document.write('		<SCR' + 'IPT LANGUAGE="javascr' + 'ipt">\n');
document.write('<!--\n');
document.write('\n');
document.write('		function validate() {\n');
document.write('if (document.form.a002First_Name.value==""){\n');
document.write('  alert("Please enter First Name");\n');
document.write('  document.form.a002First_Name.focus();\n');
document.write('return false;\n');
document.write('}\n');
document.write('\n');
document.write('if (document.form.a004Last_Name.value==""){\n');
document.write('  alert("Please enter Last Name");\n');
document.write('  document.form.a004Last_Name.focus();\n');
document.write('return false;\n');
document.write('}\n');
document.write('\n');
document.write('if (document.form.a006Email.value==""){\n');
document.write('  alert("Please enter E-Mail");\n');
document.write('  document.form.a006Email.focus();\n');
document.write('return false;\n');
document.write('}\n');
document.write('\n');
document.write('if (document.form.a008Phone.value==""){\n');
document.write('  alert("Please enter your Phone Number");\n');
document.write('  document.form.a008Phone.focus();\n');
document.write('return false;\n');
document.write('}\n');
document.write('/*\n');
document.write('if (document.form.a010Loan_Amount.value==""){\n');
document.write('  alert("Please enter Loan Amount");\n');
document.write('  document.form.a010Loan_Amount.focus();\n');
document.write('return false;\n');
document.write('}\n');
document.write('\n');
document.write('if (document.form.a012Loan_Purpose.options[document.form.a012Loan_Purpose.selectedIndex].value==""){\n');
document.write('  alert("Please enter Loan Purpose");\n');
document.write('  document.form.a012Loan_Purpose.focus();\n');
document.write('return false;\n');
document.write('}\n');
document.write('\n');
document.write('if (document.form.a014Loan_Program.options[document.form.a014Loan_Program.selectedIndex].value==""){\n');
document.write('  alert("Please enter Loan Program");\n');
document.write('  document.form.a014Loan_Program.focus();\n');
document.write('return false;\n');
document.write('}\n');
document.write('\n');
document.write('if (document.form.a016Property_Use.options[document.form.a016Property_Use.selectedIndex].value==""){\n');
document.write('  alert("Please enter Property Use");\n');
document.write('  document.form.a016Property_Use.focus();\n');
document.write('return false;\n');
document.write('}\n');
document.write('\n');
document.write('if (document.form.a018Property_Type.options[document.form.a018Property_Type.selectedIndex].value==""){\n');
document.write('  alert("Please enter Property Type");\n');
document.write('  document.form.a018Property_Type.focus();\n');
document.write('return false;\n');
document.write('}\n');
document.write('\n');
document.write('if (document.form.a020Property_Value.value==""){\n');
document.write('  alert("Please enter Property Value");\n');
document.write('  document.form.a020Property_Value.focus();\n');
document.write('return false;\n');
document.write('}\n');
document.write('*/\n');
document.write('}\n');
document.write('// -->\n');
document.write('</SCR' + 'IPT>\n');
document.write('\n');
document.write('		<TABLE CELLPADDING="0" CELLSPACING="0" BORDER="0" WIDTH="289"> \n');
document.write('			<TR>\n');
document.write('				<TD COLSPAN="3">\n');
document.write('					<TABLE CELLPADDING="0" CELLSPACING="0" BORDER="0" WIDTH="100%"> \n');
document.write('						<TR VALIGN="top"> \n');
document.write('							<TD><IMG SRC="http://images.agentcenter.com/img/mirada/blue/elements/top_left.gif" ALT=""></TD> \n');
document.write('							<TD STYLE="background-image:url(http://images.agentcenter.com/img/mirada/blue/elements/top_middle_bg.gif); background-repeat:repeat-x;" WIDTH="100%"><IMG SRC="http://images.agentcenter.com/img/mirada/blue/elements/top_quickquote.gif" ALT=""></TD> \n');
document.write('							<TD><IMG SRC="http://images.agentcenter.com/img/mirada/blue/elements/top_right.gif" ALT=""></TD> \n');
document.write('						</TR>\n');
document.write('					</TABLE></TD> \n');
document.write('			</TR> \n');
document.write('			<TR VALIGN="top"> \n');
document.write('				<TD STYLE="background:url(http://images.agentcenter.com/img/mirada/blue/elements/middle_left_bg.gif);"><IMG SRC="http://images.agentcenter.com/img/mirada/blue/elements/middle_left.gif" ALT=""></TD> \n');
document.write('				<TD CLASS="element" STYLE="padding:4px;width:100%;"> \n');
document.write('					<FORM ACTION="/cgi-bin/mailme_ordered2.cgi" METHOD="post" NAME="form" ONSUBMIT="return validate()">\n');
document.write('						<INPUT TYPE="hidden" NAME="_mailto" VALUE="lhf@eznet.net">\n');
document.write('<!-- Replace Mail Subject (VALUE) with the subject of the message -->\n');
document.write('						<INPUT TYPE="hidden" NAME="_mailsubject" VALUE="mis203302 Liberty Home Funding, Inc.  -- Quick Quote">\n');
document.write('<!-- Do not modify values below-->\n');
document.write('						<INPUT TYPE="hidden" NAME="_emailfield" VALUE="a006Email"> \n');
document.write('						<INPUT TYPE="hidden" NAME="_requiredfields" VALUE="_mailto"> \n');
document.write('						<INPUT TYPE="hidden" NAME="_orderdigits" VALUE="4"> \n');
document.write('						<INPUT TYPE="hidden" NAME="_formatted" VALUE="no"> \n');
document.write('						<INPUT TYPE="hidden" NAME="_URI" VALUE=""><!-- Custom Output Page Value -->\n');
document.write('						<INPUT TYPE="hidden" NAME="_endformpage" VALUE="/Thank_20_You.html">\n');
document.write('\n');
document.write('<!-- Auto Response Related -->\n');
document.write('<!--        <INPUT TYPE="hidden" NAME="_emailresponse" VALUE="RESPONSE EMAIL MESSAGE GOES HERE"> -->\n');
document.write('<!--        <INPUT TYPE="hidden" NAME="_responsesubject" VALUE="RESPONSE EMAIL SUBJECT LINE GOES HERE"> -->\n');
document.write('<!--        <INPUT TYPE="hidden" NAME="_responsefrom" VALUE="RESPONSE REPLY ADDRESS GOES HERE"> -->\n');
document.write('<!-- Thank You Page Message If No File -->\n');
document.write('<!--    <INPUT TYPE="hidden" NAME="_replytitle" VALUE=""> -->\n');
document.write('<!--    <INPUT TYPE="hidden" NAME="_replymessage" VALUE=""> -->\n');
document.write('						<TABLE STYLE="width:100%;margin-left:auto;margin-right:auto;" CELLPADDING="0" CELLSPACING="0" BORDER="0" CLASS="element"> \n');
document.write('							<TR> \n');
document.write('								<TD STYLE="width:100%;">First Name:<span class=asterisk>*</SPAN></TD> \n');
document.write('								<TD> \n');
document.write('									<INPUT TYPE="TEXT" class=input NAME="a002First_Name" VALUE=""></TD> \n');
document.write('							</TR> \n');
document.write('							<TR> \n');
document.write('								<TD>Last Name:<span class=asterisk>*</SPAN></TD> \n');
document.write('								<TD> \n');
document.write('									<INPUT TYPE="TEXT" class=input NAME="a004Last_Name" VALUE=""></TD> \n');
document.write('							</TR> \n');
document.write('							<TR> \n');
document.write('								<TD>E-Mail:<span class=asterisk>*</SPAN></TD> \n');
document.write('								<TD> \n');
document.write('									<INPUT TYPE="TEXT" class=input NAME="a006Email" VALUE=""></TD> \n');
document.write('							</TR> \n');
document.write('							<TR> \n');
document.write('								<TD>Phone:<span class=asterisk>*</SPAN></TD> \n');
document.write('								<TD> \n');
document.write('									<INPUT TYPE="TEXT" class=input NAME="a008Phone" VALUE=""></TD> \n');
document.write('							</TR> \n');
document.write('							<TR> \n');
document.write('								<TD>Loan Amount:</TD> \n');
document.write('								<TD> \n');
document.write('									<INPUT TYPE="TEXT" class=input NAME="a010Loan_Amount" VALUE=""></TD> \n');
document.write('							</TR> \n');
document.write('							<TR> \n');
document.write('								<TD>Loan Purpose:</TD> \n');
document.write('								<TD> \n');
document.write('									<SELECT NAME="a012Loan_Purpose" class=input> \n');
document.write('										<OPTION VALUE="" SELECTED="SELECTED">Please Select</OPTION> \n');
document.write('										<OPTION VALUE="Purchase">Purchase</OPTION> \n');
document.write('										<OPTION VALUE="Refinance">Refinance</OPTION> \n');
document.write('										<OPTION VALUE="Refinance & Cash Out">Refinance & Cash Out</OPTION> \n');
document.write('									</SELECT></TD> \n');
document.write('							</TR> \n');
document.write('							<TR> \n');
document.write('								<TD>Loan Program:</TD> \n');
document.write('								<TD> \n');
document.write('									<SELECT NAME="a014Loan_Program" class=input> \n');
document.write('										<OPTION VALUE="" SELECTED="SELECTED">Please Select</OPTION> \n');
document.write('										<OPTION VALUE="50 Year Fixed">50 Year Fixed</OPTION>\n');
document.write('										<OPTION VALUE="40 Year Fixed">40 Year Fixed</OPTION>\n');
document.write('										<OPTION VALUE="30 Year Fixed">30 Year Fixed</OPTION> \n');
document.write('										<OPTION VALUE="20 Year Fixed">20 Year Fixed</OPTION> \n');
document.write('										<OPTION VALUE="15 Year Fixed">15 Year Fixed</OPTION> \n');
document.write('										<OPTION VALUE="3/1 ARM">3/1 ARM</OPTION> \n');
document.write('										<OPTION VALUE="5/1 ARM">5/1 ARM</OPTION> \n');
document.write('										<OPTION VALUE="7/1 ARM">7/1 ARM</OPTION> \n');
document.write('										<OPTION VALUE="10/1 ARM">10/1 ARM</OPTION> \n');
document.write('										<OPTION VALUE="Adjustable">Adjustable</OPTION> \n');
document.write('										<OPTION VALUE="Interest Only">Interest Only</OPTION> \n');
document.write('									</SELECT></TD> \n');
document.write('							</TR> \n');
document.write('							<TR> \n');
document.write('								<TD>Property Use:</TD> \n');
document.write('								<TD> \n');
document.write('									<SELECT NAME="a016Property_Use" class=input> \n');
document.write('										<OPTION VALUE="" SELECTED="SELECTED">Please Select</OPTION> \n');
document.write('										<OPTION VALUE="Primary Residence">Primary Residence</OPTION> \n');
document.write('										<OPTION VALUE="Second Home">Second Home</OPTION> \n');
document.write('										<OPTION VALUE="Rental or Investment">Rental or Investment</OPTION> \n');
document.write('									</SELECT></TD> \n');
document.write('							</TR> \n');
document.write('							<TR> \n');
document.write('								<TD>Property Type:</TD> \n');
document.write('								<TD> \n');
document.write('									<SELECT NAME="a018Property_Type" class=input> \n');
document.write('										<OPTION VALUE="" SELECTED="SELECTED">Please Select</OPTION> \n');
document.write('										<OPTION VALUE="Co-Op">Co-Op</OPTION> \n');
document.write('										<OPTION VALUE="Other">Other</OPTION> \n');
document.write('									</SELECT></TD> \n');
document.write('							</TR> \n');
document.write('							<TR> \n');
document.write('								<TD>Property Value:</TD> \n');
document.write('								<TD> \n');
document.write('								<INPUT TYPE="TEXT" NAME="a020Property_Value" class=input VALUE=""></TD> \n');
document.write('							</TR> \n');
document.write('							<TR> \n');
document.write('								<TD COLSPAN="2"><span class=asterisk>*</SPAN> Required</TD> \n');
document.write('							</TR>\n');
document.write('							<tr><td height="10"></td></tr>\n');
document.write('							<TR> \n');
document.write('								<TD COLSPAN="2" ALIGN="center"><A HREF="javascr' + 'ipt:form.submit();" ONCLICK="return validate();"><IMG SRC="http://images.agentcenter.com/img/mirada/blue/elements/button2_sendinformation.gif" BORDER="0" STYLE="margin:0px;"></A></TD> \n');
document.write('							</TR> \n');
document.write('						</TABLE> </FORM> </TD> \n');
document.write('				<TD STYLE="background:url(http://images.agentcenter.com/img/mirada/blue/elements/middle_right_bg.gif);"><IMG SRC="http://images.agentcenter.com/img/mirada/blue/elements/middle_right_bg.gif" ALT=""></TD> \n');
document.write('			</TR> \n');
document.write('			<TR VALIGN="top"> \n');
document.write('				<TD COLSPAN="3">\n');
document.write('					<TABLE STYLE="width:100%;" CELLPADDING="0" CELLSPACING="0" BORDER="0"> \n');
document.write('						<TR>\n');
document.write('							<TD><IMG SRC="http://images.agentcenter.com/img/mirada/blue/elements/bottom_left.gif" ALT=""></TD> \n');
document.write('							<TD STYLE="background:url(http://images.agentcenter.com/img/mirada/blue/elements/bottom_middle_bg.gif);width:100%;"><IMG SRC="http://images.agentcenter.com/img/mirada/blue/elements/bottom_middle.gif" ALT=""></TD> \n');
document.write('							<TD><IMG SRC="http://images.agentcenter.com/img/mirada/blue/elements/bottom_right.gif" ALT=""></TD> \n');
document.write('						</TR>\n');
document.write('					</TABLE></TD> \n');
document.write('			</TR> \n');
document.write('		</TABLE>');