_Lt_Disability_Policy"}),"Does the applicant have a disability policy?",e);var t}(),function(e={}){return be("applicantMonthlySalary",y({name:t?t+":Applicant_Monthly_Salary":"Applicant_Monthly_Salary",options:["< $1,000","$1,000 - $2,000","$2,000 - $3,000","$3,000 - $4,000","$4,000 - $5,000","$5,000 - $6,000","$6,000 - $7,000","$7,000 - $8,000","$8,000 - $9,000","$9,000 - $10,000",">$10,000"]}),"Applicant's monthly pay when last working:",e);var t}(),function(e={}){return be("applicantOccupation",g({name:t?t+":Applicant_Occupation":"Applicant_Occupation",placeholder:"Occupation"}),"What is the applicant's occupation?",e);var t}({nextOnInput:!1}),function(e={}){return be("applicantPreviouslyAppliedLtdBenefits",c({name:t?t+":Applicant_Previously_Apply_Ltd_Benefits":"Applicant_Previously_Apply_Ltd_Benefits",options:["Yes, claim pending","Yes, claim denied","No"]}),"Has the applicant previously applied for long-term disability benefits?",e);var t}(),function(e={}){return be("applicantReceivedDisabilityBenefits",c({name:t?t+":Applicant_Received_Disability_Benefits":"Applicant_Received_Disability_Benefits",options:["Yes, currently receiving","Yes, appealing a decision to stop payment of benefits","No"]}),"Has the applicant received disability benefits for this claim?",e);var t}(),function(e={}){return be("atFault",d({name:t?t+":At_Fault":"At_Fault"}),"Were you at fault?",e);var t}(),function(e={}){return be("bloodContentAlcoholTest",y({name:t?t+":Blood_Alcohol_Content_Test":"Blood_Alcohol_Content_Test",options:["No Test","0.00% - 0.04%","0.05% - 0.08%","0.09% - 0.12%","0.13% - 0.16%","0.17% - 0.20%","More than 0.20%","Don't know"]}),"What was your blood alcohol content?",e);var t}(),function(e={}){return be("businessServices",s({id:"Business_Services",name:"Business_Services",options:["Business Formation","Contracts","Insurance and Liability","Mergers and Acquisition","Regulatory Compliance","Employee Dispute","Other"]}),"What legal services do you need?",e)}(),function(e={}){return be("businessType",u({name:"Business_Type",options:["Public","Private"]}),"Is the business public or private?",e)}(),function(e={}){return be("causeOfDeath",s({name:"Cause_Of_Death",options:["Vehicle Accident","Negligent/Careless Act","Reckless Act","Other"]}),"What was the cause of death?",e)}(),function(e={}){return be("causeOfInjury",s({name:t?t+":Cause_Of_Injury":"Cause_Of_Injury",options:["Traumatic Physical Injury (Accident)","Repeated Trauma Injury","Mental Injury","Occupational Disease","Not Sure"]}),"What was the cause of the injury?",e);var t}(),function(e={}){return be("childHome",s({name:t?t+":Child_Home":"Child_Home",options:["Mother","Father","Grandparents","Other"]}),"Who do the children currently live with?",e);var t}(),function(e={}){return be("childPrimaryCaregiver",u({name:t?t+":Child_Primary_Caregiver":"Child_Primary_Caregiver",options:["Mother","Father","Other"]}),"Who is the primary caregiver?",e);var t}(),function(e={}){return be("childRelationship",s({name:t?t+":Child_Relationship":"Child_Relationship",options:["Father","Mother","Grandparent","Aunt/Uncle","Other"]}),"Your relationship to the children:",e);var t}(),function(t={}){return be("civilLawsuitTOLPDisplay",(t=>s(e({name:"Type_Of_Legal_Problem_Display",options:["Automobile Accident","Contract Disputes","Defamation and Slander","Dog Bite","Employment and Workplace","Fraud","Medical Malpractice","Personal Injury","Property Damage","Small Claims","Real Estate","Not Sure or Other"]},t)))(),"What type of lawsuit would you like to file?",t)}({nextStepMap:Me}),function(e={}){return be("civilRightsType",s({name:"Civil_Rights_Type",options:["Age","Disability","Gender","Race","Religion","Other"]}),"How were your rights violated?",e)}(),function(e={}){return be("claimStatus",s({name:t?t+":Claim_Status":"Claim_Status",options:["No action taken yet","Demand for compensation made","Lawsuit filed","Other"]}),"What is the status of the claim?",e);var t}(),function(e={}){return be("consumerLawyerType",y({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"]}),"What best describes your issue?",e)}(),function(e={}){return be("countryOfCitizenship",y({name:t?t+":Country_Of_Citizenship":"Country_Of_Citizenship",options:["Afghanistan","Albania","Algeria","Andorra","Angola","Antigua and Barbuda","Argentina","Armenia","Australia","Austria","Azerbaijan","Bahamas","The Bahrain","Bangladesh","Barbados","Belarus","Belgium","Belize","Benin","Bhutan","Bolivia","Bosnia and Herzegovina","Botswana","Brazil","Brunei","Bulgaria","Burkina Faso","Burundi","Cambodia","Cameroon","Canada","Cape Verde","Central African Republic","Chad","Chile","China","Colombia","Comoros","Congo (Congoâ Kinshasa)","Congo (Congoâ Brazzaville)","Costa Rica","Coted'Ivoire (Ivory Coast)","Croatia","Cuba","Cyprus","Czech Republic","Denmark","Djibouti","Dominica","Dominican Republic","Ecuador","Egypt","El Salvador","Equatorial Guinea","Eritrea","Estonia","Ethiopia","Fiji","Finland","France","Gabon","Gambia","Georgia","Germany","Ghana","Greece","Grenada","Guatemala","Guinea","Guinea-Bissau","Guyana","Haiti","Honduras","Hungary","Iceland","India","Indonesia","Iran","Iraq","Ireland","Israel","Italy","Jamaica","Japan","Jordan","Kazakhstan","Kenya","Kiribati","Korea (North Korea)","Korea (South Korea)","Kuwait","Kyrgyzstan","Laos","Latvia","Lebanon","Lesotho","Liberia","Libya","Liechtenstein","Lithuania","Luxembourg","Macedonia","Madagascar","Malawi","Malaysia","Maldives","Mali","Malta","Marshall Islands","Mauritania","Mauritius","Mexico","Micronesia","Moldova","Monaco","Mongolia","Montenegro","Morocco","Mozambique","Myanmar (Burma)","Namibia","Nauru","Nepal","Netherlands","New Zealand","Nicaragua","Niger","Nigeria","Norway","Oman","Pakistan","Palau","Panama","Papua New Guinea","Paraguay","Peru","Philippines","Poland","Portugal","Qatar","Romania","Russia","Rwanda","Saint Kitts and Nevis","SaintLucia","Saint Vincent and the Grenadines","Samoa","San Marino","Sao Tome and Principe","Saudi Arabia","Senegal","Serbia","Seychelles","Sierra Leone","Singapore","Slovakia","Slovenia","Solomon Islands","Somalia","South Africa","Spain","SriLanka","Sudan","Suriname","Swaziland","Sweden","Switzerland","Syria","Tajikistan","Tanzania","Thailand","Timor-Leste (East Timor)","Togo","Tonga","Trinidad and Tobago","Tunisia","Turkey","Turkmenistan","Tuvalu","Uganda","Ukraine","United Arab Emirates","United Kingdom","United States","Uruguay","Uzbekistan","Vanuatu","Vatican City","Venezuela","Vietnam","Yemen","Zambia","Zimbabwe"]}),"What is your current country of citizenship?",e);var t}(),function(e={}){return be("crimeCommittedDate",b({name:"Crime_Committed_Date"}),"When was the alleged crime?",e)}({nextOnInput:!1}),function(e={}){return be("criminalChargeType",s({name:"Criminal_Charge_Type",options:["Felony","Misdemeanor","Juvenile","Other"]}),"What type of criminal charge?",e)}(),function(e={}){return be("criminalChargesFiled",c({name:"Criminal_Charges_Filed",options:["Yes","No","Not Sure"]}),"Have criminal charges been filed?",e)}(),function(t={}){return be("criminalTOLPDisplay",(t=>s(e({name:"Type_Of_Legal_Problem_Display",options:["Criminal Defense","Victim of a Crime","DUI and DWI","Expungement","Harassment","Not Sure or Other"]},t)))(),"Which type of criminal issue?",t)}({nextStepMap:Be}),function(e={}){return be("defaultNotice",d({name:"Default_Notice"}),"Have you received a default notice from the lender?",e)}(),function(e={}){return be("degreeOfInterest",s({name:t?t+":Degree_Of_Interest":"Degree_Of_Interest",id:t?t+":Degree_Of_Interest":"Degree_Of_Interest",help:a,options:["Definitely","Probably","Maybe","Absolutely Can't Afford"]}),"Could you pay if your issue could be resolved?",e);var t,a}(),function(e={}){return be("disabilityConditionStopWork",d({name:t?t+":Disability_Condition_Stop_Work":"Disability_Condition_Stop_Work"}),"Do you expect to be out of work for at least a year?",e);var t}(),function(e={}){return be("disabilityWorkHistory",d({name:t?t+":Disability_Work_History":"Disability_Work_History"}),"Have you had a full-time job in the past 5 years?",e);var t}(),function(e={}){return be("doctorTreatment",d({name:"Doctor_Treatment"}),"Have you seen a doctor about this?",e)}(),function(e={}){return be("driversLicenseType",u({name:"Drivers_License_Type",options:["Private","Commercial"]}),"What type of license do you have?",e)}(),function(e={}){return be("estateLegalServicesNeeded",s({name:t?t+":Estate_Legal_Services_Needed":"Estate_Legal_Services_Needed",options:["Charitable Giving","Contested Wills","Drafting Wills or Trust","Estate Administration","Asset Protection","Other"]}),"What legal services are needed?",e);var t}(),function(e={}){return be("employerType",s({name:"Employer_Type",options:["Sole proprietorship (mom and pop)","Partnership","Franchise","Privately held company","Public corporation","Government Agency","Don't know"]}),"What type of employer is it?",e)}(),function(e={}){return be("employeeAtCompany",d({name:t?t+":Employee_At_Company":"Employee_At_Company"}),"Do you/they still work at the company?",e);var t}(),function(t={}){return be("employmentAndWorkplaceTOLPDisplay",(t=>s(e({name:"Type_Of_Legal_Problem_Display",options:["Workplace Harassment","Workplace Discrimination","Wrongful Termination","Payment Disputes","Workers Compensation","Personal Injury","Unemployment","Other Workplace Issues"]},t)))(),"What type of workplace issue?",t)}({nextStepMap:je}),function(e={}){return be("haveAttorney",d({name:"Have_Attorney"}),"Already working with an attorney?",e)}(),function(e={}){return be("haveChildren",d({name:t?t+":Have_Children":"Have_Children"}),"Do you have children?",e);var t}(),function(e={}){return be("haveCourtDate",d({name:"Have_Court_Date"}),"Do you have a court date?",e)}(),function(e={}){return be("immigrationDetails",y({name:t?t+":Immigration_Details":"Immigration_Details",options:["In the USA with proper documentation","In the USA without proper documentation","Not in the USA","In Deportation/Removal Proceedings","Currently Detained (friend or family submitting this request)","Out on Bond","None Apply"]}),"Where is the person seeking immigration located?",e);var t}(),function(e={}){return be("immigrationEntry",y({name:t?t+":Immigration_Entry":"Immigration_Entry",options:["With Proper Documents/Visa and Inspection through Customs Border Patrol","Illegally","No Entry","Other"]}),"How are you trying to enter the country?",e);var t}(),function(e={}){return be("immigrationLocation",s({name:t?t+":Immigration_Location":"Immigration_Location",options:["In the USA","Outside the USA"]}),"Where are you migrating to?",e);var t}(),function(e={}){return be("immigrationStatus",y({name:t?t+":Immigration_Status":"Immigration_Status",options:["Out of Status (overstayed my visa)","Current Visa Holder (in status)","Lawful Permanent Resident (green card)","Not Applicable (outside the USA)","Other"]}),"Current statue of the immigration case:",e);var t}(),function(e={}){return be("immigrationType",y({name:t?t+":Immigration_Type":"Immigration_Type",options:["Citizenship (for current green card holders)","Permanent Visa Family Based (green cards)","Permanent Visa Business Based (green cards)","Temporary Business Visa","Temporary Tourist Visa","Investor","Asylum","Self Petition (violence & abuse victims)","Removal/Deportation Proceeding","Other"]}),"What type of immigration issue?",e);var t}(),function(e={}){return be("incidentDate",b({name:t?t+":Incident_Date":"Incident_Date"}),"When did the incident occur?",e);var t}({nextOnInput:!1}),function(e={}){return be("landlordTenantIssue",s({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"]}),"What is the landlord / tenant issue?",e)}(),function(e={}){return be("landlordTenantParty",u({name:"Landlord_Tenant_Party",options:["Landlord","Tenant","Other"]}),"I am the:",e)}(),function(e={}){return be("lawsuitOtherParty",s({name:"Lawsuit_Other_Party",options:["Individual","Small Business","Large Corporation","Government Entity"]}),"What describes the other party in the lawsuit?",e)}(),function(e={}){return be("lawyerPaymentMethod",s({name:t?t+":Lawyer_Payment_Method":"Lawyer_Payment_Method",help:"No payment necessary to start a consultation.",options:{Cash:"Cash","Credit Card":"Credit Card",Family:"Family or Friend",Other:"Other"},fieldsetClass:"$reset t-flex t-flex-col t-items-center"}),"How would you pay if a solution required it?",e);var t}(),function(e={}){return be("loanAmount",y({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"]}),"Total amount of the loan:",e)}(),function(e={}){return be("maritalStatus",s({name:t?t+":Marital_Status":"Marital_Status",options:["Unmarried, Living Together","Unmarried, Do Not Live Together","Married, Living Together","Separated","Divorced","Other"]}),"What is your marital status?",e);var t}(),function(e={}){return be("medicalMalpracticeInjuries",y({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"]}),"What injuries did you suffer?",e)}(),function(e={}){return be("numEmployeesOfBusiness",s({name:"Num_Employees_Of_Business",options:["1-5","6-20","21-50","51-100","101-500","501-1,000","More than 1,000"]}),"How many employees does the business have?",e)}(),function(e={}){return be("ownRealEstate",d({name:"Own_Real_Estate"}),"Do you own real estate?",e)}(),function(e={}){return be("patentAssistanceType",y({name:"Patent_Assistance_Type",options:["Obtaining a Patent","Avoiding Patent Infringement","Suing for Patent Infringement","Defending Against a Claim of Patent Infringement","Other"]}),"What type of assistance do you need?",e)}(),function(e={}){return be("patentFor",s({name:"Patent_For",options:["Product or Machine","Process","Computer Software","Living Organism or Plant","Ornamental Design","Other"]}),"What is the patent for?",e)}(),function(e={}){return be("pendingCharges",d({name:t?t+":Pending_Charges":"Pending_Charges"}),"Do you have any pending charges?",e);var t}(),function(e={}){return be("policeReportFiled",d({name:t?t+":Police_Report_Filed":"Police_Report_Filed"}),"Was a police report filed?",e);var t}(),function(e={}){return be("primaryInjury",s({name:t?t+":Primary_Injury":"Primary_Injury",options:["Anxiety","Back or Neck Pain","Broken Bones","Cuts and Bruises","Headaches","Memory Loss","Loss of Limb","Not Sure or Other"]}),"What was the primary injury?",e);var t}(),function(e={}){return be("priorAlcoholOffenses",d({name:t?t+":Prior_Alcohol_Offenses":"Prior_Alcohol_Offenses"}),"Do you have prior alcohol offenses?",e);var t}(),function(e={}){return be("realEstateArea",s({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"]}),"What area of real estate?",e)}(),function(t={}){return be("realEstateTOLPDisplay",(t=>s(e({name:"Type_Of_Legal_Problem_Display",options:["Contracts and Agreements","Deeds, Liens, and Titles","Foreclosure","Insurance","Landlord and Tenant","Loans and Mortgages","Wills, Trusts, and Estates","Property Damage","Not Sure or Other"]},t)))(),"What type of real estate issue?",t)}({nextStepMap:Fe}),function(e={}){return be("relationshipToVictim",s({name:"Relationship_To_Victim",options:["Parent","Spouse","Sibling","Friend","Other"]}),"What is your relationship to the victim?",e)}(),function(e={}){return be("roleInMatterCriminal",c({name:"Role_In_Matter_Criminal",options:["I have been accused","I am acting on behalf of someone who has been accused","Other"]}),"What is your role in this matter?",e)}(),function(e={}){return be("roleInMatterProbate",s({name:t?t+":Role_In_Matter_Probate":"Role_In_Matter_Probate",options:["Preparing My Will","Executor","Heir","Other"]}),"What is your role in this matter?",e);var t}(),function(e={}){return be("socialSecurityDisabilityReceivingBenefits",d({name:t?t+":Social_Security_Disability_Receiving_Benefits":"Social_Security_Disability_Receiving_Benefits"}),"Are you receiving Social Security Disability benefits?",e);var t}(),function(e={}){return be("taxIssueType",s({name:"Tax_Issue_Type",options:["Income","Property","Corporate"]}),"What type of tax issue?",e)}(),function(e={}){return be("taxLevel",s({name:"Tax_Level",options:["Federal","State","Local"]}),"What level of tax issue?",e)}(),function(e={}){return be("taxProblemDetails",y({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"]}),"Details of the tax problem:",e)}(),function(e={}){return be("totalDebt",s({name:"Total_Debt",options:["Less than 5K","5K to 10K","10K to 20K","20K to 50K","More than 50K"]}),"What is your total debt?",e)}(),function(e={}){return be("totalMonthlyIncome",y({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"]}),"What is your total monthly income?",e)}(),function(e={}){return be("trafficViolations",y({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"]}),"What type of traffic violation?",e)}(),function(e={}){return be("typeOfAlcoholTest",s({name:t?t+":Type_Of_Alcohol_Test":"Type_Of_Alcohol_Test",options:["No Test","Refused Test","Breath Test","Blood Test","Urine Test","Don't Know"]}),"What type of alcohol test was performed?",e);var t}(),function(e={}){return void 0===e.nextOnInput&&(e.nextOnInput=!1),be("typeOfAssets",Z(),"What type of assets are involved?",e)}(),function(e={}){return be("typeOfProperty",s({name:"Type_Of_Property",options:["Residential","Commercial","Industrial","Agricultural","Recreational","Other"]}),"What type of property is involved?",e)}(),function(e={}){return be("valueOfAssets",s({name:t?t+":Value_Of_Assets":"Value_Of_Assets",options:["Less than 50K","50K to 100K","100K to 250K","250K to 500K","500K to 1M","More than 1M"]}),"What is the value of your assets?",e);var t}(),function(e={}){return be("veteransDisabilityApplied",y({name:"Veterans_Disability_Applied",options:["Yes, Claim filed and awaiting decision","Yes, Claim denied","Yes, Claim on appeal","Yes, Claim approved","Yes, Benefits awarded","No, Claim has not been filed"]}),"Has the applicant applied for VA disability benefits?",e)}(),function(e={}){return be("veteransDisabilityConditions",X(),"What conditions or injuries are applicable?",e)}(),function(e={}){return be("veteransDisabilityInjured",d({name:"Veterans_Disability_Injured"}),"Is the condition or injury related to military service?",e)}(),function(e={}){return be("veteransDisabilityRelationship",y({name:"Veterans_Disability_Relationship",options:["Self, Active Duty","Self, Active Reserve","Self, Discharged from Active Duty","Self, Discharged as Reservist","Surviving Family Member","Other"]}),"What is your relationship to the applicant?",e)}(),function(e={}){return be("wouldLikeLawyerTo",c({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"]}),"I would like the lawyer to:",e)}(),function(e={}){return be("zipcode",((e={})=>f({placeholder:"#####",help:e.help??"We try to match you with local legal help",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"},wrapperClass:"t-flex t-justify-center",messagesClass:"t-flex t-justify-center",inputClass:"t-text-center",helpClass:"t-mt-2.5 !t-text-sm t-text-center"}))(e),"Please verify your Zip Code",e)}(),function(e={}){return _e("commentsWithBankruptcy",[ce(e),L({label:void 0===e.label?"Please briefly describe your legal issue in a few words:":e.label,placeholder:e.placeholder||t,inputClass:void 0===e.inputClass?"!t-h-32":e.inputClass}),P(),{$el:"div",if:"$get(CrossSell_Bankruptcy).value == true",children:[L({label:"Bankruptcy or debt details:",placeholder:"Please describe your bankrtupcy or debt situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Bankruptcy")]}],!1)}({label:null,headline:"Please briefly describe your situation:",headlineClass:"!t-text-dark"}),function(e={}){return _e("legalCrossSells",[me(e),r({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,"$get(Type_Of_Legal_Problem).value")}({headlineClass:"!t-text-dark"}),function(e={}){return _e("autoAndCarAccidentCrossSellQuestions",[se({headline:"You May Be Entitled To Compensation"}),le({subheadline:"Tell us about your accident:"}),(t="true",a="CrossSell:Auto_and_Car_Accidents",ee("AutoAndCarAccidentsQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Auto and Car Accidents"',children:[j(a),N(a),v(a),q(a),W(a),Y(a)]})),L({label:"Accident Description:",placeholder:"Please describe your accident in a few words...",inputClass:"!t-h-16"},"CrossSell:Auto_and_Car_Accidents")],e.nextOnEnter);var t,a}(),function(e={}){return _e("personalInjuryCrossSellQuestions",[se({headline:"You May Be Entitled To Compensation"}),le({subheadline:"Tell us about your injury:"}),(t="true",a="CrossSell:Personal_Injury",ee("PersonalInjuryQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Personal Injury"',children:[j(a),N(a),x(a),v(a),q(a),W(a)]})),L({label:"Injury Description:",placeholder:"Please describe your injury in a few words...",inputClass:"!t-h-16"},"CrossSell:Personal_Injury")],e.nextOnEnter);var t,a}(),function(e={}){return _e("workersCompensationCrossSellQuestions",[se({headline:"You May Be Entitled To Benefits"}),le({subheadline:"Tell us about your injury:"}),(t="true",a="CrossSell:Workers_Compensation",ee("WorkersCompensationQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Workers Compensation"',children:[j(a),N(a),x(a),q(a),w(a),W(a)]})),L({label:"Injury Description:",placeholder:"Please describe your injury in a few words...",inputClass:"!t-h-16"},"CrossSell:Workers_Compensation")],e.nextOnEnter);var t,a}(),function(e={}){return _e("duiAndDWICrossSellQuestions",[se({headline:"About Your DUI/DWI"}),(t="true",a="CrossSell:DUI_and_DWI",ee("DUIAndDWIQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "DUI and DWI"',children:[j(a),N(a),K(a),G(a),I(a),U(a),A(a)]})),L({label:"Incident Description:",placeholder:"Please describe your incident in a few words...",inputClass:"!t-h-16"},"CrossSell:DUI_and_DWI")],e.nextOnEnter);var t,a}(),function(e={}){return _e("ssdiCrossSellQuestions",[se({headline:"You May Be Entitled To Benefits"}),le({subheadline:"Tell us about your disability:"}),(t="true",a="CrossSell:Social_Security_Disability_and_Insurance",ee("SocialSecurityDisabilityAndInsuranceQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Social Security Disability and Insurance"',children:[j(a),C(a),k(a),$(a),z(a),W(a)]})),L({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Social_Security_Disability_and_Insurance")],e.nextOnEnter);var t,a}(),function(e={}){return _e("powerOfAttorneyCrossSellQuestions",[se({headline:"Power of Attorney Information"}),(t="true",a="CrossSell:Power_of_Attorney",ee("PowerofAttorneyQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Power of Attorney"',children:[j(a),A(a)]})),L({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Power_of_Attorney")],e.nextOnEnter);var t,a}(),function(e={}){return _e("willsAndTrustsCrossSellQuestions",[se({headline:"Will or Trust Information"}),(t="true",a="CrossSell:Wills_and_Trusts",ee("WillsAndTrustsQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Wills and Trusts"',children:[j(a),J(a),Q(a),V(a),E(a),A(a)]})),L({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Wills_and_Trusts")],e.nextOnEnter);var t,a}(),function(e={}){return _e("divorceAndSeparationCrossSellQuestions",[se({headline:"Divorce or Separation Information"}),(t="true",a="CrossSell:Divorce_and_Separation",ee("DivorceQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Divorce and Separation"',children:[j(a),H(a),F(a),O(a),R(a)]})),L({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Divorce_and_Separation")],e.nextOnEnter);var t,a}(),function(e={}){return _e("childCustodyCrossSellQuestions",[se({headline:"Child Custody Information"}),(t="true",a="CrossSell:Child_Custody",ee("ChildCustodyQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Child Custody"',children:[j(a),S(a),T(a),D(a),O(a),R(a)]})),L({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Child_Custody")],e.nextOnEnter);var t,a}(),function(e={}){return _e("firstAndLast",[pe({headline:e.headline??"Who is looking for help?",headlineClass:e.headlineClass}),de({subheadline:e.subheadline??"Note: we never share info without consent",subheadlineClass:"!t-text-sm !t-text-gray-500"}),h({$formkit:"text",label:"First Name:",placeholder:"First",name:"First_Name",autocomplete:"given-name",validationMessages:{required:"First Name is required"}}),h({$formkit:"text",label:"Last Name:",placeholder:"Last",name:"Last_Name",autocomplete:"family-name",validationMessages:{required:"Last Name is required"}})],e.nextOnEnter)}({headlineClass:"!t-text-dark"})];const Re=[Ne,e(Ie,He),{$cmp:"FormKit",props:function(t){const a=e(Ce,t);return a.formId&&!a.name&&(a.name=a.formId),a}({formId:"generalLegalSingle",redirectMap:function(t){return e(De,t)}(),valueOverrideMap:Se}),children:[function(t){return e(we,t)}(),function(t={}){return e(function(e={}){return{$el:"h1",attrs:{class:"t-flex t-justify-center t-text-center !t-text-[2rem] t-font-semibold t-pt-5 t-px-7 md:t-px-3 "+(e.headlineClass||"")}}}(t),t)}({children:'$urlParam("hl", "Need Legal Help? Start Here!")',if:"$activeStep === $firstStep()"}),function(t={}){return e(function(e={}){return{$el:"h3",attrs:{class:"t-flex t-justify-center t-text-center !t-text-[1.2rem] t-font-medium t-text-blue-500 t-px-10 "+(e.subheadlineClass||"")}}}(t),t)}({children:'$urlParam("shl", "Our Service is Fast and Free!")',if:"$activeStep === $firstStep()"}),...Te,{$el:"div",attrs:{class:"form-body"},children:[function(e={}){return _e("generalTOLP",[B(e.input)],e.nextOnEnter,e.nextOnInput,e.stepKey,e.nextStepMap)}({nextOnInput:!1,nextStepMap:We,headlineClass:"t-text-lg",input:{placeholder:"Select a Category",innerClass:"!t-max-w-[275px] md:!t-max-w-xl"}}),{$cmp:"FormKitSchema",if:"$get(Type_Of_Legal_Problem).value",props:{schema:"$meta.dynamicSchema",data:"$buildData($meta)"}},function(e={}){return _e("contactInfo",[ye(e),fe(e),{$el:"script",if:"$activeStep === $lastStep()",children:he},h({$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"}}),h({$formkit:"tel",name:"Primary_Phone",label:"Phone Number:",placeholder:"###-###-####",maxlength:12,help:"10-digit phone number, hyphens optional",autocomplete:"tel-national","data-tf-sensitive":"false",validation:"required|matches:/^[0-9]{3}-?[0-9]{3}-?[0-9]{4}$/|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"}},oe()],!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: ","$stepKeys()"],attrs:{class:"t-text-xs",style:"overflow: scroll"}}]}]}]}];var He;const Ue=Re.find((e=>"FormKit"===e.$cmp));return Ue.props.name="generalLegalPopUnderSingle",Ue.props.formId="generalLegalPopUnderSingle",Ue.props.popUnderMap={"*":"/thank-you"},Re}();