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document.write(".fsSubFieldGroup .fsSubField:nth-child(3):nth-last-child(1).fsNameSuffix {"+"\n");
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document.write("}"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(1):nth-last-child(4).fsNameFirst,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(2):nth-last-child(3).fsNameFirst,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(3):nth-last-child(2).fsNameFirst,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(4):nth-last-child(1).fsNameFirst {"+"\n");
document.write("  width: calc(35% - 10px);"+"\n");
document.write("}"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(1):nth-last-child(4).fsNamePrefix, .fsSubFieldGroup .fsSubField:nth-child(1):nth-last-child(4).fsNameInitial, .fsSubFieldGroup .fsSubField:nth-child(1):nth-last-child(4).fsNameMiddle, .fsSubFieldGroup .fsSubField:nth-child(1):nth-last-child(4).fsNameSuffix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(2):nth-last-child(3).fsNamePrefix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(2):nth-last-child(3).fsNameInitial,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(2):nth-last-child(3).fsNameMiddle,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(2):nth-last-child(3).fsNameSuffix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(3):nth-last-child(2).fsNamePrefix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(3):nth-last-child(2).fsNameInitial,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(3):nth-last-child(2).fsNameMiddle,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(3):nth-last-child(2).fsNameSuffix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(4):nth-last-child(1).fsNamePrefix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(4):nth-last-child(1).fsNameInitial,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(4):nth-last-child(1).fsNameMiddle,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(4):nth-last-child(1).fsNameSuffix {"+"\n");
document.write("  width: calc(15% - 10px);"+"\n");
document.write("}"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(1):nth-last-child(5).fsNameFirst,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(2):nth-last-child(4).fsNameFirst,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(3):nth-last-child(3).fsNameFirst,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(4):nth-last-child(2).fsNameFirst,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(5):nth-last-child(1).fsNameFirst {"+"\n");
document.write("  width: calc(32% - 10px);"+"\n");
document.write("}"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(1):nth-last-child(5).fsNamePrefix, .fsSubFieldGroup .fsSubField:nth-child(1):nth-last-child(5).fsNameInitial, .fsSubFieldGroup .fsSubField:nth-child(1):nth-last-child(5).fsNameMiddle, .fsSubFieldGroup .fsSubField:nth-child(1):nth-last-child(5).fsNameSuffix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(2):nth-last-child(4).fsNamePrefix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(2):nth-last-child(4).fsNameInitial,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(2):nth-last-child(4).fsNameMiddle,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(2):nth-last-child(4).fsNameSuffix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(3):nth-last-child(3).fsNamePrefix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(3):nth-last-child(3).fsNameInitial,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(3):nth-last-child(3).fsNameMiddle,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(3):nth-last-child(3).fsNameSuffix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(4):nth-last-child(2).fsNamePrefix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(4):nth-last-child(2).fsNameInitial,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(4):nth-last-child(2).fsNameMiddle,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(4):nth-last-child(2).fsNameSuffix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(5):nth-last-child(1).fsNamePrefix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(5):nth-last-child(1).fsNameInitial,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(5):nth-last-child(1).fsNameMiddle,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(5):nth-last-child(1).fsNameSuffix {"+"\n");
document.write("  width: calc(12% - 10px);"+"\n");
document.write("}"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(1):nth-last-child(6).fsNameFirst,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(2):nth-last-child(5).fsNameFirst,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(3):nth-last-child(4).fsNameFirst,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(4):nth-last-child(3).fsNameFirst,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(5):nth-last-child(2).fsNameFirst,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(6):nth-last-child(1).fsNameFirst {"+"\n");
document.write("  width: calc(28% - 10px);"+"\n");
document.write("}"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(1):nth-last-child(6).fsNamePrefix, .fsSubFieldGroup .fsSubField:nth-child(1):nth-last-child(6).fsNameInitial, .fsSubFieldGroup .fsSubField:nth-child(1):nth-last-child(6).fsNameMiddle, .fsSubFieldGroup .fsSubField:nth-child(1):nth-last-child(6).fsNameSuffix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(2):nth-last-child(5).fsNamePrefix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(2):nth-last-child(5).fsNameInitial,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(2):nth-last-child(5).fsNameMiddle,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(2):nth-last-child(5).fsNameSuffix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(3):nth-last-child(4).fsNamePrefix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(3):nth-last-child(4).fsNameInitial,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(3):nth-last-child(4).fsNameMiddle,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(3):nth-last-child(4).fsNameSuffix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(4):nth-last-child(3).fsNamePrefix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(4):nth-last-child(3).fsNameInitial,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(4):nth-last-child(3).fsNameMiddle,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(4):nth-last-child(3).fsNameSuffix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(5):nth-last-child(2).fsNamePrefix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(5):nth-last-child(2).fsNameInitial,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(5):nth-last-child(2).fsNameMiddle,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(5):nth-last-child(2).fsNameSuffix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(6):nth-last-child(1).fsNamePrefix,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(6):nth-last-child(1).fsNameInitial,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(6):nth-last-child(1).fsNameMiddle,"+"\n");
document.write(".fsSubFieldGroup .fsSubField:nth-child(6):nth-last-child(1).fsNameSuffix {"+"\n");
document.write("  width: calc(11% - 10px);"+"\n");
document.write("}"+"\n");
document.write(".fsBody .fsSubField.fsFieldAddress {"+"\n");
document.write("  width: 100%;"+"\n");
document.write("}"+"\n");
document.write(".fsBody .fsSubField.fsFieldAddress2 {"+"\n");
document.write("  width: 100%;"+"\n");
document.write("}"+"\n");
document.write(".fsBody .fsSubField.fsFieldCity {"+"\n");
document.write("  width: calc(60% - 10px);"+"\n");
document.write("}"+"\n");
document.write(".fsBody .fsSubField.fsFieldState {"+"\n");
document.write("  width: calc(30% - 10px);"+"\n");
document.write("}"+"\n");
document.write(".fsBody .fsSubFieldGroup ~ select[name*=\'-country\'] {"+"\n");
document.write("  margin-top: 10px !important;"+"\n");
document.write("}"+"\n");
document.write(".fsBody .fsSubField.fsFieldAddress,"+"\n");
document.write(".fsBody .fsSubField.fsFieldAddress2 {"+"\n");
document.write("  margin-bottom: 10px;"+"\n");
document.write("}"+"\n");
document.write("@media all and (max-width: 699px), all and (device-height: 1024px) and (device-width: 768px) and (orientation: portrait), all and (device-height: 1024px) and (device-width: 768px) and (orientation: landscape) {"+"\n");
document.write("  .fsBody .fsSubField.fsFieldCity {"+"\n");
document.write("    margin-bottom: 10px;"+"\n");
document.write("  }"+"\n");
document.write("  .fsBody .fsSubField.fsFieldState {"+"\n");
document.write("    width: calc(70% - 10px);"+"\n");
document.write("  }"+"\n");
document.write("}"+"\n");
document.write("@media (max-width: 40em) {"+"\n");
document.write("  div.fsSubField.fsFieldState {"+"\n");
document.write("    margin-right: 10px;"+"\n");
document.write("  }"+"\n");
document.write("}"+"\n");
document.write("div.fsSliderValue {"+"\n");
document.write("  padding: 7px 14px;"+"\n");
document.write("  -moz-border-radius: 0px;"+"\n");
document.write("  -webkit-border-radius: 0px;"+"\n");
document.write("  border-radius: 0px;"+"\n");
document.write("  font-size: 14px;"+"\n");
document.write("  line-height: 21px;"+"\n");
document.write("  color: #f9f9f9;"+"\n");
document.write("  background-color: #1176bc;"+"\n");
document.write("}"+"\n");
document.write(".fsSliderDiv {"+"\n");
document.write("  font-size: 14px;"+"\n");
document.write("  background-color: #1176bc;"+"\n");
document.write("}"+"\n");
document.write(".fsSliderDiv .ui-state-default,"+"\n");
document.write(".fsSliderDiv .ui-widget-content .ui-state-default {"+"\n");
document.write("  background-color: #1176bc;"+"\n");
document.write("}"+"\n");
document.write(".fsSliderDiv .ui-state-active,"+"\n");
document.write(".fsSliderDiv .ui-widget-content .ui-state-active {"+"\n");
document.write("  background-color: #5d5d5d;"+"\n");
document.write("}"+"\n");
document.write(".fsSliderDiv .ui-corner-all, .fsSliderDiv.ui-corner-all {"+"\n");
document.write("  -moz-border-radius-topleft: 0px;"+"\n");
document.write("  -webkit-border-top-left-radius: 0px;"+"\n");
document.write("  border-top-left-radius: 0px;"+"\n");
document.write("  -moz-border-radius-topright: 0px;"+"\n");
document.write("  -webkit-border-top-right-radius: 0px;"+"\n");
document.write("  border-top-right-radius: 0px;"+"\n");
document.write("  -moz-border-radius-bottomleft: 0px;"+"\n");
document.write("  -webkit-border-bottom-left-radius: 0px;"+"\n");
document.write("  border-bottom-left-radius: 0px;"+"\n");
document.write("  -moz-border-radius-bottomright: 0px;"+"\n");
document.write("  -webkit-border-bottom-right-radius: 0px;"+"\n");
document.write("  border-bottom-right-radius: 0px;"+"\n");
document.write("}"+"\n");
document.write(".fsSliderDiv.ui-widget-content {"+"\n");
document.write("  border: 1px solid #d4d4d4 !important;"+"\n");
document.write("}"+"\n");
document.write(".fsSliderDiv .ui-widget-header {"+"\n");
document.write("  background-color: #d4d4d4;"+"\n");
document.write("}"+"\n");
document.write(".fsCurrency {"+"\n");
document.write("  margin-right: 5px !important;"+"\n");
document.write("  font-size: 14px;"+"\n");
document.write("  line-height: 42px;"+"\n");
document.write("  color: #5d5d5d;"+"\n");
document.write("}"+"\n");
document.write(".fsCurrency.fsCurrencySuffix {"+"\n");
document.write("  margin-right: 0 !important;"+"\n");
document.write("  margin-left: 5px !important;"+"\n");
document.write("}"+"\n");
document.write(".fsCurrency ~ input.fsField {"+"\n");
document.write("  width: calc(96% - 5px) !important;"+"\n");
document.write("}"+"\n");
document.write(".fsRowBody input[type=\"email\"] ~ p {"+"\n");
document.write("  margin-top: 10px;"+"\n");
document.write("}"+"\n");
document.write("@font-face {"+"\n");
document.write("  font-family: \'TextMask\';"+"\n");
document.write("  src: url(\"/forms/fonts/3/password.ttf\") format(\"truetype\");"+"\n");
document.write("  font-weight: 400;"+"\n");
document.write("  font-style: normal;"+"\n");
document.write("}"+"\n");
document.write(".fsTextMask {"+"\n");
document.write("  font-family: \'TextMask\' !important;"+"\n");
document.write("}"+"\n");
document.write(".fsRowBody input[type=\"text\"] ~ p {"+"\n");
document.write("  margin-top: 10px;"+"\n");
document.write("}"+"\n");
document.write(".fsProductField__fields__quantity {"+"\n");
document.write("  color: #5d5d5d;"+"\n");
document.write("}"+"\n");
document.write(".fsProductField__fields__fixed-amount,"+"\n");
document.write(".fsProductField__fields__no-charge {"+"\n");
document.write("  font-size: 14px;"+"\n");
document.write("  color: #308596;"+"\n");
document.write("}"+"\n");
document.write(".fsProductField__info__name {"+"\n");
document.write("  font-size: 21px;"+"\n");
document.write("  color: #5d5d5d;"+"\n");
document.write("}"+"\n");
document.write(".fsProductField__info__description {"+"\n");
document.write("  margin-top: 5px;"+"\n");
document.write("  font-size: 12px;"+"\n");
document.write("  line-height: 12px;"+"\n");
document.write("  color: #5d5d5d;"+"\n");
document.write("}"+"\n");
document.write(".fsProductField__fields__sold-out {"+"\n");
document.write("  font-size: 14px;"+"\n");
document.write("  color: #5d5d5d;"+"\n");
document.write("}"+"\n");
document.write(".fsProductField__wait-list {"+"\n");
document.write("  margin-top: 10px;"+"\n");
document.write("}"+"\n");
document.write("@media (max-width: 40em) {"+"\n");
document.write("  .fsProductField__image {"+"\n");
document.write("    -moz-border-radius: 0px;"+"\n");
document.write("    -webkit-border-radius: 0px;"+"\n");
document.write("    border-radius: 0px;"+"\n");
document.write("  }"+"\n");
document.write("  .fsProductField__fields__fixed-amount,"+"\n");
document.write("  .fsProductField__fields__quantity {"+"\n");
document.write("    font-size: 14px;"+"\n");
document.write("  }"+"\n");
document.write("}"+"\n");
document.write(".fsMatrix {"+"\n");
document.write("  font-size: 12px;"+"\n");
document.write("  color: #5d5d5d;"+"\n");
document.write("}"+"\n");
document.write(".fsMatrix th,"+"\n");
document.write(".fsMatrix td {"+"\n");
document.write("  border-top: 1px solid #c8c8c8;"+"\n");
document.write("  border-left: 1px solid #c8c8c8;"+"\n");
document.write("}"+"\n");
document.write(".fsMatrix th:nth-child(2) {"+"\n");
document.write("  -moz-border-radius: 0px 0 0 0;"+"\n");
document.write("  -webkit-border-radius: 0px;"+"\n");
document.write("  border-radius: 0px 0 0 0;"+"\n");
document.write("}"+"\n");
document.write(".fsMatrix tr:first-child th:last-child {"+"\n");
document.write("  -moz-border-radius: 0 0px 0 0;"+"\n");
document.write("  -webkit-border-radius: 0;"+"\n");
document.write("  border-radius: 0 0px 0 0;"+"\n");
document.write("}"+"\n");
document.write(".fsMatrix tr:last-child td:last-child {"+"\n");
document.write("  -moz-border-radius: 0 0 0px 0;"+"\n");
document.write("  -webkit-border-radius: 0;"+"\n");
document.write("  border-radius: 0 0 0px 0;"+"\n");
document.write("}"+"\n");
document.write(".fsMatrix tr:last-child th {"+"\n");
document.write("  -moz-border-radius: 0 0 0 0px;"+"\n");
document.write("  -webkit-border-radius: 0;"+"\n");
document.write("  border-radius: 0 0 0 0px;"+"\n");
document.write("}"+"\n");
document.write(".fsMatrix tr:last-child th,"+"\n");
document.write(".fsMatrix tr:last-child td {"+"\n");
document.write("  border-bottom: 1px solid #c8c8c8;"+"\n");
document.write("}"+"\n");
document.write(".fsMatrix tr th:last-child,"+"\n");
document.write(".fsMatrix tr td:last-child {"+"\n");
document.write("  border-right: 1px solid #c8c8c8;"+"\n");
document.write("}"+"\n");
document.write(".fsMatrix th.fsMatrixLabelColumn {"+"\n");
document.write("  text-align: center;"+"\n");
document.write("}"+"\n");
document.write(".fsMatrix th.fsMatrixLabelRow {"+"\n");
document.write("  text-align: right;"+"\n");
document.write("}"+"\n");
document.write(".fsMatrix th.fsMatrixLabelColumn,"+"\n");
document.write(".fsMatrix th.fsMatrixLabelRow {"+"\n");
document.write("  padding: 6px;"+"\n");
document.write("}"+"\n");
document.write(".fsMatrixCol1 {"+"\n");
document.write("  background: #ebebeb;"+"\n");
document.write("  background: rgba(235,235,235, 0.2);"+"\n");
document.write("}"+"\n");
document.write(".fsMatrixCol2 {"+"\n");
document.write("  background: #d4d4d4;"+"\n");
document.write("  background: rgba(212,212,212, 0.2);"+"\n");
document.write("}"+"\n");
document.write(".rtl .fsMatrix th, .rtl .fsMatrix td {"+"\n");
document.write("  border-right: 1px solid #c8c8c8;"+"\n");
document.write("}"+"\n");
document.write(".fsForm input[type=\"file\"]::-webkit-file-upload-button, .fsForm .fsFileUploadButton {"+"\n");
document.write("  height: 42px;"+"\n");
document.write("  -moz-border-radius: 0px;"+"\n");
document.write("  -webkit-border-radius: 0px;"+"\n");
document.write("  border-radius: 0px;"+"\n");
document.write("  font-size: 14px;"+"\n");
document.write("  color: #f9f9f9;"+"\n");
document.write("  background-color: #1176bc;"+"\n");
document.write("}"+"\n");
document.write(".fsFileUploadName {"+"\n");
document.write("  font-size: 14px;"+"\n");
document.write("}"+"\n");
document.write(".fsBody .fieldset-content .always-ltr {"+"\n");
document.write("  margin-top: 10px;"+"\n");
document.write("}"+"\n");
document.write(".fsBody .fieldset-content select span,"+"\n");
document.write(".fsBody .fieldset-content .always-ltr span, .fsBody .fieldset-content .always-ltr-align-right span {"+"\n");
document.write("  top: 10.5px;"+"\n");
document.write("}"+"\n");
document.write(".fsBody .fieldset-content select {"+"\n");
document.write("  margin-right: 10px;"+"\n");
document.write("}"+"\n");
document.write(".fsBody .fieldset-content span {"+"\n");
document.write("  right: 5px;"+"\n");
document.write("}"+"\n");
document.write(".fsBody .ui-datepicker-trigger {"+"\n");
document.write("  top: 10.5px;"+"\n");
document.write("  margin-left: 10px;"+"\n");
document.write("}"+"\n");
document.write(".fsSignatureClear {"+"\n");
document.write("  font-size: 12px;"+"\n");
document.write("  color: #5d5d5d;"+"\n");
document.write("}"+"\n");
document.write(".fsSignature + div {"+"\n");
document.write("  margin-left: 10px;"+"\n");
document.write("  line-height: 12px;"+"\n");
document.write("}"+"\n");
document.write(".wf-active .fsSignature {"+"\n");
document.write("  font-family: Arial, Tahoma, sans-serif;"+"\n");
document.write("}"+"\n");
document.write("img.fsCreditCardLogo {"+"\n");
document.write("  margin-top: 5px;"+"\n");
document.write("}"+"\n");
document.write(".fsBody .fsSectionHeader {"+"\n");
document.write("  background-color: transparent;"+"\n");
document.write("}"+"\n");
document.write(".fsBody .fsForm .fsSectionHeading {"+"\n");
document.write("  margin-bottom: 10px;"+"\n");
document.write("  text-align: center;"+"\n");
document.write("  font-size: 25px;"+"\n");
document.write("  font-weight: 700;"+"\n");
document.write("  font-style: normal;"+"\n");
document.write("  line-height: 25px;"+"\n");
document.write("  color: #1176bc;"+"\n");
document.write("}"+"\n");
document.write(".fsborderradius .fsBody .fsSectionHeader {"+"\n");
document.write("  -moz-border-radius: 0px;"+"\n");
document.write("  -webkit-border-radius: 0px;"+"\n");
document.write("  border-radius: 0px;"+"\n");
document.write("}"+"\n");
document.write(".fsborderradius .fsBody .fsSectionHeader {"+"\n");
document.write("  margin-bottom: 40px;"+"\n");
document.write("}"+"\n");
document.write(".fsBody .fsSectionHeader {"+"\n");
document.write("  padding: 20px;"+"\n");
document.write("}"+"\n");
document.write(".fsForm select[multiple=\"multiple\"]::-webkit-scrollbar-thumb,"+"\n");
document.write(".fsForm textarea::-webkit-scrollbar-thumb {"+"\n");
document.write("  background-color: #c8c8c8;"+"\n");
document.write("}"+"\n");
document.write(".fsForm .fsSubmit {"+"\n");
document.write("  margin-top: 40px;"+"\n");
document.write("  padding: 20px 0;"+"\n");
document.write("}"+"\n");
document.write(".fsPreviousButton,"+"\n");
document.write(".fsSubmitButton,"+"\n");
document.write(".fsNextButton {"+"\n");
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document.write("    padding: 30px 19px;"+"\n");
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document.write("                    <p>Unfortunately, you do no qualify for this loan. Please refer to our <a href=\"https://risemiamidade.com/s/Rise-FAQs.pdf\" rel=\"noopener noreferrer\" target=\"_blank\">FAQ</a>&nbsp;for details.</p>"+"\n");
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document.write("                                    <option value=\"SC\">South Carolina</option>"+"\n");
document.write("                                    <option value=\"SD\">South Dakota</option>"+"\n");
document.write("                                    <option value=\"TN\">Tennessee</option>"+"\n");
document.write("                                    <option value=\"TX\">Texas</option>"+"\n");
document.write("                                    <option value=\"UT\">Utah</option>"+"\n");
document.write("                                    <option value=\"VT\">Vermont</option>"+"\n");
document.write("                                    <option value=\"VA\">Virginia</option>"+"\n");
document.write("                                    <option value=\"WA\">Washington</option>"+"\n");
document.write("                                    <option value=\"WV\">West Virginia</option>"+"\n");
document.write("                                    <option value=\"WI\">Wisconsin</option>"+"\n");
document.write("                                    <option value=\"WY\">Wyoming</option>"+"\n");
document.write("                                    <option value=\"AA\">Armed Forces (the) Americas</option>"+"\n");
document.write("                                    <option value=\"AE\">Armed Forces Europe</option>"+"\n");
document.write("                                    <option value=\"AP\">Armed Forces Pacific</option>"+"\n");
document.write("                                    <option value=\"APO\">Army Post Office (U.S. Army and U.S. Air Force)</option>"+"\n");
document.write("                                    <option value=\"FPO\">Fleet Post Office (U.S. Navy and U.S. Marine Corps)</option>"+"\n");
document.write("                            </select>"+"\n");
document.write("            <label class=\"fsSupporting\" for=\"field92989092-state\">State</label>"+"\n");
document.write("            </div>"+"\n");
document.write("    "+"\n");
document.write("        <div class=\"fsSubField fsFieldZip\">"+"\n");
document.write("                    <input type=\"text\" id=\"field92989092-zip\" aria-label=\"ZIP Code\" name=\"field92989092-zip\" size=\"6\" value=\"\" required class=\"fsField fsFieldZip fsFormatZipUS fsRequired\" aria-required=\"true\" />"+"\n");
document.write("            <label class=\"fsSupporting\" for=\"field92989092-zip\">ZIP Code</label>"+"\n");
document.write("            </div>"+"\n");
document.write("    "+"\n");
document.write("</div>"+"\n");
document.write("<div class=\"clear\"></div>"+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
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document.write("                    "+"\n");
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document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-22\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
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document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92989097\" lang=\"en\" fs-field-type=\"phone\" fs-field-validation-name=\"Business Phone\">"+"\n");
document.write("                                                                                                        <label id=\"label92989097\" class=\"fsLabel fsRequiredLabel\" for=\"field92989097\">Business Phone<span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
document.write("                                            "+"\n");
document.write("                                        "+"\n");
document.write("                    <input type=\"tel\" id=\"field92989097\" name=\"field92989097\" size=\"2\" required value=\"\" class=\"fsField fsFormatPhoneUS  fsRequired\" aria-required=\"true\" data-country=\"US\" data-format=\"user\" />"+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
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document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-23\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
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document.write("            "+"\n");
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document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92989108\" lang=\"en\" fs-field-type=\"phone\" fs-field-validation-name=\"Cell Phone\">"+"\n");
document.write("                                                                                                        <label id=\"label92989108\" class=\"fsLabel fsRequiredLabel\" for=\"field92989108\">Cell Phone<span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
document.write("                                            "+"\n");
document.write("                                        "+"\n");
document.write("                    <input type=\"tel\" id=\"field92989108\" name=\"field92989108\" size=\"2\" required value=\"\" class=\"fsField fsFormatPhoneUS  fsRequired\" aria-required=\"true\" data-country=\"US\" data-format=\"national\" />"+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
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document.write("                    "+"\n");
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document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-24\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92989117\" lang=\"en\" fs-field-type=\"email\" fs-field-validation-name=\"Business Email\">"+"\n");
document.write("                                                                                                        <label id=\"label92989117\" class=\"fsLabel fsRequiredLabel\" for=\"field92989117\">Business Email<span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
document.write("                                            "+"\n");
document.write("                                        "+"\n");
document.write("                    <input type=\"email\" id=\"field92989117\" name=\"field92989117\" size=\"50\" required=\"required\" value=\"\" class=\"fsField fsFormatEmail fsRequired\" aria-required=\"true\" />"+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-25\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92989128\" lang=\"en\" fs-field-type=\"text\" fs-field-validation-name=\"Website\">"+"\n");
document.write("                                                                                                        <label id=\"label92989128\" class=\"fsLabel\" for=\"field92989128\">Website                                                    </label>"+"\n");
document.write("                                            "+"\n");
document.write("                                        "+"\n");
document.write("                    <input"+"\n");
document.write("  type=\"text\" id=\"field92989128\""+"\n");
document.write("  name=\"field92989128\""+"\n");
document.write("  size=\"50\""+"\n");
document.write("         value=\"\""+"\n");
document.write("  "+"\n");
document.write("  class=\"fsField fsFormatText    \""+"\n");
document.write("      />"+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-26\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92989180\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Business Structure\">"+"\n");
document.write("                                                                                <fieldset role=\"group\" aria-labelledby=\"fsLegend92989180\" id=\"label92989180\">"+"\n");
document.write("                            <legend id=\"fsLegend92989180\" class=\"fsLabel fsRequiredLabel fsLabelVertical\"><span>Business Structure<span class=\"fsRequiredMarker\">*</span></span></legend>"+"\n");
document.write("                            <div class=\"fieldset-content\">"+"\n");
document.write("                    "+"\n");
document.write("                                        "+"\n");
document.write("                                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field92989180_1\"><input type=\"radio\" id=\"field92989180_1\" name=\"field92989180\" value=\"LLC\" class=\"fsField fsRequired vertical\" aria-required=\"true\" />LLC</label>"+"\n");
document.write("            "+"\n");
document.write("                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field92989180_2\"><input type=\"radio\" id=\"field92989180_2\" name=\"field92989180\" value=\"S Corp\" class=\"fsField fsRequired vertical\" aria-required=\"true\" />S Corp</label>"+"\n");
document.write("            "+"\n");
document.write("                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field92989180_3\"><input type=\"radio\" id=\"field92989180_3\" name=\"field92989180\" value=\"C Corp\" class=\"fsField fsRequired vertical\" aria-required=\"true\" />C Corp</label>"+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("    "+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                                                </div></fieldset>"+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-27\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92989338\" lang=\"en\" fs-field-type=\"text\" fs-field-validation-name=\"Industry\">"+"\n");
document.write("                                                                                                        <label id=\"label92989338\" class=\"fsLabel fsRequiredLabel\" for=\"field92989338\">Industry<span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
document.write("                                            "+"\n");
document.write("                                        "+"\n");
document.write("                    <input"+"\n");
document.write("  type=\"text\" id=\"field92989338\""+"\n");
document.write("  name=\"field92989338\""+"\n");
document.write("  size=\"50\""+"\n");
document.write("   required       value=\"\""+"\n");
document.write("  "+"\n");
document.write("  class=\"fsField fsFormatText fsRequired   \""+"\n");
document.write("   aria-required=\"true\"     />"+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-28\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92991601\" lang=\"en\" fs-field-type=\"textarea\" fs-field-validation-name=\"Brief Description of your Business\">"+"\n");
document.write("                                                                                                        <label id=\"label92991601\" class=\"fsLabel fsRequiredLabel\" for=\"field92991601\">Brief Description of your Business<span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
document.write("                                            "+"\n");
document.write("                                        "+"\n");
document.write("                    "+"\n");
document.write("<textarea id=\"field92991601\""+"\n");
document.write("          class=\"fsField fsRequired \""+"\n");
document.write("          name=\"field92991601\""+"\n");
document.write("          rows=\"10\""+"\n");
document.write("          cols=\"50\""+"\n");
document.write("          required aria-required=\"true\"                                                            ></textarea>"+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-29\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92989349\" lang=\"en\" fs-field-type=\"datetime\" fs-field-validation-name=\"Date Established\">"+"\n");
document.write("                                                                                <fieldset role=\"group\" aria-labelledby=\"fsLegend92989349\" id=\"label92989349\">"+"\n");
document.write("                            <legend id=\"fsLegend92989349\" class=\"fsLabel fsRequiredLabel fsLabelVertical\"><span>Date Established<span class=\"fsRequiredMarker\">*</span></span></legend>"+"\n");
document.write("                            <div class=\"fieldset-content\">"+"\n");
document.write("                    "+"\n");
document.write("                                        "+"\n");
document.write("                                <!-- Used to pull in url for jquery -->"+"\n");
document.write("        <span aria-hidden=\"true\" style=\"display:none;\" id=\"fsCalendar92989349ImageUrl\">https://omnicommander-hkggn.formstack.com/forms/images/2/calendar.png</span>"+"\n");
document.write("    "+"\n");
document.write("    "+"\n");
document.write("    "+"\n");
document.write("    <input data-skip-validation data-date-format=\"M Y\" type=\"hidden\" id=\"field92989349Format\" name=\"field92989349Format\" value=\"MY\" />"+"\n");
document.write("    "+"\n");
document.write("                    <div class=\"hidden\"><label for=\"field92989349M\">Month</label></div>"+"\n");
document.write("        <select id=\"field92989349M\" name=\"field92989349M\" class=\" fsField fsRequired\" aria-required=\"true\">"+"\n");
document.write("                    <option value=\"\"> </option>"+"\n");
document.write("                    <option value=\"Jan\">Jan</option>"+"\n");
document.write("                    <option value=\"Feb\">Feb</option>"+"\n");
document.write("                    <option value=\"Mar\">Mar</option>"+"\n");
document.write("                    <option value=\"Apr\">Apr</option>"+"\n");
document.write("                    <option value=\"May\">May</option>"+"\n");
document.write("                    <option value=\"Jun\">Jun</option>"+"\n");
document.write("                    <option value=\"Jul\">Jul</option>"+"\n");
document.write("                    <option value=\"Aug\">Aug</option>"+"\n");
document.write("                    <option value=\"Sep\">Sep</option>"+"\n");
document.write("                    <option value=\"Oct\">Oct</option>"+"\n");
document.write("                    <option value=\"Nov\">Nov</option>"+"\n");
document.write("                    <option value=\"Dec\">Dec</option>"+"\n");
document.write("                </select>"+"\n");
document.write("             <div class=\"hidden\"><label for=\"field92989349Y\">Year</label></div>"+"\n");
document.write("        <select id=\"field92989349Y\" name=\"field92989349Y\" class=\" fsField fsRequired\" aria-required=\"true\">"+"\n");
document.write("                    <option value=\"\"> </option>"+"\n");
document.write("                    <option value=\"1920\">1920</option>"+"\n");
document.write("                    <option value=\"1921\">1921</option>"+"\n");
document.write("                    <option value=\"1922\">1922</option>"+"\n");
document.write("                    <option value=\"1923\">1923</option>"+"\n");
document.write("                    <option value=\"1924\">1924</option>"+"\n");
document.write("                    <option value=\"1925\">1925</option>"+"\n");
document.write("                    <option value=\"1926\">1926</option>"+"\n");
document.write("                    <option value=\"1927\">1927</option>"+"\n");
document.write("                    <option value=\"1928\">1928</option>"+"\n");
document.write("                    <option value=\"1929\">1929</option>"+"\n");
document.write("                    <option value=\"1930\">1930</option>"+"\n");
document.write("                    <option value=\"1931\">1931</option>"+"\n");
document.write("                    <option value=\"1932\">1932</option>"+"\n");
document.write("                    <option value=\"1933\">1933</option>"+"\n");
document.write("                    <option value=\"1934\">1934</option>"+"\n");
document.write("                    <option value=\"1935\">1935</option>"+"\n");
document.write("                    <option value=\"1936\">1936</option>"+"\n");
document.write("                    <option value=\"1937\">1937</option>"+"\n");
document.write("                    <option value=\"1938\">1938</option>"+"\n");
document.write("                    <option value=\"1939\">1939</option>"+"\n");
document.write("                    <option value=\"1940\">1940</option>"+"\n");
document.write("                    <option value=\"1941\">1941</option>"+"\n");
document.write("                    <option value=\"1942\">1942</option>"+"\n");
document.write("                    <option value=\"1943\">1943</option>"+"\n");
document.write("                    <option value=\"1944\">1944</option>"+"\n");
document.write("                    <option value=\"1945\">1945</option>"+"\n");
document.write("                    <option value=\"1946\">1946</option>"+"\n");
document.write("                    <option value=\"1947\">1947</option>"+"\n");
document.write("                    <option value=\"1948\">1948</option>"+"\n");
document.write("                    <option value=\"1949\">1949</option>"+"\n");
document.write("                    <option value=\"1950\">1950</option>"+"\n");
document.write("                    <option value=\"1951\">1951</option>"+"\n");
document.write("                    <option value=\"1952\">1952</option>"+"\n");
document.write("                    <option value=\"1953\">1953</option>"+"\n");
document.write("                    <option value=\"1954\">1954</option>"+"\n");
document.write("                    <option value=\"1955\">1955</option>"+"\n");
document.write("                    <option value=\"1956\">1956</option>"+"\n");
document.write("                    <option value=\"1957\">1957</option>"+"\n");
document.write("                    <option value=\"1958\">1958</option>"+"\n");
document.write("                    <option value=\"1959\">1959</option>"+"\n");
document.write("                    <option value=\"1960\">1960</option>"+"\n");
document.write("                    <option value=\"1961\">1961</option>"+"\n");
document.write("                    <option value=\"1962\">1962</option>"+"\n");
document.write("                    <option value=\"1963\">1963</option>"+"\n");
document.write("                    <option value=\"1964\">1964</option>"+"\n");
document.write("                    <option value=\"1965\">1965</option>"+"\n");
document.write("                    <option value=\"1966\">1966</option>"+"\n");
document.write("                    <option value=\"1967\">1967</option>"+"\n");
document.write("                    <option value=\"1968\">1968</option>"+"\n");
document.write("                    <option value=\"1969\">1969</option>"+"\n");
document.write("                    <option value=\"1970\">1970</option>"+"\n");
document.write("                    <option value=\"1971\">1971</option>"+"\n");
document.write("                    <option value=\"1972\">1972</option>"+"\n");
document.write("                    <option value=\"1973\">1973</option>"+"\n");
document.write("                    <option value=\"1974\">1974</option>"+"\n");
document.write("                    <option value=\"1975\">1975</option>"+"\n");
document.write("                    <option value=\"1976\">1976</option>"+"\n");
document.write("                    <option value=\"1977\">1977</option>"+"\n");
document.write("                    <option value=\"1978\">1978</option>"+"\n");
document.write("                    <option value=\"1979\">1979</option>"+"\n");
document.write("                    <option value=\"1980\">1980</option>"+"\n");
document.write("                    <option value=\"1981\">1981</option>"+"\n");
document.write("                    <option value=\"1982\">1982</option>"+"\n");
document.write("                    <option value=\"1983\">1983</option>"+"\n");
document.write("                    <option value=\"1984\">1984</option>"+"\n");
document.write("                    <option value=\"1985\">1985</option>"+"\n");
document.write("                    <option value=\"1986\">1986</option>"+"\n");
document.write("                    <option value=\"1987\">1987</option>"+"\n");
document.write("                    <option value=\"1988\">1988</option>"+"\n");
document.write("                    <option value=\"1989\">1989</option>"+"\n");
document.write("                    <option value=\"1990\">1990</option>"+"\n");
document.write("                    <option value=\"1991\">1991</option>"+"\n");
document.write("                    <option value=\"1992\">1992</option>"+"\n");
document.write("                    <option value=\"1993\">1993</option>"+"\n");
document.write("                    <option value=\"1994\">1994</option>"+"\n");
document.write("                    <option value=\"1995\">1995</option>"+"\n");
document.write("                    <option value=\"1996\">1996</option>"+"\n");
document.write("                    <option value=\"1997\">1997</option>"+"\n");
document.write("                    <option value=\"1998\">1998</option>"+"\n");
document.write("                    <option value=\"1999\">1999</option>"+"\n");
document.write("                    <option value=\"2000\">2000</option>"+"\n");
document.write("                    <option value=\"2001\">2001</option>"+"\n");
document.write("                    <option value=\"2002\">2002</option>"+"\n");
document.write("                    <option value=\"2003\">2003</option>"+"\n");
document.write("                    <option value=\"2004\">2004</option>"+"\n");
document.write("                    <option value=\"2005\">2005</option>"+"\n");
document.write("                    <option value=\"2006\">2006</option>"+"\n");
document.write("                    <option value=\"2007\">2007</option>"+"\n");
document.write("                    <option value=\"2008\">2008</option>"+"\n");
document.write("                    <option value=\"2009\">2009</option>"+"\n");
document.write("                    <option value=\"2010\">2010</option>"+"\n");
document.write("                    <option value=\"2011\">2011</option>"+"\n");
document.write("                    <option value=\"2012\">2012</option>"+"\n");
document.write("                    <option value=\"2013\">2013</option>"+"\n");
document.write("                    <option value=\"2014\">2014</option>"+"\n");
document.write("                    <option value=\"2015\">2015</option>"+"\n");
document.write("                    <option value=\"2016\">2016</option>"+"\n");
document.write("                    <option value=\"2017\">2017</option>"+"\n");
document.write("                    <option value=\"2018\">2018</option>"+"\n");
document.write("                    <option value=\"2019\">2019</option>"+"\n");
document.write("                    <option value=\"2020\">2020</option>"+"\n");
document.write("                </select>"+"\n");
document.write("    "+"\n");
document.write("    "+"\n");
document.write("    "+"\n");
document.write("    <input data-skip-validation type=\"text\" id=\"fsCalendar92989349Link\" class=\"fsCalendarPickerLink\" style=\"display:none;\" aria-hidden=\"true\" />"+"\n");
document.write("        <div id=\"fsCalendar92989349\" class=\"fsCalendar\" style=\" position:absolute\"></div>"+"\n");
document.write("        "+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                                                </div></fieldset>"+"\n");
document.write("                    "+"\n");
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document.write("                                                </div>"+"\n");
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document.write("            "+"\n");
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document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92989401\" lang=\"en\" fs-field-type=\"number\" fs-field-validation-name=\"Number of Full-Time Employees including 1099\'s \">"+"\n");
document.write("                                                                                                        <label id=\"label92989401\" class=\"fsLabel fsRequiredLabel\" for=\"field92989401\">Number of Full-Time Employees including 1099\'s <span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
document.write("                                            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("        <input type=\"number\" step=\"any\" id=\"field92989401\" name=\"field92989401\"  required class=\"fsField fsFormatNumber fsNumberMin-1 fsNumberMax-25 fsNumberDecimals-0 fsRequired\" min=\"1\" max=\"25\" aria-required=\"true\" />"+"\n");
document.write("    "+"\n");
document.write("    <script>"+"\n");
document.write("    //This script is to address some quirkiness of Safari where commas are interchangeable with decimal points on number fields."+"\n");
document.write("    //Normal attempts to restrict the comma such as our own validation or .replace(\",\", \"\") results in the value of the field being removed entirely."+"\n");
document.write("    //Below the keypress itself is being blocked as a workaround to keep our value."+"\n");
document.write("    document.getElementById(\"field92989401\").addEventListener(\"keydown\", function blockComma(e) {"+"\n");
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document.write("    "+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
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document.write("                        "+"\n");
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document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-31\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
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document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell94666837\" lang=\"en\" fs-field-type=\"richtext\" fs-field-validation-name=\"\">"+"\n");
document.write("                                                        "+"\n");
document.write("                                        "+"\n");
document.write("                    <p>Maximum of 25. Please refer to the <a href=\"https://static1.squarespace.com/static/5ec6cb23bda3fb1fa4c7ffdf/t/5eda818b950bf5612ca401fc/1591378315508/Rise-FAQs.pdf\" rel=\"noopener noreferrer\" target=\"_blank\">FAQ guide</a>.</p>"+"\n");
document.write("                    "+"\n");
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document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
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document.write("                        "+"\n");
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document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-32\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92989419\" lang=\"en\" fs-field-type=\"number\" fs-field-validation-name=\"Annual Business Revenue\">"+"\n");
document.write("                                                                                                        <label id=\"label92989419\" class=\"fsLabel fsRequiredLabel\" for=\"field92989419\">Annual Business Revenue<span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
document.write("                                            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("        <input type=\"number\" step=\"any\" id=\"field92989419\" name=\"field92989419\"  required class=\"fsField fsFormatNumber fsNumberMin-1 fsNumberDecimals-0 fsRequired\" min=\"1\" aria-required=\"true\" />"+"\n");
document.write("    "+"\n");
document.write("    <script>"+"\n");
document.write("    //This script is to address some quirkiness of Safari where commas are interchangeable with decimal points on number fields."+"\n");
document.write("    //Normal attempts to restrict the comma such as our own validation or .replace(\",\", \"\") results in the value of the field being removed entirely."+"\n");
document.write("    //Below the keypress itself is being blocked as a workaround to keep our value."+"\n");
document.write("    document.getElementById(\"field92989419\").addEventListener(\"keydown\", function blockComma(e) {"+"\n");
document.write("    if (e.code === \'Comma\') {"+"\n");
document.write("    e.preventDefault();}})"+"\n");
document.write("    </script>"+"\n");
document.write("    "+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
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document.write("                    "+"\n");
document.write("                        "+"\n");
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document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-33\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92990773\" aria-describedby=\"fsSupporting92990773\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Have you received any Business technical Assistance or support in the past 12 months?\">"+"\n");
document.write("                                                                                <fieldset role=\"group\" aria-labelledby=\"fsLegend92990773\" id=\"label92990773\">"+"\n");
document.write("                            <legend id=\"fsLegend92990773\" class=\"fsLabel fsRequiredLabel fsLabelVertical\"><span>Have you received any Business technical Assistance or support in the past 12 months?<span class=\"fsRequiredMarker\">*</span></span></legend>"+"\n");
document.write("                            <div class=\"fieldset-content\">"+"\n");
document.write("                    "+"\n");
document.write("                                        "+"\n");
document.write("                                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field92990773_1\"><input type=\"radio\" id=\"field92990773_1\" name=\"field92990773\" value=\"Yes\" class=\"fsField fsRequired vertical\" aria-required=\"true\" />Yes</label>"+"\n");
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document.write("                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field92990773_2\"><input type=\"radio\" id=\"field92990773_2\" name=\"field92990773\" value=\"No\" class=\"fsField fsRequired vertical\" aria-required=\"true\" />No</label>"+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("    "+"\n");
document.write("                                                                                                        <div id=\"fsSupporting92990773\" class=\"fsSupporting\">*Technical assistance is any support from local business groups to assist in Marketing, Business Plan,  Development, taxes, accounting etc</div>"+"\n");
document.write("                                                                        "+"\n");
document.write("                    "+"\n");
document.write("                                                </div></fieldset>"+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("                                "+"\n");
document.write("                </div>"+"\n");
document.write("                                "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                "+"\n");
document.write("                    </div>"+"\n");
document.write("                    "+"\n");
document.write("                    <div class=\"fsPage fsHiddenPage\" id=\"fsPage3892973-4\" >"+"\n");
document.write("                "+"\n");
document.write("            "+"\n");
document.write("            <div class=\"fsSection fsFirstSection fs1Col\" id=\"fsSection92989439\">"+"\n");
document.write("                                                    "+"\n");
document.write("                                        "+"\n");
document.write("            <div class=\"fsSectionHeader\">"+"\n");
document.write("            <h2 class=\"fsSectionHeading\">Partner/Stockholder #1</h2>"+"\n");
document.write("        "+"\n");
document.write("    </div>"+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-35\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92989503\" lang=\"en\" fs-field-type=\"name\" fs-field-validation-name=\"Name\">"+"\n");
document.write("                                                                                <span id=\"label92989503\" class=\"fsLabel fsRequiredLabel\">Name<span class=\"fsRequiredMarker\">*</span></span>"+"\n");
document.write("                    "+"\n");
document.write("                                        "+"\n");
document.write("                    <div class=\"fsSubFieldGroup\">"+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("    "+"\n");
document.write("    <div class=\"fsSubField fsNameFirst\">"+"\n");
document.write("        <input type=\"text\" id=\"field92989503-first\" name=\"field92989503-first\" size=\"20\" aria-label=\"First Name\" value=\"\" required class=\"fsField fsFieldName fsRequired\" aria-required=\"true\" />"+"\n");
document.write("        <label class=\"fsSupporting fsRequiredLabel\" for=\"field92989503-first\">First Name<span class=\"hidden\">*</span></label>"+"\n");
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document.write("    "+"\n");
document.write("    "+"\n");
document.write("    <div class=\"fsSubField fsNameLast\">"+"\n");
document.write("        <input type=\"text\" id=\"field92989503-last\" name=\"field92989503-last\" size=\"20\" aria-label=\"Last Name\" value=\"\" required class=\"fsField fsFieldName fsRequired\" aria-required=\"true\" />"+"\n");
document.write("        <label class=\"fsSupporting fsRequiredLabel\" for=\"field92989503-last\">Last Name<span class=\"hidden\">*</span></label>"+"\n");
document.write("    </div>"+"\n");
document.write("    "+"\n");
document.write("</div>"+"\n");
document.write("<div class=\"clear\"></div>"+"\n");
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document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
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document.write("                        "+"\n");
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document.write("                "+"\n");
document.write("                    "+"\n");
document.write("                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-36\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
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document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell94667394\" lang=\"en\" fs-field-type=\"text\" fs-field-validation-name=\"Title\">"+"\n");
document.write("                                                                                                        <label id=\"label94667394\" class=\"fsLabel fsRequiredLabel\" for=\"field94667394\">Title<span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
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document.write("                                        "+"\n");
document.write("                    <input"+"\n");
document.write("  type=\"text\" id=\"field94667394\""+"\n");
document.write("  name=\"field94667394\""+"\n");
document.write("  size=\"50\""+"\n");
document.write("   required       value=\"\""+"\n");
document.write("  "+"\n");
document.write("  class=\"fsField fsFormatText fsRequired   \""+"\n");
document.write("   aria-required=\"true\"     />"+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
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document.write("                    "+"\n");
document.write("                        "+"\n");
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document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-37\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell94667984\" aria-describedby=\"fsSupporting94667984\" lang=\"en\" fs-field-type=\"number\" fs-field-validation-name=\"% Owned\">"+"\n");
document.write("                                                                                                        <label id=\"label94667984\" class=\"fsLabel fsRequiredLabel\" for=\"field94667984\">% Owned<span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
document.write("                                            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("        <input type=\"number\" step=\"any\" id=\"field94667984\" name=\"field94667984\"  required class=\"fsField fsFormatNumber fsNumberMin-1 fsNumberMax-100 fsNumberDecimals-0 fsRequired\" min=\"1\" max=\"100\" aria-required=\"true\" />"+"\n");
document.write("    "+"\n");
document.write("    <script>"+"\n");
document.write("    //This script is to address some quirkiness of Safari where commas are interchangeable with decimal points on number fields."+"\n");
document.write("    //Normal attempts to restrict the comma such as our own validation or .replace(\",\", \"\") results in the value of the field being removed entirely."+"\n");
document.write("    //Below the keypress itself is being blocked as a workaround to keep our value."+"\n");
document.write("    document.getElementById(\"field94667984\").addEventListener(\"keydown\", function blockComma(e) {"+"\n");
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document.write("    "+"\n");
document.write("                                                                                                        <div id=\"fsSupporting94667984\" class=\"fsSupporting\">Enter a number between 1 and 100</div>"+"\n");
document.write("                                                                        "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-38\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell94366188\" lang=\"en\" fs-field-type=\"text\" fs-field-validation-name=\"Date of Birth\">"+"\n");
document.write("                                                                                                        <label id=\"label94366188\" class=\"fsLabel fsRequiredLabel\" for=\"field94366188\">Date of Birth<span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
document.write("                                            "+"\n");
document.write("                                        "+"\n");
document.write("                    <input"+"\n");
document.write("  type=\"text\" id=\"field94366188\""+"\n");
document.write("  name=\"field94366188\""+"\n");
document.write("  size=\"50\""+"\n");
document.write("   required          placeholder=\"MM/DD/YYYY\""+"\n");
document.write("    title=\"MM/DD/YYYY\""+"\n");
document.write("   value=\"\""+"\n");
document.write("  "+"\n");
document.write("  class=\"fsField fsFormatText fsRequired   \""+"\n");
document.write("   aria-required=\"true\"     />"+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-39\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
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document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92989544\" lang=\"en\" fs-field-type=\"text\" fs-field-validation-name=\"SSN\">"+"\n");
document.write("                                                                                                        <label id=\"label92989544\" class=\"fsLabel fsRequiredLabel\" for=\"field92989544\">SSN<span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92989575\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Gender\">"+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92989646\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Citizenship\">"+"\n");
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document.write("            <label class=\"fsOptionLabel vertical\" for=\"field92989646_2\"><input type=\"radio\" id=\"field92989646_2\" name=\"field92989646\" value=\"Green Card\" class=\"fsField fsRequired vertical\" aria-required=\"true\" />Green Card</label>"+"\n");
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document.write("                                                                "+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell94667463\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Are you a Veteran?\">"+"\n");
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document.write("                            <legend id=\"fsLegend94667463\" class=\"fsLabel fsRequiredLabel fsLabelVertical\"><span>Are you a Veteran?<span class=\"fsRequiredMarker\">*</span></span></legend>"+"\n");
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document.write("                    "+"\n");
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document.write("            <label class=\"fsOptionLabel vertical\" for=\"field94667463_1\"><input type=\"radio\" id=\"field94667463_1\" name=\"field94667463\" value=\"Yes\" class=\"fsField fsRequired vertical\" aria-required=\"true\" />Yes</label>"+"\n");
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document.write("            <label class=\"fsOptionLabel vertical\" for=\"field94667463_2\"><input type=\"radio\" id=\"field94667463_2\" name=\"field94667463\" value=\"No\" class=\"fsField fsRequired vertical\" aria-required=\"true\" />No</label>"+"\n");
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document.write("                                                                "+"\n");
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document.write("                                                                                <span id=\"label92989727\" class=\"fsLabel fsRequiredLabel\">Home Address<span class=\"fsRequiredMarker\">*</span></span>"+"\n");
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document.write("                                    <option value=\"AK\">Alaska</option>"+"\n");
document.write("                                    <option value=\"AZ\">Arizona</option>"+"\n");
document.write("                                    <option value=\"AR\">Arkansas</option>"+"\n");
document.write("                                    <option value=\"CA\">California</option>"+"\n");
document.write("                                    <option value=\"CO\">Colorado</option>"+"\n");
document.write("                                    <option value=\"CT\">Connecticut</option>"+"\n");
document.write("                                    <option value=\"DE\">Delaware</option>"+"\n");
document.write("                                    <option value=\"DC\">District of Columbia</option>"+"\n");
document.write("                                    <option value=\"FL\">Florida</option>"+"\n");
document.write("                                    <option value=\"GA\">Georgia</option>"+"\n");
document.write("                                    <option value=\"GU\">Guam</option>"+"\n");
document.write("                                    <option value=\"HI\">Hawaii</option>"+"\n");
document.write("                                    <option value=\"ID\">Idaho</option>"+"\n");
document.write("                                    <option value=\"IL\">Illinois</option>"+"\n");
document.write("                                    <option value=\"IN\">Indiana</option>"+"\n");
document.write("                                    <option value=\"IA\">Iowa</option>"+"\n");
document.write("                                    <option value=\"KS\">Kansas</option>"+"\n");
document.write("                                    <option value=\"KY\">Kentucky</option>"+"\n");
document.write("                                    <option value=\"LA\">Louisiana</option>"+"\n");
document.write("                                    <option value=\"ME\">Maine</option>"+"\n");
document.write("                                    <option value=\"MD\">Maryland</option>"+"\n");
document.write("                                    <option value=\"MA\">Massachusetts</option>"+"\n");
document.write("                                    <option value=\"MI\">Michigan</option>"+"\n");
document.write("                                    <option value=\"MN\">Minnesota</option>"+"\n");
document.write("                                    <option value=\"MS\">Mississippi</option>"+"\n");
document.write("                                    <option value=\"MO\">Missouri</option>"+"\n");
document.write("                                    <option value=\"MT\">Montana</option>"+"\n");
document.write("                                    <option value=\"NE\">Nebraska</option>"+"\n");
document.write("                                    <option value=\"NV\">Nevada</option>"+"\n");
document.write("                                    <option value=\"NH\">New Hampshire</option>"+"\n");
document.write("                                    <option value=\"NJ\">New Jersey</option>"+"\n");
document.write("                                    <option value=\"NM\">New Mexico</option>"+"\n");
document.write("                                    <option value=\"NY\">New York</option>"+"\n");
document.write("                                    <option value=\"NC\">North Carolina</option>"+"\n");
document.write("                                    <option value=\"ND\">North Dakota</option>"+"\n");
document.write("                                    <option value=\"OH\">Ohio</option>"+"\n");
document.write("                                    <option value=\"OK\">Oklahoma</option>"+"\n");
document.write("                                    <option value=\"OR\">Oregon</option>"+"\n");
document.write("                                    <option value=\"PA\">Pennsylvania</option>"+"\n");
document.write("                                    <option value=\"PR\">Puerto Rico</option>"+"\n");
document.write("                                    <option value=\"RI\">Rhode Island</option>"+"\n");
document.write("                                    <option value=\"SC\">South Carolina</option>"+"\n");
document.write("                                    <option value=\"SD\">South Dakota</option>"+"\n");
document.write("                                    <option value=\"TN\">Tennessee</option>"+"\n");
document.write("                                    <option value=\"TX\">Texas</option>"+"\n");
document.write("                                    <option value=\"UT\">Utah</option>"+"\n");
document.write("                                    <option value=\"VT\">Vermont</option>"+"\n");
document.write("                                    <option value=\"VA\">Virginia</option>"+"\n");
document.write("                                    <option value=\"WA\">Washington</option>"+"\n");
document.write("                                    <option value=\"WV\">West Virginia</option>"+"\n");
document.write("                                    <option value=\"WI\">Wisconsin</option>"+"\n");
document.write("                                    <option value=\"WY\">Wyoming</option>"+"\n");
document.write("                                    <option value=\"AA\">Armed Forces (the) Americas</option>"+"\n");
document.write("                                    <option value=\"AE\">Armed Forces Europe</option>"+"\n");
document.write("                                    <option value=\"AP\">Armed Forces Pacific</option>"+"\n");
document.write("                                    <option value=\"APO\">Army Post Office (U.S. Army and U.S. Air Force)</option>"+"\n");
document.write("                                    <option value=\"FPO\">Fleet Post Office (U.S. Navy and U.S. Marine Corps)</option>"+"\n");
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document.write("                                            "+"\n");
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document.write("                    <input type=\"tel\" id=\"field92989802\" name=\"field92989802\" size=\"2\" required value=\"\" class=\"fsField fsFormatPhoneUS  fsRequired\" aria-required=\"true\" data-country=\"US\" data-format=\"national\" />"+"\n");
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document.write("                                                        "+"\n");
document.write("                                        "+"\n");
document.write("                    <p>If unknown, please <a href=\"https://www.creditkarma.com/free-credit-report\" rel=\"noopener noreferrer\" target=\"_blank\">check Credit Karma</a>.</p>"+"\n");
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document.write("                    <p><a href=\"https://static1.squarespace.com/static/5ec6cb23bda3fb1fa4c7ffdf/t/5eda818b950bf5612ca401fc/1591378315508/Rise-FAQs.pdf\" rel=\"noopener noreferrer\" target=\"_blank\"><strong>Please refer to our FAQs</strong></a></p>"+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92990029\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Is there another Partner/Shareholder with greater than 20% ownership?\">"+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92989973\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Gender\">"+"\n");
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document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field92989973_1\"><input type=\"radio\" id=\"field92989973_1\" name=\"field92989973\" value=\"Male\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />Male</label>"+"\n");
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document.write("            <label class=\"fsOptionLabel vertical\" for=\"field92989973_2\"><input type=\"radio\" id=\"field92989973_2\" name=\"field92989973\" value=\"Female\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />Female</label>"+"\n");
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document.write("            "+"\n");
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document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field92989974_2\"><input type=\"radio\" id=\"field92989974_2\" name=\"field92989974\" value=\"Single\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />Single</label>"+"\n");
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document.write("            "+"\n");
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document.write("                    "+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92989975\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Citizenship\">"+"\n");
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document.write("                            <legend id=\"fsLegend92989975\" class=\"fsLabel fsRequiredLabel fsLabelVertical\"><span>Citizenship<span class=\"fsRequiredMarker\">*</span></span></legend>"+"\n");
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document.write("                    "+"\n");
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document.write("            "+"\n");
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document.write("            "+"\n");
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document.write("    "+"\n");
document.write("                                                                "+"\n");
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document.write("                    "+"\n");
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document.write("                                                </div>"+"\n");
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document.write("            "+"\n");
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document.write("                                        "+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell94667504\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Are you a Veteran?\">"+"\n");
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document.write("                            <legend id=\"fsLegend94667504\" class=\"fsLabel fsRequiredLabel fsLabelVertical\"><span>Are you a Veteran?<span class=\"fsRequiredMarker\">*</span></span></legend>"+"\n");
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document.write("                    "+"\n");
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document.write("            "+"\n");
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document.write("            <label class=\"fsOptionLabel vertical\" for=\"field94667504_2\"><input type=\"radio\" id=\"field94667504_2\" name=\"field94667504\" value=\"No\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />No</label>"+"\n");
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document.write("    "+"\n");
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document.write("                                    <option value=\"AA\">Armed Forces (the) Americas</option>"+"\n");
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document.write("                                                        "+"\n");
document.write("                                        "+"\n");
document.write("                    <p>If unknown, please <a href=\"https://www.creditkarma.com/free-credit-report\" rel=\"noopener noreferrer\" target=\"_blank\">check Credit Karma</a>.</p>"+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell94667586\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Have you filed bankruptcy in the past 3 years?\">"+"\n");
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document.write("                    <p><a href=\"https://static1.squarespace.com/static/5ec6cb23bda3fb1fa4c7ffdf/t/5eda818b950bf5612ca401fc/1591378315508/Rise-FAQs.pdf\" rel=\"noopener noreferrer\" target=\"_blank\"><strong>Please refer to our FAQs</strong></a></p>"+"\n");
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document.write("            <h2 class=\"fsSectionHeading\">Partner/Stockholder #3</h2>"+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell93793747\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Gender\">"+"\n");
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document.write("                            <legend id=\"fsLegend93793747\" class=\"fsLabel fsRequiredLabel fsLabelVertical\"><span>Gender<span class=\"fsRequiredMarker\">*</span></span></legend>"+"\n");
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document.write("            <label class=\"fsOptionLabel vertical\" for=\"field93793747_1\"><input type=\"radio\" id=\"field93793747_1\" name=\"field93793747\" value=\"Male\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />Male</label>"+"\n");
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document.write("            <label class=\"fsOptionLabel vertical\" for=\"field93793747_3\"><input type=\"radio\" id=\"field93793747_3\" name=\"field93793747\" value=\"Prefer not to say\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />Prefer not to say</label>"+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell93793749\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Marital Status\">"+"\n");
document.write("                                                                                <fieldset role=\"group\" aria-labelledby=\"fsLegend93793749\" id=\"label93793749\">"+"\n");
document.write("                            <legend id=\"fsLegend93793749\" class=\"fsLabel fsRequiredLabel fsLabelVertical\"><span>Marital Status<span class=\"fsRequiredMarker\">*</span></span></legend>"+"\n");
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document.write("                    "+"\n");
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document.write("            <label class=\"fsOptionLabel vertical\" for=\"field93793749_1\"><input type=\"radio\" id=\"field93793749_1\" name=\"field93793749\" value=\"Married\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />Married</label>"+"\n");
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document.write("            <label class=\"fsOptionLabel vertical\" for=\"field93793749_2\"><input type=\"radio\" id=\"field93793749_2\" name=\"field93793749\" value=\"Single\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />Single</label>"+"\n");
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document.write("                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field93793749_3\"><input type=\"radio\" id=\"field93793749_3\" name=\"field93793749\" value=\"Divorced\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />Divorced</label>"+"\n");
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document.write("                                                                "+"\n");
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document.write("            "+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell93793750\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Citizenship\">"+"\n");
document.write("                                                                                <fieldset role=\"group\" aria-labelledby=\"fsLegend93793750\" id=\"label93793750\">"+"\n");
document.write("                            <legend id=\"fsLegend93793750\" class=\"fsLabel fsRequiredLabel fsLabelVertical\"><span>Citizenship<span class=\"fsRequiredMarker\">*</span></span></legend>"+"\n");
document.write("                            <div class=\"fieldset-content\">"+"\n");
document.write("                    "+"\n");
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document.write("            <label class=\"fsOptionLabel vertical\" for=\"field93793750_1\"><input type=\"radio\" id=\"field93793750_1\" name=\"field93793750\" value=\"US C\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />US C</label>"+"\n");
document.write("            "+"\n");
document.write("                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field93793750_2\"><input type=\"radio\" id=\"field93793750_2\" name=\"field93793750\" value=\"GC\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />GC</label>"+"\n");
document.write("            "+"\n");
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document.write("                                                                "+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell94667507\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Are you a Veteran?\">"+"\n");
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document.write("                            <legend id=\"fsLegend94667507\" class=\"fsLabel fsRequiredLabel fsLabelVertical\"><span>Are you a Veteran?<span class=\"fsRequiredMarker\">*</span></span></legend>"+"\n");
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document.write("                    "+"\n");
document.write("                                        "+"\n");
document.write("                                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field94667507_1\"><input type=\"radio\" id=\"field94667507_1\" name=\"field94667507\" value=\"Yes\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />Yes</label>"+"\n");
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document.write("                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field94667507_2\"><input type=\"radio\" id=\"field94667507_2\" name=\"field94667507\" value=\"No\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />No</label>"+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("    "+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                                                </div></fieldset>"+"\n");
document.write("                    "+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell93793751\" lang=\"en\" fs-field-type=\"address\" fs-field-validation-name=\"Home Address\">"+"\n");
document.write("                                                                                <span id=\"label93793751\" class=\"fsLabel fsRequiredLabel\">Home Address<span class=\"fsRequiredMarker\">*</span></span>"+"\n");
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document.write("        <label class=\"fsSupporting\" for=\"field93793751-address\">Address Line 1</label>"+"\n");
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document.write("                <option value=\"\">&nbsp;</option>"+"\n");
document.write("                                    <option value=\"AL\">Alabama</option>"+"\n");
document.write("                                    <option value=\"AK\">Alaska</option>"+"\n");
document.write("                                    <option value=\"AZ\">Arizona</option>"+"\n");
document.write("                                    <option value=\"AR\">Arkansas</option>"+"\n");
document.write("                                    <option value=\"CA\">California</option>"+"\n");
document.write("                                    <option value=\"CO\">Colorado</option>"+"\n");
document.write("                                    <option value=\"CT\">Connecticut</option>"+"\n");
document.write("                                    <option value=\"DE\">Delaware</option>"+"\n");
document.write("                                    <option value=\"DC\">District of Columbia</option>"+"\n");
document.write("                                    <option value=\"FL\">Florida</option>"+"\n");
document.write("                                    <option value=\"GA\">Georgia</option>"+"\n");
document.write("                                    <option value=\"GU\">Guam</option>"+"\n");
document.write("                                    <option value=\"HI\">Hawaii</option>"+"\n");
document.write("                                    <option value=\"ID\">Idaho</option>"+"\n");
document.write("                                    <option value=\"IL\">Illinois</option>"+"\n");
document.write("                                    <option value=\"IN\">Indiana</option>"+"\n");
document.write("                                    <option value=\"IA\">Iowa</option>"+"\n");
document.write("                                    <option value=\"KS\">Kansas</option>"+"\n");
document.write("                                    <option value=\"KY\">Kentucky</option>"+"\n");
document.write("                                    <option value=\"LA\">Louisiana</option>"+"\n");
document.write("                                    <option value=\"ME\">Maine</option>"+"\n");
document.write("                                    <option value=\"MD\">Maryland</option>"+"\n");
document.write("                                    <option value=\"MA\">Massachusetts</option>"+"\n");
document.write("                                    <option value=\"MI\">Michigan</option>"+"\n");
document.write("                                    <option value=\"MN\">Minnesota</option>"+"\n");
document.write("                                    <option value=\"MS\">Mississippi</option>"+"\n");
document.write("                                    <option value=\"MO\">Missouri</option>"+"\n");
document.write("                                    <option value=\"MT\">Montana</option>"+"\n");
document.write("                                    <option value=\"NE\">Nebraska</option>"+"\n");
document.write("                                    <option value=\"NV\">Nevada</option>"+"\n");
document.write("                                    <option value=\"NH\">New Hampshire</option>"+"\n");
document.write("                                    <option value=\"NJ\">New Jersey</option>"+"\n");
document.write("                                    <option value=\"NM\">New Mexico</option>"+"\n");
document.write("                                    <option value=\"NY\">New York</option>"+"\n");
document.write("                                    <option value=\"NC\">North Carolina</option>"+"\n");
document.write("                                    <option value=\"ND\">North Dakota</option>"+"\n");
document.write("                                    <option value=\"OH\">Ohio</option>"+"\n");
document.write("                                    <option value=\"OK\">Oklahoma</option>"+"\n");
document.write("                                    <option value=\"OR\">Oregon</option>"+"\n");
document.write("                                    <option value=\"PA\">Pennsylvania</option>"+"\n");
document.write("                                    <option value=\"PR\">Puerto Rico</option>"+"\n");
document.write("                                    <option value=\"RI\">Rhode Island</option>"+"\n");
document.write("                                    <option value=\"SC\">South Carolina</option>"+"\n");
document.write("                                    <option value=\"SD\">South Dakota</option>"+"\n");
document.write("                                    <option value=\"TN\">Tennessee</option>"+"\n");
document.write("                                    <option value=\"TX\">Texas</option>"+"\n");
document.write("                                    <option value=\"UT\">Utah</option>"+"\n");
document.write("                                    <option value=\"VT\">Vermont</option>"+"\n");
document.write("                                    <option value=\"VA\">Virginia</option>"+"\n");
document.write("                                    <option value=\"WA\">Washington</option>"+"\n");
document.write("                                    <option value=\"WV\">West Virginia</option>"+"\n");
document.write("                                    <option value=\"WI\">Wisconsin</option>"+"\n");
document.write("                                    <option value=\"WY\">Wyoming</option>"+"\n");
document.write("                                    <option value=\"AA\">Armed Forces (the) Americas</option>"+"\n");
document.write("                                    <option value=\"AE\">Armed Forces Europe</option>"+"\n");
document.write("                                    <option value=\"AP\">Armed Forces Pacific</option>"+"\n");
document.write("                                    <option value=\"APO\">Army Post Office (U.S. Army and U.S. Air Force)</option>"+"\n");
document.write("                                    <option value=\"FPO\">Fleet Post Office (U.S. Navy and U.S. Marine Corps)</option>"+"\n");
document.write("                            </select>"+"\n");
document.write("            <label class=\"fsSupporting\" for=\"field93793751-state\">State</label>"+"\n");
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document.write("    "+"\n");
document.write("        <div class=\"fsSubField fsFieldZip\">"+"\n");
document.write("                    <input type=\"text\" id=\"field93793751-zip\" aria-label=\"ZIP Code\" name=\"field93793751-zip\" size=\"6\" value=\"\" required class=\"fsField fsFieldZip fsFormatZipUS fsRequired\" aria-required=\"true\" disabled=\"disabled\" />"+"\n");
document.write("            <label class=\"fsSupporting\" for=\"field93793751-zip\">ZIP Code</label>"+"\n");
document.write("            </div>"+"\n");
document.write("    "+"\n");
document.write("</div>"+"\n");
document.write("<div class=\"clear\"></div>"+"\n");
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document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
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document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-93\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
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document.write("            "+"\n");
document.write("            "+"\n");
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document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell93793752\" lang=\"en\" fs-field-type=\"phone\" fs-field-validation-name=\"Primary Phone\">"+"\n");
document.write("                                                                                                        <label id=\"label93793752\" class=\"fsLabel fsRequiredLabel\" for=\"field93793752\">Primary Phone<span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
document.write("                                            "+"\n");
document.write("                                        "+"\n");
document.write("                    <input type=\"tel\" id=\"field93793752\" name=\"field93793752\" size=\"2\" required value=\"\" class=\"fsField fsFormatPhoneUS  fsRequired\" aria-required=\"true\" disabled=\"disabled\" data-country=\"US\" data-format=\"national\" />"+"\n");
document.write("                                                                "+"\n");
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document.write("            "+"\n");
document.write("            <div class=\"fsSection fs1Col fsHidden\" id=\"fsSection94707868\">"+"\n");
document.write("                                                    "+"\n");
document.write("                                        "+"\n");
document.write("            <div class=\"fsSectionHeader\">"+"\n");
document.write("        "+"\n");
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document.write("                <div id=\"fsRow3892973-95\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell93793755\" lang=\"en\" fs-field-type=\"email\" fs-field-validation-name=\"Email\">"+"\n");
document.write("                                                                                                        <label id=\"label93793755\" class=\"fsLabel fsRequiredLabel\" for=\"field93793755\">Email<span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
document.write("                                            "+"\n");
document.write("                                        "+"\n");
document.write("                    <input type=\"email\" id=\"field93793755\" name=\"field93793755\" size=\"50\" required=\"required\" value=\"\" class=\"fsField fsFormatEmail fsRequired\" aria-required=\"true\" disabled=\"disabled\" />"+"\n");
document.write("                                                                "+"\n");
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document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
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document.write("            "+"\n");
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document.write("                    <p>If unknown, please <a href=\"https://www.creditkarma.com/free-credit-report\" rel=\"noopener noreferrer\" target=\"_blank\">check Credit Karma</a>.</p>"+"\n");
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document.write("                    <p><a href=\"https://static1.squarespace.com/static/5ec6cb23bda3fb1fa4c7ffdf/t/5eda818b950bf5612ca401fc/1591378315508/Rise-FAQs.pdf\" rel=\"noopener noreferrer\" target=\"_blank\"><strong>Please refer to our FAQs</strong></a></p>"+"\n");
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document.write("    <div class=\"fsSubField fsNameLast\">"+"\n");
document.write("        <input type=\"text\" id=\"field93793774-last\" name=\"field93793774-last\" size=\"20\" aria-label=\"Last Name\" value=\"\" required class=\"fsField fsFieldName fsRequired\" aria-required=\"true\" disabled=\"disabled\" />"+"\n");
document.write("        <label class=\"fsSupporting fsRequiredLabel\" for=\"field93793774-last\">Last Name<span class=\"hidden\">*</span></label>"+"\n");
document.write("    </div>"+"\n");
document.write("    "+"\n");
document.write("</div>"+"\n");
document.write("<div class=\"clear\"></div>"+"\n");
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document.write("                                                </div>"+"\n");
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document.write("                <div id=\"fsRow3892973-108\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell94667494\" lang=\"en\" fs-field-type=\"text\" fs-field-validation-name=\"Title\">"+"\n");
document.write("                                                                                                        <label id=\"label94667494\" class=\"fsLabel fsRequiredLabel\" for=\"field94667494\">Title<span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
document.write("                                            "+"\n");
document.write("                                        "+"\n");
document.write("                    <input"+"\n");
document.write("  type=\"text\" id=\"field94667494\""+"\n");
document.write("  name=\"field94667494\""+"\n");
document.write("  size=\"50\""+"\n");
document.write("   required       value=\"\""+"\n");
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document.write("   aria-required=\"true\"       disabled=\"disabled\""+"\n");
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document.write("                                                                "+"\n");
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document.write("                <div id=\"fsRow3892973-109\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
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document.write("            "+"\n");
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document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell94668150\" aria-describedby=\"fsSupporting94668150\" lang=\"en\" fs-field-type=\"number\" fs-field-validation-name=\"% Owned\">"+"\n");
document.write("                                                                                                        <label id=\"label94668150\" class=\"fsLabel fsRequiredLabel\" for=\"field94668150\">% Owned<span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
document.write("                                            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("        <input type=\"number\" step=\"any\" id=\"field94668150\" name=\"field94668150\"  required class=\"fsField fsFormatNumber fsNumberMin-1 fsNumberMax-100 fsNumberDecimals-0 fsRequired\" min=\"1\" max=\"100\" aria-required=\"true\" disabled=\"disabled\" />"+"\n");
document.write("    "+"\n");
document.write("    <script>"+"\n");
document.write("    //This script is to address some quirkiness of Safari where commas are interchangeable with decimal points on number fields."+"\n");
document.write("    //Normal attempts to restrict the comma such as our own validation or .replace(\",\", \"\") results in the value of the field being removed entirely."+"\n");
document.write("    //Below the keypress itself is being blocked as a workaround to keep our value."+"\n");
document.write("    document.getElementById(\"field94668150\").addEventListener(\"keydown\", function blockComma(e) {"+"\n");
document.write("    if (e.code === \'Comma\') {"+"\n");
document.write("    e.preventDefault();}})"+"\n");
document.write("    </script>"+"\n");
document.write("    "+"\n");
document.write("                                                                                                        <div id=\"fsSupporting94668150\" class=\"fsSupporting\">Enter a number between 1 and 100</div>"+"\n");
document.write("                                                                        "+"\n");
document.write("                    "+"\n");
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document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
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document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-110\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
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document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell94366316\" lang=\"en\" fs-field-type=\"text\" fs-field-validation-name=\"Date of Birth\">"+"\n");
document.write("                                                                                                        <label id=\"label94366316\" class=\"fsLabel fsRequiredLabel\" for=\"field94366316\">Date of Birth<span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
document.write("                                            "+"\n");
document.write("                                        "+"\n");
document.write("                    <input"+"\n");
document.write("  type=\"text\" id=\"field94366316\""+"\n");
document.write("  name=\"field94366316\""+"\n");
document.write("  size=\"50\""+"\n");
document.write("   required          placeholder=\"MM/DD/YYYY\""+"\n");
document.write("    title=\"MM/DD/YYYY\""+"\n");
document.write("   value=\"\""+"\n");
document.write("  "+"\n");
document.write("  class=\"fsField fsFormatText fsRequired   \""+"\n");
document.write("   aria-required=\"true\"       disabled=\"disabled\""+"\n");
document.write("    />"+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-111\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
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document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell93793777\" lang=\"en\" fs-field-type=\"text\" fs-field-validation-name=\"SSN\">"+"\n");
document.write("                                                                                                        <label id=\"label93793777\" class=\"fsLabel fsRequiredLabel\" for=\"field93793777\">SSN<span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
document.write("                                            "+"\n");
document.write("                                        "+"\n");
document.write("                    <input"+"\n");
document.write("  type=\"text\" id=\"field93793777\""+"\n");
document.write("  name=\"field93793777\""+"\n");
document.write("  size=\"50\""+"\n");
document.write("   required        maxlength=\"9\""+"\n");
document.write("     value=\"\""+"\n");
document.write("  "+"\n");
document.write("  class=\"fsField fsFormatText fsRequired  fsTextMask  fsFormatLength\""+"\n");
document.write("   aria-required=\"true\"       disabled=\"disabled\""+"\n");
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document.write("    <p>"+"\n");
document.write("        <label"+"\n");
document.write("          for=\"field93793777_confirm\""+"\n");
document.write("          class=\"fsLabel fsRequiredLabel\""+"\n");
document.write("        >"+"\n");
document.write("          Confirm"+"\n");
document.write("          SSN<span>*</span>"+"\n");
document.write("        </label>"+"\n");
document.write("                <input"+"\n");
document.write("          type=\"text\""+"\n");
document.write("          id=\"field93793777_confirm\""+"\n");
document.write("          name=\"field93793777_confirm\""+"\n");
document.write("          size=\"50\""+"\n");
document.write("                     required=\"required\"                      maxlength=\"9\""+"\n");
document.write("                    "+"\n");
document.write("          "+"\n");
document.write("          class=\"fsFieldConfirm fsField fsFormatText fsTextMask fsRequired  fsFormatLength\""+"\n");
document.write("                      aria-required=\"true\""+"\n");
document.write("                                disabled=\"disabled\""+"\n");
document.write("                            />"+"\n");
document.write("            </p>"+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-112\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell93793778\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Gender\">"+"\n");
document.write("                                                                                <fieldset role=\"group\" aria-labelledby=\"fsLegend93793778\" id=\"label93793778\">"+"\n");
document.write("                            <legend id=\"fsLegend93793778\" class=\"fsLabel fsRequiredLabel fsLabelVertical\"><span>Gender<span class=\"fsRequiredMarker\">*</span></span></legend>"+"\n");
document.write("                            <div class=\"fieldset-content\">"+"\n");
document.write("                    "+"\n");
document.write("                                        "+"\n");
document.write("                                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field93793778_1\"><input type=\"radio\" id=\"field93793778_1\" name=\"field93793778\" value=\"Male\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />Male</label>"+"\n");
document.write("            "+"\n");
document.write("                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field93793778_2\"><input type=\"radio\" id=\"field93793778_2\" name=\"field93793778\" value=\"Female\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />Female</label>"+"\n");
document.write("            "+"\n");
document.write("                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field93793778_3\"><input type=\"radio\" id=\"field93793778_3\" name=\"field93793778\" value=\"Prefer not to say\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />Prefer not to say</label>"+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("    "+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                                                </div></fieldset>"+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-113\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell93793779\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Marital Status\">"+"\n");
document.write("                                                                                <fieldset role=\"group\" aria-labelledby=\"fsLegend93793779\" id=\"label93793779\">"+"\n");
document.write("                            <legend id=\"fsLegend93793779\" class=\"fsLabel fsRequiredLabel fsLabelVertical\"><span>Marital Status<span class=\"fsRequiredMarker\">*</span></span></legend>"+"\n");
document.write("                            <div class=\"fieldset-content\">"+"\n");
document.write("                    "+"\n");
document.write("                                        "+"\n");
document.write("                                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field93793779_1\"><input type=\"radio\" id=\"field93793779_1\" name=\"field93793779\" value=\"Married\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />Married</label>"+"\n");
document.write("            "+"\n");
document.write("                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field93793779_2\"><input type=\"radio\" id=\"field93793779_2\" name=\"field93793779\" value=\"Single\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />Single</label>"+"\n");
document.write("            "+"\n");
document.write("                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field93793779_3\"><input type=\"radio\" id=\"field93793779_3\" name=\"field93793779\" value=\"Divorced\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />Divorced</label>"+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("    "+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                                                </div></fieldset>"+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-114\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell93793780\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Citizenship\">"+"\n");
document.write("                                                                                <fieldset role=\"group\" aria-labelledby=\"fsLegend93793780\" id=\"label93793780\">"+"\n");
document.write("                            <legend id=\"fsLegend93793780\" class=\"fsLabel fsRequiredLabel fsLabelVertical\"><span>Citizenship<span class=\"fsRequiredMarker\">*</span></span></legend>"+"\n");
document.write("                            <div class=\"fieldset-content\">"+"\n");
document.write("                    "+"\n");
document.write("                                        "+"\n");
document.write("                                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field93793780_1\"><input type=\"radio\" id=\"field93793780_1\" name=\"field93793780\" value=\"US Citizen\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />US Citizen</label>"+"\n");
document.write("            "+"\n");
document.write("                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field93793780_2\"><input type=\"radio\" id=\"field93793780_2\" name=\"field93793780\" value=\"Green Card\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />Green Card</label>"+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("    "+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                                                </div></fieldset>"+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
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document.write("                    "+"\n");
document.write("                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-115\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell94667509\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Are you a Veteran?\">"+"\n");
document.write("                                                                                <fieldset role=\"group\" aria-labelledby=\"fsLegend94667509\" id=\"label94667509\">"+"\n");
document.write("                            <legend id=\"fsLegend94667509\" class=\"fsLabel fsRequiredLabel fsLabelVertical\"><span>Are you a Veteran?<span class=\"fsRequiredMarker\">*</span></span></legend>"+"\n");
document.write("                            <div class=\"fieldset-content\">"+"\n");
document.write("                    "+"\n");
document.write("                                        "+"\n");
document.write("                                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field94667509_1\"><input type=\"radio\" id=\"field94667509_1\" name=\"field94667509\" value=\"Yes\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />Yes</label>"+"\n");
document.write("            "+"\n");
document.write("                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field94667509_2\"><input type=\"radio\" id=\"field94667509_2\" name=\"field94667509\" value=\"No\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />No</label>"+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("    "+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                                                </div></fieldset>"+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-116\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell93793781\" lang=\"en\" fs-field-type=\"address\" fs-field-validation-name=\"Home Address\">"+"\n");
document.write("                                                                                <span id=\"label93793781\" class=\"fsLabel fsRequiredLabel\">Home Address<span class=\"fsRequiredMarker\">*</span></span>"+"\n");
document.write("                    "+"\n");
document.write("                                        "+"\n");
document.write("                    "+"\n");
document.write("<div class=\"fsSubFieldGroup\">"+"\n");
document.write("        <div class=\"fsSubField fsFieldAddress\">"+"\n");
document.write("        <input type=\"text\" id=\"field93793781-address\" aria-label=\"Address Line 1\" name=\"field93793781-address\" size=\"50\" value=\"\" required class=\"fsField fsFieldAddress fsRequired\" aria-required=\"true\" disabled=\"disabled\" />"+"\n");
document.write("        <label class=\"fsSupporting\" for=\"field93793781-address\">Address Line 1</label>"+"\n");
document.write("    </div>"+"\n");
document.write("    "+"\n");
document.write("        <div class=\"fsSubField fsFieldAddress2\">"+"\n");
document.write("        <input type=\"text\" id=\"field93793781-address2\" aria-label=\"Address Line 2\" name=\"field93793781-address2\" size=\"50\" value=\"\" class=\"fsField fsFieldAddress2\" disabled=\"disabled\" />"+"\n");
document.write("        <label class=\"fsSupporting\" for=\"field93793781-address2\">Address Line 2</label>"+"\n");
document.write("    </div>"+"\n");
document.write("    "+"\n");
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document.write("                                    <option value=\"AA\">Armed Forces (the) Americas</option>"+"\n");
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document.write("                                                        "+"\n");
document.write("                                        "+"\n");
document.write("                    <p>If unknown, please <a href=\"https://www.creditkarma.com/free-credit-report\" rel=\"noopener noreferrer\" target=\"_blank\">check Credit Karma</a>.</p>"+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell94670069\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Have you filed bankruptcy in the past 3 years?\">"+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100\" id=\"fsCell94670074\" lang=\"en\" fs-field-type=\"richtext\" fs-field-validation-name=\"\">"+"\n");
document.write("                                                        "+"\n");
document.write("                                        "+"\n");
document.write("                    <p><a href=\"https://static1.squarespace.com/static/5ec6cb23bda3fb1fa4c7ffdf/t/5eda818b950bf5612ca401fc/1591378315508/Rise-FAQs.pdf\" rel=\"noopener noreferrer\" target=\"_blank\"><strong>Please refer to our FAQs</strong></a></p>"+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell94670091\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Do you owe any past taxes?\">"+"\n");
document.write("                                                                                <fieldset role=\"group\" aria-labelledby=\"fsLegend94670091\" id=\"label94670091\">"+"\n");
document.write("                            <legend id=\"fsLegend94670091\" class=\"fsLabel fsRequiredLabel fsLabelVertical\"><span>Do you owe any past taxes?<span class=\"fsRequiredMarker\">*</span></span></legend>"+"\n");
document.write("                            <div class=\"fieldset-content\">"+"\n");
document.write("                    "+"\n");
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document.write("            <label class=\"fsOptionLabel vertical\" for=\"field94670091_1\"><input type=\"radio\" id=\"field94670091_1\" name=\"field94670091\" value=\"Yes\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />Yes</label>"+"\n");
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document.write("            <label class=\"fsOptionLabel vertical\" for=\"field94670091_2\"><input type=\"radio\" id=\"field94670091_2\" name=\"field94670091\" value=\"No\" class=\"fsField fsRequired vertical\" aria-required=\"true\" disabled=\"disabled\" />No</label>"+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100\" id=\"fsCell94670111\" lang=\"en\" fs-field-type=\"textarea\" fs-field-validation-name=\"Please provide more details about the past taxes\">"+"\n");
document.write("                                                                                                        <label id=\"label94670111\" class=\"fsLabel fsRequiredLabel\" for=\"field94670111\">Please provide more details about the past taxes<span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
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document.write("          cols=\"50\""+"\n");
document.write("          required aria-required=\"true\"                                                  disabled=\"disabled\"          ></textarea>"+"\n");
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document.write("                    "+"\n");
document.write("                    "+"\n");
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document.write("                    "+"\n");
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document.write("                </div>"+"\n");
document.write("                                "+"\n");
document.write("            "+"\n");
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document.write("                    "+"\n");
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document.write("            <div class=\"fsSection fsFirstSection fs1Col\" id=\"fsSection94046888\">"+"\n");
document.write("                                                    "+"\n");
document.write("                                        "+"\n");
document.write("            <div class=\"fsSectionHeader\">"+"\n");
document.write("            <h2 class=\"fsSectionHeading\">Borrower Demographic Information</h2>"+"\n");
document.write("        "+"\n");
document.write("    </div>"+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-130\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
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document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell94046908\" lang=\"en\" fs-field-type=\"richtext\" fs-field-validation-name=\"\">"+"\n");
document.write("                                                        "+"\n");
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document.write("                    <p><strong>The purpose of collecting this information</strong> is to help ensure that all applicants are treated fairly and that the needs of communities and neighborhoods are being fulfilled. The County Commissioners have asked us to gather the applicants their demographic information (ethnicity, sex, and race) to monitor our compliance with equal distribution of the RISE Miami Dade Fund program. &nbsp;You are not required to provide this information but are encouraged to do so. &nbsp;You may select one or more designations for \"ethnicity\" and one or more designations for \"Race.\" <strong>The law provides that we may not discriminate</strong> on the basis of this information, or on whether you choose to provide it. The law also provides that we may not discriminate based on age or marital status information you provide in this application. If you do not wish to provide some or all of this information, please check below.</p>"+"\n");
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document.write("                                                </div>"+"\n");
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document.write("                                        "+"\n");
document.write("                                        "+"\n");
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document.write("                                                "+"\n");
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document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell94047140\" lang=\"en\" fs-field-type=\"checkbox\" fs-field-validation-name=\"Ethnicity - Check one or more\">"+"\n");
document.write("                                                                                <fieldset role=\"group\" aria-labelledby=\"fsLegend94047140\" id=\"label94047140\">"+"\n");
document.write("                            <legend id=\"fsLegend94047140\" class=\"fsLabel fsLabelVertical\"><span>Ethnicity - Check one or more</span></legend>"+"\n");
document.write("                            <div class=\"fieldset-content\">"+"\n");
document.write("                    "+"\n");
document.write("                                        "+"\n");
document.write("                                                            <label class=\"fsOptionLabel vertical\" for=\"field94047140_1\"><input type=\"checkbox\" id=\"field94047140_1\" name=\"field94047140[]\" value=\"Hispanic or Latino\" class=\"fsField vertical\" />Hispanic or Latino</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047140_2\"><input type=\"checkbox\" id=\"field94047140_2\" name=\"field94047140[]\" value=\"Mexican\" class=\"fsField vertical\" />Mexican</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047140_3\"><input type=\"checkbox\" id=\"field94047140_3\" name=\"field94047140[]\" value=\"Puerto Rican\" class=\"fsField vertical\" />Puerto Rican</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047140_4\"><input type=\"checkbox\" id=\"field94047140_4\" name=\"field94047140[]\" value=\"Cuban\" class=\"fsField vertical\" />Cuban</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047140_5\"><input type=\"checkbox\" id=\"field94047140_5\" name=\"field94047140[]\" value=\"Not Hispanic or Latino\" class=\"fsField vertical\" />Not Hispanic or Latino</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047140_6\"><input type=\"checkbox\" id=\"field94047140_6\" name=\"field94047140[]\" value=\"I do not wish to provide this information\" class=\"fsField vertical\" />I do not wish to provide this information</label>"+"\n");
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document.write("            <div class=\"vertical fs-clear\">"+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" style=\"margin-right: 5px;\" for=\"field94047140_other\"><input type=\"checkbox\" id=\"field94047140_other\" name=\"field94047140[]\" value=\"Other\" class=\"fsField\" />Other:</label>"+"\n");
document.write("            <input type=\"text\" id=\"field94047140_othervalue\" name=\"field94047140_other\" size=\"15\" class=\"fsOtherField\"            /><label class=\"hidden\" for=\"field94047140_othervalue\">Other Value</label>"+"\n");
document.write("        </div>"+"\n");
document.write("    "+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                                                </div></fieldset>"+"\n");
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document.write("                                                </div>"+"\n");
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document.write("                <div id=\"fsRow3892973-132\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
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document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell94047159\" lang=\"en\" fs-field-type=\"checkbox\" fs-field-validation-name=\"Race - Check one or more\">"+"\n");
document.write("                                                                                <fieldset role=\"group\" aria-labelledby=\"fsLegend94047159\" id=\"label94047159\">"+"\n");
document.write("                            <legend id=\"fsLegend94047159\" class=\"fsLabel fsLabelVertical\"><span>Race - Check one or more</span></legend>"+"\n");
document.write("                            <div class=\"fieldset-content\">"+"\n");
document.write("                    "+"\n");
document.write("                                        "+"\n");
document.write("                                                            <label class=\"fsOptionLabel vertical\" for=\"field94047159_1\"><input type=\"checkbox\" id=\"field94047159_1\" name=\"field94047159[]\" value=\"American Indian or Alaska Native\" class=\"fsField vertical\" />American Indian or Alaska Native</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047159_2\"><input type=\"checkbox\" id=\"field94047159_2\" name=\"field94047159[]\" value=\"Asian\" class=\"fsField vertical\" />Asian</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047159_3\"><input type=\"checkbox\" id=\"field94047159_3\" name=\"field94047159[]\" value=\"Asian Indian\" class=\"fsField vertical\" />Asian Indian</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047159_4\"><input type=\"checkbox\" id=\"field94047159_4\" name=\"field94047159[]\" value=\"Chinese\" class=\"fsField vertical\" />Chinese</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047159_5\"><input type=\"checkbox\" id=\"field94047159_5\" name=\"field94047159[]\" value=\"Filipino\" class=\"fsField vertical\" />Filipino</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047159_6\"><input type=\"checkbox\" id=\"field94047159_6\" name=\"field94047159[]\" value=\"Japanese\" class=\"fsField vertical\" />Japanese</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047159_7\"><input type=\"checkbox\" id=\"field94047159_7\" name=\"field94047159[]\" value=\"Korean\" class=\"fsField vertical\" />Korean</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047159_8\"><input type=\"checkbox\" id=\"field94047159_8\" name=\"field94047159[]\" value=\"Vietnamese\" class=\"fsField vertical\" />Vietnamese</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047159_9\"><input type=\"checkbox\" id=\"field94047159_9\" name=\"field94047159[]\" value=\"Black or African American\" class=\"fsField vertical\" />Black or African American</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047159_10\"><input type=\"checkbox\" id=\"field94047159_10\" name=\"field94047159[]\" value=\"Native Hawaiian or Other Pacific Islander\" class=\"fsField vertical\" />Native Hawaiian or Other Pacific Islander</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047159_11\"><input type=\"checkbox\" id=\"field94047159_11\" name=\"field94047159[]\" value=\"Native Hawaiian\" class=\"fsField vertical\" />Native Hawaiian</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047159_12\"><input type=\"checkbox\" id=\"field94047159_12\" name=\"field94047159[]\" value=\"Guamanian or Chamorro\" class=\"fsField vertical\" />Guamanian or Chamorro</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047159_13\"><input type=\"checkbox\" id=\"field94047159_13\" name=\"field94047159[]\" value=\"Samoan\" class=\"fsField vertical\" />Samoan</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047159_14\"><input type=\"checkbox\" id=\"field94047159_14\" name=\"field94047159[]\" value=\"White\" class=\"fsField vertical\" />White</label>"+"\n");
document.write("                                                        <label class=\"fsOptionLabel vertical\" for=\"field94047159_15\"><input type=\"checkbox\" id=\"field94047159_15\" name=\"field94047159[]\" value=\"I do not wish to provide this information\" class=\"fsField vertical\" />I do not wish to provide this information</label>"+"\n");
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document.write("    "+"\n");
document.write("            <div class=\"vertical fs-clear\">"+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" style=\"margin-right: 5px;\" for=\"field94047159_other\"><input type=\"checkbox\" id=\"field94047159_other\" name=\"field94047159[]\" value=\"Other\" class=\"fsField\" />Other:</label>"+"\n");
document.write("            <input type=\"text\" id=\"field94047159_othervalue\" name=\"field94047159_other\" size=\"15\" class=\"fsOtherField\"            /><label class=\"hidden\" for=\"field94047159_othervalue\">Other Value</label>"+"\n");
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document.write("    "+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                                                </div></fieldset>"+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
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document.write("                        "+"\n");
document.write("                        "+"\n");
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document.write("                                        "+"\n");
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document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-133\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
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document.write("                                        "+"\n");
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document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell94047575\" lang=\"en\" fs-field-type=\"select\" fs-field-validation-name=\"Sex\">"+"\n");
document.write("                                                                                                        <label id=\"label94047575\" class=\"fsLabel\" for=\"field94047575\">Sex                                                    </label>"+"\n");
document.write("                                            "+"\n");
document.write("                                        "+"\n");
document.write("                    <select id=\"field94047575\" name=\"field94047575\" size=\"1\" class=\"fsField\">"+"\n");
document.write("        <option value=\"\">&nbsp;</option>"+"\n");
document.write("        <option value=\"Male\">Male</option>"+"\n");
document.write("        <option value=\"Female\">Female</option>"+"\n");
document.write("        <option value=\"I do not wish to provide this information\">I do not wish to provide this information</option>"+"\n");
document.write("</select>"+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
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document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
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document.write("                </div>"+"\n");
document.write("                                "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                "+"\n");
document.write("                    </div>"+"\n");
document.write("                    "+"\n");
document.write("                    <div class=\"fsPage fsHiddenPage\" id=\"fsPage3892973-10\" >"+"\n");
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document.write("                                                    "+"\n");
document.write("                                        "+"\n");
document.write("            <div class=\"fsSectionHeader\">"+"\n");
document.write("            <h2 class=\"fsSectionHeading\">Authorization to Release Information</h2>"+"\n");
document.write("        "+"\n");
document.write("    </div>"+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3892973-135\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92991718\" lang=\"en\" fs-field-type=\"richtext\" fs-field-validation-name=\"\">"+"\n");
document.write("                                                        "+"\n");
document.write("                                        "+"\n");
document.write("                    <p>I authorize Lender to make inquiries as necessary to verify the accuracy of the statements made and determine the creditworthiness of all stakeholders listed and understand that all stakeholders will be required to sign documents before funding. &nbsp;I/We hereby authorize the release to Lender of any and all information they may require at any time for any purpose related to our credit transaction with them. I/We further authorize Lender to release such information to any entity deemed necessary for any purpose related to our credit transaction with them.<br>I/We certify the statements contained herein and in the attachments are true and accurate as best of my knowledge as of the stated date(s). These statements are made for the purpose of either obtaining a loan or guaranteeing a loan on behalf of all owners of the business. I/We understand that falsifying statements may result in forfeiture of benefits and possible prosecution by the U.S. Attorney General (Reference 18 U.S.C. 10001).</p>"+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                          <div class=\"fs-clear\"></div>"+"\n");
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document.write("                <div id=\"fsRow3892973-136\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell92991822\" aria-describedby=\"fsSupporting92991822\" lang=\"en\" fs-field-type=\"signature\" fs-field-validation-name=\"Signature\">"+"\n");
document.write("                                                                                                        <label id=\"label92991822\" class=\"fsLabel fsRequiredLabel\" for=\"field92991822\">Signature<span class=\"fsRequiredMarker\">*</span>                                                    </label>"+"\n");
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