tr , td {
padding:6px;
border-spacing:0px;
border-width:0px;
}

test
First Name
Last Name*
Email
Phone
Loan Amount
Enter the Captcha

Reload

var mndFileds=new Array(‘Last Name’);
var fldLangVal=new Array(‘Last Name’);

/* Do not remove this code. */
function reloadImg() {
if(document.getElementById(‘imgid’).src.indexOf(‘&d’) !== -1 ) {
document.getElementById(‘imgid’).src=document.getElementById(‘imgid’).src.substring(0,document.getElementById(‘imgid’).src.indexOf(‘&d’))+’&d’+new Date().getTime();
} else {
document.getElementById(‘imgid’).src = document.getElementById(‘imgid’).src+’&d’+new Date().getTime();
}
}

function checkMandatory() {
var name=”;
var email=”;
for(i=0;i<mndFileds.length;i++) {
var fieldObj=document.forms['WebToLeads46132000001541001'][mndFileds[i]];
if(fieldObj) {
if (((fieldObj.value).replace(/^\s+|\s+$/g, '')).length==0) {
alert(fldLangVal[i] +' cannot be empty');
fieldObj.focus();
return false;
} else if(fieldObj.nodeName=='SELECT') {
if(fieldObj.options[fieldObj.selectedIndex].value=='-None-') {
alert(fldLangVal[i] +' cannot be none');
fieldObj.focus();
return false;
}
} else if(fieldObj.type =='checkbox'){
if(fieldObj.checked == false){
alert('Please accept '+fldLangVal[i]);
fieldObj.focus();
return false;
}
}
try {
if(fieldObj.name == 'Last Name') {
name = fieldObj.value;
}
} catch (e) {}
}
}
try {
if($zoho) {
var LDTuvidObj = document.forms['WebToLeads46132000001541001']['LDTuvid'];
if(LDTuvidObj) {
LDTuvidObj.value = $zoho.salesiq.visitor.uniqueid();
}
var firstnameObj = document.forms['WebToLeads46132000001541001']['First Name'];
if(firstnameObj) {
name = firstnameObj.value +' '+name;
}
$zoho.salesiq.visitor.name(name);
var emailObj = document.forms['WebToLeads46132000001541001']['Email'];
if(emailObj) {
email = emailObj.value;
$zoho.salesiq.visitor.email(email);
}
}
} catch(e) {}
}
var $zoho= $zoho || {salesiq:{values:{},ready:function(){$zoho.salesiq.floatbutton.visible(‘hide’);}}};var d=document;s=d.createElement(‘script’);s.type=’text/javascript’;s.defer=true;s.src=’https://salesiq.zoho.com/webuychicagohouses/float.ls?embedname=webuychicagohouses’;t=d.getElementsByTagName(‘script’)[0];t.parentNode.insertBefore(s,t);