[et_pb_section fb_built=”1″ _builder_version=”3.9″ background_image=”https:\/\/wiggmax.com\/blog\/wp-content\/uploads\/2018\/09\/bg-main.gif” background_size=”initial” background_repeat=”repeat” custom_padding=”46px|0px|54px|0px|false|false”][et_pb_row custom_padding=”0|0px|27px|0px|false|false” _builder_version=”3.9″][et_pb_column type=”2_3″ _builder_version=”3.0.47″ parallax=”off” parallax_method=”on”][et_pb_blog show_author=”off” show_date=”off” _builder_version=”3.14″][\/et_pb_blog][\/et_pb_column][et_pb_column type=”1_3″ _builder_version=”3.0.47″ parallax=”off” parallax_method=”on”][et_pb_code _builder_version=”3.14″]<div class="form_container"><!– [et_pb_line_break_holder] –><div class="inner"><!– [et_pb_line_break_holder] –> <h1>Free Case Evaluation<\/h1><!– [et_pb_line_break_holder] –><p style="color: #fff !important; padding: 5px;">Fill out the form to receive a free confidential consultation<\/p><!– [et_pb_line_break_holder] –><div id="crmWebToEntityForm"><form accept-charset="UTF-8" action="https:\/\/crm.zoho.com\/crm\/WebToLeadForm" method="POST" name="WebToLeads1991924000000192001"><!– Do not remove this code. –><!– [et_pb_line_break_holder] –><input style="display: none;" name="xnQsjsdp" type="text" value="35b6a97e6862b7ca4b553c6eba7dd15cf486d94fd5de6c81e1419cf6d8c1bcaf" \/><!– [et_pb_line_break_holder] –><input id="zc_gad" name="zc_gad" type="hidden" value="" \/><!– [et_pb_line_break_holder] –><input style="display: none;" name="xmIwtLD" type="text" value="bf24775388658989fef8714b043727af1f181af99e15340449c7170ce18fa8a9" \/><!– [et_pb_line_break_holder] –><input style="display: none;" name="actionType" type="text" value="TGVhZHM=" \/><!– [et_pb_line_break_holder] –><!– [et_pb_line_break_holder] –><input style="display: none;" name="returnURL" type="text" value="https:\/\/wiggmax.com\/free-legal-consultation-thank-you\/" \/><!– [et_pb_line_break_holder] –><!– Do not remove this code. –><!– [et_pb_line_break_holder] –><!– [et_pb_line_break_holder] –><table><!– [et_pb_line_break_holder] –><tbody><!– [et_pb_line_break_holder] –><tr><!– [et_pb_line_break_holder] –><!– [et_pb_line_break_holder] –><td><input maxlength="100" name="Email" type="text" placeholder="Email" \/><\/td><!– [et_pb_line_break_holder] –><\/tr><!– [et_pb_line_break_holder] –><tr><!– [et_pb_line_break_holder] –><td><input maxlength="40" name="First Name" type="text" placeholder="First Name" \/><\/td><!– [et_pb_line_break_holder] –><\/tr><!– [et_pb_line_break_holder] –><tr><!– [et_pb_line_break_holder] –><td><input maxlength="80" name="Last Name" type="text" placeholder="Last Name" \/><\/td><!– [et_pb_line_break_holder] –><\/tr><!– [et_pb_line_break_holder] –><tr><!– [et_pb_line_break_holder] –><td><input maxlength="30" name="Phone" type="text" placeholder="Phone" \/><\/td><!– [et_pb_line_break_holder] –><\/tr><!– [et_pb_line_break_holder] –><tr><!– [et_pb_line_break_holder] –><td style="nowrap: nowrap; text-align: left; font-size: 12px; font-family: Arial;color:#fff; padding-left: 15%;">Case Type<span style="color: red;">*<\/span><\/td><!– [et_pb_line_break_holder] –><\/tr><!– [et_pb_line_break_holder] –><tr><!– [et_pb_line_break_holder] –><td><select name="LEADCF1"><!– [et_pb_line_break_holder] –><option value="USA Tax Issue">USA Tax Issue<\/option><!– [et_pb_line_break_holder] –><option value="International Taxes">International Taxes<\/option><!– [et_pb_line_break_holder] –><option value="Business Law">Business Law<\/option><!– [et_pb_line_break_holder] –><option value="Estates">Estates<\/option><!– [et_pb_line_break_holder] –><option value="Other">Other<\/option><!– [et_pb_line_break_holder] –><\/select><\/td><!– [et_pb_line_break_holder] –><\/tr><!– [et_pb_line_break_holder] –><tr><!– [et_pb_line_break_holder] –><td><textarea maxlength="1000" name="Description">Message<\/textarea><\/td><!– [et_pb_line_break_holder] –><\/tr><!– [et_pb_line_break_holder] –><tr><!– [et_pb_line_break_holder] –><td style="nowrap: nowrap; text-align: left; font-size: 12px; font-family: Arial ;color:#fff;padding-left: 15%;">Enter the Captcha<\/td><!– [et_pb_line_break_holder] –><\/tr><!– [et_pb_line_break_holder] –><tr><!– [et_pb_line_break_holder] –><td><input maxlength="80" name="enterdigest" type="text" \/><\/td><!– [et_pb_line_break_holder] –><\/tr><!– [et_pb_line_break_holder] –><tr><!– [et_pb_line_break_holder] –><!– Do not remove this code. –><!– [et_pb_line_break_holder] –><td style="padding-left: 15%;"><img id="imgid" src="https:\/\/crm.zoho.com\/crm\/CaptchaServlet?formId=bf24775388658989fef8714b043727af1f181af99e15340449c7170ce18fa8a9&grpid=35b6a97e6862b7ca4b553c6eba7dd15cf486d94fd5de6c81e1419cf6d8c1bcaf" \/><br><!– [et_pb_line_break_holder] –><a>Reload<\/a><\/td><!– [et_pb_line_break_holder] –><\/tr><!– [et_pb_line_break_holder] –><tr><!– [et_pb_line_break_holder] –><td style="text-align: center; padding-top: 15px;"><input style="font-size: 12px; color: #fff; width: 220px; clear: both; display: block; margin-bottom: 25px;" type="submit" value="Request Consultation Now" \/><\/td><!– [et_pb_line_break_holder] –><\/tr><!– [et_pb_line_break_holder] –><\/tbody><!– [et_pb_line_break_holder] –><\/table><!– [et_pb_line_break_holder] –><script><!– [et_pb_line_break_holder] –> var mndFileds=new Array('Last Name','Email','LEADCF1');<!– [et_pb_line_break_holder] –> var fldLangVal=new Array('Last Name','Email','Case Type');<!– [et_pb_line_break_holder] –> var name='';<!– [et_pb_line_break_holder] –> var email='';<!– [et_pb_line_break_holder] –><!– [et_pb_line_break_holder] –> \/ Do not remove this code. \/<!– [et_pb_line_break_holder] –> function reloadImg() {<!– [et_pb_line_break_holder] –> if(document.getElementById('imgid').src.indexOf('&d') !== -1 ) {<!– [et_pb_line_break_holder] –> document.getElementById('imgid').src=document.getElementById('imgid').src.substring(0,document.getElementById('imgid').src.indexOf('&d'))+'&d'+new Date().getTime();<!– [et_pb_line_break_holder] –> } else {<!– [et_pb_line_break_holder] –> document.getElementById('imgid').src = document.getElementById('imgid').src+'&d'+new Date().getTime();<!– [et_pb_line_break_holder] –> } <!– [et_pb_line_break_holder] –> }<!– [et_pb_line_break_holder] –><!– [et_pb_line_break_holder] –> function checkMandatory() {<!– [et_pb_line_break_holder] –> for(i=0;i<mndFileds.length;i++) {<!– [et_pb_line_break_holder] –> var fieldObj=document.forms['WebToLeads1991924000000192001'][mndFileds[i]];<!– [et_pb_line_break_holder] –> if(fieldObj) {<!– [et_pb_line_break_holder] –> if (((fieldObj.value).replace(\/^\\s+|\\s+$\/g, '')).length==0) {<!– [et_pb_line_break_holder] –> if(fieldObj.type =='file')<!– [et_pb_line_break_holder] –> { <!– [et_pb_line_break_holder] –> alert('Please select a file to upload.'); <!– [et_pb_line_break_holder] –> fieldObj.focus(); <!– [et_pb_line_break_holder] –> return false;<!– [et_pb_line_break_holder] –> } <!– [et_pb_line_break_holder] –> alert(fldLangVal[i] +' cannot be empty.'); <!– [et_pb_line_break_holder] –> fieldObj.focus();<!– [et_pb_line_break_holder] –> return false;<!– [et_pb_line_break_holder] –> } else if(fieldObj.nodeName=='SELECT') {<!– [et_pb_line_break_holder] –> if(fieldObj.options[fieldObj.selectedIndex].value=='-None-') {<!– [et_pb_line_break_holder] –> alert(fldLangVal[i] +' cannot be none.'); <!– [et_pb_line_break_holder] –> fieldObj.focus();<!– [et_pb_line_break_holder] –> return false;<!– [et_pb_line_break_holder] –> }<!– [et_pb_line_break_holder] –> } else if(fieldObj.type =='checkbox'){<!– [et_pb_line_break_holder] –> if(fieldObj.checked == false){<!– [et_pb_line_break_holder] –> alert('Please accept '+fldLangVal[i]);<!– [et_pb_line_break_holder] –> fieldObj.focus();<!– [et_pb_line_break_holder] –> return false;<!– [et_pb_line_break_holder] –> } <!– [et_pb_line_break_holder] –> } <!– [et_pb_line_break_holder] –> try {<!– [et_pb_line_break_holder] –> if(fieldObj.name == 'Last Name') {<!– [et_pb_line_break_holder] –> name = fieldObj.value;<!– [et_pb_line_break_holder] –> }<!– [et_pb_line_break_holder] –> } catch (e) {}<!– [et_pb_line_break_holder] –> }<!– [et_pb_line_break_holder] –> }<!– [et_pb_line_break_holder] –> }<!– [et_pb_line_break_holder] –> <!– [et_pb_line_break_holder] –><\/script><!– [et_pb_line_break_holder] –><!– [et_pb_line_break_holder] –><\/form><!– Do not remove this code. –><!– [et_pb_line_break_holder] –><iframe style="display: none;" name="captchaFrame"><\/iframe><!– [et_pb_line_break_holder] –><div style="clear:both"><!– [et_pb_line_break_holder] –><\/div><!– [et_pb_line_break_holder] –><\/div><!– [et_pb_line_break_holder] –><\/div><\/div><!– [et_pb_line_break_holder] –><div style="clear:both"><!– [et_pb_line_break_holder] –><\/div><!– [et_pb_line_break_holder] –><style><!– [et_pb_line_break_holder] –>.form_container tr td {<!– [et_pb_line_break_holder] –> padding: 6px 24px;<!– [et_pb_line_break_holder] –> border-top: none;<!– [et_pb_line_break_holder] –>}<!– [et_pb_line_break_holder] –> .form_container table {<!– [et_pb_line_break_holder] –> width: 100%;<!– [et_pb_line_break_holder] –> margin: auto;<!– [et_pb_line_break_holder] –> border: none;<!– [et_pb_line_break_holder] –> text-align: left;<!– [et_pb_line_break_holder] –>}<!– [et_pb_line_break_holder] –>.form_container {<!– [et_pb_line_break_holder] –> background: none repeat scroll 0 0 #0068a5;<!– [et_pb_line_break_holder] –> float: left;<!– [et_pb_line_break_holder] –> padding: 30px 0;<!– [et_pb_line_break_holder] –> text-align: center;<!– [et_pb_line_break_holder] –> width: 100%;<!– [et_pb_line_break_holder] –>}<!– [et_pb_line_break_holder] –>.contact_form table td {<!– [et_pb_line_break_holder] –> padding: 0!important;<!– [et_pb_line_break_holder] –> border-top: none!important;<!– [et_pb_line_break_holder] –> width:250px;<!– [et_pb_line_break_holder] –>}<!– [et_pb_line_break_holder] –>.contact_form input[type="text"], .contact_form input[type="email"] {<!– [et_pb_line_break_holder] –> background: none repeat scroll 0 0 #033f62;<!– [et_pb_line_break_holder] –> border: medium none;<!– [et_pb_line_break_holder] –> color: #d3d3d3;<!– [et_pb_line_break_holder] –> font-family: "Raleway",sans-serif;<!– [et_pb_line_break_holder] –> font-size: 18px;<!– [et_pb_line_break_holder] –> margin: 0 0 10px;<!– [et_pb_line_break_holder] –> padding: 5px !important;<!– [et_pb_line_break_holder] –>}<!– [et_pb_line_break_holder] –>input.text, input.title, input[type=text], select, textarea {<!– [et_pb_line_break_holder] –> width: 200px;<!– [et_pb_line_break_holder] –> margin: auto;<!– [et_pb_line_break_holder] –>}<!– [et_pb_line_break_holder] –> <!– [et_pb_line_break_holder] –>.contact_form table {<!– [et_pb_line_break_holder] –> width: 100%;<!– [et_pb_line_break_holder] –> margin: auto;<!– [et_pb_line_break_holder] –> border: none;<!– [et_pb_line_break_holder] –> text-align: left;<!– [et_pb_line_break_holder] –>}<!– [et_pb_line_break_holder] –>.form_container span {<!– [et_pb_line_break_holder] –> display: initial;<!– [et_pb_line_break_holder] –> font-size: 24px;<!– [et_pb_line_break_holder] –>}<!– [et_pb_line_break_holder] –>input.text, input.title, input[type=text], select, textarea {<!– [et_pb_line_break_holder] –> width: 80%;<!– [et_pb_line_break_holder] –> margin: auto !important;<!– [et_pb_line_break_holder] –> display: block;<!– [et_pb_line_break_holder] –> padding: 10px !important;<!– [et_pb_line_break_holder] –>}<!– [et_pb_line_break_holder] –>.contact_form input[type="submit"] {<!– [et_pb_line_break_holder] –> background: none repeat scroll 0 0 rgba(0,0,0,0);<!– [et_pb_line_break_holder] –> border: 3px solid #fff;<!– [et_pb_line_break_holder] –> color: #fff;<!– [et_pb_line_break_holder] –> cursor: pointer;<!– [et_pb_line_break_holder] –> font-family: "Raleway",sans-serif;<!– [et_pb_line_break_holder] –> font-size: 16px;<!– [et_pb_line_break_holder] –> font-weight: 700;<!– [et_pb_line_break_holder] –> padding: 11px;<!– [et_pb_line_break_holder] –> text-align: center;<!– [et_pb_line_break_holder] –> width: 100%;<!– [et_pb_line_break_holder] –>}<!– [et_pb_line_break_holder] –>.form_container input[type="submit"] {<!– [et_pb_line_break_holder] –> font-size: 14px !important;<!– [et_pb_line_break_holder] –> color: #fff;<!– [et_pb_line_break_holder] –> width: 220px;<!– [et_pb_line_break_holder] –> clear: both;<!– [et_pb_line_break_holder] –> display: block;<!– [et_pb_line_break_holder] –> margin-bottom: 25px;<!– [et_pb_line_break_holder] –> background: transparent;<!– [et_pb_line_break_holder] –> margin: auto;<!– [et_pb_line_break_holder] –> padding: 10px;<!– [et_pb_line_break_holder] –> font-weight: bold;<!– [et_pb_line_break_holder] –>}<!– [et_pb_line_break_holder] –><\/style>[\/et_pb_code][et_pb_code _builder_version=”3.14″ custom_padding=”|20px||20px” custom_margin=”20px|||” background_color=”#ffffff”]