www.capitalfinancialusa.com
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Submitted URL: https://5starfinancialcamp.com/
Effective URL: https://www.capitalfinancialusa.com/
Submission: On September 01 via api from US — Scanned from US
Effective URL: https://www.capitalfinancialusa.com/
Submission: On September 01 via api from US — Scanned from US
Form analysis 8 forms found in the DOM
POST /#gf_21
<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_21" id="gform_21" action="/#gf_21" data-formid="21" novalidate="">
<div class="gform-body gform_body">
<div id="gform_fields_21" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_21_1" class="gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_21_1">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row" id="input_21_1">
<span id="input_21_1_3_container" class="name_first gform-grid-col gform-grid-col--size-auto">
<input type="text" name="input_1.3" id="input_21_1_3" value="" aria-required="true">
<label for="input_21_1_3" class="gform-field-label gform-field-label--type-sub ">First</label>
</span>
<span id="input_21_1_6_container" class="name_last gform-grid-col gform-grid-col--size-auto">
<input type="text" name="input_1.6" id="input_21_1_6" value="" aria-required="true">
<label for="input_21_1_6" class="gform-field-label gform-field-label--type-sub ">Last</label>
</span>
</div>
</fieldset>
<div id="field_21_2" class="gfield gfield--type-phone gfield--input-type-phone gf_left_half gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_21_2"><label class="gfield_label gform-field-label" for="input_21_2">Phone</label>
<div class="ginput_container ginput_container_phone"><input name="input_2" id="input_21_2" type="tel" value="" class="medium" aria-invalid="false"></div>
</div>
<div id="field_21_3"
class="gfield gfield--type-email gfield--input-type-email gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_21_3"><label class="gfield_label gform-field-label" for="input_21_3">Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_3" id="input_21_3" type="email" value="" class="medium" aria-required="true" aria-invalid="false">
</div>
</div>
<div id="field_21_5" class="gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_21_5"><label
class="gfield_label gform-field-label" for="input_21_5">Question</label>
<div class="ginput_container ginput_container_textarea"><textarea name="input_5" id="input_21_5" class="textarea medium" aria-invalid="false" rows="10" cols="50"></textarea></div>
</div>
<fieldset id="field_21_8"
class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible"
data-js-reload="field_21_8">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Consent</legend>
<div class="ginput_container ginput_container_consent"><input name="input_8.1" id="input_21_8_1" type="checkbox" value="1" aria-invalid="false"> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label"
for="input_21_8_1">I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply.
<a href="https://www.capitalfinancialusa.com/privacy-policy" target="_blank">Privacy Policy</a></label><input type="hidden" name="input_8.2"
value="I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply. <a href="https://www.capitalfinancialusa.com/privacy-policy" target="_blank">Privacy Policy</a>"
class="gform_hidden"><input type="hidden" name="input_8.3" value="97" class="gform_hidden"></div>
</fieldset>
<div id="field_21_7" class="gfield gfield--type-captcha gfield--input-type-captcha field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible" data-js-reload="field_21_7">
<label class="gfield_label gform-field-label" for="input_21_7">CAPTCHA</label>
<div id="input_21_7" class="ginput_container ginput_recaptcha gform-initialized" data-sitekey="6Lc9U1AdAAAAAA_8EgB9epZWugG1_sCtIjVvxJ3R" data-theme="light" data-tabindex="0" data-badge="">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-5taw375uxpw8" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6Lc9U1AdAAAAAA_8EgB9epZWugG1_sCtIjVvxJ3R&co=aHR0cHM6Ly93d3cuY2FwaXRhbGZpbmFuY2lhbHVzYS5jb206NDQz&hl=en&v=WV-mUKO4xoWKy9M4ZzRyNrP_&theme=light&size=normal&cb=hufxnko29dje"></iframe>
</div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div>
</div>
</div>
</div>
</div>
<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_21" class="gform_button button" value="Submit"
onclick="if(window["gf_submitting_21"]){return false;} if( !jQuery("#gform_21")[0].checkValidity || jQuery("#gform_21")[0].checkValidity()){window["gf_submitting_21"]=true;} "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_21"]){return false;} if( !jQuery("#gform_21")[0].checkValidity || jQuery("#gform_21")[0].checkValidity()){window["gf_submitting_21"]=true;} jQuery("#gform_21").trigger("submit",[true]); }">
<input type="hidden" name="gform_ajax" value="form_id=21&title=1&description=1&tabindex=0&theme=orbital">
<input type="hidden" class="gform_hidden" name="is_submit_21" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="21">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_21"
value="WyJ7XCI4LjFcIjpcIjExODA5YjE5YWUyNTcwMDhiOWVjN2VlMWRjNTdkZGY5XCIsXCI4LjJcIjpcImM4MWQ2MjYzMDkxMDIxZTU2ZGY1MWI3NzNmMjg5ZGU0XCIsXCI4LjNcIjpcIjYwNmExZWVmMTdiZGRlMjNmYThjN2RiNzZkNmU4YTZmXCJ9IiwiMjIyMmM3ZDk1MmVkYzI5YTZkNDNiZGUxY2E2Y2Y4ZDkiXQ==">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_21" id="gform_target_page_number_21" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_21" id="gform_source_page_number_21" value="1">
<input type="hidden" name="gform_field_values" value="">
</div>
</form>POST /#gf_108
<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_108" id="gform_108" action="/#gf_108" data-formid="108" novalidate="">
<div id="gf_progressbar_wrapper_108" class="gf_progressbar_wrapper" data-start-at-zero="">
<p class="gf_progressbar_title">Step <span class="gf_step_current_page">1</span> of <span class="gf_step_page_count">6</span>
</p>
<div class="gf_progressbar gf_progressbar_blue" aria-hidden="true">
<div class="gf_progressbar_percentage percentbar_blue percentbar_16" style="width:16%;"><span>16%</span></div>
</div>
</div>
<div class="gform-body gform_body">
<div id="gform_page_108_1" class="gform_page " data-js="page-field-id-1">
<div class="gform_page_fields">
<div id="gform_fields_108" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_108_14" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_108_14">
<legend class="gfield_label gform-field-label">Are you currently working with a financial planner?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_108_14">
<div class="gchoice gchoice_108_14_0">
<input class="gfield-choice-input" name="input_14" type="radio" value="Yes" id="choice_108_14_0" onchange="gformToggleRadioOther( this )">
<label for="choice_108_14_0" id="label_108_14_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_108_14_1">
<input class="gfield-choice-input" name="input_14" type="radio" value="No" id="choice_108_14_1" onchange="gformToggleRadioOther( this )">
<label for="choice_108_14_1" id="label_108_14_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_next_button_108_20" class="gform_next_button gform-theme-button button" value="Next"
onclick="jQuery("#gform_target_page_number_108").val("2"); jQuery("#gform_108").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_108").val("2"); jQuery("#gform_108").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_108_2" class="gform_page" data-js="page-field-id-20" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_108_2" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_108_15"
class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_108_15">
<legend class="gfield_label gform-field-label">Are you retired?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_108_15">
<div class="gchoice gchoice_108_15_0">
<input class="gfield-choice-input" name="input_15" type="radio" value="Yes" id="choice_108_15_0" onchange="gformToggleRadioOther( this )">
<label for="choice_108_15_0" id="label_108_15_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_108_15_1">
<input class="gfield-choice-input" name="input_15" type="radio" value="No" id="choice_108_15_1" onchange="gformToggleRadioOther( this )">
<label for="choice_108_15_1" id="label_108_15_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_108_21" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_108").val("1"); jQuery("#gform_108").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_108").val("1"); jQuery("#gform_108").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_108_21"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_108").val("3"); jQuery("#gform_108").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_108").val("3"); jQuery("#gform_108").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_108_3" class="gform_page" data-js="page-field-id-21" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_108_3" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_108_8"
class="gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_108_8">
<legend class="gfield_label gform-field-label gfield_label_before_complex">What is your name?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row" id="input_108_8">
<span id="input_108_8_3_container" class="name_first gform-grid-col gform-grid-col--size-auto">
<input type="text" name="input_8.3" id="input_108_8_3" value="" aria-required="true" autocomplete="given-name">
<label for="input_108_8_3" class="gform-field-label gform-field-label--type-sub ">First</label>
</span>
<span id="input_108_8_6_container" class="name_last gform-grid-col gform-grid-col--size-auto">
<input type="text" name="input_8.6" id="input_108_8_6" value="" aria-required="true" autocomplete="family-name">
<label for="input_108_8_6" class="gform-field-label gform-field-label--type-sub ">Last</label>
</span>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_108_22" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_108").val("2"); jQuery("#gform_108").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_108").val("2"); jQuery("#gform_108").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_108_22"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_108").val("4"); jQuery("#gform_108").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_108").val("4"); jQuery("#gform_108").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_108_4" class="gform_page" data-js="page-field-id-22" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_108_4" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_108_16"
class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_108_16">
<legend class="gfield_label gform-field-label">What are you total estimated investable assets?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_108_16">
<div class="gchoice gchoice_108_16_0">
<input class="gfield-choice-input" name="input_16" type="radio" value="Less than $100,000" id="choice_108_16_0" onchange="gformToggleRadioOther( this )">
<label for="choice_108_16_0" id="label_108_16_0" class="gform-field-label gform-field-label--type-inline">Less than $100,000</label>
</div>
<div class="gchoice gchoice_108_16_1">
<input class="gfield-choice-input" name="input_16" type="radio" value="$100,000 - $250,000" id="choice_108_16_1" onchange="gformToggleRadioOther( this )">
<label for="choice_108_16_1" id="label_108_16_1" class="gform-field-label gform-field-label--type-inline">$100,000 - $250,000</label>
</div>
<div class="gchoice gchoice_108_16_2">
<input class="gfield-choice-input" name="input_16" type="radio" value="$250,000 - $500,000" id="choice_108_16_2" onchange="gformToggleRadioOther( this )">
<label for="choice_108_16_2" id="label_108_16_2" class="gform-field-label gform-field-label--type-inline">$250,000 - $500,000</label>
</div>
<div class="gchoice gchoice_108_16_3">
<input class="gfield-choice-input" name="input_16" type="radio" value="$500,000 - $1,000,000" id="choice_108_16_3" onchange="gformToggleRadioOther( this )">
<label for="choice_108_16_3" id="label_108_16_3" class="gform-field-label gform-field-label--type-inline">$500,000 - $1,000,000</label>
</div>
<div class="gchoice gchoice_108_16_4">
<input class="gfield-choice-input" name="input_16" type="radio" value="More than $1,000,000" id="choice_108_16_4" onchange="gformToggleRadioOther( this )">
<label for="choice_108_16_4" id="label_108_16_4" class="gform-field-label gform-field-label--type-inline">More than $1,000,000</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_108_23" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_108").val("3"); jQuery("#gform_108").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_108").val("3"); jQuery("#gform_108").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_108_23"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_108").val("5"); jQuery("#gform_108").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_108").val("5"); jQuery("#gform_108").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_108_5" class="gform_page" data-js="page-field-id-23" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_108_5" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_108_19" class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_108_19">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Is there anything specific you would like to discuss?</legend>
<div class="ginput_container ginput_container_checkbox">
<div class="gfield_checkbox" id="input_108_19">
<div class="gchoice gchoice_108_19_1">
<input class="gfield-choice-input" name="input_19.1" type="checkbox" value="Retirement Planning" id="choice_108_19_1">
<label for="choice_108_19_1" id="label_108_19_1" class="gform-field-label gform-field-label--type-inline">Retirement Planning</label>
</div>
<div class="gchoice gchoice_108_19_2">
<input class="gfield-choice-input" name="input_19.2" type="checkbox" value="Improving Investment Strategy" id="choice_108_19_2">
<label for="choice_108_19_2" id="label_108_19_2" class="gform-field-label gform-field-label--type-inline">Improving Investment Strategy</label>
</div>
<div class="gchoice gchoice_108_19_3">
<input class="gfield-choice-input" name="input_19.3" type="checkbox" value="Estate Planning" id="choice_108_19_3">
<label for="choice_108_19_3" id="label_108_19_3" class="gform-field-label gform-field-label--type-inline">Estate Planning</label>
</div>
<div class="gchoice gchoice_108_19_4">
<input class="gfield-choice-input" name="input_19.4" type="checkbox" value="Reviewing Insurance Coverage" id="choice_108_19_4">
<label for="choice_108_19_4" id="label_108_19_4" class="gform-field-label gform-field-label--type-inline">Reviewing Insurance Coverage</label>
</div>
<div class="gchoice gchoice_108_19_5">
<input class="gfield-choice-input" name="input_19.5" type="checkbox" value="High-Net-Worth Investing" id="choice_108_19_5">
<label for="choice_108_19_5" id="label_108_19_5" class="gform-field-label gform-field-label--type-inline">High-Net-Worth Investing</label>
</div>
<div class="gchoice gchoice_108_19_6">
<input class="gfield-choice-input" name="input_19.6" type="checkbox" value="Tax Planning" id="choice_108_19_6">
<label for="choice_108_19_6" id="label_108_19_6" class="gform-field-label gform-field-label--type-inline">Tax Planning</label>
</div>
<div class="gchoice gchoice_108_19_7">
<input class="gfield-choice-input" name="input_19.7" type="checkbox" value="Second Opinion Review" id="choice_108_19_7">
<label for="choice_108_19_7" id="label_108_19_7" class="gform-field-label gform-field-label--type-inline">Second Opinion Review</label>
</div>
<div class="gchoice gchoice_108_19_8">
<input class="gfield-choice-input" name="input_19.8" type="checkbox" value="Fee Analysis" id="choice_108_19_8">
<label for="choice_108_19_8" id="label_108_19_8" class="gform-field-label gform-field-label--type-inline">Fee Analysis</label>
</div>
<div class="gchoice gchoice_108_19_9">
<input class="gfield-choice-input" name="input_19.9" type="checkbox" value="Lifetime Income Plan" id="choice_108_19_9">
<label for="choice_108_19_9" id="label_108_19_9" class="gform-field-label gform-field-label--type-inline">Lifetime Income Plan</label>
</div>
<div class="gchoice gchoice_108_19_11">
<input class="gfield-choice-input" name="input_19.11" type="checkbox" value="Spend & Leave Plan" id="choice_108_19_11">
<label for="choice_108_19_11" id="label_108_19_11" class="gform-field-label gform-field-label--type-inline">Spend & Leave Plan</label>
</div>
<div class="gchoice gchoice_108_19_12">
<input class="gfield-choice-input" name="input_19.12" type="checkbox" value="Roth Conversion Strategy" id="choice_108_19_12">
<label for="choice_108_19_12" id="label_108_19_12" class="gform-field-label gform-field-label--type-inline">Roth Conversion Strategy</label>
</div>
<div class="gchoice gchoice_108_19_13">
<input class="gfield-choice-input" name="input_19.13" type="checkbox" value="IUL Strategy" id="choice_108_19_13">
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<p>Great! What is the best way for us to reach out to you to set up a meeting?</p>
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for="input_108_29_1">I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may
apply. <a href="https://www.capitalfinancialusa.com/privacy-policy" target="_blank">Privacy Policy</a></label><input type="hidden" name="input_29.2"
value="I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply. <a href="https://www.capitalfinancialusa.com/privacy-policy" target="_blank">Privacy Policy</a>"
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for="input_111_9_1">I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply.
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value="I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply. <a href="https://www.capitalfinancialusa.com/privacy-policy" target="_blank">Privacy Policy</a>"
class="gform_hidden"><input type="hidden" name="input_9.3" value="106" class="gform_hidden"></div>
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<div class="ginput_container"><input name="input_10" id="input_111_10" type="text" value="" autocomplete="new-password"></div>
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for="input_111_9_1">I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply.
<a href="https://www.capitalfinancialusa.com/privacy-policy" target="_blank">Privacy Policy</a></label><input type="hidden" name="input_9.2"
value="I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply. <a href="https://www.capitalfinancialusa.com/privacy-policy" target="_blank">Privacy Policy</a>"
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<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_111" class="gform_button button" value="Register"
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onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_111"]){return false;} if( !jQuery("#gform_111")[0].checkValidity || jQuery("#gform_111")[0].checkValidity()){window["gf_submitting_111"]=true;} jQuery("#gform_111").trigger("submit",[true]); }">
<input type="hidden" class="gform_hidden" name="is_submit_111" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="111">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_111"
value="WyJ7XCI5LjFcIjpcIjExODA5YjE5YWUyNTcwMDhiOWVjN2VlMWRjNTdkZGY5XCIsXCI5LjJcIjpcImM4MWQ2MjYzMDkxMDIxZTU2ZGY1MWI3NzNmMjg5ZGU0XCIsXCI5LjNcIjpcIjM2ZmQzZTI3MzRiOTE4M2I5MzE5NmZlNzhlOGM3NGY3XCJ9IiwiZWZlOGI2MzgwMGE0ODU1NjY4YTcwNTFlOWNlNzE5ODgiXQ==">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_111" id="gform_target_page_number_111" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_111" id="gform_source_page_number_111" value="1">
<input type="hidden" name="gform_field_values" value="">
</div>
</form>POST /
<form method="post" enctype="multipart/form-data" id="gform_104" action="/" data-formid="104" novalidate="">
<div class="gform-body gform_body">
<ul id="gform_fields_104" class="gform_fields top_label form_sublabel_below description_below validation_below">
<li id="field_104_1" class="gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_104_1"><label class="gfield_label gform-field-label gfield_label_before_complex">First Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name no_last_name no_suffix gf_name_has_1 ginput_container_name gform-grid-row" id="input_104_1">
<span id="input_104_1_3_container" class="name_first gform-grid-col gform-grid-col--size-auto">
<input type="text" name="input_1.3" id="input_104_1_3" value="" aria-required="true" autocomplete="given-name">
<label for="input_104_1_3" class="gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text">First</label>
</span>
</div>
</li>
<li id="field_104_8"
class="gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_104_8"><label class="gfield_label gform-field-label gfield_label_before_complex">Last Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_complex ginput_container ginput_container--name no_prefix no_first_name no_middle_name has_last_name no_suffix gf_name_has_1 ginput_container_name gform-grid-row" id="input_104_8">
<span id="input_104_8_6_container" class="name_last gform-grid-col gform-grid-col--size-auto">
<input type="text" name="input_8.6" id="input_104_8_6" value="" aria-required="true" autocomplete="family-name">
<label for="input_104_8_6" class="gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text">Last</label>
</span>
</div>
</li>
<li id="field_104_3" class="gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_104_3"><label class="gfield_label gform-field-label" for="input_104_3">Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_3" id="input_104_3" type="email" value="" class="large" aria-required="true" aria-invalid="false" autocomplete="email">
</div>
</li>
<li id="field_104_2" class="gfield gfield--type-phone gfield--input-type-phone field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_104_2"><label
class="gfield_label gform-field-label" for="input_104_2">Phone</label>
<div class="ginput_container ginput_container_phone"><input name="input_2" id="input_104_2" type="tel" value="" class="large" aria-invalid="false" autocomplete="tel"></div>
</li>
<li id="field_104_9"
class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible"
data-js-reload="field_104_9"><label class="gfield_label gform-field-label gfield_label_before_complex">Consent</label>
<div class="ginput_container ginput_container_consent"><input name="input_9.1" id="input_104_9_1" type="checkbox" value="1" aria-invalid="false"> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label"
for="input_104_9_1">I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply.
<a href="https://www.capitalfinancialusa.com/privacy-policy" target="_blank">Privacy Policy</a></label><input type="hidden" name="input_9.2"
value="I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply. <a href="https://www.capitalfinancialusa.com/privacy-policy" target="_blank">Privacy Policy</a>"
class="gform_hidden"><input type="hidden" name="input_9.3" value="102" class="gform_hidden"></div>
</li>
<li id="field_104_10" class="gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_104_10"><label
class="gfield_label gform-field-label" for="input_104_10">Comments</label>
<div class="ginput_container"><input name="input_10" id="input_104_10" type="text" value="" autocomplete="new-password"></div>
<div class="gfield_description" id="gfield_description_104_10">This field is for validation purposes and should be left unchanged.</div>
</li>
</ul>
</div>
<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_104" class="gform_button button" value="Register"
onclick="if(window["gf_submitting_104"]){return false;} if( !jQuery("#gform_104")[0].checkValidity || jQuery("#gform_104")[0].checkValidity()){window["gf_submitting_104"]=true;} "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_104"]){return false;} if( !jQuery("#gform_104")[0].checkValidity || jQuery("#gform_104")[0].checkValidity()){window["gf_submitting_104"]=true;} jQuery("#gform_104").trigger("submit",[true]); }">
<input type="hidden" class="gform_hidden" name="is_submit_104" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="104">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_104"
value="WyJ7XCI5LjFcIjpcIjExODA5YjE5YWUyNTcwMDhiOWVjN2VlMWRjNTdkZGY5XCIsXCI5LjJcIjpcImM4MWQ2MjYzMDkxMDIxZTU2ZGY1MWI3NzNmMjg5ZGU0XCIsXCI5LjNcIjpcIjEzMzU2OTg3ODYwNGE0MjRkYjNhZmQ2MTIwN2Y5MGUzXCJ9IiwiN2VmMWJiZjM3MTliOWJkODdkODU4ZmY0NTg5ODUzYWMiXQ==">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_104" id="gform_target_page_number_104" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_104" id="gform_source_page_number_104" value="1">
<input type="hidden" name="gform_field_values" value="">
</div>
</form>POST /
<form method="post" enctype="multipart/form-data" id="gform_102" action="/" data-formid="102" novalidate="">
<div class="gform-body gform_body">
<ul id="gform_fields_102" class="gform_fields top_label form_sublabel_below description_below validation_below">
<li id="field_102_1" class="gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_102_1"><label class="gfield_label gform-field-label gfield_label_before_complex">Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row" id="input_102_1">
<span id="input_102_1_3_container" class="name_first gform-grid-col gform-grid-col--size-auto">
<input type="text" name="input_1.3" id="input_102_1_3" value="" aria-required="true">
<label for="input_102_1_3" class="gform-field-label gform-field-label--type-sub ">First</label>
</span>
<span id="input_102_1_6_container" class="name_last gform-grid-col gform-grid-col--size-auto">
<input type="text" name="input_1.6" id="input_102_1_6" value="" aria-required="true">
<label for="input_102_1_6" class="gform-field-label gform-field-label--type-sub ">Last</label>
</span>
</div>
</li>
<li id="field_102_2"
class="gfield gfield--type-email gfield--input-type-email gfield--width-full gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_102_2"><label class="gfield_label gform-field-label" for="input_102_2">Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_2" id="input_102_2" type="email" value="" class="medium" aria-required="true" aria-invalid="false">
</div>
</li>
<li id="field_102_3" class="gfield gfield--type-phone gfield--input-type-phone gfield--width-full gf_right_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_102_3"><label class="gfield_label gform-field-label" for="input_102_3">Phone</label>
<div class="ginput_container ginput_container_phone"><input name="input_3" id="input_102_3" type="tel" value="" class="medium" aria-invalid="false"></div>
</li>
<li id="field_102_7"
class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible"
data-js-reload="field_102_7"><label class="gfield_label gform-field-label gfield_label_before_complex">Consent</label>
<div class="ginput_container ginput_container_consent"><input name="input_7.1" id="input_102_7_1" type="checkbox" value="1" aria-invalid="false"> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label"
for="input_102_7_1">I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply.
<a href="https://www.capitalfinancialusa.com/privacy-policy" target="_blank">Privacy Policy</a></label><input type="hidden" name="input_7.2"
value="I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply. <a href="https://www.capitalfinancialusa.com/privacy-policy" target="_blank">Privacy Policy</a>"
class="gform_hidden"><input type="hidden" name="input_7.3" value="25" class="gform_hidden"></div>
</li>
<li id="field_102_6" class="gfield gfield--type-captcha gfield--input-type-captcha field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible" data-js-reload="field_102_6">
<label class="gfield_label gform-field-label" for="input_102_6">CAPTCHA</label>
<div id="input_102_6" class="ginput_container ginput_recaptcha gform-initialized" data-sitekey="6Lc9U1AdAAAAAA_8EgB9epZWugG1_sCtIjVvxJ3R" data-theme="light" data-tabindex="0" data-badge="">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-yce4eel4h60n" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6Lc9U1AdAAAAAA_8EgB9epZWugG1_sCtIjVvxJ3R&co=aHR0cHM6Ly93d3cuY2FwaXRhbGZpbmFuY2lhbHVzYS5jb206NDQz&hl=en&v=WV-mUKO4xoWKy9M4ZzRyNrP_&theme=light&size=normal&cb=uu8n4iknchnu"></iframe>
</div><textarea id="g-recaptcha-response-1" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div>
</div>
</li>
</ul>
</div>
<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_102" class="gform_button button" value="Download Now"
onclick="if(window["gf_submitting_102"]){return false;} if( !jQuery("#gform_102")[0].checkValidity || jQuery("#gform_102")[0].checkValidity()){window["gf_submitting_102"]=true;} "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_102"]){return false;} if( !jQuery("#gform_102")[0].checkValidity || jQuery("#gform_102")[0].checkValidity()){window["gf_submitting_102"]=true;} jQuery("#gform_102").trigger("submit",[true]); }">
<input type="hidden" class="gform_hidden" name="is_submit_102" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="102">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_102"
value="WyJ7XCI3LjFcIjpcIjExODA5YjE5YWUyNTcwMDhiOWVjN2VlMWRjNTdkZGY5XCIsXCI3LjJcIjpcImM4MWQ2MjYzMDkxMDIxZTU2ZGY1MWI3NzNmMjg5ZGU0XCIsXCI3LjNcIjpcIjkxNTQwZjEyNjA1OGNhNmM3NjlkZDY4NTc5OGM3N2YwXCJ9IiwiNTY3ZDk2ODg4YzhjYWUzYjAzM2IyMTAzNWU3MGViNjMiXQ==">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_102" id="gform_target_page_number_102" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_102" id="gform_source_page_number_102" value="1">
<input type="hidden" name="gform_field_values" value="">
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</form>POST /#gf_109
<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_109" id="gform_109" action="/#gf_109" data-formid="109" novalidate="">
<div id="gf_progressbar_wrapper_109" class="gf_progressbar_wrapper" data-start-at-zero="">
<p class="gf_progressbar_title">Step <span class="gf_step_current_page">1</span> of <span class="gf_step_page_count">6</span>
</p>
<div class="gf_progressbar gf_progressbar_blue" aria-hidden="true">
<div class="gf_progressbar_percentage percentbar_blue percentbar_16" style="width:16%;"><span>16%</span></div>
</div>
</div>
<div class="gform-body gform_body">
<div id="gform_page_109_1" class="gform_page " data-js="page-field-id-1">
<div class="gform_page_fields">
<div id="gform_fields_109" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_109_14" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_109_14">
<legend class="gfield_label gform-field-label">Are you currently working with a financial planner?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_109_14">
<div class="gchoice gchoice_109_14_0">
<input class="gfield-choice-input" name="input_14" type="radio" value="Yes" id="choice_109_14_0" onchange="gformToggleRadioOther( this )">
<label for="choice_109_14_0" id="label_109_14_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
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<div class="gchoice gchoice_109_14_1">
<input class="gfield-choice-input" name="input_14" type="radio" value="No" id="choice_109_14_1" onchange="gformToggleRadioOther( this )">
<label for="choice_109_14_1" id="label_109_14_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_next_button_109_20" class="gform_next_button gform-theme-button button" value="Next"
onclick="jQuery("#gform_target_page_number_109").val("2"); jQuery("#gform_109").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_109").val("2"); jQuery("#gform_109").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_109_2" class="gform_page" data-js="page-field-id-20" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_109_2" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_109_15"
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data-js-reload="field_109_15">
<legend class="gfield_label gform-field-label">Are you retired?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_109_15">
<div class="gchoice gchoice_109_15_0">
<input class="gfield-choice-input" name="input_15" type="radio" value="Yes" id="choice_109_15_0" onchange="gformToggleRadioOther( this )">
<label for="choice_109_15_0" id="label_109_15_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_109_15_1">
<input class="gfield-choice-input" name="input_15" type="radio" value="No" id="choice_109_15_1" onchange="gformToggleRadioOther( this )">
<label for="choice_109_15_1" id="label_109_15_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_109_21" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_109").val("1"); jQuery("#gform_109").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_109").val("1"); jQuery("#gform_109").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_109_21"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_109").val("3"); jQuery("#gform_109").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_109").val("3"); jQuery("#gform_109").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_109_3" class="gform_page" data-js="page-field-id-21" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_109_3" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_109_8"
class="gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_109_8">
<legend class="gfield_label gform-field-label gfield_label_before_complex">What is your name?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row" id="input_109_8">
<span id="input_109_8_3_container" class="name_first gform-grid-col gform-grid-col--size-auto">
<input type="text" name="input_8.3" id="input_109_8_3" value="" aria-required="true" autocomplete="given-name">
<label for="input_109_8_3" class="gform-field-label gform-field-label--type-sub ">First</label>
</span>
<span id="input_109_8_6_container" class="name_last gform-grid-col gform-grid-col--size-auto">
<input type="text" name="input_8.6" id="input_109_8_6" value="" aria-required="true" autocomplete="family-name">
<label for="input_109_8_6" class="gform-field-label gform-field-label--type-sub ">Last</label>
</span>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_109_22" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_109").val("2"); jQuery("#gform_109").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_109").val("2"); jQuery("#gform_109").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_109_22"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_109").val("4"); jQuery("#gform_109").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_109").val("4"); jQuery("#gform_109").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_109_4" class="gform_page" data-js="page-field-id-22" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_109_4" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_109_16"
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<legend class="gfield_label gform-field-label">What are you total estimated investable assets?</legend>
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<div class="gform_page_footer top_label">
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onclick="jQuery("#gform_target_page_number_109").val("3"); jQuery("#gform_109").trigger("submit",[true]); "
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</div>
<div id="gform_page_109_5" class="gform_page" data-js="page-field-id-23" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_109_5" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_109_19" class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
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<legend class="gfield_label gform-field-label gfield_label_before_complex">Is there anything specific you would like to discuss?</legend>
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<div class="gfield_checkbox" id="input_109_19">
<div class="gchoice gchoice_109_19_1">
<input class="gfield-choice-input" name="input_19.1" type="checkbox" value="Retirement Planning" id="choice_109_19_1">
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<div class="gchoice gchoice_109_19_4">
<input class="gfield-choice-input" name="input_19.4" type="checkbox" value="Reviewing Insurance Coverage" id="choice_109_19_4">
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<input type="button" id="gform_previous_button_109_24" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
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<p>Great! What is the best way for us to reach out to you to set up a meeting?</p>
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<div id="field_109_11"
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<legend class="gfield_label gform-field-label gfield_label_before_complex">Consent</legend>
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for="input_109_29_1">I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may
apply. <a href="https://www.capitalfinancialusa.com/privacy-policy" target="_blank">Privacy Policy</a></label><input type="hidden" name="input_29.2"
value="I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply. <a href="https://www.capitalfinancialusa.com/privacy-policy" target="_blank">Privacy Policy</a>"
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<label class="gfield_label gform-field-label" for="input_109_30">Comments</label>
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<div class="gfield_description" id="gfield_description_109_30">This field is for validation purposes and should be left unchanged.</div>
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<div class="gform_page_footer top_label"><input type="submit" id="gform_previous_button_109" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
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<p class="gf_progressbar_title">Step <span class="gf_step_current_page">1</span> of <span class="gf_step_page_count">29</span>
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<div class="gf_progressbar_percentage percentbar_blues percentbar_0" style="width:0%;"><span>0%</span></div>
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<div class="gchoice gchoice_43_3_0">
<input class="gfield-choice-input" name="input_3" type="radio" value="Just getting started" id="choice_43_3_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_3_0" id="label_43_3_0" class="gform-field-label gform-field-label--type-inline">Just getting started</label>
</div>
<div class="gchoice gchoice_43_3_1">
<input class="gfield-choice-input" name="input_3" type="radio" value="Building up my savings" id="choice_43_3_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_3_1" id="label_43_3_1" class="gform-field-label gform-field-label--type-inline">Building up my savings</label>
</div>
<div class="gchoice gchoice_43_3_2">
<input class="gfield-choice-input" name="input_3" type="radio" value="Growing my wealth" id="choice_43_3_2" onchange="gformToggleRadioOther( this )">
<label for="choice_43_3_2" id="label_43_3_2" class="gform-field-label gform-field-label--type-inline">Growing my wealth</label>
</div>
<div class="gchoice gchoice_43_3_3">
<input class="gfield-choice-input" name="input_3" type="radio" value="Retaining my wealth" id="choice_43_3_3" onchange="gformToggleRadioOther( this )">
<label for="choice_43_3_3" id="label_43_3_3" class="gform-field-label gform-field-label--type-inline">Retaining my wealth</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_6" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("1"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("1"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_6"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("3"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("3"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_3" class="gform_page" data-js="page-field-id-6" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_3" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_4" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_4">
<legend class="gfield_label gform-field-label">Are you retired?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_4">
<div class="gchoice gchoice_43_4_0">
<input class="gfield-choice-input" name="input_4" type="radio" value="No" id="choice_43_4_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_4_0" id="label_43_4_0" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
<div class="gchoice gchoice_43_4_1">
<input class="gfield-choice-input" name="input_4" type="radio" value="Yes" id="choice_43_4_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_4_1" id="label_43_4_1" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_41" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("2"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("2"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_41"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("4"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("4"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_4" class="gform_page" data-js="page-field-id-41" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_4" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_7" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_7">
<legend class="gfield_label gform-field-label">How confident are you in your long-term financial plan?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_7">
<div class="gchoice gchoice_43_7_0">
<input class="gfield-choice-input" name="input_7" type="radio" value="Extremely Confident" id="choice_43_7_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_7_0" id="label_43_7_0" class="gform-field-label gform-field-label--type-inline">Extremely Confident</label>
</div>
<div class="gchoice gchoice_43_7_1">
<input class="gfield-choice-input" name="input_7" type="radio" value="Very Confident" id="choice_43_7_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_7_1" id="label_43_7_1" class="gform-field-label gform-field-label--type-inline">Very Confident</label>
</div>
<div class="gchoice gchoice_43_7_2">
<input class="gfield-choice-input" name="input_7" type="radio" value="Confident" id="choice_43_7_2" onchange="gformToggleRadioOther( this )">
<label for="choice_43_7_2" id="label_43_7_2" class="gform-field-label gform-field-label--type-inline">Confident</label>
</div>
<div class="gchoice gchoice_43_7_3">
<input class="gfield-choice-input" name="input_7" type="radio" value="Fairly Confident" id="choice_43_7_3" onchange="gformToggleRadioOther( this )">
<label for="choice_43_7_3" id="label_43_7_3" class="gform-field-label gform-field-label--type-inline">Fairly Confident</label>
</div>
<div class="gchoice gchoice_43_7_4">
<input class="gfield-choice-input" name="input_7" type="radio" value="Not Confident" id="choice_43_7_4" onchange="gformToggleRadioOther( this )">
<label for="choice_43_7_4" id="label_43_7_4" class="gform-field-label gform-field-label--type-inline">Not Confident</label>
</div>
<div class="gchoice gchoice_43_7_5">
<input class="gfield-choice-input" name="input_7" type="radio" value="Unsure" id="choice_43_7_5" onchange="gformToggleRadioOther( this )">
<label for="choice_43_7_5" id="label_43_7_5" class="gform-field-label gform-field-label--type-inline">Unsure</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_42" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("3"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("3"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_42"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("5"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("5"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_5" class="gform_page" data-js="page-field-id-42" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_5" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_8" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_8">
<legend class="gfield_label gform-field-label">What activity is most important to you in retirement?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_8">
<div class="gchoice gchoice_43_8_0">
<input class="gfield-choice-input" name="input_8" type="radio" value="Travelling" checked="checked" id="choice_43_8_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_8_0" id="label_43_8_0" class="gform-field-label gform-field-label--type-inline">Travelling</label>
</div>
<div class="gchoice gchoice_43_8_1">
<input class="gfield-choice-input" name="input_8" type="radio" value="Spending time with family and friends" id="choice_43_8_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_8_1" id="label_43_8_1" class="gform-field-label gform-field-label--type-inline">Spending time with family and friends</label>
</div>
<div class="gchoice gchoice_43_8_2">
<input class="gfield-choice-input" name="input_8" type="radio" value="Pursuing hobbies" id="choice_43_8_2" onchange="gformToggleRadioOther( this )">
<label for="choice_43_8_2" id="label_43_8_2" class="gform-field-label gform-field-label--type-inline">Pursuing hobbies</label>
</div>
<div class="gchoice gchoice_43_8_3">
<input class="gfield-choice-input" name="input_8" type="radio" value="Working part-time" id="choice_43_8_3" onchange="gformToggleRadioOther( this )">
<label for="choice_43_8_3" id="label_43_8_3" class="gform-field-label gform-field-label--type-inline">Working part-time</label>
</div>
<div class="gchoice gchoice_43_8_4">
<input class="gfield-choice-input" name="input_8" type="radio" value="Other" id="choice_43_8_4" onchange="gformToggleRadioOther( this )">
<label for="choice_43_8_4" id="label_43_8_4" class="gform-field-label gform-field-label--type-inline">Other</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_43" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("4"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("4"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_43"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("6"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("6"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_6" class="gform_page" data-js="page-field-id-43" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_6" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_9" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_9">
<legend class="gfield_label gform-field-label">Which word most accurately describes your vision of retirement?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_9">
<div class="gchoice gchoice_43_9_0">
<input class="gfield-choice-input" name="input_9" type="radio" value="Enjoyment" id="choice_43_9_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_9_0" id="label_43_9_0" class="gform-field-label gform-field-label--type-inline">Enjoyment</label>
</div>
<div class="gchoice gchoice_43_9_1">
<input class="gfield-choice-input" name="input_9" type="radio" value="Freedom" id="choice_43_9_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_9_1" id="label_43_9_1" class="gform-field-label gform-field-label--type-inline">Freedom</label>
</div>
<div class="gchoice gchoice_43_9_2">
<input class="gfield-choice-input" name="input_9" type="radio" value="Leisure" id="choice_43_9_2" onchange="gformToggleRadioOther( this )">
<label for="choice_43_9_2" id="label_43_9_2" class="gform-field-label gform-field-label--type-inline">Leisure</label>
</div>
<div class="gchoice gchoice_43_9_3">
<input class="gfield-choice-input" name="input_9" type="radio" value="Other" id="choice_43_9_3" onchange="gformToggleRadioOther( this )">
<label for="choice_43_9_3" id="label_43_9_3" class="gform-field-label gform-field-label--type-inline">Other</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_44" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("5"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("5"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_44"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("7"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("7"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_7" class="gform_page" data-js="page-field-id-44" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_7" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_10" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_10">
<legend class="gfield_label gform-field-label">Where do you expect the majority of your retirement income to come from?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_10">
<div class="gchoice gchoice_43_10_0">
<input class="gfield-choice-input" name="input_10" type="radio" value="Savings & Investments" id="choice_43_10_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_10_0" id="label_43_10_0" class="gform-field-label gform-field-label--type-inline">Savings & Investments</label>
</div>
<div class="gchoice gchoice_43_10_1">
<input class="gfield-choice-input" name="input_10" type="radio" value="Employer Pension" id="choice_43_10_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_10_1" id="label_43_10_1" class="gform-field-label gform-field-label--type-inline">Employer Pension</label>
</div>
<div class="gchoice gchoice_43_10_2">
<input class="gfield-choice-input" name="input_10" type="radio" value="Government" id="choice_43_10_2" onchange="gformToggleRadioOther( this )">
<label for="choice_43_10_2" id="label_43_10_2" class="gform-field-label gform-field-label--type-inline">Government</label>
</div>
<div class="gchoice gchoice_43_10_3">
<input class="gfield-choice-input" name="input_10" type="radio" value="Other" id="choice_43_10_3" onchange="gformToggleRadioOther( this )">
<label for="choice_43_10_3" id="label_43_10_3" class="gform-field-label gform-field-label--type-inline">Other</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_57" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("6"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("6"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_57"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("8"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("8"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_8" class="gform_page" data-js="page-field-id-57" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_8" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_11" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_11">
<legend class="gfield_label gform-field-label">Are you planning on relocating for retirement?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_11">
<div class="gchoice gchoice_43_11_0">
<input class="gfield-choice-input" name="input_11" type="radio" value="Yes" id="choice_43_11_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_11_0" id="label_43_11_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_43_11_1">
<input class="gfield-choice-input" name="input_11" type="radio" value="No" id="choice_43_11_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_11_1" id="label_43_11_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
<div class="gchoice gchoice_43_11_2">
<input class="gfield-choice-input" name="input_11" type="radio" value="Not Sure" id="choice_43_11_2" onchange="gformToggleRadioOther( this )">
<label for="choice_43_11_2" id="label_43_11_2" class="gform-field-label gform-field-label--type-inline">Not Sure</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_45" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("7"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("7"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_45"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("9"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("9"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_9" class="gform_page" data-js="page-field-id-45" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_9" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_12" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_12">
<legend class="gfield_label gform-field-label">How would you characterize your overall health?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_12">
<div class="gchoice gchoice_43_12_0">
<input class="gfield-choice-input" name="input_12" type="radio" value="Excellent" id="choice_43_12_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_12_0" id="label_43_12_0" class="gform-field-label gform-field-label--type-inline">Excellent</label>
</div>
<div class="gchoice gchoice_43_12_1">
<input class="gfield-choice-input" name="input_12" type="radio" value="Above Average" id="choice_43_12_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_12_1" id="label_43_12_1" class="gform-field-label gform-field-label--type-inline">Above Average</label>
</div>
<div class="gchoice gchoice_43_12_2">
<input class="gfield-choice-input" name="input_12" type="radio" value="Average" id="choice_43_12_2" onchange="gformToggleRadioOther( this )">
<label for="choice_43_12_2" id="label_43_12_2" class="gform-field-label gform-field-label--type-inline">Average</label>
</div>
<div class="gchoice gchoice_43_12_3">
<input class="gfield-choice-input" name="input_12" type="radio" value="Below Average" id="choice_43_12_3" onchange="gformToggleRadioOther( this )">
<label for="choice_43_12_3" id="label_43_12_3" class="gform-field-label gform-field-label--type-inline">Below Average</label>
</div>
<div class="gchoice gchoice_43_12_4">
<input class="gfield-choice-input" name="input_12" type="radio" value="Poor" id="choice_43_12_4" onchange="gformToggleRadioOther( this )">
<label for="choice_43_12_4" id="label_43_12_4" class="gform-field-label gform-field-label--type-inline">Poor</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_46" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("8"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("8"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_46"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("10"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("10"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_10" class="gform_page" data-js="page-field-id-46" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_10" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_13" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_13">
<legend class="gfield_label gform-field-label">Has your health caused you financial difficulty or stress?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_13">
<div class="gchoice gchoice_43_13_0">
<input class="gfield-choice-input" name="input_13" type="radio" value="Yes" id="choice_43_13_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_13_0" id="label_43_13_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_43_13_1">
<input class="gfield-choice-input" name="input_13" type="radio" value="No" id="choice_43_13_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_13_1" id="label_43_13_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
<div class="gchoice gchoice_43_13_2">
<input class="gfield-choice-input" name="input_13" type="radio" value="Not Sure" id="choice_43_13_2" onchange="gformToggleRadioOther( this )">
<label for="choice_43_13_2" id="label_43_13_2" class="gform-field-label gform-field-label--type-inline">Not Sure</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_58" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("9"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("9"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_58"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("11"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("11"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_11" class="gform_page" data-js="page-field-id-58" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_11" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_14" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_14">
<legend class="gfield_label gform-field-label">How comfortable are you with investing?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_14">
<div class="gchoice gchoice_43_14_0">
<input class="gfield-choice-input" name="input_14" type="radio" value="Extremely Comfortable" id="choice_43_14_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_14_0" id="label_43_14_0" class="gform-field-label gform-field-label--type-inline">Extremely Comfortable</label>
</div>
<div class="gchoice gchoice_43_14_1">
<input class="gfield-choice-input" name="input_14" type="radio" value="Very Comfortable" id="choice_43_14_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_14_1" id="label_43_14_1" class="gform-field-label gform-field-label--type-inline">Very Comfortable</label>
</div>
<div class="gchoice gchoice_43_14_2">
<input class="gfield-choice-input" name="input_14" type="radio" value="Comfortable" id="choice_43_14_2" onchange="gformToggleRadioOther( this )">
<label for="choice_43_14_2" id="label_43_14_2" class="gform-field-label gform-field-label--type-inline">Comfortable</label>
</div>
<div class="gchoice gchoice_43_14_3">
<input class="gfield-choice-input" name="input_14" type="radio" value="Somewhat Comfortable" id="choice_43_14_3" onchange="gformToggleRadioOther( this )">
<label for="choice_43_14_3" id="label_43_14_3" class="gform-field-label gform-field-label--type-inline">Somewhat Comfortable</label>
</div>
<div class="gchoice gchoice_43_14_4">
<input class="gfield-choice-input" name="input_14" type="radio" value="Not Comfortable" id="choice_43_14_4" onchange="gformToggleRadioOther( this )">
<label for="choice_43_14_4" id="label_43_14_4" class="gform-field-label gform-field-label--type-inline">Not Comfortable</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_47" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("10"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("10"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_47"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("12"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("12"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_12" class="gform_page" data-js="page-field-id-47" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_12" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_15" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_15">
<legend class="gfield_label gform-field-label">How quickly would you like to improve your long-term financial strategy?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_15">
<div class="gchoice gchoice_43_15_0">
<input class="gfield-choice-input" name="input_15" type="radio" value="As soon as possible" id="choice_43_15_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_15_0" id="label_43_15_0" class="gform-field-label gform-field-label--type-inline">As soon as possible</label>
</div>
<div class="gchoice gchoice_43_15_1">
<input class="gfield-choice-input" name="input_15" type="radio" value="Within the next 3 months" id="choice_43_15_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_15_1" id="label_43_15_1" class="gform-field-label gform-field-label--type-inline">Within the next 3 months</label>
</div>
<div class="gchoice gchoice_43_15_2">
<input class="gfield-choice-input" name="input_15" type="radio" value="Within the next year" id="choice_43_15_2" onchange="gformToggleRadioOther( this )">
<label for="choice_43_15_2" id="label_43_15_2" class="gform-field-label gform-field-label--type-inline">Within the next year</label>
</div>
<div class="gchoice gchoice_43_15_3">
<input class="gfield-choice-input" name="input_15" type="radio" value="No specific timeframe / I don't want to make any changes" id="choice_43_15_3" onchange="gformToggleRadioOther( this )">
<label for="choice_43_15_3" id="label_43_15_3" class="gform-field-label gform-field-label--type-inline">No specific timeframe / I don't want to make any changes</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_59" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("11"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("11"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_59"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("13"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("13"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_13" class="gform_page" data-js="page-field-id-59" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_13" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_16" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_16">
<legend class="gfield_label gform-field-label">Are you married?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_16">
<div class="gchoice gchoice_43_16_0">
<input class="gfield-choice-input" name="input_16" type="radio" value="Yes" id="choice_43_16_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_16_0" id="label_43_16_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_43_16_1">
<input class="gfield-choice-input" name="input_16" type="radio" value="No" id="choice_43_16_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_16_1" id="label_43_16_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_64" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("12"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("12"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_64"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("14"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("14"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_14" class="gform_page" data-js="page-field-id-64" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_14" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_17" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_17">
<legend class="gfield_label gform-field-label">Do you own your home?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_17">
<div class="gchoice gchoice_43_17_0">
<input class="gfield-choice-input" name="input_17" type="radio" value="Yes" id="choice_43_17_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_17_0" id="label_43_17_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_43_17_1">
<input class="gfield-choice-input" name="input_17" type="radio" value="No" id="choice_43_17_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_17_1" id="label_43_17_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_65" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("13"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("13"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_65"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("15"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("15"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_15" class="gform_page" data-js="page-field-id-65" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_15" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_18" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_18">
<legend class="gfield_label gform-field-label">Do you currently have children under 18?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_18">
<div class="gchoice gchoice_43_18_0">
<input class="gfield-choice-input" name="input_18" type="radio" value="No" id="choice_43_18_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_18_0" id="label_43_18_0" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
<div class="gchoice gchoice_43_18_1">
<input class="gfield-choice-input" name="input_18" type="radio" value="Yes, 1" id="choice_43_18_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_18_1" id="label_43_18_1" class="gform-field-label gform-field-label--type-inline">Yes, 1</label>
</div>
<div class="gchoice gchoice_43_18_2">
<input class="gfield-choice-input" name="input_18" type="radio" value="Yes, 2" id="choice_43_18_2" onchange="gformToggleRadioOther( this )">
<label for="choice_43_18_2" id="label_43_18_2" class="gform-field-label gform-field-label--type-inline">Yes, 2</label>
</div>
<div class="gchoice gchoice_43_18_3">
<input class="gfield-choice-input" name="input_18" type="radio" value="Yes, 3+" id="choice_43_18_3" onchange="gformToggleRadioOther( this )">
<label for="choice_43_18_3" id="label_43_18_3" class="gform-field-label gform-field-label--type-inline">Yes, 3+</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_48" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("14"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("14"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_48"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("16"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("16"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_16" class="gform_page" data-js="page-field-id-48" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_16" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_19" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_19">
<legend class="gfield_label gform-field-label">Do you own a business?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_19">
<div class="gchoice gchoice_43_19_0">
<input class="gfield-choice-input" name="input_19" type="radio" value="Yes" id="choice_43_19_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_19_0" id="label_43_19_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_43_19_1">
<input class="gfield-choice-input" name="input_19" type="radio" value="No" id="choice_43_19_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_19_1" id="label_43_19_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_60" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("15"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("15"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_60"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("17"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("17"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_17" class="gform_page" data-js="page-field-id-60" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_17" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_20" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_20">
<legend class="gfield_label gform-field-label">Are you currently invested in inflation protected assets?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_20">
<div class="gchoice gchoice_43_20_0">
<input class="gfield-choice-input" name="input_20" type="radio" value="Yes" id="choice_43_20_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_20_0" id="label_43_20_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_43_20_1">
<input class="gfield-choice-input" name="input_20" type="radio" value="No" id="choice_43_20_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_20_1" id="label_43_20_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
<div class="gchoice gchoice_43_20_2">
<input class="gfield-choice-input" name="input_20" type="radio" value="Not Sure" id="choice_43_20_2" onchange="gformToggleRadioOther( this )">
<label for="choice_43_20_2" id="label_43_20_2" class="gform-field-label gform-field-label--type-inline">Not Sure</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_63" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("16"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("16"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_63"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("18"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("18"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_18" class="gform_page" data-js="page-field-id-63" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_18" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_21" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_21">
<legend class="gfield_label gform-field-label">Do you have an emergency fund?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_21">
<div class="gchoice gchoice_43_21_0">
<input class="gfield-choice-input" name="input_21" type="radio" value="Yes, Fully Funded" id="choice_43_21_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_21_0" id="label_43_21_0" class="gform-field-label gform-field-label--type-inline">Yes, Fully Funded</label>
</div>
<div class="gchoice gchoice_43_21_1">
<input class="gfield-choice-input" name="input_21" type="radio" value="Yes, Partially Funded" id="choice_43_21_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_21_1" id="label_43_21_1" class="gform-field-label gform-field-label--type-inline">Yes, Partially Funded</label>
</div>
<div class="gchoice gchoice_43_21_2">
<input class="gfield-choice-input" name="input_21" type="radio" value="No" id="choice_43_21_2" onchange="gformToggleRadioOther( this )">
<label for="choice_43_21_2" id="label_43_21_2" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_61" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("17"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("17"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_61"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("19"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("19"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_19" class="gform_page" data-js="page-field-id-61" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_19" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_22" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_22">
<legend class="gfield_label gform-field-label">Do you have a 401(k)?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_22">
<div class="gchoice gchoice_43_22_0">
<input class="gfield-choice-input" name="input_22" type="radio" value="Yes" id="choice_43_22_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_22_0" id="label_43_22_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_43_22_1">
<input class="gfield-choice-input" name="input_22" type="radio" value="No" id="choice_43_22_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_22_1" id="label_43_22_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_49" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("18"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("18"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_49"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("20"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("20"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_20" class="gform_page" data-js="page-field-id-49" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_20" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_23" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_23">
<legend class="gfield_label gform-field-label">Do you have an IRA?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_23">
<div class="gchoice gchoice_43_23_0">
<input class="gfield-choice-input" name="input_23" type="radio" value="Yes" id="choice_43_23_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_23_0" id="label_43_23_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_43_23_1">
<input class="gfield-choice-input" name="input_23" type="radio" value="No" id="choice_43_23_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_23_1" id="label_43_23_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_62" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("19"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("19"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_62"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("21"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("21"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_21" class="gform_page" data-js="page-field-id-62" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_21" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_24" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_24">
<legend class="gfield_label gform-field-label">Which of these is most important for your financial advisor to have?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_24">
<div class="gchoice gchoice_43_24_0">
<input class="gfield-choice-input" name="input_24" type="radio" value="Tax expertise" id="choice_43_24_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_24_0" id="label_43_24_0" class="gform-field-label gform-field-label--type-inline">Tax expertise</label>
</div>
<div class="gchoice gchoice_43_24_1">
<input class="gfield-choice-input" name="input_24" type="radio" value="Investment management expertise" id="choice_43_24_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_24_1" id="label_43_24_1" class="gform-field-label gform-field-label--type-inline">Investment management expertise</label>
</div>
<div class="gchoice gchoice_43_24_2">
<input class="gfield-choice-input" name="input_24" type="radio" value="Estate planning expertise" id="choice_43_24_2" onchange="gformToggleRadioOther( this )">
<label for="choice_43_24_2" id="label_43_24_2" class="gform-field-label gform-field-label--type-inline">Estate planning expertise</label>
</div>
<div class="gchoice gchoice_43_24_3">
<input class="gfield-choice-input" name="input_24" type="radio" value="None of the above" id="choice_43_24_3" onchange="gformToggleRadioOther( this )">
<label for="choice_43_24_3" id="label_43_24_3" class="gform-field-label gform-field-label--type-inline">None of the above</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_50" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("20"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("20"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_50"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("22"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("22"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_22" class="gform_page" data-js="page-field-id-50" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_22" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_25" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_25">
<legend class="gfield_label gform-field-label">Do you currently have a financial advisor?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_25">
<div class="gchoice gchoice_43_25_0">
<input class="gfield-choice-input" name="input_25" type="radio" value="Yes" id="choice_43_25_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_25_0" id="label_43_25_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_43_25_1">
<input class="gfield-choice-input" name="input_25" type="radio" value="No" id="choice_43_25_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_25_1" id="label_43_25_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_56" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("21"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("21"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_56"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("23"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("23"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_23" class="gform_page" data-js="page-field-id-56" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_23" class="gform_fields top_label form_sublabel_below description_below validation_below">
<div id="field_43_28" class="gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_43_28"><label
class="gfield_label gform-field-label" for="input_43_28">Where do you live (Zip Code)?</label>
<div class="ginput_container ginput_container_text"><input name="input_28" id="input_43_28" type="text" value="" class="large" placeholder="12345" aria-invalid="false"> </div>
</div>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_55" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("22"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("22"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_55"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("24"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("24"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_24" class="gform_page" data-js="page-field-id-55" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_24" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_29" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_29">
<legend class="gfield_label gform-field-label">Please estimate your household income.</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_29">
<div class="gchoice gchoice_43_29_0">
<input class="gfield-choice-input" name="input_29" type="radio" value="Less than $40,000" id="choice_43_29_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_29_0" id="label_43_29_0" class="gform-field-label gform-field-label--type-inline">Less than $40,000</label>
</div>
<div class="gchoice gchoice_43_29_1">
<input class="gfield-choice-input" name="input_29" type="radio" value="$40,000 - $74,999" id="choice_43_29_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_29_1" id="label_43_29_1" class="gform-field-label gform-field-label--type-inline">$40,000 - $74,999</label>
</div>
<div class="gchoice gchoice_43_29_2">
<input class="gfield-choice-input" name="input_29" type="radio" value="$75,000 - $99,999" id="choice_43_29_2" onchange="gformToggleRadioOther( this )">
<label for="choice_43_29_2" id="label_43_29_2" class="gform-field-label gform-field-label--type-inline">$75,000 - $99,999</label>
</div>
<div class="gchoice gchoice_43_29_3">
<input class="gfield-choice-input" name="input_29" type="radio" value="$100,000 - $149,999" id="choice_43_29_3" onchange="gformToggleRadioOther( this )">
<label for="choice_43_29_3" id="label_43_29_3" class="gform-field-label gform-field-label--type-inline">$100,000 - $149,999</label>
</div>
<div class="gchoice gchoice_43_29_4">
<input class="gfield-choice-input" name="input_29" type="radio" value="$150,000 - $249,999" id="choice_43_29_4" onchange="gformToggleRadioOther( this )">
<label for="choice_43_29_4" id="label_43_29_4" class="gform-field-label gform-field-label--type-inline">$150,000 - $249,999</label>
</div>
<div class="gchoice gchoice_43_29_5">
<input class="gfield-choice-input" name="input_29" type="radio" value="Over $250,000" id="choice_43_29_5" onchange="gformToggleRadioOther( this )">
<label for="choice_43_29_5" id="label_43_29_5" class="gform-field-label gform-field-label--type-inline">Over $250,000</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_54" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("23"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("23"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_54"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("25"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("25"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_25" class="gform_page" data-js="page-field-id-54" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_25" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_30" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_30">
<legend class="gfield_label gform-field-label">Please estimate your total investable assets.</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_30">
<div class="gchoice gchoice_43_30_0">
<input class="gfield-choice-input" name="input_30" type="radio" value="Less than $25,000" id="choice_43_30_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_30_0" id="label_43_30_0" class="gform-field-label gform-field-label--type-inline">Less than $25,000</label>
</div>
<div class="gchoice gchoice_43_30_1">
<input class="gfield-choice-input" name="input_30" type="radio" value="$25,000 - $99,999" id="choice_43_30_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_30_1" id="label_43_30_1" class="gform-field-label gform-field-label--type-inline">$25,000 - $99,999</label>
</div>
<div class="gchoice gchoice_43_30_2">
<input class="gfield-choice-input" name="input_30" type="radio" value="$100,000 - $249,999" id="choice_43_30_2" onchange="gformToggleRadioOther( this )">
<label for="choice_43_30_2" id="label_43_30_2" class="gform-field-label gform-field-label--type-inline">$100,000 - $249,999</label>
</div>
<div class="gchoice gchoice_43_30_3">
<input class="gfield-choice-input" name="input_30" type="radio" value="$250,000 - $999,999" id="choice_43_30_3" onchange="gformToggleRadioOther( this )">
<label for="choice_43_30_3" id="label_43_30_3" class="gform-field-label gform-field-label--type-inline">$250,000 - $999,999</label>
</div>
<div class="gchoice gchoice_43_30_4">
<input class="gfield-choice-input" name="input_30" type="radio" value="$1,000,000 - $4,999,999" id="choice_43_30_4" onchange="gformToggleRadioOther( this )">
<label for="choice_43_30_4" id="label_43_30_4" class="gform-field-label gform-field-label--type-inline">$1,000,000 - $4,999,999</label>
</div>
<div class="gchoice gchoice_43_30_5">
<input class="gfield-choice-input" name="input_30" type="radio" value="Over $5,000,000" id="choice_43_30_5" onchange="gformToggleRadioOther( this )">
<label for="choice_43_30_5" id="label_43_30_5" class="gform-field-label gform-field-label--type-inline">Over $5,000,000</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_51" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("24"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("24"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_51"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("26"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("26"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_26" class="gform_page" data-js="page-field-id-51" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_26" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_31" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_31">
<legend class="gfield_label gform-field-label">Please estimate your current monthly savings.</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_31">
<div class="gchoice gchoice_43_31_0">
<input class="gfield-choice-input" name="input_31" type="radio" value="Less than $100" id="choice_43_31_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_31_0" id="label_43_31_0" class="gform-field-label gform-field-label--type-inline">Less than $100</label>
</div>
<div class="gchoice gchoice_43_31_1">
<input class="gfield-choice-input" name="input_31" type="radio" value="$100 - $249" id="choice_43_31_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_31_1" id="label_43_31_1" class="gform-field-label gform-field-label--type-inline">$100 - $249</label>
</div>
<div class="gchoice gchoice_43_31_2">
<input class="gfield-choice-input" name="input_31" type="radio" value="$250 - $499" id="choice_43_31_2" onchange="gformToggleRadioOther( this )">
<label for="choice_43_31_2" id="label_43_31_2" class="gform-field-label gform-field-label--type-inline">$250 - $499</label>
</div>
<div class="gchoice gchoice_43_31_3">
<input class="gfield-choice-input" name="input_31" type="radio" value="$500 - $999" id="choice_43_31_3" onchange="gformToggleRadioOther( this )">
<label for="choice_43_31_3" id="label_43_31_3" class="gform-field-label gform-field-label--type-inline">$500 - $999</label>
</div>
<div class="gchoice gchoice_43_31_4">
<input class="gfield-choice-input" name="input_31" type="radio" value="$1,000 - $1,999" id="choice_43_31_4" onchange="gformToggleRadioOther( this )">
<label for="choice_43_31_4" id="label_43_31_4" class="gform-field-label gform-field-label--type-inline">$1,000 - $1,999</label>
</div>
<div class="gchoice gchoice_43_31_5">
<input class="gfield-choice-input" name="input_31" type="radio" value="Over $2,000" id="choice_43_31_5" onchange="gformToggleRadioOther( this )">
<label for="choice_43_31_5" id="label_43_31_5" class="gform-field-label gform-field-label--type-inline">Over $2,000</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_53" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("25"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("25"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_53"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("27"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("27"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_27" class="gform_page" data-js="page-field-id-53" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_27" class="gform_fields top_label form_sublabel_below description_below validation_below">
<fieldset id="field_43_32" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_32">
<legend class="gfield_label gform-field-label">How did you hear about us?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_43_32">
<div class="gchoice gchoice_43_32_0">
<input class="gfield-choice-input" name="input_32" type="radio" value="Social Media" id="choice_43_32_0" onchange="gformToggleRadioOther( this )">
<label for="choice_43_32_0" id="label_43_32_0" class="gform-field-label gform-field-label--type-inline">Social Media</label>
</div>
<div class="gchoice gchoice_43_32_1">
<input class="gfield-choice-input" name="input_32" type="radio" value="Radio/Podcast" id="choice_43_32_1" onchange="gformToggleRadioOther( this )">
<label for="choice_43_32_1" id="label_43_32_1" class="gform-field-label gform-field-label--type-inline">Radio/Podcast</label>
</div>
<div class="gchoice gchoice_43_32_2">
<input class="gfield-choice-input" name="input_32" type="radio" value="TV" id="choice_43_32_2" onchange="gformToggleRadioOther( this )">
<label for="choice_43_32_2" id="label_43_32_2" class="gform-field-label gform-field-label--type-inline">TV</label>
</div>
<div class="gchoice gchoice_43_32_3">
<input class="gfield-choice-input" name="input_32" type="radio" value="Referral" id="choice_43_32_3" onchange="gformToggleRadioOther( this )">
<label for="choice_43_32_3" id="label_43_32_3" class="gform-field-label gform-field-label--type-inline">Referral</label>
</div>
<div class="gchoice gchoice_43_32_4">
<input class="gfield-choice-input" name="input_32" type="radio" value="Internet Search" id="choice_43_32_4" onchange="gformToggleRadioOther( this )">
<label for="choice_43_32_4" id="label_43_32_4" class="gform-field-label gform-field-label--type-inline">Internet Search</label>
</div>
<div class="gchoice gchoice_43_32_5">
<input class="gfield-choice-input" name="input_32" type="radio" value="Online Advertisement" id="choice_43_32_5" onchange="gformToggleRadioOther( this )">
<label for="choice_43_32_5" id="label_43_32_5" class="gform-field-label gform-field-label--type-inline">Online Advertisement</label>
</div>
<div class="gchoice gchoice_43_32_6">
<input class="gfield-choice-input" name="input_32" type="radio" value="Airport Advertisement" id="choice_43_32_6" onchange="gformToggleRadioOther( this )">
<label for="choice_43_32_6" id="label_43_32_6" class="gform-field-label gform-field-label--type-inline">Airport Advertisement</label>
</div>
<div class="gchoice gchoice_43_32_7">
<input class="gfield-choice-input" name="input_32" type="radio" value="WRAL Money Desk" id="choice_43_32_7" onchange="gformToggleRadioOther( this )">
<label for="choice_43_32_7" id="label_43_32_7" class="gform-field-label gform-field-label--type-inline">WRAL Money Desk</label>
</div>
<div class="gchoice gchoice_43_32_8">
<input class="gfield-choice-input" name="input_32" type="radio" value="gf_other_choice" id="choice_43_32_8" onchange="gformToggleRadioOther( this )">
<label for="choice_43_32_8" id="label_43_32_8" class="gform-field-label gform-field-label--type-inline">Other</label><br><input id="input_43_32_other" class="gchoice_other_control" name="input_32_other" type="text" value="Other"
aria-label="Other Choice, please specify" disabled="disabled">
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_52" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("26"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("26"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_52"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("28"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("28"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_28" class="gform_page" data-js="page-field-id-52" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_28" class="gform_fields top_label form_sublabel_below description_below validation_below">
<div id="field_43_33" class="gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_43_33"><label
class="gfield_label gform-field-label" for="input_43_33">Is there anything else you'd like our advisors to know?</label>
<div class="ginput_container ginput_container_text"><input name="input_33" id="input_43_33" type="text" value="" class="large" maxlength="1000" aria-invalid="false">
<div class="charleft ginput_counter gfield_description" aria-live="polite">0 of 1000 max characters</div>
</div>
</div>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_43_37" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_43").val("27"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("27"); jQuery("#gform_43").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_43_37"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_43").val("29"); jQuery("#gform_43").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_43").val("29"); jQuery("#gform_43").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_43_29" class="gform_page" data-js="page-field-id-37" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_43_29" class="gform_fields top_label form_sublabel_below description_below validation_below">
<div id="field_43_40"
class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_40">
<h2>What is the best way to get in touch?</h2>
</div>
<fieldset id="field_43_34" class="gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_34">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Name<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></legend>
<div class="ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row" id="input_43_34">
<span id="input_43_34_3_container" class="name_first gform-grid-col gform-grid-col--size-auto">
<input type="text" name="input_34.3" id="input_43_34_3" value="" aria-required="true" autocomplete="given-name">
<label for="input_43_34_3" class="gform-field-label gform-field-label--type-sub ">First</label>
</span>
<span id="input_43_34_6_container" class="name_last gform-grid-col gform-grid-col--size-auto">
<input type="text" name="input_34.6" id="input_43_34_6" value="" aria-required="true" autocomplete="family-name">
<label for="input_43_34_6" class="gform-field-label gform-field-label--type-sub ">Last</label>
</span>
</div>
</fieldset>
<div id="field_43_35"
class="gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_35"><label class="gfield_label gform-field-label" for="input_43_35">Phone<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label>
<div class="ginput_container ginput_container_phone"><input name="input_35" id="input_43_35" type="tel" value="" class="large" aria-required="true" aria-invalid="false"></div>
</div>
<div id="field_43_36"
class="gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_36"><label class="gfield_label gform-field-label" for="input_43_36">Email<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_36" id="input_43_36" type="email" value="" class="large" aria-required="true" aria-invalid="false">
</div>
</div>
<fieldset id="field_43_67"
class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible"
data-js-reload="field_43_67">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Consent</legend>
<div class="ginput_container ginput_container_consent"><input name="input_67.1" id="input_43_67_1" type="checkbox" value="1" aria-invalid="false"> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label"
for="input_43_67_1">I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may
apply. <a href="https://www.capitalfinancialusa.com/privacy-policy" target="_blank">Privacy Policy</a></label><input type="hidden" name="input_67.2"
value="I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply. <a href="https://www.capitalfinancialusa.com/privacy-policy" target="_blank">Privacy Policy</a>"
class="gform_hidden"><input type="hidden" name="input_67.3" value="103" class="gform_hidden"></div>
</fieldset>
<div id="field_43_66" class="gfield gfield--type-captcha gfield--input-type-captcha gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_43_66"><label class="gfield_label gform-field-label" for="input_43_66">CAPTCHA</label>
<div id="input_43_66" class="ginput_container ginput_recaptcha gform-initialized" data-sitekey="6Lc9U1AdAAAAAA_8EgB9epZWugG1_sCtIjVvxJ3R" data-theme="light" data-tabindex="0" data-badge="">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-1im9amkurhpt" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6Lc9U1AdAAAAAA_8EgB9epZWugG1_sCtIjVvxJ3R&co=aHR0cHM6Ly93d3cuY2FwaXRhbGZpbmFuY2lhbHVzYS5jb206NDQz&hl=en&v=WV-mUKO4xoWKy9M4ZzRyNrP_&theme=light&size=normal&cb=dwpie3mleqq7"></iframe>
</div><textarea id="g-recaptcha-response-2" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div>
</div>
<div id="field_43_68" class="gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_43_68"><label
class="gfield_label gform-field-label" for="input_43_68">Name</label>
<div class="ginput_container"><input name="input_68" id="input_43_68" type="text" value="" autocomplete="new-password"></div>
<div class="gfield_description" id="gfield_description_43_68">This field is for validation purposes and should be left unchanged.</div>
</div>
</div>
</div>
<div class="gform_page_footer top_label"><input type="submit" id="gform_previous_button_43" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="if(window["gf_submitting_43"]){return false;} if( !jQuery("#gform_43")[0].checkValidity || jQuery("#gform_43")[0].checkValidity()){window["gf_submitting_43"]=true;} "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_43"]){return false;} if( !jQuery("#gform_43")[0].checkValidity || jQuery("#gform_43")[0].checkValidity()){window["gf_submitting_43"]=true;} jQuery("#gform_43").trigger("submit",[true]); }">
<input type="submit" id="gform_submit_button_43" class="gform_button button" value="Submit"
onclick="if(window["gf_submitting_43"]){return false;} if( !jQuery("#gform_43")[0].checkValidity || jQuery("#gform_43")[0].checkValidity()){window["gf_submitting_43"]=true;} "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_43"]){return false;} if( !jQuery("#gform_43")[0].checkValidity || jQuery("#gform_43")[0].checkValidity()){window["gf_submitting_43"]=true;} jQuery("#gform_43").trigger("submit",[true]); }">
<input type="hidden" name="gform_ajax" value="form_id=43&title=1&description=1&tabindex=0&theme=orbital">
<input type="hidden" class="gform_hidden" name="is_submit_43" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="43">
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* About Us * Coach Pete * Who We Are * Community * Services * Financial Fill-Up * Financial Planning Services * Financial Termites * Investment Services * Life Insurance * Retirement Autopilot * Tax Planning Services * Resources & Media * The Big Book On Retirement * Financial Safari * Retirement Help Center * Rock On Retirement * The Marty Hensley Show * The Parker Holland Show * Webinar: 7 Financial Blind Spots * Webinar: Retirement Puzzle * Connect * Connect with Us * Get a Plan Client Portal Video Player -------------------------------------------------------------------------------- YOUR PARTNER IN DEVELOPING A SECURE RETIREMENT. Request a Strategic Retirement ReviewWith a local retirement Professional AS SEEN ON -------------------------------------------------------------------------------- Comprehensive financial planning with a focus on strategies to help you generate adequate retirement income that lasts throughout your lifetime. Our clients have typically saved $100,000 or more for retirement. -------------------------------------------------------------------------------- Learn More About Financial Advice -------------------------------------------------------------------------------- Structured wealth management through investment, financial, retirement, estate and tax planning customized to meet their individual financial needs. Most investment clients have $500,000 or more in investable assets. -------------------------------------------------------------------------------- Learn More About Investment Services ABOUT OUR FOUNDER -------------------------------------------------------------------------------- PETER J. D'ARRUDA MRFC®, RICP® -------------------------------------------------------------------------------- Peter J. D’Arruda has been in the financial arena for almost three decades. He is a best-selling author, radio and television host, former 2-time President of the International Association of Registered Financial Consultants, an investment advisor and fiduciary. He founded Capital Financial to help his clients “cross the street of life.“ He and his team strive to help their clients take the worry out of living in retirement. Known as Coach Pete to most of his clients and radio show listeners, his lifetime goal is to assist his clients in achieving the levels of success they desire. -------------------------------------------------------------------------------- Learn More about Coach Pete Featured Webinar 7 FINANCIAL BLIND SPOTS Monday, Sept. 16 6:00 PM ET Sign Up Today!Free Webinar As you approach retirement, it becomes even more important to have a clear vision of your financial goals. You will come across financial challenges that can have a significant impact on your long-term financial well-being. By exploring the 7 Financial Blind Spots, we aim to empower you with knowledge and tools to make informed decisions, or at least begin the journey, which will ultimately enable you to create a retirement plan that aligns with your dreams and aspirations. Whether you're just entering the Financial Red Zone or already a good way in, we hope this webinar will serve as a valuable resource to help you navigate the complexities of retirement planning with confidence. -------------------------------------------------------------------------------- In this free webinar, you'll discover: Developing Written Goals Taxes in Retirement Government Programs Handling Your Mortgage Inflation When You Can Retire Pension Systems ...and much more! Sign Up Today!Free Webinar -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- Sign Up Today!Free Webinar Featured Webinar SOLVING THE RETIREMENT PUZZLE Thursday, Sept. 12 | 3:00 PM ET Learn how to make sense of retirement, plan for your needs and desires, and secure lifetime income for you and your spouse. Sign up today! -------------------------------------------------------------------------------- In this free webinar, you'll discover: Retiring today looks different How to plan for taxes Why Social Security isn't enough Inflation protection strategies The current state of pensions How to have lifetime income Why planning is so important ...and much more! -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- OUR TEAM Coach Pete D'Arruda has built a team of invaluable professionals at Capital Financial. -------------------------------------------------------------------------------- Learn More About Our Team Featured Resource Provided by the Capital Financial Team Download NowFree eBook Featured Resource THE BIG BOOK ON RETIREMENT Coach Pete's newest book is now available - absolutely free on this site only!The Big Book On Retirement is the eighth book from best-selling and award-winning author Coach Pete D'Arruda. More than 20 years after publishing his first book, Financial Safari, Coach Pete is bringing yet another highly-useful tool to the masses with his latest publication. This comprehensive and concise book helps readers navigate all the ins and outs of retirement planning. -------------------------------------------------------------------------------- With this free resource, you'll discover: Learning the importance of working with a licensed fiduciary and how to choose the right one to advise you and your family. Understanding the investment options you have available to you in retirement and how to take advantage of a plan that best suits your needs. Learning how to secure Guaranteed Lifetime Income for you and your spouse. Learning how to organize records and documentation critical to retirement planning and beyond. Understanding how to defend yourself against financial and healthcare risks. How to ensure you have a proper legacy plan in place for your loved ones. Knowing how to maximize the opportunities available to you and your loved ones. ...and much more! EXPERIENCED -------------------------------------------------------------------------------- We provide affluent retirees and pre-retirees with strategies to reduce taxes and market risk on their life savings while developing and maintaining a close, trusting relationship. CUSTOM -------------------------------------------------------------------------------- Our strategic development process begins with an analysis to determine a custom designed course of action that is aligned with your goals and maximizes results. INDEPENDENT -------------------------------------------------------------------------------- Being independent, we offer an experience that is personal and responsive while also maintaining our values of simplicity and transparency. FIDUCIARY -------------------------------------------------------------------------------- By partnering with us as a fiduciary, we will strive to communicate with you clearly and with integrity what is in your best interest throughout the planning process. RADIO & PODCASTS Each week Coach Pete and the team reveal the latest developments in the financial world and share common sense strategies that will help you make the most out of your retirement savings. Tune in to our family of shows each weekend on Mix 101.5 WRAL, FM 106.1 WTKK and AM680 WPTF as well as Apple Podcasts, Amazon Alexa, Spotify and more! -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- DAVE RAMSEY SMARTVESTOR PRO -------------------------------------------------------------------------------- Peter D’Arruda, MRFC is a SmartVestor Pro, selected by Dave Ramsey and the Ramsey Solutions organization to help with your retirement, college savings and other investments. Our retirement advisors provide solid, professional investing guidance and are committed to educating and empowering every individual while providing top-notch customer service. -------------------------------------------------------------------------------- DAVE RAMSEY SMARTVESTOR PRO -------------------------------------------------------------------------------- LATEST POSTS -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- BONDS FOR BEGINNERS Everybody gives the same financial advice: “Diversify your portfolio!” The problem is, most folks saying that only diversify their stocks,… WHEN IS THE BEST TIME TO RETIRE? Nine times out of ten, folks say the best time to retire is “Yesterday!” The average retirement age in America… THE 3 PILLARS OF A RETIREMENT PLAN We are bombarded with financial advice from everywhere: news outlets, social media, even your bartender with a Bitcoin wallet. Everyone… GET TO KNOW US Watch this immersive video to discover the vision and values of Capital Financial and what makes us different. CONTACT US Interested in getting started with our Financial Planning Services? Contact our team at one of our offices in Raleigh, Greenville, Wilmington, or Myrtle Beach today for a no-obligation financial review. Let Capital Financial USA be your partner in financial planning. Request a Retirement Review CONTACT US Interested in getting started with our Financial Planning Services? Contact our team at one of our offices in Raleigh, Greenville, Wilmington, or Myrtle Beach today for a no-obligation financial review. Let Capital Financial USA be your partner in financial planning. Schedule Your Review Session Raleigh, NC 1500 Town Side Drive Suite 201 Apex, NC 27502 (919) 657-4201 Greenville, NC 102B Regency Blvd Suite 3 Greenville, NC 27834 (919) 585-5876 Wilmington, NC 1213 Culbreth Drive Suite 117 Wilmington, NC 28405 (919) 260-6007 Myrtle Beach, SC 1039 44th Ave North Suite 204 Myrtle Beach, SC 29577 (854) 444-8083 Scottsdale, AZ 18700 North Hayden Rd, Suite 310 Scottsdale, AZ, 85255 (480) 999-4996 Las Vegas, NV 410 S. Rampart Blvd Suite 390 Las Vegas, NV 89145 (800) 656-8326 Privacy Policy ADV2 Disclosure Developed by Broadcasting Experts SCHEDULE YOUR REVIEW SESSION Sit down with a fiduciary financial advisor who can guide you and have a conversation that will indicate if you are in need of a comprehensive financial plan. Fill out the form below to schedule a consultation with us. "*" indicates required fields Name* First Last Phone Email* Question Consent I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply. Privacy Policy CAPTCHA * About Us * Coach Pete * Who We Are * Community * Services * Financial Fill-Up * Financial Planning Services * Financial Termites * Investment Services * Life Insurance * Retirement Autopilot * Tax Planning Services * Resources & Media * The Big Book On Retirement * Financial Safari * Retirement Help Center * Rock On Retirement * The Marty Hensley Show * The Parker Holland Show * Webinar: 7 Financial Blind Spots * Webinar: Retirement Puzzle * Connect * Connect with Us * Get a Plan Client Portal -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- Schedule Your Review Session CONNECT WITH A FINANCIAL PLANNER Meet with a fiduciary advisor "*" indicates required fields Step 1 of 6 16% Are you currently working with a financial planner? Yes No Are you retired? Yes No What is your name?* First Last What are you total estimated investable assets? Less than $100,000 $100,000 - $250,000 $250,000 - $500,000 $500,000 - $1,000,000 More than $1,000,000 Is there anything specific you would like to discuss? Retirement Planning Improving Investment Strategy Estate Planning Reviewing Insurance Coverage High-Net-Worth Investing Tax Planning Second Opinion Review Fee Analysis Lifetime Income Plan Spend & Leave Plan Roth Conversion Strategy IUL Strategy Tactical Management Great! What is the best way for us to reach out to you to set up a meeting? Email* Phone* Questions/Comments Consent I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply. Privacy Policy Email This field is for validation purposes and should be left unchanged. Featured Webinar 7 FINANCIAL BLIND SPOTS Free Webinar • REGISTER NOW * First Name* First * Last Name* Last * Email* * Phone * Consent I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply. Privacy Policy * Email This field is for validation purposes and should be left unchanged. Featured Webinar 7 FINANCIAL BLIND SPOTS Free Webinar • REGISTER NOW * First Name* First * Last Name* Last * Email* * Phone * Consent I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply. Privacy Policy * Name This field is for validation purposes and should be left unchanged. Featured Webinar SOLVING THE RETIREMENT PUZZLE Free Webinar • REGISTER NOW * First Name* First * Last Name* Last * Email* * Phone * Consent I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply. Privacy Policy * Comments This field is for validation purposes and should be left unchanged. COACH PETE'S BIG BOOK ON RETIREMENT Free ebook Download * Name* First Last * Email* * Phone * Consent I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply. Privacy Policy * CAPTCHA CONNECT WITH A FINANCIAL PLANNER Meet with a fiduciary advisor "*" indicates required fields Step 1 of 6 16% Are you currently working with a financial planner? Yes No Are you retired? Yes No What is your name?* First Last What are you total estimated investable assets? Less than $100,000 $100,000 - $250,000 $250,000 - $500,000 $500,000 - $1,000,000 More than $1,000,000 Is there anything specific you would like to discuss? Retirement Planning Improving Investment Strategy Estate Planning Reviewing Insurance Coverage High-Net-Worth Investing Tax Planning Second Opinion Review Fee Analysis Lifetime Income Plan Spend & Leave Plan Roth Conversion Strategy IUL Strategy Tactical Management Great! What is the best way for us to reach out to you to set up a meeting? Email* Phone* Questions/Comments Consent I agree to be contacted by Capital Financial & Insurance, LLC via call, email, and text. To opt-out, you can reply 'stop' at any time or click the unsubscribe link in the emails. Message and data rates may apply. Privacy Policy Comments This field is for validation purposes and should be left unchanged. REQUEST A STRATEGIC RETIREMENT REVIEW Fill out the details below and a team member will be in touch shortly to schedule a review with an advisor. Step 1 of 29 0% What is your current age? Over 65 61 - 65 56 - 60 46 - 55 36 - 45 Under 35 What is your current financial priority? Just getting started Building up my savings Growing my wealth Retaining my wealth Are you retired? No Yes How confident are you in your long-term financial plan? Extremely Confident Very Confident Confident Fairly Confident Not Confident Unsure What activity is most important to you in retirement? Travelling Spending time with family and friends Pursuing hobbies Working part-time Other Which word most accurately describes your vision of retirement? Enjoyment Freedom Leisure Other Where do you expect the majority of your retirement income to come from? Savings & Investments Employer Pension Government Other Are you planning on relocating for retirement? Yes No Not Sure How would you characterize your overall health? Excellent Above Average Average Below Average Poor Has your health caused you financial difficulty or stress? Yes No Not Sure How comfortable are you with investing? Extremely Comfortable Very Comfortable Comfortable Somewhat Comfortable Not Comfortable How quickly would you like to improve your long-term financial strategy? As soon as possible Within the next 3 months Within the next year No specific timeframe / I don't want to make any changes Are you married? Yes No Do you own your home? Yes No Do you currently have children under 18? No Yes, 1 Yes, 2 Yes, 3+ Do you own a business? Yes No Are you currently invested in inflation protected assets? Yes No Not Sure Do you have an emergency fund? Yes, Fully Funded Yes, Partially Funded No Do you have a 401(k)? Yes No Do you have an IRA? Yes No Which of these is most important for your financial advisor to have? Tax expertise Investment management expertise Estate planning expertise None of the above Do you currently have a financial advisor? Yes No Where do you live (Zip Code)? Please estimate your household income. Less than $40,000 $40,000 - $74,999 $75,000 - $99,999 $100,000 - $149,999 $150,000 - $249,999 Over $250,000 Please estimate your total investable assets. Less than $25,000 $25,000 - $99,999 $100,000 - $249,999 $250,000 - $999,999 $1,000,000 - $4,999,999 Over $5,000,000 Please estimate your current monthly savings. Less than $100 $100 - $249 $250 - $499 $500 - $999 $1,000 - $1,999 Over $2,000 How did you hear about us? Social Media Radio/Podcast TV Referral Internet Search Online Advertisement Airport Advertisement WRAL Money Desk Other Is there anything else you'd like our advisors to know? 0 of 1000 max characters WHAT IS THE BEST WAY TO GET IN TOUCH? 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