function validEmail(txt)
{
return refind("(^([A-Za-z0-9_\-\.])+\@([A-Za-z0-9_\-\.])+\.([A-Za-z]{2,4})$)",txt);
}
function trimNonNumbers(txt){
return rereplace(txt,'(\D)', '',"ALL");
}
function isValidPhone(txt){
var stripped = trimNonNumbers(txt);
if (not isNumeric(stripped) OR len(stripped) neq 10)
return false;
return true;
}
Free Quote Request:
*************** Submittor Information ***************
Contact Information
First Name: #form.firstname#
Email: #form.email#
Primary Phone: #form.phone#
Cell Phone: #form.cellphone#
Best Time to Call: #form.timetocall#
Primary Address: #form.address#
City: #form.city#
State: #form.state#
Zip: #form.zip#
Information About Your Payments
I Receive: #form.ireceive#
Payments of: #form.paymentsof#
Dates:
First Payment Date: #form.firstpaydate#
Last Payment Date: #form.lastpaydate#
Lump Sum Payments Information
Date: #form.date1#
Amount: #form.amount1#
Date: #form.date2#
Amount: #form.amount2#
Date: #form.date3#
Amount: #form.amount3#
Date: #form.date4#
Amount: #form.amount4#
Additional Comments
Name of Insurance Company or Entity Making Payments to You: #form.insurance#
Additional Comments or Information: #form.comments#
Structured Settlement Analysis at Covered Bridge Capital, LLC
The following form errors have been found:
#errors#
You have successfully submitted your application.
Proud sponsor and Hero Partner of the Pennsylvania Association for Justice (formerly, Pennsylvania Trial Lawyers Association)
