lelandsmith.com
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35.215.73.212
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Submitted URL: http://kulwickihilton.com/
Effective URL: https://lelandsmith.com/
Submission Tags: phish.gg anti.fish automated Search All
Submission: On September 22 via api from DE — Scanned from DE
Effective URL: https://lelandsmith.com/
Submission Tags: phish.gg anti.fish automated Search All
Submission: On September 22 via api from DE — Scanned from DE
Form analysis
2 forms found in the DOMPOST /#gf_6
<form method="post" enctype="multipart/form-data" id="gform_6" action="/#gf_6" data-formid="6"> <input type="hidden" class="gforms-pum"
value="{"closepopup":false,"closedelay":0,"openpopup":false,"openpopup_id":0}">
<div id="gf_progressbar_wrapper_6" class="gf_progressbar_wrapper">
<h3 class="gf_progressbar_title">Step <span class="gf_step_current_page">1</span> of <span class="gf_step_page_count">3</span></h3>
<div class="gf_progressbar gf_progressbar_blue" aria-hidden="true">
<div class="gf_progressbar_percentage percentbar_blue percentbar_33" style="width:33%;"><span>33%</span></div>
</div>
</div>
<div class="gform-body gform_body">
<div id="gform_page_6_1" class="gform_page " data-js="page-field-id-1">
<div class="gform_page_fields">
<ul id="gform_fields_6" class="gform_fields top_label form_sublabel_below description_below">
<li id="field_6_12" class="gfield gfield--type-checkbox gfield--type-choice service-list-pop field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_6_12"><label
class="gfield_label gform-field-label gfield_label_before_complex">What services are you interested? Check all that apply*</label>
<div class="ginput_container ginput_container_checkbox">
<ul class="gfield_checkbox" id="input_6_12">
<li class="gchoice gchoice_select_all"> <input class="gfield-choice-input" type="checkbox" id="choice_12_select_all" onclick="gformToggleCheckboxes( this )" onkeypress="gformToggleCheckboxes( this )"> <label for="choice_12_select_all"
id="label_12_select_all" class="gform-field-label gform-field-label--type-inline" data-label-select="Select All" data-label-deselect="Deselect All">Select All</label></li>
<li class="gchoice gchoice_6_12_1"> <input class="gfield-choice-input" name="input_12.1" type="checkbox" value="Annuities" id="choice_6_12_1"> <label for="choice_6_12_1" id="label_6_12_1"
class="gform-field-label gform-field-label--type-inline">Annuities</label></li>
<li class="gchoice gchoice_6_12_2"> <input class="gfield-choice-input" name="input_12.2" type="checkbox" value="Antique Auto" id="choice_6_12_2"> <label for="choice_6_12_2" id="label_6_12_2"
class="gform-field-label gform-field-label--type-inline">Antique Auto</label></li>
<li class="gchoice gchoice_6_12_3"> <input class="gfield-choice-input" name="input_12.3" type="checkbox" value="Auto" id="choice_6_12_3"> <label for="choice_6_12_3" id="label_6_12_3"
class="gform-field-label gform-field-label--type-inline">Auto</label></li>
<li class="gchoice gchoice_6_12_4"> <input class="gfield-choice-input" name="input_12.4" type="checkbox" value="Boat & Jet Ski" id="choice_6_12_4"> <label for="choice_6_12_4" id="label_6_12_4"
class="gform-field-label gform-field-label--type-inline">Boat & Jet Ski</label></li>
<li class="gchoice gchoice_6_12_5"> <input class="gfield-choice-input" name="input_12.5" type="checkbox" value="Business Owners Package" id="choice_6_12_5"> <label for="choice_6_12_5" id="label_6_12_5"
class="gform-field-label gform-field-label--type-inline">Business Owners Package</label></li>
<li class="gchoice gchoice_6_12_6"> <input class="gfield-choice-input" name="input_12.6" type="checkbox" value="Commercial Auto" id="choice_6_12_6"> <label for="choice_6_12_6" id="label_6_12_6"
class="gform-field-label gform-field-label--type-inline">Commercial Auto</label></li>
<li class="gchoice gchoice_6_12_7"> <input class="gfield-choice-input" name="input_12.7" type="checkbox" value="Condo" id="choice_6_12_7"> <label for="choice_6_12_7" id="label_6_12_7"
class="gform-field-label gform-field-label--type-inline">Condo</label></li>
<li class="gchoice gchoice_6_12_8"> <input class="gfield-choice-input" name="input_12.8" type="checkbox" value="Flood" id="choice_6_12_8"> <label for="choice_6_12_8" id="label_6_12_8"
class="gform-field-label gform-field-label--type-inline">Flood</label></li>
<li class="gchoice gchoice_6_12_9"> <input class="gfield-choice-input" name="input_12.9" type="checkbox" value="Home" id="choice_6_12_9"> <label for="choice_6_12_9" id="label_6_12_9"
class="gform-field-label gform-field-label--type-inline">Home</label></li>
<li class="gchoice gchoice_6_12_11"> <input class="gfield-choice-input" name="input_12.11" type="checkbox" value="Landlord" id="choice_6_12_11"> <label for="choice_6_12_11" id="label_6_12_11"
class="gform-field-label gform-field-label--type-inline">Landlord</label></li>
<li class="gchoice gchoice_6_12_12"> <input class="gfield-choice-input" name="input_12.12" type="checkbox" value="Life Insurance" id="choice_6_12_12"> <label for="choice_6_12_12" id="label_6_12_12"
class="gform-field-label gform-field-label--type-inline">Life Insurance</label></li>
<li class="gchoice gchoice_6_12_13"> <input class="gfield-choice-input" name="input_12.13" type="checkbox" value="Long Term Care" id="choice_6_12_13"> <label for="choice_6_12_13" id="label_6_12_13"
class="gform-field-label gform-field-label--type-inline">Long Term Care</label></li>
<li class="gchoice gchoice_6_12_14"> <input class="gfield-choice-input" name="input_12.14" type="checkbox" value="Motorcycle" id="choice_6_12_14"> <label for="choice_6_12_14" id="label_6_12_14"
class="gform-field-label gform-field-label--type-inline">Motorcycle</label></li>
<li class="gchoice gchoice_6_12_15"> <input class="gfield-choice-input" name="input_12.15" type="checkbox" value="Renters" id="choice_6_12_15"> <label for="choice_6_12_15" id="label_6_12_15"
class="gform-field-label gform-field-label--type-inline">Renters</label></li>
<li class="gchoice gchoice_6_12_16"> <input class="gfield-choice-input" name="input_12.16" type="checkbox" value="Umbrella" id="choice_6_12_16"> <label for="choice_6_12_16" id="label_6_12_16"
class="gform-field-label gform-field-label--type-inline">Umbrella</label></li>
<li class="gchoice gchoice_6_12_17"> <input class="gfield-choice-input" name="input_12.17" type="checkbox" value="Work Comp" id="choice_6_12_17"> <label for="choice_6_12_17" id="label_6_12_17"
class="gform-field-label gform-field-label--type-inline">Work Comp</label></li>
<li class="gchoice gchoice_6_12_18"> <input class="gfield-choice-input" name="input_12.18" type="checkbox" value="Other" id="choice_6_12_18"> <label for="choice_6_12_18" id="label_6_12_18"
class="gform-field-label gform-field-label--type-inline">Other</label></li>
</ul>
</div>
</li>
</ul>
</div>
<div class="gform_page_footer top_label"> <input type="button" id="gform_next_button_6_1" class="gform_next_button gform-theme-button button" value="Next"
onclick="jQuery("#gform_target_page_number_6").val("2"); jQuery("#gform_6").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_6").val("2"); jQuery("#gform_6").trigger("submit",[true]); } "></div>
</div>
<div id="gform_page_6_2" class="gform_page" data-js="page-field-id-1" style="display:none;">
<div class="gform_page_fields">
<ul id="gform_fields_6_2" class="gform_fields top_label form_sublabel_below description_below">
<li id="field_6_16" class="gfield gfield--type-name gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_6_16"><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_6_16"> <span id="input_6_16_3_container"
class="name_first gform-grid-col gform-grid-col--size-auto"> <input type="text" name="input_16.3" id="input_6_16_3" value="" aria-required="true"> <label for="input_6_16_3"
class="gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text">First</label> </span></div>
</li>
<li id="field_6_21" class="gfield gfield--type-name gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_6_21"><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 has_first_name no_middle_name no_last_name no_suffix gf_name_has_1 ginput_container_name gform-grid-row" id="input_6_21"> <span id="input_6_21_3_container"
class="name_first gform-grid-col gform-grid-col--size-auto"> <input type="text" name="input_21.3" id="input_6_21_3" value="" aria-required="true"> <label for="input_6_21_3"
class="gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text">First</label> </span></div>
</li>
<li id="field_6_22" class="gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_6_22"><label class="gfield_label gform-field-label"
for="input_6_22">Phone</label>
<div class="ginput_container ginput_container_phone"><input name="input_22" id="input_6_22" type="text" value="" class="medium" aria-invalid="false"></div>
</li>
<li id="field_6_18" class="gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_6_18"><label
class="gfield_label gform-field-label" for="input_6_18">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_18" id="input_6_18" type="text" value="" class="medium" aria-required="true" aria-invalid="false"></div>
</li>
<li id="field_6_19" class="gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_6_19"><label
class="gfield_label gform-field-label gfield_label_before_complex">How did you find our agency?</label>
<div class="ginput_container ginput_container_checkbox">
<ul class="gfield_checkbox" id="input_6_19">
<li class="gchoice gchoice_6_19_1"> <input class="gfield-choice-input" name="input_19.1" type="checkbox" value="Google Search" id="choice_6_19_1"> <label for="choice_6_19_1" id="label_6_19_1"
class="gform-field-label gform-field-label--type-inline">Google Search</label></li>
<li class="gchoice gchoice_6_19_2"> <input class="gfield-choice-input" name="input_19.2" type="checkbox" value="Facebook Page/Post" id="choice_6_19_2"> <label for="choice_6_19_2" id="label_6_19_2"
class="gform-field-label gform-field-label--type-inline">Facebook Page/Post</label></li>
<li class="gchoice gchoice_6_19_3"> <input class="gfield-choice-input" name="input_19.3" type="checkbox" value="Facebook/Instagram Ad" id="choice_6_19_3"> <label for="choice_6_19_3" id="label_6_19_3"
class="gform-field-label gform-field-label--type-inline">Facebook/Instagram Ad</label></li>
<li class="gchoice gchoice_6_19_4"> <input class="gfield-choice-input" name="input_19.4" type="checkbox" value="Google Ad" id="choice_6_19_4"> <label for="choice_6_19_4" id="label_6_19_4"
class="gform-field-label gform-field-label--type-inline">Google Ad</label></li>
<li class="gchoice gchoice_6_19_5"> <input class="gfield-choice-input" name="input_19.5" type="checkbox" value="Customer Referral" id="choice_6_19_5"> <label for="choice_6_19_5" id="label_6_19_5"
class="gform-field-label gform-field-label--type-inline">Customer Referral</label></li>
<li class="gchoice gchoice_6_19_6"> <input class="gfield-choice-input" name="input_19.6" type="checkbox" value="YouTube Channel" id="choice_6_19_6"> <label for="choice_6_19_6" id="label_6_19_6"
class="gform-field-label gform-field-label--type-inline">YouTube Channel</label></li>
</ul>
</div>
</li>
</ul>
</div>
<div class="gform_page_footer top_label"> <input type="button" id="gform_previous_button_6_5" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_6").val("1"); jQuery("#gform_6").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_6").val("1"); jQuery("#gform_6").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_6_5"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_6").val("3"); jQuery("#gform_6").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_6").val("3"); jQuery("#gform_6").trigger("submit",[true]); } "></div>
</div>
<div id="gform_page_6_3" class="gform_page" data-js="page-field-id-5" style="display:none;">
<div class="gform_page_fields">
<ul id="gform_fields_6_3" class="gform_fields top_label form_sublabel_below description_below">
<li id="field_6_20" class="gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_6_20"><label class="gfield_label gform-field-label"
for="input_6_20">Zip</label>
<div class="ginput_container ginput_container_number"><input name="input_20" id="input_6_20" type="text" value="" class="medium" aria-invalid="false"></div>
</li>
<li id="field_6_15" class="gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_6_15"><label class="gfield_label gform-field-label"
for="input_6_15">Comment Box:</label>
<div class="ginput_container ginput_container_textarea"><textarea name="input_15" id="input_6_15" class="textarea medium" aria-invalid="false" rows="10" cols="50"></textarea></div>
</li>
<li id="field_6_23" class="gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_6_23"><label class="gfield_label gform-field-label"
for="input_6_23">Upload current insurance declaration page for comparison.</label>
<div class="ginput_container ginput_container_fileupload"><input type="hidden" name="MAX_FILE_SIZE" value="268435456"><input name="input_23" id="input_6_23" type="file" class="medium"
onchange="javascript:gformValidateFileSize( this, 268435456 );"><span class="gfield_description gform_fileupload_rules" id="gfield_upload_rules_6_23">Max. file size: 256 MB.</span>
<div class="gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty" id="live_validation_message_6_23"></div>
</div>
</li>
<li id="field_6_24" class="gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible" data-js-reload="field_6_24"><label
class="gfield_label gform-field-label" for="input_6_24">Email</label>
<div class="ginput_container"><input name="input_24" id="input_6_24" type="text" value=""></div>
<div class="gfield_description" id="gfield_description_6_24">This field is for validation purposes and should be left unchanged.</div>
</li>
</ul>
</div>
<div class="gform_page_footer top_label"><input type="submit" id="gform_previous_button_6" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="if(window["gf_submitting_6"]){return false;} window["gf_submitting_6"]=true; "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_6"]){return false;} window["gf_submitting_6"]=true; jQuery("#gform_6").trigger("submit",[true]); }"> <input type="submit"
id="gform_submit_button_6" class="gform_button button" value="Submit" onclick="if(window["gf_submitting_6"]){return false;} window["gf_submitting_6"]=true; "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_6"]){return false;} window["gf_submitting_6"]=true; jQuery("#gform_6").trigger("submit",[true]); }"> <input type="hidden"
class="gform_hidden" name="is_submit_6" value="1"> <input type="hidden" class="gform_hidden" name="gform_submit" value="6"> <input type="hidden" class="gform_hidden" name="gform_unique_id" value=""> <input type="hidden" class="gform_hidden"
name="state_6" value="WyJbXSIsImY3NDEyNGJiMWRkNjI3Mjg0NmYyOGE2YzA3ODE0MDJiIl0="> <input type="hidden" class="gform_hidden" name="gform_target_page_number_6" id="gform_target_page_number_6" value="2"> <input type="hidden"
class="gform_hidden" name="gform_source_page_number_6" id="gform_source_page_number_6" value="1"> <input type="hidden" name="gform_field_values" value=""></div>
</div>
</div>
<p style="display: none !important;"><label>Δ<textarea name="ak_hp_textarea" cols="45" rows="8" maxlength="100"></textarea></label><input type="hidden" id="ak_js_1" name="ak_js" value="1695418841720">
<script>
document.getElementById("ak_js_1").setAttribute("value", (new Date()).getTime());
</script>
</p><input type="hidden" name="pum_form_popup_id" value="10596">
</form>
POST /
<form method="post" enctype="multipart/form-data" id="gform_9" action="/" data-formid="9"> <input type="hidden" class="gforms-pum" value="{"closepopup":false,"closedelay":0,"openpopup":false,"openpopup_id":0}">
<div class="gform-body gform_body">
<div id="gform_fields_9" class="gform_fields top_label form_sublabel_below description_below">
<div id="field_9_7" class="gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_9_7"></div>
<div id="field_9_1" class="gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_9_1"><label
class="gfield_label gform-field-label" for="input_9_1">First Name<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_1" id="input_9_1" type="text" value="" class="large" placeholder="First Name*" aria-required="true" aria-invalid="false"></div>
</div>
<div id="field_9_2" class="gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_9_2"><label
class="gfield_label gform-field-label" for="input_9_2">Last Name<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_2" id="input_9_2" type="text" value="" class="large" placeholder="Last Name*" aria-required="true" aria-invalid="false"></div>
</div>
<div id="field_9_3" class="gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_9_3"><label
class="gfield_label gform-field-label" for="input_9_3">College Currently Attending<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_3" id="input_9_3" type="text" value="" class="large" placeholder="College Currently Attending*" aria-required="true" aria-invalid="false"></div>
</div>
<div id="field_9_11" class="gfield gfield--type-select gfield--width-two-thirds field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_9_11"><label
class="gfield_label gform-field-label" for="input_9_11">Year</label>
<div class="ginput_container ginput_container_select"><select name="input_11" id="input_9_11" class="large gfield_select" aria-invalid="false">
<option value="" selected="selected" class="gf_placeholder">Year*</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
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If you’re looking for an insurance agency that values honesty, kindness, and excellent service, I highly recommend Kyle Strawn and the entire team at Hickey Morris Insurance! Jon H. on Google 5.0 09-16-2023 You saved me about $3k a year! Thanks! Tim B. on Google 5.0 03-31-2023 Lisa was extremely helpful and gave me a great price thank you again! Abram M. on Google WHERE WE SERVE OH, IN, MI, PA, AZ, WI, KY, TN How We Help WORKING WITH LSI IS SIMPLE With over 30 years of experience, we save you time, money, and aggravation. Knowing you’re protected. WE LISTEN Gather information WE GUIDE Review best coverage options WE SERVE Apply, save, & join the family GET A QUOTE SERVING OUR COMMUNITY SINCE 1984. IT’S MORE THAN A BUSINESS, IT’S A FAMILY. 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