michaelpittmaninsurance.com
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urlscan Pro
34.69.219.172
Public Scan
Submitted URL: http://michaelpittmaninsurance.com/
Effective URL: https://michaelpittmaninsurance.com/
Submission: On March 08 via api from US — Scanned from DE
Effective URL: https://michaelpittmaninsurance.com/
Submission: On March 08 via api from US — Scanned from DE
Form analysis 4 forms found in the DOM
POST /contact[object Object]
<form x-show="!sendResponse && !sending" class="flex flex-col text-base font-mecherlesans-reg text-sf-charcoal" :action="`/contact${qs}`" method="post" aria-describedby="disclaimers" aria-labelledby="formLabel"
action="/contact[object Object]">
<div class="flex flex-col" :class="{ "lg:flex-row": false }">
<!-- start partial: m2-cf-contact-info.hbs -->
<div class="flex flex-col w-full space-y-5" :class="{ "lg:flex-row lg:space-x-4 lg:w-3/4": false }" x-id="['contact-form-name', 'contact-form-phone', 'contact-form-email', 'contact-form-email-or-phone']">
<!-- start partial: m2-cf-text-field.hbs -->
<div class="relative w-full">
<input :id="$id('contact-form-name')" class="m2-form-input peer" :class="{ "bg-white": false, "lg:mt-5": false }" name="contact-form-name" x-model="form.name" :aria-required="true" autocomplete="name" type="text"
placeholder="Your Name" :aria-invalid="hasError('name')" :aria-describedby="hasError('name') ? $id('error', 'name') : null" :error="hasError('name')" @keydown.debounce.750ms="validateName()" id="contact-form-name-1" aria-required="true">
<label class="m2-form-label" :for="$id('contact-form-name')" for="contact-form-name-1"> Your Name <span aria-hidden="true" x-show="hasError('name')" style="display: none;"> * </span>
</label>
</div>
<!-- end partial: m2-cf-text-field.hbs -->
<!-- start partial: m2-cf-text-field.hbs -->
<div class="relative w-full">
<input :id="$id('contact-form-email-or-phone')" class="m2-form-input peer" :class="{ "bg-white": false, "lg:mt-5": false }" name="contact-form-email-or-phone" x-model="form.emailOrPhone" :aria-required="true"
autocomplete="on" type="text" placeholder="Your Email or Phone" :aria-invalid="hasError('emailOrPhone')" :aria-describedby="hasError('emailOrPhone') ? $id('error', 'emailOrPhone') : null" :error="hasError('emailOrPhone')"
@keydown.debounce.750ms="validateEmailOrPhone()" id="contact-form-email-or-phone-1" aria-required="true">
<label class="m2-form-label" :for="$id('contact-form-email-or-phone')" for="contact-form-email-or-phone-1"> Your Email or Phone <span aria-hidden="true" x-show="hasError('emailOrPhone')" style="display: none;"> * </span>
</label>
</div>
<!-- end partial: m2-cf-text-field.hbs -->
</div>
<!-- end partial: m2-cf-contact-info.hbs -->
<div class="mt-4">
<!-- start partial: cf-message-warning.hbs -->
<p class="text-xs" :id="$id('message-warning')" id="message-warning-1"> For your protection, please do not include sensitive personal information such as social security numbers, credit/debit card number, or health/medical information. </p>
<!-- end partial: cf-message-warning.hbs -->
</div>
<div class="mt-5">
<!-- start partial: m2-cf-message.hbs -->
<div class="relative h-full" x-id="[
'contact-form-message'
]">
<textarea :id="$id('contact-form-message')" ref="message" x-model="form.message" class="m2-form-input peer h-48 " :class="{ "bg-white": false }" placeholder="Your Message:" :aria-invalid="hasError('message')"
:aria-describedby="`${$id("message-warning")} ${hasError("message") ? $id("error", "message") : ""}`" :aria-required="hasError('message')" @keydown.debounce.750ms="validateMessage()"
:error="hasError('message')" id="contact-form-message-1" aria-describedby="message-warning-1 "></textarea>
<label :for="$id('contact-form-message')" class="m2-form-label" for="contact-form-message-1"> Your Message: <span aria-hidden="true" x-show="hasError('message')" style="display: none;"> * </span>
</label>
</div>
<!-- end partial: m2-cf-message.hbs -->
</div>
<div class="mt-5" :class="{ 'lg:w-1/4 lg:ml-4': false }">
<!-- start partial: m2-cf-submit.hbs -->
<button @click="submit" type="button" :aria-disabled="isSendDisabled()" class="btn btn-primary"> Send Email </button>
<!-- end partial: m2-cf-submit.hbs -->
</div>
</div>
<!-- start partial: m2-cf-errors.hbs -->
<div x-show="hasErrors" role="alert" class="my-4 rounded-2xl bg-sf-red-100 p-4 text-sf-red-700" style="display: none;">
<!-- The only way ATs will read all of the text below on failed validation is if they are rendered as <p> elements -->
<!-- "Please forgive this" -->
<h3 class="font-mecherlesans-demi mb-2 text-xl"> Please correct the following: </h3>
<ul class="list-inside list-disc">
<template x-for="(message, key) in errors" :key="$id('error', key)">
<li class="mb-1" :id="$id('error', key)" x-html="message"></li>
</template>
</ul>
</div>
<!-- end partial: m2-cf-errors.hbs -->
<div class="mt-4 space-y-2 italic" id="region-banner">
<!-- start partial: cf-disclaimer.hbs -->
<p :id="$id('cf-disclaimer')" class="text-xs leading-3" id="cf-disclaimer-1"> By filling out the form, you are providing express consent by electronic signature that you may be contacted by telephone (via call and/or text messages) and/or email
for marketing purposes by State Farm Mutual Automobile Insurance Company, its subsidiaries and affiliates ("State Farm") or an independent contractor State Farm agent regarding insurance products and services using the phone number and/or email
address you have provided to State Farm, even if your phone number is listed on a Do Not Call Registry. You further agree that such contact may be made using an automatic telephone dialing system and/or prerecorded voice (message and data rates
may apply). Your consent is not a condition of purchase. By continuing, you agree to the terms of the disclosures above. </p>
<!-- end partial: cf-disclaimer.hbs -->
<!-- start partial: cf-coverage-disclaimer.hbs -->
<p class="text-xs leading-3">
<span class="font-mecherlesans-bold"> Please note: </span> Insurance coverage cannot be bound or changed via submission of this online e-mail form or via voice mail. To make policy changes or request additional coverage, please speak with a
licensed representative in the agent's office, or by contacting the State Farm toll-free customer service line at <a href="tel:8557337333" class="red-link">
(855) 733-7333
</a> .
</p>
<!-- end partial: cf-coverage-disclaimer.hbs -->
</div>
</form>#
<form id="quote-start-wbqcg10" action="#">
<!-- start partial: form-label.hbs -->
<label for="gaq-product-wbqcg10" class="block w-full px-2 pb-1 border rounded-md bg-white mt-3 border-gray-600" :class="false ? 'border-2 border-sf-red' : 'border-gray-600'">
<span class="block pt-2 text-sm text-gray-700">Insurance Product:</span>
<div class="relative inline-block w-full">
<select id="gaq-product-wbqcg10" name="field-auto" class="block w-full pr-8 text-xl leading-tight bg-white appearance-none cursor-pointer" @change="selectProduct()" x-model="productKey" aria-label="Product Quote Select"
aria-controls="specific-location-info-wbqcg10">
<template x-for="line in lineOptions">
<option :value="line.key" x-text="line.label"></option>
</template>
<option :value="line.key" x-text="line.label" value="auto">Auto</option>
<option :value="line.key" x-text="line.label" value="homeowners">Homeowners</option>
<option :value="line.key" x-text="line.label" value="condo">Condo Owners</option>
<option :value="line.key" x-text="line.label" value="renters">Renters</option>
<option :value="line.key" x-text="line.label" value="life">Life</option>
<option :value="line.key" x-text="line.label" value="hospital">Hospital Income</option>
<option :value="line.key" x-text="line.label" value="medicare">Medicare Supplement</option>
<option :value="line.key" x-text="line.label" value="pet">Pet Insurance</option>
</select>
<div class="absolute inset-y-0 right-0 flex items-center px-2 text-gray-700 pointer-events-none">
<div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 8 14" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet">
<path d="M8 5.5a.5.5 0 0 1-.148.352l-3.5 3.5c-.094.094-.219.148-.352.148s-.258-.055-.352-.148l-3.5-3.5A.497.497 0 0 1 .5 5h7c.273 0 .5.227.5.5z"></path>
</svg></div>
</div>
</div>
</label>
<!-- end partial: form-label.hbs -->
<div id="specific-location-info-wbqcg10" class="flex mt-2 flex-nowrap">
<div class="w-full">
<template x-if="type()=='zip'">
<!-- start partial: form-label.hbs -->
<label for="gaq-zip-wbqcg10" class="block w-full px-2 pb-1 border rounded-md bg-white " :class="false ? 'border-2 border-sf-red' : 'border-gray-600'">
<span class="block pt-2 text-sm text-gray-700">Zipcode:</span>
<input id="gaq-zip-wbqcg10" type="text" class="w-full text-xl" x-model="zip" name="field-zip" autocomplete="postal-code" aria-label="Zipcode Input" aria-required="true" :aria-invalid="!isZipValid()" :aria-describedby="describeErrorsID()"
@keydown.enter.prevent="validate()">
</label>
<!-- end partial: form-label.hbs -->
</template><label for="gaq-zip-wbqcg10" class="block w-full px-2 pb-1 border rounded-md bg-white border-gray-600" :class="false ? 'border-2 border-sf-red' : 'border-gray-600'">
<span class="block pt-2 text-sm text-gray-700">Zipcode:</span>
<input id="gaq-zip-wbqcg10" type="text" class="w-full text-xl" x-model="zip" name="field-zip" autocomplete="postal-code" aria-label="Zipcode Input" aria-required="true" :aria-invalid="!isZipValid()" :aria-describedby="describeErrorsID()"
@keydown.enter.prevent="validate()" aria-describedby="">
</label>
<template x-if="type()!='zip'">
<!-- start partial: form-label.hbs -->
<label for="gaq-loc-wbqcg10" class="block w-full px-2 pb-1 border rounded-md bg-white " :class="false ? 'border-2 border-sf-red' : 'border-gray-600'">
<span class="block pt-2 text-sm text-gray-700">State:</span>
<div class="relative inline-block w-full">
<select id="gaq-loc-wbqcg10" x-model="state" name="field-state" aria-label="State Selection" aria-required="true" :aria-invalid="!isStateValid()" :aria-describedby="describeErrorsID()"
class="block w-full pr-8 text-xl leading-tight bg-white appearance-none cursor-pointer" @keydown.enter.prevent="validate()">
<option value="" selected="" hidden="">Your State</option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="DC">Washington, D.C.</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
</select>
<div class="absolute inset-y-0 right-0 flex items-center px-2 text-gray-700 pointer-events-none">
<div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 8 14" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet">
<path d="M8 5.5a.5.5 0 0 1-.148.352l-3.5 3.5c-.094.094-.219.148-.352.148s-.258-.055-.352-.148l-3.5-3.5A.497.497 0 0 1 .5 5h7c.273 0 .5.227.5.5z"></path>
</svg></div>
</div>
</div>
</label>
<!-- end partial: form-label.hbs -->
</template>
</div>
<div class="w-full pl-2 md:w-2/5">
<button @click.stop.prevent="validate()" type="button" :disabled="submitting" class="block w-full h-full py-4 text-2xl rounded-md btn btn-primary font-mecherlesans-demi" aria-label="Submit quote form"> GO </button>
</div>
</div>
<div role="alert" aria-atomic="true" :id="ariaDescribedByErrorsID" id="error-description-wbqcg10">
<template x-for="error in errors">
<h3 class="p-1 my-2 border rounded-sm text-sf-red-700 bg-sf-red-100 border-sf-red-700" x-html="error">
</h3>
</template>
</div>
</form>#
<form id="quote-start-dmsmiuk" action="#">
<!-- start partial: form-label.hbs -->
<label for="gaq-product-dmsmiuk" class="block w-full px-2 pb-1 border rounded-md bg-white mt-3 border-gray-600" :class="false ? 'border-2 border-sf-red' : 'border-gray-600'">
<span class="block pt-2 text-sm text-gray-700">Insurance Product:</span>
<div class="relative inline-block w-full">
<select id="gaq-product-dmsmiuk" name="field-auto" class="block w-full pr-8 text-xl leading-tight bg-white appearance-none cursor-pointer" @change="selectProduct()" x-model="productKey" aria-label="Product Quote Select"
aria-controls="specific-location-info-dmsmiuk">
<template x-for="line in lineOptions">
<option :value="line.key" x-text="line.label"></option>
</template>
<option :value="line.key" x-text="line.label" value="auto">Auto</option>
<option :value="line.key" x-text="line.label" value="homeowners">Homeowners</option>
<option :value="line.key" x-text="line.label" value="condo">Condo Owners</option>
<option :value="line.key" x-text="line.label" value="renters">Renters</option>
<option :value="line.key" x-text="line.label" value="life">Life</option>
<option :value="line.key" x-text="line.label" value="hospital">Hospital Income</option>
<option :value="line.key" x-text="line.label" value="medicare">Medicare Supplement</option>
<option :value="line.key" x-text="line.label" value="pet">Pet Insurance</option>
</select>
<div class="absolute inset-y-0 right-0 flex items-center px-2 text-gray-700 pointer-events-none">
<div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 8 14" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet">
<path d="M8 5.5a.5.5 0 0 1-.148.352l-3.5 3.5c-.094.094-.219.148-.352.148s-.258-.055-.352-.148l-3.5-3.5A.497.497 0 0 1 .5 5h7c.273 0 .5.227.5.5z"></path>
</svg></div>
</div>
</div>
</label>
<!-- end partial: form-label.hbs -->
<div id="specific-location-info-dmsmiuk" class="flex mt-2 flex-nowrap">
<div class="w-full">
<template x-if="type()=='zip'">
<!-- start partial: form-label.hbs -->
<label for="gaq-zip-dmsmiuk" class="block w-full px-2 pb-1 border rounded-md bg-white " :class="false ? 'border-2 border-sf-red' : 'border-gray-600'">
<span class="block pt-2 text-sm text-gray-700">Zipcode:</span>
<input id="gaq-zip-dmsmiuk" type="text" class="w-full text-xl" x-model="zip" name="field-zip" autocomplete="postal-code" aria-label="Zipcode Input" aria-required="true" :aria-invalid="!isZipValid()" :aria-describedby="describeErrorsID()"
@keydown.enter.prevent="validate()">
</label>
<!-- end partial: form-label.hbs -->
</template><label for="gaq-zip-dmsmiuk" class="block w-full px-2 pb-1 border rounded-md bg-white border-gray-600" :class="false ? 'border-2 border-sf-red' : 'border-gray-600'">
<span class="block pt-2 text-sm text-gray-700">Zipcode:</span>
<input id="gaq-zip-dmsmiuk" type="text" class="w-full text-xl" x-model="zip" name="field-zip" autocomplete="postal-code" aria-label="Zipcode Input" aria-required="true" :aria-invalid="!isZipValid()" :aria-describedby="describeErrorsID()"
@keydown.enter.prevent="validate()" aria-describedby="">
</label>
<template x-if="type()!='zip'">
<!-- start partial: form-label.hbs -->
<label for="gaq-loc-dmsmiuk" class="block w-full px-2 pb-1 border rounded-md bg-white " :class="false ? 'border-2 border-sf-red' : 'border-gray-600'">
<span class="block pt-2 text-sm text-gray-700">State:</span>
<div class="relative inline-block w-full">
<select id="gaq-loc-dmsmiuk" x-model="state" name="field-state" aria-label="State Selection" aria-required="true" :aria-invalid="!isStateValid()" :aria-describedby="describeErrorsID()"
class="block w-full pr-8 text-xl leading-tight bg-white appearance-none cursor-pointer" @keydown.enter.prevent="validate()">
<option value="" selected="" hidden="">Your State</option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="DC">Washington, D.C.</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
</select>
<div class="absolute inset-y-0 right-0 flex items-center px-2 text-gray-700 pointer-events-none">
<div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 8 14" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet">
<path d="M8 5.5a.5.5 0 0 1-.148.352l-3.5 3.5c-.094.094-.219.148-.352.148s-.258-.055-.352-.148l-3.5-3.5A.497.497 0 0 1 .5 5h7c.273 0 .5.227.5.5z"></path>
</svg></div>
</div>
</div>
</label>
<!-- end partial: form-label.hbs -->
</template>
</div>
<div class="w-full pl-2 md:w-2/5">
<button @click.stop.prevent="validate()" type="button" :disabled="submitting" class="block w-full h-full py-4 text-2xl rounded-md btn btn-primary font-mecherlesans-demi" aria-label="Submit quote form"> GO </button>
</div>
</div>
<div role="alert" aria-atomic="true" :id="ariaDescribedByErrorsID" id="error-description-dmsmiuk">
<template x-for="error in errors">
<h3 class="p-1 my-2 border rounded-sm text-sf-red-700 bg-sf-red-100 border-sf-red-700" x-html="error">
</h3>
</template>
</div>
</form>POST
<form x-show="!sendResponse && !sending" class="form-contact" :action="`/contact${qs}`" method="post">
<div x-show="true" class="italic md:hidden"> Call our office anytime at <a id="phone-link-contact-me" href="tel:3368545011" class="red-link">
(336) 854-5011
</a>
</div>
<div class="flex flex-wrap min-w-0 md:mt-4 md:flex-nowrap">
<div class="w-full md:mr-4 md:w-1/4 md:shrink-0">
<!-- start partial: cf-prefs.hbs -->
<fieldset class="mt-2 flex flex-nowrap justify-start">
<legend class="font-mecherlesans-bold"> How should we contact you? </legend>
<div class="mt-2 flex flex-row">
<input id="contact-form-pref-email" class="m2-radio-input pointer-events-none absolute m-0 h-0 w-0 p-0 opacity-0" type="radio" value="email" x-model="form.pref" aria-label="Your email" @change="clearPrefErrors()">
<label for="contact-form-pref-email" class="m2-radio-label mr-4 inline-flex cursor-pointer select-none items-start text-sm leading-6 md:mr-4"> Your Email </label>
<input id="contact-form-pref-phone" class="m2-radio-input pointer-events-none absolute m-0 h-0 w-0 p-0 opacity-0" type="radio" value="phone" x-model="form.pref" aria-label="Your phone" @change="clearPrefErrors()">
<label for="contact-form-pref-phone" class="m2-radio-label mr-4 inline-flex cursor-pointer select-none items-start text-sm leading-6 md:mr-4"> Your Phone </label>
</div>
</fieldset>
<!-- end partial: cf-prefs.hbs -->
<!-- start partial: cf-contact-info.hbs -->
<div class="w-full mt-4">
<!-- start partial: form-label.hbs -->
<label for="contact-form-name" class="block w-full px-2 pb-1 border rounded-md bg-white " :class="hasError('name') ? 'border-2 border-sf-red' : 'border-gray-600'">
<span class="block pt-2 text-sm text-gray-700">Your First & Last Name</span>
<input id="contact-form-name" class="w-full" x-ref="name" x-model="form.name" type="text" :aria-invalid="hasError('name')" :aria-describedby="hasError('name') ? $id('error', 'name') : null" aria-required="true"
@keydown.debounce.750ms="validateName()">
</label>
<!-- end partial: form-label.hbs -->
</div>
<div class="w-full mt-4">
<!-- start partial: form-label.hbs -->
<label for="contact-form-phone" class="block w-full px-2 pb-1 border rounded-md bg-white " :class="hasError('phone') ? 'border-2 border-sf-red' : 'border-gray-600'">
<span class="block pt-2 text-sm text-gray-700">Your Phone Number</span>
<input id="contact-form-phone" class="w-full" x-ref="name" x-model="form.phone" type="text" :aria-invalid="hasError('phone')" :aria-describedby="hasError('phone') ? $id('error', 'phone') : null"
aria-required="hasError('phone') && form.pref == 'phone'" @keydown.debounce.750ms="validatePhone()">
</label>
<!-- end partial: form-label.hbs -->
</div>
<div class="w-full mt-4">
<!-- start partial: form-label.hbs -->
<label for="contact-form-email" class="block w-full px-2 pb-1 border rounded-md bg-white " :class="hasError('email') ? 'border-2 border-sf-red' : 'border-gray-600'">
<span class="block pt-2 text-sm text-gray-700">Your E-Mail Address</span>
<input id="contact-form-email" class="w-full" x-ref="email" x-model="form.email" type="text" :aria-invalid="hasError('email')" :aria-describedby="hasError('email') ? $id('error', 'email') : null"
aria-required="hasError('email') && form.pref == 'email'" @keydown.debounce.750ms="validateEmail()">
</label>
<!-- end partial: form-label.hbs -->
</div>
<!-- end partial: cf-contact-info.hbs -->
</div>
<div class="w-full md:mr-4 md:w-1/2">
<div class="hidden italic text-center md:block">
<span id="callAnytime">Call our office anytime at</span>
<a id="phone-link-contact-me-md" href="tel:3368545011" class="red-link" aria-describedby="callAnytime">
(336) 854-5011
</a>
</div>
<div id="contact-form-message-block" class="mt-4">
<div class="italic">
<!-- start partial: cf-message-warning.hbs -->
<p class="text-xs" :id="$id('message-warning')"> For your protection, please do not include sensitive personal information such as social security numbers, credit/debit card number, or health/medical information. </p>
<!-- end partial: cf-message-warning.hbs -->
</div>
<!-- start partial: cf-message.hbs -->
<!-- start partial: form-label.hbs -->
<label for="contact-form-message" class="block w-full px-2 pb-1 border rounded-md bg-white mt-4" :class="hasError('message') ? 'border-2 border-sf-red' : 'border-gray-600'">
<span class="block pt-2 text-sm text-gray-700">Your Message:</span>
<textarea id="contact-form-message" x-ref="message" x-model="form.message" class="w-full font-sans text-xl" rows="4" :aria-invalid="hasError('message')"
:aria-describedby="`${$id("message-warning")} ${hasError("message") ? $id("error", "message") : ""}`" aria-required="hasError('message')"
@keydown.debounce.750ms="validateMessage()"></textarea>
</label>
<!-- end partial: form-label.hbs -->
<!-- end partial: cf-message.hbs -->
</div>
<!-- start partial: file-input.hbs -->
<div x-ref="contactFormAttachments" class="w-full" x-data="initFileInput()">
<div x-show="$store.fileList.length" class="w-full mt-2 mb-2 text-xl italic text-center border-b-2 border-gray-400 border-dashed" x-text="$store.fileList.length + ' attached file' + ($store.fileList.length > 1 ? 's:' : ':')">
</div>
<template x-for="(att, idx) in $store.fileList">
<div :key="idx" class="flex w-full my-2 flex-nowrap">
<div class="flex w-1/5 h-12 mr-1">
<img x-show="checkType(att) === 'img'" :id="att.name" class="object-contain w-16 p-1 border-2 border-gray-400" :alt="att.name">
<template x-if="checkType(att) != 'img'">
<div x-html="svgIcon(checkType(att), "h-full")" class="h-full">
</div>
</template>
</div>
<div class="w-3/5 mr-1">
<span class="inline-block text-sm align-middle md:text-base" x-text="att.name">
</span>
</div>
<div class="w-1/5 text-right">
<span :aria-label="`This file is ${friendlySize(att.size)} in size`" data-microtip-position="top-left" role="tooltip" class="px-2 py-1 text-xs rounded-full bg-sf-charcoal-100" x-html="friendlySize(att.size)"></span>
<div class="text-sm">
<a href="#" :title="`Cancel upload of ${att.name}`" @click.prevent="removeFile(idx)">
<span class="red-link whitespace-nowrap">
<div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 12 14" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet"><path d="M8.57 8.43 7.429 9.571a.249.249 0 0 1-.359 0L6 8.501l-1.07 1.07a.249.249 0 0 1-.359 0L3.43 8.43a.249.249 0 0 1 0-.359l1.07-1.07-1.07-1.07a.249.249 0 0 1 0-.359l1.141-1.141a.249.249 0 0 1 .359 0L6 5.501l1.07-1.07a.249.249 0 0 1 .359 0L8.57 5.572a.249.249 0 0 1 0 .359L7.5 7.001l1.07 1.07a.249.249 0 0 1 0 .359zM10.25 7c0-2.344-1.906-4.25-4.25-4.25S1.75 4.656 1.75 7 3.656 11.25 6 11.25 10.25 9.344 10.25 7zM12 7A6 6 0 0 1 0 7a6 6 0 0 1 12 0z"></path></svg></div>
Remove
</span>
</a>
</div>
</div>
</div>
</template>
<div class="file-select">
<div class="relative overflow-hidden cursor-pointer">
<label for="contact-me-attachment-upload" class="mt-4 rounded-md btn btn-secondary">
<span role="button" aria-controls="contact-me-attachment-upload" tabindex="0" @keydown.enter="$refs['file-upload-input'].click()" @keydown.space="$refs['file-upload-input'].click()" x-text="`Add Attachments ${sizeRemainingMessage()}`">
</span>
</label>
<input x-ref="file-upload-input" type="file" hidden="" id="contact-me-attachment-upload" name="cf-attachments" multiple="" :aria-disabled="tooManyBytes" :accept="acceptableFileTypes" @change="pickFiles($event.target.files)">
</div>
<div class="mt-2 text-xs italic"> Please attach only <span x-text="readableExtensionList()"></span> file(s) — Unsupported file types will not be delivered to the agent. </div>
</div>
</div>
<!-- end partial: file-input.hbs -->
</div>
<!-- start partial: cf-more-info.hbs -->
<fieldset class="mt-4 w-full md:mt-0 md:w-1/4">
<legend class="font-mecherlesans-bold mb-2 w-full"> I'd like more info about: </legend>
<template x-for="(i, k) in moreVals">
<div class="m2-contact-form-checkbox flex w-full" :id="`contact-form-${i.id}-checkbox`" :key="`contact-form-${i.id}`">
<input :id="`contact-form-${i.id}`" class="m2-checkbox-input absolute h-0 w-0 overflow-hidden border-none p-0" x-model="form.more" type="checkbox" :aria-describedby="hasError('message') ? $id('error', 'message') : null"
:class="{ error: hasError('more') }" :value="i.label" :aria-label="`${k + 1} of ${moreVals().length}, I'd like more info about ${i.label}`" :aria-invalid="hasError('more')" @click="validateMessage()">
<label :for="`contact-form-${i.id}`" class="m2-checkbox-label flex w-full cursor-pointer items-center rounded py-2 pl-8 transition-all hover:bg-sf-charcoal-100">
<svg viewBox="0 0 100 100" class="absolute left-1 h-4 w-4">
<path class="path" fill="none" stroke="#000" stroke-width="13" stroke-linecap="round" stroke-linejoin="round" stroke-miterlimit="10" d="M12.1 52.1l24.4 24.4 53-53"></path>
</svg>
<span class="text-sm" x-html="i.label"></span>
</label>
</div>
</template>
</fieldset>
<!-- end partial: cf-more-info.hbs -->
</div>
<div class="flex flex-col md:mt-4">
<div class="flex flex-col md:flex-row-reverse">
<div class="w-full md:w-1/4 mt-4 md:mt-0 lg:-mt-[6.8rem]">
<!-- start partial: cf-submit.hbs -->
<button @click="submit" type="button" :aria-disabled="isSendDisabled()" class="btn btn-primary rounded-md"> Send Email </button>
<!-- end partial: cf-submit.hbs -->
</div>
<div class="w-full mt-2 md:w-3/4">
<!-- start partial: cf-errors.hbs -->
<div x-show="hasErrors" role="alert" class="rounded-md border-2 border-sf-red-700 bg-sf-red-100 p-4 text-sf-red-700">
<!-- The only way ATs will read all of the text below on failed validation is if they are rendered as <p> elements -->
<!-- "Please forgive this" -->
<h2 class="text-xl font-bold"> Please correct the following: </h2>
<ul class="list-inside list-disc">
<template x-for="(message, key) in errors" :key="$id('error', key)">
<li class="mb-1" :id="$id('error', key)" x-html="message"></li>
</template>
</ul>
</div>
<!-- end partial: cf-errors.hbs -->
</div>
</div>
<div class="w-full mt-4 space-y-2">
<!-- start partial: cf-coverage-disclaimer.hbs -->
<p class="text-xs leading-3">
<span class="font-mecherlesans-bold"> Please note: </span> Insurance coverage cannot be bound or changed via submission of this online e-mail form or via voice mail. To make policy changes or request additional coverage, please speak with a
licensed representative in the agent's office, or by contacting the State Farm toll-free customer service line at <a href="tel:8557337333" class="red-link">
(855) 733-7333
</a> .
</p>
<!-- end partial: cf-coverage-disclaimer.hbs -->
<!-- start partial: cf-disclaimer.hbs -->
<p :id="$id('cf-disclaimer')" class="text-xs leading-3"> By filling out the form, you are providing express consent by electronic signature that you may be contacted by telephone (via call and/or text messages) and/or email for marketing
purposes by State Farm Mutual Automobile Insurance Company, its subsidiaries and affiliates ("State Farm") or an independent contractor State Farm agent regarding insurance products and services using the phone number and/or email address you
have provided to State Farm, even if your phone number is listed on a Do Not Call Registry. You further agree that such contact may be made using an automatic telephone dialing system and/or prerecorded voice (message and data rates may
apply). Your consent is not a condition of purchase. By continuing, you agree to the terms of the disclosures above. </p>
<!-- end partial: cf-disclaimer.hbs -->
</div>
</div>
</form>Text Content
CONTACT MICHAEL PITTMAN FOR A PERSONALIZED QUOTE
Your Name *
Your Email or Phone *
For your protection, please do not include sensitive personal information such
as social security numbers, credit/debit card number, or health/medical
information.
Your Message: *
Send Email
PLEASE CORRECT THE FOLLOWING:
By filling out the form, you are providing express consent by electronic
signature that you may be contacted by telephone (via call and/or text messages)
and/or email for marketing purposes by State Farm Mutual Automobile Insurance
Company, its subsidiaries and affiliates ("State Farm") or an independent
contractor State Farm agent regarding insurance products and services using the
phone number and/or email address you have provided to State Farm, even if your
phone number is listed on a Do Not Call Registry. You further agree that such
contact may be made using an automatic telephone dialing system and/or
prerecorded voice (message and data rates may apply). Your consent is not a
condition of purchase. By continuing, you agree to the terms of the disclosures
above.
Please note: Insurance coverage cannot be bound or changed via submission of
this online e-mail form or via voice mail. To make policy changes or request
additional coverage, please speak with a licensed representative in the agent's
office, or by contacting the State Farm toll-free customer service line at (855)
733-7333 .
Close
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(336) 854-5011Call
Text
Office Hours
Mon-Fri 9:00am to 5:00pm
After Hours by Appointment
INSURANCE PRODUCTS OFFERED
Auto, Homeowners, Condo, Renters, Personal Articles, Business, Life, Health
OTHER PRODUCTS OFFERED
Banking, Annuities
View Licenses
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MICHAEL PITTMAN
Michael Pittman Ins Agcy Inc
LUTCF®
5834 W. Gate City Blvd Ste. B
Greensboro, NC 27407
Located next to Marisol and Lou Bella's Salon
Map & Directions
Contact Us
Get ID Card
ABOUT ME
Middle Tennessee State University, B.S. Mathematics Associated with State Farm
since March 1989 Focusing on Auto, Home, Renters, Life, Health Insurance Bronze
Tablet Qualifier Board Member- BBBS of the Central Piedmont Past Board
Member-Guilford County Parks and Recreation Past Board Member Guilford
City/County Insurance Board of Directors State Farm Employees/Agents PAC Life
Member Alpha Phi Alpha Fraternity Inc. Past President Jamestown Rotary Club IIA
General Insurance Life Underwriting Training Council Fellow (LUTCF) ATS Member
WOULD YOU LIKE TO CREATE A PERSONALIZED QUOTE?
Insurance Product:
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Insurance
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Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington
Washington, D.C. West Virginia Wisconsin Wyoming
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WOULD YOU LIKE TO CREATE A PERSONALIZED QUOTE?
Insurance Product:
AutoHomeownersCondo OwnersRentersLifeHospital IncomeMedicare SupplementPet
Insurance
Zipcode: Zipcode: State:
Your State Alabama Alaska Arizona Arkansas California Colorado Connecticut
Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky
Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri
Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North
Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South
Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington
Washington, D.C. West Virginia Wisconsin Wyoming
GO
Continue a saved quote Items needed for a quote
About Me
Middle Tennessee State University, B.S. Mathematics Associated with State Farm
since March 1989 Focusing on Auto, Home, Renters, Life, Health Insurance Bronze
Tablet Qualifier Board Member- BBBS of the Central Piedmont Past Board
Member-Guilford County Parks and Recreation Past Board Member Guilford
City/County Insurance Board of Directors State Farm Employees/Agents PAC Life
Member Alpha Phi Alpha Fraternity Inc. Past President Jamestown Rotary Club IIA
General Insurance Life Underwriting Training Council Fellow (LUTCF) ATS Member
Products
INSURANCE PRODUCTS OFFERED
Auto, Homeowners, Condo, Renters, Personal Articles, Business, Life, Health
OTHER PRODUCTS OFFERED
Banking, Annuities
Office Hours
Office Hours
Mon-Fri 9:00am to 5:00pm
After Hours by Appointment
Location & Phone
OFFICE INFO
5834 W. Gate City Blvd Ste. B
Greensboro, NC 27407
Map & Directions
* PHONE:
(336) 854-5011
* FAX:
(336) 854-2040
File A Claim
Send A Payment
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Contact Us Our Mission Our Team We're Hiring
Call our office anytime at (336) 854-5011
How should we contact you?
Your Email Your Phone
Your First & Last Name
Your Phone Number
Your E-Mail Address
Call our office anytime at (336) 854-5011
For your protection, please do not include sensitive personal information such
as social security numbers, credit/debit card number, or health/medical
information.
Your Message:
Remove
Please attach only file(s) — Unsupported file types will not be delivered to the
agent.
I'd like more info about:
Send Email
PLEASE CORRECT THE FOLLOWING:
Please note: Insurance coverage cannot be bound or changed via submission of
this online e-mail form or via voice mail. To make policy changes or request
additional coverage, please speak with a licensed representative in the agent's
office, or by contacting the State Farm toll-free customer service line at (855)
733-7333 .
By filling out the form, you are providing express consent by electronic
signature that you may be contacted by telephone (via call and/or text messages)
and/or email for marketing purposes by State Farm Mutual Automobile Insurance
Company, its subsidiaries and affiliates ("State Farm") or an independent
contractor State Farm agent regarding insurance products and services using the
phone number and/or email address you have provided to State Farm, even if your
phone number is listed on a Do Not Call Registry. You further agree that such
contact may be made using an automatic telephone dialing system and/or
prerecorded voice (message and data rates may apply). Your consent is not a
condition of purchase. By continuing, you agree to the terms of the disclosures
above.
SB
SANDRA BOYLES
Office Representative
GR
GAIL ROBERTSON
AVAILABLE POSITIONS
https://michaelpittman.sfagentjobs.com/jobs
Click to view all of Michael's current openings!
Please Note: This opportunity is about potential employment with an independent
contractor agent who solicits applications for State Farm products and services,
and does NOT result in employment with any of the State Farm Insurance
Companies. The employment selection decision , terms and conditions of
employment (such as compensation and benefits) are all determined solely by the
independent contractor agent.
Agent License for Michael Pittman
NC-1000008462
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call (336) 854-5011 .
DISCLOSURES
Life Insurance and annuities are issued by State Farm Life Insurance Company.
(Not Licensed in MA, NY, and WI) State Farm Life and Accident Assurance Company
(Licensed in New York and Wisconsin) Home Office, Bloomington, Illinois.
Deposit products offered by U.S. Bank National Association. Member FDIC.
State Farm VP Management Corp. is a separate entity from those State Farm
entities which provide banking and insurance products. Investing involves risk,
including potential for loss.
Neither State Farm nor its agents provide tax or legal advice. Please consult a
tax or legal advisor for advice regarding your personal circumstances.
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