www.atlanticcoastmortgage.com
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141.193.213.11
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Submitted URL: https://acmllc.com/
Effective URL: https://www.atlanticcoastmortgage.com/
Submission: On May 22 via api from US — Scanned from DE
Effective URL: https://www.atlanticcoastmortgage.com/
Submission: On May 22 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
POST /#gf_9
<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_9" id="gform_9" action="/#gf_9" data-formid="9" novalidate=""><span class="wrap_progress_bar" style="visibility:hidden;display:none">
<div id="gf_progressbar_wrapper_9" class="gf_progressbar_wrapper" data-start-at-zero="">
<h3 class="gf_progressbar_title">Step <span class="gf_step_current_page">1</span> of <span class="gf_step_page_count">2</span>
</h3>
<div class="gf_progressbar gf_progressbar_blue" aria-hidden="true">
<div class="gf_progressbar_percentage percentbar_blue percentbar_50" style="width:50%;"><span>50%</span></div>
</div>
</div>
</span>
<div class="gform-body gform_body">
<div id="gform_page_9_1" class="gform_page " data-js="page-field-id-1">
<div class="gform_page_fields">
<ul id="gform_fields_9" class="gform_fields top_label form_sublabel_below description_below validation_below">
<li id="field_9_43" class="gfield gfield--type-html 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_9_43">
<h3 style="color: #000000; margin-bottom: 20px">Let's Get Started!</h3>
<p style="max-width: 600px; font-size:16px; font-weight:400; color: #000000; margin: 0 auto 0 auto;">Please enter your information below, and we'll follow up shortly with more information and next steps to help you get started with your
Reverse Mortgage.</p> <!--<p>We're excited to help you with this next step in your homebuying journey! Let's get started.</p> -->
</li>
<li id="field_9_16" class="gfield gfield--type-name gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible"
data-js-reload="field_9_16"><label class="gfield_label gform-field-label gfield_label_before_complex">What is your full 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_9_16">
<span id="input_9_16_3_container" class="name_first gform-grid-col gform-grid-col--size-auto">
<input type="text" name="input_16.3" id="input_9_16_3" value="" aria-required="true" placeholder="First Name">
<label for="input_9_16_3" class="gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text">First</label>
</span>
<span id="input_9_16_6_container" class="name_last gform-grid-col gform-grid-col--size-auto">
<input type="text" name="input_16.6" id="input_9_16_6" value="" aria-required="true" placeholder="Last Name">
<label for="input_9_16_6" class="gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text">Last</label>
</span>
</div>
</li>
<li id="field_9_17" class="gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible" data-js-reload="field_9_17">
<label class="gfield_label gform-field-label" for="input_9_17">What is your email address?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_17" id="input_9_17" type="email" value="" class="medium" placeholder="example@gmail.com" aria-required="true" aria-invalid="false">
</div>
</li>
<li id="field_9_18" class="gfield gfield--type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible" data-js-reload="field_9_18">
<label class="gfield_label gform-field-label" for="input_9_18">What is your phone number?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_phone"><input name="input_18" id="input_9_18" type="tel" value="" class="medium" placeholder="(XXX) XXX-XXXX" aria-required="true" aria-invalid="false"></div>
</li>
</ul>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_next_button_9_26" class="gform_next_button gform-theme-button button" value="Next >"
onclick="jQuery("#gform_target_page_number_9").val("2"); jQuery("#gform_9").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_9").val("2"); jQuery("#gform_9").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_9_2" class="gform_page" data-js="page-field-id-26" style="display:none;">
<div class="gform_page_fields">
<ul id="gform_fields_9_2" class="gform_fields top_label form_sublabel_below description_below validation_below">
<li id="field_9_47" class="gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_9_47"><label
class="gfield_label gform-field-label">How do you prefer being contacted?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_9_47">
<li class="gchoice gchoice_9_47_0">
<input name="input_47" type="radio" value="Phone Call" id="choice_9_47_0">
<label for="choice_9_47_0" id="label_9_47_0" class="gform-field-label gform-field-label--type-inline">Phone Call</label>
</li>
<li class="gchoice gchoice_9_47_1">
<input name="input_47" type="radio" value="Email" id="choice_9_47_1">
<label for="choice_9_47_1" id="label_9_47_1" class="gform-field-label gform-field-label--type-inline">Email</label>
</li>
<li class="gchoice gchoice_9_47_2">
<input name="input_47" type="radio" value="Phone Call and/or Email" id="choice_9_47_2">
<label for="choice_9_47_2" id="label_9_47_2" class="gform-field-label gform-field-label--type-inline">Phone Call and/or Email</label>
</li>
</ul>
</div>
</li>
<li id="field_9_65" class="gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_9_65"><label class="gfield_label gform-field-label gfield_label_before_complex">When is the best time to call?<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_checkbox">
<ul class="gfield_checkbox" id="input_9_65">
<li class="gchoice gchoice_9_65_1">
<input class="gfield-choice-input" name="input_65.1" type="checkbox" value="As soon as possible" id="choice_9_65_1">
<label for="choice_9_65_1" id="label_9_65_1" class="gform-field-label gform-field-label--type-inline">As soon as possible</label>
</li>
<li class="gchoice gchoice_9_65_2">
<input class="gfield-choice-input" name="input_65.2" type="checkbox" value="Early morning (7:00 AM to 10:00 AM)" id="choice_9_65_2">
<label for="choice_9_65_2" id="label_9_65_2" class="gform-field-label gform-field-label--type-inline">Early morning (7:00 AM to 10:00 AM)</label>
</li>
<li class="gchoice gchoice_9_65_3">
<input class="gfield-choice-input" name="input_65.3" type="checkbox" value="Late morning (10:00 AM to 12:00 PM)" id="choice_9_65_3">
<label for="choice_9_65_3" id="label_9_65_3" class="gform-field-label gform-field-label--type-inline">Late morning (10:00 AM to 12:00 PM)</label>
</li>
<li class="gchoice gchoice_9_65_4">
<input class="gfield-choice-input" name="input_65.4" type="checkbox" value="Early afternoon (12:00 PM to 2:00 PM)" id="choice_9_65_4">
<label for="choice_9_65_4" id="label_9_65_4" class="gform-field-label gform-field-label--type-inline">Early afternoon (12:00 PM to 2:00 PM)</label>
</li>
<li class="gchoice gchoice_9_65_5">
<input class="gfield-choice-input" name="input_65.5" type="checkbox" value="Mid-afternoon (2:00 PM to 4:00 PM)" id="choice_9_65_5">
<label for="choice_9_65_5" id="label_9_65_5" class="gform-field-label gform-field-label--type-inline">Mid-afternoon (2:00 PM to 4:00 PM)</label>
</li>
<li class="gchoice gchoice_9_65_6">
<input class="gfield-choice-input" name="input_65.6" type="checkbox" value="Late afternoon (4:00 PM to 6:00 PM)" id="choice_9_65_6">
<label for="choice_9_65_6" id="label_9_65_6" class="gform-field-label gform-field-label--type-inline">Late afternoon (4:00 PM to 6:00 PM)</label>
</li>
<li class="gchoice gchoice_9_65_7">
<input class="gfield-choice-input" name="input_65.7" type="checkbox" value="Evening (6:00 PM to 8:00 PM)" id="choice_9_65_7">
<label for="choice_9_65_7" id="label_9_65_7" class="gform-field-label gform-field-label--type-inline">Evening (6:00 PM to 8:00 PM)</label>
</li>
<li class="gchoice gchoice_9_65_8">
<input class="gfield-choice-input" name="input_65.8" type="checkbox" value="Night (8:00 PM to 10:00 PM)" id="choice_9_65_8">
<label for="choice_9_65_8" id="label_9_65_8" class="gform-field-label gform-field-label--type-inline">Night (8:00 PM to 10:00 PM)</label>
</li>
</ul>
</div>
</li>
<li id="field_9_67"
class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_9_67"><label class="gfield_label gform-field-label gfield_label_before_complex">Agreement<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="gfield_description gfield_consent_description" id="gfield_consent_description_9_67">By entering a phone number and/or email address and clicking the "Submit" button or otherwise submitting or sending the information entered by
you, you are giving express written consent to Atlantic Coast Mortgage, its affiliates, agents, and service providers to contact you via email, or live, automated or pre-recorded telephone call, or text message (SMS and MMS) even if
your telephone number is a cellular number or on a corporate, state, or national Do Not Call Registry or other do not contact list. You accept the charges, which your phone carrier may impose for these communications. By communicating
with us by phone, you consent to calls being recorded and monitored. You can revoke any of these consents at any time by contacting us <a href="https://www.atlanticcoastmortgage.com/contact/" target="_blank">here</a>, and you are not
required to provide any of the foregoing consents as a condition of purchasing goods or services from Atlantic Coast Mortgage. The following additional terms and conditions may apply:
<a href="https://www.atlanticcoastmortgage.com/privacy-policy/" target="_blank">Privacy Policy</a>, <a href="https://www.atlanticcoastmortgage.com/privacy-notice/" target="_blank">Privacy Notice</a>,
<a href="https://www.atlanticcoastmortgage.com/terms-of-service/" target="_blank">Terms of Service</a>, and <a href="https://www.atlanticcoastmortgage.com/legal/" target="_blank">Additional Legal Information</a>.</div>
<div class="ginput_container ginput_container_consent"><input name="input_67.1" id="input_9_67_1" type="checkbox" value="1" aria-describedby="gfield_consent_description_9_67" aria-required="true" aria-invalid="false"> <label
class="gform-field-label gform-field-label--type-inline gfield_consent_label" for="input_9_67_1">I Agree</label><input type="hidden" name="input_67.2" value="I Agree" class="gform_hidden"><input type="hidden" name="input_67.3"
value="4" class="gform_hidden"></div>
</li>
<li id="field_9_56" class="gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden" data-js-reload="field_9_56">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label gform-field-label" for="input_9_56">LO Profile Image URL</label>
<div class="ginput_container ginput_container_phone"><input name="input_56" id="input_9_56" type="tel" value="" class="medium" aria-invalid="false"></div>
</li>
<li id="field_9_48" class="gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden" data-js-reload="field_9_48">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label gform-field-label" for="input_9_48">LO First Name</label>
<div class="ginput_container ginput_container_phone"><input name="input_48" id="input_9_48" type="tel" value="" class="medium" aria-invalid="false"></div>
</li>
<li id="field_9_60" class="gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden" data-js-reload="field_9_60">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label gform-field-label" for="input_9_60">LO Last Name</label>
<div class="ginput_container ginput_container_phone"><input name="input_60" id="input_9_60" type="tel" value="" class="medium" aria-invalid="false"></div>
</li>
<li id="field_9_57" class="gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden" data-js-reload="field_9_57">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label gform-field-label" for="input_9_57">LO Title</label>
<div class="ginput_container ginput_container_phone"><input name="input_57" id="input_9_57" type="tel" value="" class="medium" aria-invalid="false"></div>
</li>
<li id="field_9_58" class="gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden" data-js-reload="field_9_58">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label gform-field-label" for="input_9_58">LO NMLS ID</label>
<div class="ginput_container ginput_container_phone"><input name="input_58" id="input_9_58" type="tel" value="" class="medium" aria-invalid="false"></div>
</li>
<li id="field_9_38" class="gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden" data-js-reload="field_9_38">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label gform-field-label" for="input_9_38">LO Mobile Phone</label>
<div class="ginput_container ginput_container_phone"><input name="input_38" id="input_9_38" type="tel" value="" class="medium" aria-invalid="false"></div>
</li>
<li id="field_9_49" class="gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden" data-js-reload="field_9_49">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label gform-field-label" for="input_9_49">LO Office Phone</label>
<div class="ginput_container ginput_container_phone"><input name="input_49" id="input_9_49" type="tel" value="" class="medium" aria-invalid="false"></div>
</li>
<li id="field_9_51" class="gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden" data-js-reload="field_9_51">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label gform-field-label" for="input_9_51">LO Address</label>
<div class="ginput_container ginput_container_phone"><input name="input_51" id="input_9_51" type="tel" value="" class="medium" aria-invalid="false"></div>
</li>
<li id="field_9_52" class="gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden" data-js-reload="field_9_52">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label gform-field-label" for="input_9_52">LO City</label>
<div class="ginput_container ginput_container_phone"><input name="input_52" id="input_9_52" type="tel" value="" class="medium" aria-invalid="false"></div>
</li>
<li id="field_9_53" class="gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden" data-js-reload="field_9_53">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label gform-field-label" for="input_9_53">LO State</label>
<div class="ginput_container ginput_container_phone"><input name="input_53" id="input_9_53" type="tel" value="" class="medium" aria-invalid="false"></div>
</li>
<li id="field_9_54" class="gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden" data-js-reload="field_9_54">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label gform-field-label" for="input_9_54">LO Zip</label>
<div class="ginput_container ginput_container_phone"><input name="input_54" id="input_9_54" type="tel" value="" class="medium" aria-invalid="false"></div>
</li>
<li id="field_9_59" class="gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden" data-js-reload="field_9_59">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label gform-field-label" for="input_9_59">LO Apply Link</label>
<div class="ginput_container ginput_container_phone"><input name="input_59" id="input_9_59" type="tel" value="" class="medium" aria-invalid="false"></div>
</li>
<li id="field_9_55" class="gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden" data-js-reload="field_9_55">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label gform-field-label" for="input_9_55">LO Video ID</label>
<div class="ginput_container ginput_container_phone"><input name="input_55" id="input_9_55" type="tel" value="" class="medium" aria-invalid="false"></div>
</li>
<li id="field_9_68" class="gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_9_68">
<div class="ginput_container ginput_container_text"><input name="input_68" id="input_9_68" type="hidden" class="gform_hidden" aria-invalid="false" value=""></div>
</li>
</ul>
</div>
<div class="gform_page_footer top_label"><input type="submit" id="gform_previous_button_9" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="< Previous"
onclick="if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} jQuery("#gform_9").trigger("submit",[true]); }">
<input type="submit" id="gform_submit_button_9" class="gform_button button" value="Submit"
onclick="if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} jQuery("#gform_9").trigger("submit",[true]); }">
<input type="hidden" name="gform_ajax" value="form_id=9&title=&description=&tabindex=0&theme=legacy">
<input type="hidden" class="gform_hidden" name="is_submit_9" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="9">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_9"
value="WyJ7XCI2Ny4xXCI6XCJjNzQwZTBiYmM0MDI1YjBkNzE0Y2QyYTdlMzdlOWVhN1wiLFwiNjcuMlwiOlwiM2Y4ZjNlMTZkNmI3MmNjNmQ0YzYwZTc1YWU4Nzc5MzBcIixcIjY3LjNcIjpcIjUxOGZlNGZhM2JhMTc0NDM2YWY1ZmYzNjhiNmI1ZDJkXCJ9IiwiMDViNzU0NTczMTk2NDNjM2U2ODRhODg0ZmU2YTI1OWQiXQ==">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_9" id="gform_target_page_number_9" value="2">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_9" id="gform_source_page_number_9" value="1">
<input type="hidden" name="gform_field_values" value="">
</div>
</div>
</div>
<input type="hidden" id="ct_checkjs_3b8a614226a953a8cd9526fca6fe9ba5" name="ct_checkjs" value="0"><label class="apbct_special_field" id="apbct_label_id25457" for="apbct__email_id__gravity_form_25457">25457</label><input
id="apbct__email_id__gravity_form_25457" class="apbct_special_field apbct__email_id__gravity_form" autocomplete="off" name="apbct__email_id__gravity_form_25457" type="text" value="25457" size="30" apbct_event_id="25457" maxlength="200"><input
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