{"id":40,"date":"2020-04-23T20:27:43","date_gmt":"2020-04-23T20:27:43","guid":{"rendered":"https:\/\/www.family-lawyer-north-vancouver.ca\/?page_id=40"},"modified":"2020-04-23T20:29:24","modified_gmt":"2020-04-23T20:29:24","slug":"family-intake-form","status":"publish","type":"page","link":"https:\/\/www.family-lawyer-north-vancouver.ca\/family-intake-form\/","title":{"rendered":"Family Intake Form"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; fullwidth=&#8221;on&#8221; _builder_version=&#8221;4.4.1&#8243;][et_pb_fullwidth_slider _builder_version=&#8221;4.4.1&#8243;][et_pb_slide heading=&#8221;Family Lawyers North Vancouver&#8221; use_bg_overlay=&#8221;on&#8221; _builder_version=&#8221;4.4.1&#8243; header_font_size=&#8221;52px&#8221; body_font_size=&#8221;24px&#8221; background_image=&#8221;https:\/\/www.family-lawyer-north-vancouver.ca\/wp-content\/uploads\/2020\/04\/Family-lawyers-north-vancouver-1.jpg&#8221; background_enable_image=&#8221;on&#8221; header_font_size_tablet=&#8221;42px&#8221; header_font_size_phone=&#8221;40px&#8221; header_font_size_last_edited=&#8221;on|desktop&#8221; body_font_size_tablet=&#8221;22px&#8221; body_font_size_phone=&#8221;18px&#8221; body_font_size_last_edited=&#8221;on|phone&#8221;]<\/p>\n<p>Pettit &amp; Company &#8211; Family Lawyers\u00a0<\/p>\n<p>[\/et_pb_slide][\/et_pb_fullwidth_slider][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.4.1&#8243;][et_pb_row _builder_version=&#8221;4.4.1&#8243;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.4.1&#8243;][et_pb_text _builder_version=&#8221;4.4.3&#8243; background_color=&#8221;#fcfcfc&#8221; z_index=&#8221;500&#8243; custom_margin=&#8221;-200px||||false|false&#8221; custom_margin_tablet=&#8221;-150px||||false|false&#8221; custom_margin_phone=&#8221;-130px||||false|false&#8221; custom_margin_last_edited=&#8221;on|phone&#8221; custom_padding=&#8221;20px|20px|20px|20px|false|true&#8221; border_width_all=&#8221;1px&#8221; border_color_all=&#8221;rgba(51,51,51,0.28)&#8221; box_shadow_style=&#8221;preset3&#8243;]<\/p>\n<div class=\"caldera-grid\" id=\"caldera_form_1\" data-cf-ver=\"1.9.7\" data-cf-form-id=\"CF5ea1e7eeec40c\"><div id=\"caldera_notices_1\" data-spinner=\"https:\/\/www.family-lawyer-north-vancouver.ca\/wp-admin\/images\/spinner.gif\"><\/div><form data-instance=\"1\" class=\"CF5ea1e7eeec40c caldera_forms_form cfajax-trigger\" method=\"POST\" enctype=\"multipart\/form-data\" id=\"CF5ea1e7eeec40c_1\" data-form-id=\"CF5ea1e7eeec40c\" aria-label=\"Pettit &amp; Co Family Law Intake Form\" data-target=\"#caldera_notices_1\" data-template=\"#cfajax_CF5ea1e7eeec40c-tmpl\" data-cfajax=\"CF5ea1e7eeec40c\" data-load-element=\"_parent\" data-load-class=\"cf_processing\" data-post-disable=\"0\" data-action=\"cf_process_ajax_submit\" data-request=\"https:\/\/www.family-lawyer-north-vancouver.ca\/cf-api\/CF5ea1e7eeec40c\" data-hiderows=\"true\">\r\n<input type=\"hidden\" id=\"_cf_verify_CF5ea1e7eeec40c\" name=\"_cf_verify\" value=\"0607e6676b\"  data-nonce-time=\"1711941927\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/pages\/40\" \/><div id=\"cf2-CF5ea1e7eeec40c_1\"><\/div><input type=\"hidden\" name=\"_cf_frm_id\" value=\"CF5ea1e7eeec40c\">\r\n<input type=\"hidden\" name=\"_cf_frm_ct\" value=\"1\">\r\n<input type=\"hidden\" name=\"cfajax\" value=\"CF5ea1e7eeec40c\">\r\n<input type=\"hidden\" name=\"_cf_cr_pst\" value=\"40\">\r\n<div class=\"hide\" style=\"display:none; overflow:hidden;height:0;width:0;\">\r\n<label>Email<\/label><input type=\"text\" name=\"email\" value=\"\" autocomplete=\"off\">\r\n<\/div><div id=\"CF5ea1e7eeec40c_1-row-1\"  class=\"row  first_row\"><div  class=\"col-sm-12  single\"><\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-2\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_8716621\" class=\"form-group\" id=\"fld_8716621_1-wrap\">\r\n\t<label id=\"fld_8716621Label\" for=\"fld_8716621_1\" class=\"control-label\">First Name <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_8716621\" class=\" form-control\" id=\"fld_8716621_1\" name=\"fld_8716621\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_8716621Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_3566690\" class=\"form-group\" id=\"fld_3566690_1-wrap\">\r\n\t<label id=\"fld_3566690Label\" for=\"fld_3566690_1\" class=\"control-label\">Last Name <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_3566690\" class=\" form-control\" id=\"fld_3566690_1\" name=\"fld_3566690\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_3566690Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-3\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_9852988\" class=\"form-group\" id=\"fld_9852988_1-wrap\">\r\n\t<label id=\"fld_9852988Label\" for=\"fld_9852988_1\" class=\"control-label\">Email Address <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"email\" data-field=\"fld_9852988\" class=\" form-control\" id=\"fld_9852988_1\" name=\"fld_9852988\" value=\"\" data-type=\"email\" aria-required=\"true\"   aria-labelledby=\"fld_9852988Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_48218\" class=\"form-group\" id=\"fld_48218_1-wrap\">\r\n\t<label id=\"fld_48218Label\" for=\"fld_48218_1\" class=\"control-label\">Phone<\/label>\r\n\t<div class=\"\">\r\n\t\t<input  data-inputmask=\"'mask': '(999)999-9999'\"   type=\"phone\" data-field=\"fld_48218\" class=\" form-control\" id=\"fld_48218_1\" name=\"fld_48218\" value=\"\" data-type=\"phone\"   aria-labelledby=\"fld_48218Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-4\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_4924561\" class=\"form-group\" id=\"fld_4924561_1-wrap\">\r\n\t<label id=\"fld_4924561Label\" for=\"fld_4924561_1\" class=\"control-label\">Your Address <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_4924561\" class=\" form-control\" id=\"fld_4924561_1\" name=\"fld_4924561\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_4924561Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_2703334\" class=\"form-group\" id=\"fld_2703334_1-wrap\">\r\n\t<label id=\"fld_2703334Label\" for=\"fld_2703334_1\" class=\"control-label\">Your Occupation <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_2703334\" class=\" form-control\" id=\"fld_2703334_1\" name=\"fld_2703334\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_2703334Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-5\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_7857785\" class=\"form-group\" id=\"fld_7857785_1-wrap\">\r\n\t<label id=\"fld_7857785Label\" for=\"fld_7857785_1\" class=\"control-label\">Your Estimated Annual Income <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_7857785\" class=\" form-control\" id=\"fld_7857785_1\" name=\"fld_7857785\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_7857785Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-6\"  class=\"row \"><div  class=\"col-sm-12  single\"><div class=\"\"><h2> Other Party Information <\/h2>\n<hr>\n<\/div><\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-7\"  class=\"row \"><div  class=\"col-sm-6  first_col\">\n<div data-field-wrapper=\"fld_6800156\" class=\"form-group\" id=\"fld_6800156_1-wrap\">\r\n\t<label id=\"fld_6800156Label\" for=\"fld_6800156_1\" class=\"control-label\">Date of Marriage or Cohabitation<\/label>\r\n\t<div class=\"\">\r\n\t\t<input  type=\"text\" data-provide=\"cfdatepicker\" name=\"fld_6800156\" value=\"\" id=\"fld_6800156_1\" data-field=\"fld_6800156\" class=\"form-control cfdatepicker is-cfdatepicker\" data-date-format=\"dd-mm-yyyy\" data-date-start-view=\"month\"   aria-labelledby=\"fld_6800156Label\"   \/>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_9595887\" class=\"form-group\" id=\"fld_9595887_1-wrap\">\r\n\t<label id=\"fld_9595887Label\" for=\"fld_9595887_1\" class=\"control-label\">Are you separated or living together?<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_9595887_1_opt1434678\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Together\"\n                                data-field=\"fld_9595887\"\n                                id=\"fld_9595887_1_opt1434678\"\n                                class=\"fld_9595887_1\"\n                                name=\"fld_9595887[opt1434678]\"\n                                value=\"Together\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_9595887_1\"\n                                                                data-calc-value=\"Together\"\n                            >\n                    Together                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_9595887_1_opt1595541\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Separated \"\n                                data-field=\"fld_9595887\"\n                                id=\"fld_9595887_1_opt1595541\"\n                                class=\"fld_9595887_1\"\n                                name=\"fld_9595887[opt1595541]\"\n                                value=\"Separated \"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_9595887_1\"\n                                                                data-calc-value=\"Separated \"\n                            >\n                    Separated                 <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-8\"  class=\"row \"><div  class=\"col-sm-12  single\">\n<div data-field-wrapper=\"fld_7562525\" class=\"form-group\" id=\"fld_7562525_1-wrap\">\r\n\t<label id=\"fld_7562525Label\" for=\"fld_7562525_1\" class=\"control-label\">If separated, date of separation<\/label>\r\n\t<div class=\"\">\r\n\t\t<input  type=\"text\" data-provide=\"cfdatepicker\" name=\"fld_7562525\" value=\"\" id=\"fld_7562525_1\" data-field=\"fld_7562525\" class=\"form-control cfdatepicker is-cfdatepicker\" data-date-format=\"dd-mm-yyyy\" data-date-start-view=\"month\"   aria-labelledby=\"fld_7562525Label\"   \/>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-9\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_9996141\" class=\"form-group\" id=\"fld_9996141_1-wrap\">\r\n\t<label id=\"fld_9996141Label\" for=\"fld_9996141_1\" class=\"control-label\">Other Parties First Name <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_9996141\" class=\" form-control\" id=\"fld_9996141_1\" name=\"fld_9996141\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_9996141Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_4972987\" class=\"form-group\" id=\"fld_4972987_1-wrap\">\r\n\t<label id=\"fld_4972987Label\" for=\"fld_4972987_1\" class=\"control-label\">Other Parties Last Name <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_4972987\" class=\" form-control\" id=\"fld_4972987_1\" name=\"fld_4972987\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_4972987Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-10\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_5080506\" class=\"form-group\" id=\"fld_5080506_1-wrap\">\r\n\t<label id=\"fld_5080506Label\" for=\"fld_5080506_1\" class=\"control-label\">Other Parties Address <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_5080506\" value=\"\" data-field=\"fld_5080506\" class=\"form-control\" id=\"fld_5080506_1\" rows=\"4\" maxlength=\"500\"  required=\"required\"  aria-labelledby=\"fld_5080506Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-11\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_1777161\" class=\"form-group\" id=\"fld_1777161_1-wrap\">\r\n\t<label id=\"fld_1777161Label\" for=\"fld_1777161_1\" class=\"control-label\">Other Parties Occupation <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_1777161\" class=\" form-control\" id=\"fld_1777161_1\" name=\"fld_1777161\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_1777161Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_8063374\" class=\"form-group\" id=\"fld_8063374_1-wrap\">\r\n\t<label id=\"fld_8063374Label\" for=\"fld_8063374_1\" class=\"control-label\">Other Parties Estimated Annual Income <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_8063374\" class=\" form-control\" id=\"fld_8063374_1\" name=\"fld_8063374\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_8063374Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-12\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_4541101\" class=\"form-group\" id=\"fld_4541101_1-wrap\">\r\n\t<label id=\"fld_4541101Label\" for=\"fld_4541101_1\" class=\"control-label\">Are either yourself or the other party currently retained by counsel?<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4541101_1_opt1846867\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Yes\"\n                                data-field=\"fld_4541101\"\n                                id=\"fld_4541101_1_opt1846867\"\n                                class=\"fld_4541101_1\"\n                                name=\"fld_4541101[opt1846867]\"\n                                value=\"Yes\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4541101_1\"\n                                                                data-calc-value=\"Yes\"\n                            >\n                    Yes                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4541101_1_opt1555589\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"No\"\n                                data-field=\"fld_4541101\"\n                                id=\"fld_4541101_1_opt1555589\"\n                                class=\"fld_4541101_1\"\n                                name=\"fld_4541101[opt1555589]\"\n                                value=\"No\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4541101_1\"\n                                                                data-calc-value=\"No\"\n                            >\n                    No                <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-13\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_7775428\" class=\"form-group\" id=\"fld_7775428_1-wrap\">\r\n\t<label id=\"fld_7775428Label\" for=\"fld_7775428_1\" class=\"control-label\">If Yes, who?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_7775428\" class=\" form-control\" id=\"fld_7775428_1\" name=\"fld_7775428\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_7775428Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-14\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_8903116\" class=\"form-group\" id=\"fld_8903116_1-wrap\">\r\n\t<label id=\"fld_8903116Label\" for=\"fld_8903116_1\" class=\"control-label\">Are there any pending court dates?<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_8903116_1_opt1636452\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Yes\"\n                                data-field=\"fld_8903116\"\n                                id=\"fld_8903116_1_opt1636452\"\n                                class=\"fld_8903116_1\"\n                                name=\"fld_8903116[opt1636452]\"\n                                value=\"Yes\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_8903116_1\"\n                                                                data-calc-value=\"Yes\"\n                            >\n                    Yes                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_8903116_1_opt1439800\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"No\"\n                                data-field=\"fld_8903116\"\n                                id=\"fld_8903116_1_opt1439800\"\n                                class=\"fld_8903116_1\"\n                                name=\"fld_8903116[opt1439800]\"\n                                value=\"No\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_8903116_1\"\n                                                                data-calc-value=\"No\"\n                            >\n                    No                <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_8995345\" class=\"form-group\" id=\"fld_8995345_1-wrap\">\r\n\t<label id=\"fld_8995345Label\" for=\"fld_8995345_1\" class=\"control-label\">If so, what kind (trial\/hearing) and when?<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_8995345\" value=\"\" data-field=\"fld_8995345\" class=\"form-control\" id=\"fld_8995345_1\" rows=\"4\" maxlength=\"500\"    aria-labelledby=\"fld_8995345Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-15\"  class=\"row \"><div  class=\"col-sm-12  single\"><div id=\"cf2-fld_3943119_1\" class=\"cf2-field-wrapper\" data-field-id=\"fld_3943119_1\"><\/div><\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-16\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_6117198\" class=\"form-group\" id=\"fld_6117198_1-wrap\">\r\n\t<label id=\"fld_6117198Label\" for=\"fld_6117198_1\" class=\"control-label\">Are you separated or living together?<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_6117198_1_opt1935087\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Separated\"\n                                data-field=\"fld_6117198\"\n                                id=\"fld_6117198_1_opt1935087\"\n                                class=\"fld_6117198_1\"\n                                name=\"fld_6117198[opt1935087]\"\n                                value=\"Separated\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_6117198_1\"\n                                                                data-calc-value=\"Separated\"\n                            >\n                    Separated                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_6117198_1_opt1508216\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Living Together\"\n                                data-field=\"fld_6117198\"\n                                id=\"fld_6117198_1_opt1508216\"\n                                class=\"fld_6117198_1\"\n                                name=\"fld_6117198[opt1508216]\"\n                                value=\"Living Together\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_6117198_1\"\n                                                                data-calc-value=\"Living Together\"\n                            >\n                    Living Together                <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\">\n<div data-field-wrapper=\"fld_664204\" class=\"form-group\" id=\"fld_664204_1-wrap\">\r\n\t<label id=\"fld_664204Label\" for=\"fld_664204_1\" class=\"control-label\">If separated, date of separation<\/label>\r\n\t<div class=\"\">\r\n\t\t<input  type=\"text\" data-provide=\"cfdatepicker\" name=\"fld_664204\" value=\"\" id=\"fld_664204_1\" data-field=\"fld_664204\" class=\"form-control cfdatepicker is-cfdatepicker\" data-date-format=\"yyyy-mm-dd\" data-date-start-view=\"month\"   aria-labelledby=\"fld_664204Label\"   \/>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-17\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_615274\" class=\"form-group\" id=\"fld_615274_1-wrap\">\r\n\t<label id=\"fld_615274Label\" for=\"fld_615274_1\" class=\"control-label\">Are there children involved?<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_615274_1_opt1325016\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Yes\"\n                                data-field=\"fld_615274\"\n                                id=\"fld_615274_1_opt1325016\"\n                                class=\"fld_615274_1\"\n                                name=\"fld_615274[opt1325016]\"\n                                value=\"Yes\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_615274_1\"\n                                                                data-calc-value=\"Yes\"\n                            >\n                    Yes                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_615274_1_opt1569635\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"No\"\n                                data-field=\"fld_615274\"\n                                id=\"fld_615274_1_opt1569635\"\n                                class=\"fld_615274_1\"\n                                name=\"fld_615274[opt1569635]\"\n                                value=\"No\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_615274_1\"\n                                                                data-calc-value=\"No\"\n                            >\n                    No                <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-18\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_5381046\" class=\"form-group\" id=\"fld_5381046_1-wrap\">\r\n\t<label id=\"fld_5381046Label\" for=\"fld_5381046_1\" class=\"control-label\">Names and birth dates of children<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_5381046\" value=\"\" data-field=\"fld_5381046\" class=\"form-control\" id=\"fld_5381046_1\" rows=\"4\" maxlength=\"500\"    aria-labelledby=\"fld_5381046Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-19\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_6335582\" class=\"form-group\" id=\"fld_6335582_1-wrap\">\r\n\t<label id=\"fld_6335582Label\" for=\"fld_6335582_1\" class=\"control-label\">Who do the children reside with ?<\/label>\r\n\t<div class=\"\">\r\n\t\t<select name=\"fld_6335582\" value=\"\" data-field=\"fld_6335582\" class=\"form-control\" id=\"fld_6335582_1\"    aria-labelledby=\"fld_6335582Label\" >\n\t\t<option value=\"\"><\/option>\r\n\t\t\t\t\t<option value=\"Me\"  data-calc-value=\"Me\" >\n\t\t\t\t\t\tMe\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Opposing Party\"  data-calc-value=\"Opposing Party\" >\n\t\t\t\t\t\tOpposing Party\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Shared\"  data-calc-value=\"Shared\" >\n\t\t\t\t\t\tShared\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-20\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_3496537\" class=\"form-group\" id=\"fld_3496537_1-wrap\">\r\n\t<label id=\"fld_3496537Label\" for=\"fld_3496537_1\" class=\"control-label\">Please provide a list of known assets belonging to you or the other party<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_3496537\" value=\"\" data-field=\"fld_3496537\" class=\"form-control\" id=\"fld_3496537_1\" rows=\"7\" maxlength=\"500\"    aria-labelledby=\"fld_3496537Label\" aria-describedby=\"fld_3496537Caption\" ><\/textarea>\n\t\t<span id=\"fld_3496537Caption\" class=\"help-block\">(real estate (addresses), bank accounts, RRSP\u2019s, investments, vehicles, boats, art work, jewelry or precious metals, investments, etc.) <\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-21\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_3665422\" class=\"form-group\" id=\"fld_3665422_1-wrap\">\r\n\t<label id=\"fld_3665422Label\" for=\"fld_3665422_1\" class=\"control-label\">Estimated net value of assets<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_3665422\" class=\" form-control\" id=\"fld_3665422_1\" name=\"fld_3665422\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_3665422Label\" aria-describedby=\"fld_3665422Caption\" >\t\t<span id=\"fld_3665422Caption\" class=\"help-block\">(after debts, e.g., mortgages, loans, credit card debt, etc.)<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_4567588\" class=\"form-group\" id=\"fld_4567588_1-wrap\">\r\n\t<label id=\"fld_4567588Label\" for=\"fld_4567588_1\" class=\"control-label\">Do either you or the other party have an interest in or own a business?<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4567588_1_opt1567080\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Yes\"\n                                data-field=\"fld_4567588\"\n                                id=\"fld_4567588_1_opt1567080\"\n                                class=\"fld_4567588_1\"\n                                name=\"fld_4567588[opt1567080]\"\n                                value=\"Yes\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4567588_1\"\n                                                                data-calc-value=\"Yes\"\n                            >\n                    Yes                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4567588_1_opt1560813\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"No\"\n                                data-field=\"fld_4567588\"\n                                id=\"fld_4567588_1_opt1560813\"\n                                class=\"fld_4567588_1\"\n                                name=\"fld_4567588[opt1560813]\"\n                                value=\"No\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4567588_1\"\n                                                                data-calc-value=\"No\"\n                            >\n                    No                <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-22\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_2377231\" class=\"form-group\" id=\"fld_2377231_1-wrap\">\r\n\t<label id=\"fld_2377231Label\" for=\"fld_2377231_1\" class=\"control-label\">Estimated value of businesses<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_2377231\" class=\" form-control\" id=\"fld_2377231_1\" name=\"fld_2377231\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_2377231Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-23\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_9006779\" class=\"form-group\" id=\"fld_9006779_1-wrap\">\r\n\t<label id=\"fld_9006779Label\" for=\"fld_9006779_1\" class=\"control-label\">Please provide some brief details as to your matter<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_9006779\" value=\"\" data-field=\"fld_9006779\" class=\"form-control\" id=\"fld_9006779_1\" rows=\"7\" maxlength=\"500\"    aria-labelledby=\"fld_9006779Label\" aria-describedby=\"fld_9006779Caption\" ><\/textarea>\n\t\t<span id=\"fld_9006779Caption\" class=\"help-block\">maximum of 500 words<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-24\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_9775732\" class=\"form-group\" id=\"fld_9775732_1-wrap\">\r\n\t<label id=\"fld_9775732Label\" for=\"fld_9775732_1\" class=\"control-label\">Are there any questions you would specifically like addressed at an initial consultation?<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_9775732\" value=\"\" data-field=\"fld_9775732\" class=\"form-control\" id=\"fld_9775732_1\" rows=\"7\" maxlength=\"500\"    aria-labelledby=\"fld_9775732Label\" aria-describedby=\"fld_9775732Caption\" ><\/textarea>\n\t\t<span id=\"fld_9775732Caption\" class=\"help-block\">(please provide some brief details )<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-25\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_1051862\" class=\"form-group\" id=\"fld_1051862_1-wrap\">\r\n\t<label id=\"fld_1051862Label\" for=\"fld_1051862_1\" class=\"control-label\">Please check the box below to confirm you understand that this is an inquiry only and does not form an agreement for representation by Pettit & Co.<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_1051862_1_opt1466871\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Yes\"\n                                data-field=\"fld_1051862\"\n                                id=\"fld_1051862_1_opt1466871\"\n                                class=\"fld_1051862_1\"\n                                name=\"fld_1051862[opt1466871]\"\n                                value=\"Yes\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_1051862_1\"\n                                                                data-calc-value=\"Yes\"\n                            >\n                    Yes                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_1051862_1_opt1506842\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"No\"\n                                data-field=\"fld_1051862\"\n                                id=\"fld_1051862_1_opt1506842\"\n                                class=\"fld_1051862_1\"\n                                name=\"fld_1051862[opt1506842]\"\n                                value=\"No\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_1051862_1\"\n                                                                data-calc-value=\"No\"\n                            >\n                    No                <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_1-row-26\"  class=\"row  last_row\"><div  class=\"col-sm-12  single\"><span class=\"caldera-forms-conditional-field\" role=\"region\" aria-live=\"polite\" id=\"conditional_fld_2424226_1\" data-field-id=\"fld_2424226_1\"><\/span><\/div><\/div><\/form>\r\n<\/div>\r\n<script type=\"text\/javascript\">\r\nif( typeof caldera_conditionals === \"undefined\" ){ var caldera_conditionals = {}; }caldera_conditionals.CF5ea1e7eeec40c_1 = {\"fld_2424226_1\":{\"type\":\"show\",\"group\":{\"rw8698044737524267\":{\"cl3960398479023034\":{\"parent\":\"rw8698044737524267\",\"field\":\"fld_1051862\",\"compare\":\"is\",\"value\":\"Yes\",\"label\":\"Yes\"}}}}};\r\n<\/script>\r\n<script type=\"text\/html\" id=\"conditional-fld_2424226_1-tmpl\">\r\n<div data-field-wrapper=\"fld_2424226\" class=\"form-group\" id=\"fld_2424226_1-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default\" type=\"submit\" name=\"fld_2424226\" id=\"fld_2424226_1\" value=\"SUBMIT\" data-field=\"fld_2424226\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_1\" type=\"hidden\" name=\"fld_2424226\" id=\"fld_2424226_1_btn\" value=\"\" data-field=\"fld_2424226\"  \/>\n<\/script>\r\n\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Pettit &amp; Company &#8211; Family Lawyers\u00a0<div class=\"caldera-grid\" id=\"caldera_form_2\" data-cf-ver=\"1.9.7\" data-cf-form-id=\"CF5ea1e7eeec40c\"><div id=\"caldera_notices_2\" data-spinner=\"https:\/\/www.family-lawyer-north-vancouver.ca\/wp-admin\/images\/spinner.gif\"><\/div><form data-instance=\"2\" class=\"CF5ea1e7eeec40c caldera_forms_form cfajax-trigger\" method=\"POST\" enctype=\"multipart\/form-data\" id=\"CF5ea1e7eeec40c_2\" data-form-id=\"CF5ea1e7eeec40c\" aria-label=\"Pettit &amp; Co Family Law Intake Form\" data-target=\"#caldera_notices_2\" data-template=\"#cfajax_CF5ea1e7eeec40c-tmpl\" data-cfajax=\"CF5ea1e7eeec40c\" data-load-element=\"_parent\" data-load-class=\"cf_processing\" data-post-disable=\"0\" data-action=\"cf_process_ajax_submit\" data-request=\"https:\/\/www.family-lawyer-north-vancouver.ca\/cf-api\/CF5ea1e7eeec40c\" data-hiderows=\"true\">\r\n<input type=\"hidden\" id=\"_cf_verify_CF5ea1e7eeec40c\" name=\"_cf_verify\" value=\"0607e6676b\"  data-nonce-time=\"1711941927\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/pages\/40\" \/><div id=\"cf2-CF5ea1e7eeec40c_2\"><\/div><input type=\"hidden\" name=\"_cf_frm_id\" value=\"CF5ea1e7eeec40c\">\r\n<input type=\"hidden\" name=\"_cf_frm_ct\" value=\"2\">\r\n<input type=\"hidden\" name=\"cfajax\" value=\"CF5ea1e7eeec40c\">\r\n<input type=\"hidden\" name=\"_cf_cr_pst\" value=\"40\">\r\n<div class=\"hide\" style=\"display:none; overflow:hidden;height:0;width:0;\">\r\n<label>Url<\/label><input type=\"text\" name=\"url\" value=\"\" autocomplete=\"off\">\r\n<\/div><div id=\"CF5ea1e7eeec40c_2-row-1\"  class=\"row  first_row\"><div  class=\"col-sm-12  single\"><\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-2\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_8716621\" class=\"form-group\" id=\"fld_8716621_2-wrap\">\r\n\t<label id=\"fld_8716621Label\" for=\"fld_8716621_2\" class=\"control-label\">First Name <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_8716621\" class=\" form-control\" id=\"fld_8716621_2\" name=\"fld_8716621\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_8716621Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_3566690\" class=\"form-group\" id=\"fld_3566690_2-wrap\">\r\n\t<label id=\"fld_3566690Label\" for=\"fld_3566690_2\" class=\"control-label\">Last Name <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_3566690\" class=\" form-control\" id=\"fld_3566690_2\" name=\"fld_3566690\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_3566690Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-3\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_9852988\" class=\"form-group\" id=\"fld_9852988_2-wrap\">\r\n\t<label id=\"fld_9852988Label\" for=\"fld_9852988_2\" class=\"control-label\">Email Address <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"email\" data-field=\"fld_9852988\" class=\" form-control\" id=\"fld_9852988_2\" name=\"fld_9852988\" value=\"\" data-type=\"email\" aria-required=\"true\"   aria-labelledby=\"fld_9852988Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_48218\" class=\"form-group\" id=\"fld_48218_2-wrap\">\r\n\t<label id=\"fld_48218Label\" for=\"fld_48218_2\" class=\"control-label\">Phone<\/label>\r\n\t<div class=\"\">\r\n\t\t<input  data-inputmask=\"'mask': '(999)999-9999'\"   type=\"phone\" data-field=\"fld_48218\" class=\" form-control\" id=\"fld_48218_2\" name=\"fld_48218\" value=\"\" data-type=\"phone\"   aria-labelledby=\"fld_48218Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-4\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_4924561\" class=\"form-group\" id=\"fld_4924561_2-wrap\">\r\n\t<label id=\"fld_4924561Label\" for=\"fld_4924561_2\" class=\"control-label\">Your Address <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_4924561\" class=\" form-control\" id=\"fld_4924561_2\" name=\"fld_4924561\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_4924561Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_2703334\" class=\"form-group\" id=\"fld_2703334_2-wrap\">\r\n\t<label id=\"fld_2703334Label\" for=\"fld_2703334_2\" class=\"control-label\">Your Occupation <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_2703334\" class=\" form-control\" id=\"fld_2703334_2\" name=\"fld_2703334\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_2703334Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-5\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_7857785\" class=\"form-group\" id=\"fld_7857785_2-wrap\">\r\n\t<label id=\"fld_7857785Label\" for=\"fld_7857785_2\" class=\"control-label\">Your Estimated Annual Income <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_7857785\" class=\" form-control\" id=\"fld_7857785_2\" name=\"fld_7857785\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_7857785Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-6\"  class=\"row \"><div  class=\"col-sm-12  single\"><div class=\"\"><h2> Other Party Information <\/h2>\n<hr>\n<\/div><\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-7\"  class=\"row \"><div  class=\"col-sm-6  first_col\">\n<div data-field-wrapper=\"fld_6800156\" class=\"form-group\" id=\"fld_6800156_2-wrap\">\r\n\t<label id=\"fld_6800156Label\" for=\"fld_6800156_2\" class=\"control-label\">Date of Marriage or Cohabitation<\/label>\r\n\t<div class=\"\">\r\n\t\t<input  type=\"text\" data-provide=\"cfdatepicker\" name=\"fld_6800156\" value=\"\" id=\"fld_6800156_2\" data-field=\"fld_6800156\" class=\"form-control cfdatepicker is-cfdatepicker\" data-date-format=\"dd-mm-yyyy\" data-date-start-view=\"month\"   aria-labelledby=\"fld_6800156Label\"   \/>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_9595887\" class=\"form-group\" id=\"fld_9595887_2-wrap\">\r\n\t<label id=\"fld_9595887Label\" for=\"fld_9595887_2\" class=\"control-label\">Are you separated or living together?<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_9595887_2_opt1434678\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Together\"\n                                data-field=\"fld_9595887\"\n                                id=\"fld_9595887_2_opt1434678\"\n                                class=\"fld_9595887_2\"\n                                name=\"fld_9595887[opt1434678]\"\n                                value=\"Together\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_9595887_2\"\n                                                                data-calc-value=\"Together\"\n                            >\n                    Together                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_9595887_2_opt1595541\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Separated \"\n                                data-field=\"fld_9595887\"\n                                id=\"fld_9595887_2_opt1595541\"\n                                class=\"fld_9595887_2\"\n                                name=\"fld_9595887[opt1595541]\"\n                                value=\"Separated \"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_9595887_2\"\n                                                                data-calc-value=\"Separated \"\n                            >\n                    Separated                 <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-8\"  class=\"row \"><div  class=\"col-sm-12  single\">\n<div data-field-wrapper=\"fld_7562525\" class=\"form-group\" id=\"fld_7562525_2-wrap\">\r\n\t<label id=\"fld_7562525Label\" for=\"fld_7562525_2\" class=\"control-label\">If separated, date of separation<\/label>\r\n\t<div class=\"\">\r\n\t\t<input  type=\"text\" data-provide=\"cfdatepicker\" name=\"fld_7562525\" value=\"\" id=\"fld_7562525_2\" data-field=\"fld_7562525\" class=\"form-control cfdatepicker is-cfdatepicker\" data-date-format=\"dd-mm-yyyy\" data-date-start-view=\"month\"   aria-labelledby=\"fld_7562525Label\"   \/>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-9\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_9996141\" class=\"form-group\" id=\"fld_9996141_2-wrap\">\r\n\t<label id=\"fld_9996141Label\" for=\"fld_9996141_2\" class=\"control-label\">Other Parties First Name <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_9996141\" class=\" form-control\" id=\"fld_9996141_2\" name=\"fld_9996141\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_9996141Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_4972987\" class=\"form-group\" id=\"fld_4972987_2-wrap\">\r\n\t<label id=\"fld_4972987Label\" for=\"fld_4972987_2\" class=\"control-label\">Other Parties Last Name <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_4972987\" class=\" form-control\" id=\"fld_4972987_2\" name=\"fld_4972987\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_4972987Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-10\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_5080506\" class=\"form-group\" id=\"fld_5080506_2-wrap\">\r\n\t<label id=\"fld_5080506Label\" for=\"fld_5080506_2\" class=\"control-label\">Other Parties Address <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_5080506\" value=\"\" data-field=\"fld_5080506\" class=\"form-control\" id=\"fld_5080506_2\" rows=\"4\" maxlength=\"500\"  required=\"required\"  aria-labelledby=\"fld_5080506Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-11\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_1777161\" class=\"form-group\" id=\"fld_1777161_2-wrap\">\r\n\t<label id=\"fld_1777161Label\" for=\"fld_1777161_2\" class=\"control-label\">Other Parties Occupation <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_1777161\" class=\" form-control\" id=\"fld_1777161_2\" name=\"fld_1777161\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_1777161Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_8063374\" class=\"form-group\" id=\"fld_8063374_2-wrap\">\r\n\t<label id=\"fld_8063374Label\" for=\"fld_8063374_2\" class=\"control-label\">Other Parties Estimated Annual Income <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_8063374\" class=\" form-control\" id=\"fld_8063374_2\" name=\"fld_8063374\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_8063374Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-12\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_4541101\" class=\"form-group\" id=\"fld_4541101_2-wrap\">\r\n\t<label id=\"fld_4541101Label\" for=\"fld_4541101_2\" class=\"control-label\">Are either yourself or the other party currently retained by counsel?<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4541101_2_opt1846867\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Yes\"\n                                data-field=\"fld_4541101\"\n                                id=\"fld_4541101_2_opt1846867\"\n                                class=\"fld_4541101_2\"\n                                name=\"fld_4541101[opt1846867]\"\n                                value=\"Yes\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4541101_2\"\n                                                                data-calc-value=\"Yes\"\n                            >\n                    Yes                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4541101_2_opt1555589\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"No\"\n                                data-field=\"fld_4541101\"\n                                id=\"fld_4541101_2_opt1555589\"\n                                class=\"fld_4541101_2\"\n                                name=\"fld_4541101[opt1555589]\"\n                                value=\"No\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4541101_2\"\n                                                                data-calc-value=\"No\"\n                            >\n                    No                <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-13\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_7775428\" class=\"form-group\" id=\"fld_7775428_2-wrap\">\r\n\t<label id=\"fld_7775428Label\" for=\"fld_7775428_2\" class=\"control-label\">If Yes, who?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_7775428\" class=\" form-control\" id=\"fld_7775428_2\" name=\"fld_7775428\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_7775428Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-14\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_8903116\" class=\"form-group\" id=\"fld_8903116_2-wrap\">\r\n\t<label id=\"fld_8903116Label\" for=\"fld_8903116_2\" class=\"control-label\">Are there any pending court dates?<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_8903116_2_opt1636452\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Yes\"\n                                data-field=\"fld_8903116\"\n                                id=\"fld_8903116_2_opt1636452\"\n                                class=\"fld_8903116_2\"\n                                name=\"fld_8903116[opt1636452]\"\n                                value=\"Yes\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_8903116_2\"\n                                                                data-calc-value=\"Yes\"\n                            >\n                    Yes                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_8903116_2_opt1439800\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"No\"\n                                data-field=\"fld_8903116\"\n                                id=\"fld_8903116_2_opt1439800\"\n                                class=\"fld_8903116_2\"\n                                name=\"fld_8903116[opt1439800]\"\n                                value=\"No\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_8903116_2\"\n                                                                data-calc-value=\"No\"\n                            >\n                    No                <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_8995345\" class=\"form-group\" id=\"fld_8995345_2-wrap\">\r\n\t<label id=\"fld_8995345Label\" for=\"fld_8995345_2\" class=\"control-label\">If so, what kind (trial\/hearing) and when?<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_8995345\" value=\"\" data-field=\"fld_8995345\" class=\"form-control\" id=\"fld_8995345_2\" rows=\"4\" maxlength=\"500\"    aria-labelledby=\"fld_8995345Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-15\"  class=\"row \"><div  class=\"col-sm-12  single\"><div id=\"cf2-fld_3943119_2\" class=\"cf2-field-wrapper\" data-field-id=\"fld_3943119_2\"><\/div><\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-16\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_6117198\" class=\"form-group\" id=\"fld_6117198_2-wrap\">\r\n\t<label id=\"fld_6117198Label\" for=\"fld_6117198_2\" class=\"control-label\">Are you separated or living together?<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_6117198_2_opt1935087\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Separated\"\n                                data-field=\"fld_6117198\"\n                                id=\"fld_6117198_2_opt1935087\"\n                                class=\"fld_6117198_2\"\n                                name=\"fld_6117198[opt1935087]\"\n                                value=\"Separated\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_6117198_2\"\n                                                                data-calc-value=\"Separated\"\n                            >\n                    Separated                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_6117198_2_opt1508216\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Living Together\"\n                                data-field=\"fld_6117198\"\n                                id=\"fld_6117198_2_opt1508216\"\n                                class=\"fld_6117198_2\"\n                                name=\"fld_6117198[opt1508216]\"\n                                value=\"Living Together\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_6117198_2\"\n                                                                data-calc-value=\"Living Together\"\n                            >\n                    Living Together                <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\">\n<div data-field-wrapper=\"fld_664204\" class=\"form-group\" id=\"fld_664204_2-wrap\">\r\n\t<label id=\"fld_664204Label\" for=\"fld_664204_2\" class=\"control-label\">If separated, date of separation<\/label>\r\n\t<div class=\"\">\r\n\t\t<input  type=\"text\" data-provide=\"cfdatepicker\" name=\"fld_664204\" value=\"\" id=\"fld_664204_2\" data-field=\"fld_664204\" class=\"form-control cfdatepicker is-cfdatepicker\" data-date-format=\"yyyy-mm-dd\" data-date-start-view=\"month\"   aria-labelledby=\"fld_664204Label\"   \/>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-17\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_615274\" class=\"form-group\" id=\"fld_615274_2-wrap\">\r\n\t<label id=\"fld_615274Label\" for=\"fld_615274_2\" class=\"control-label\">Are there children involved?<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_615274_2_opt1325016\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Yes\"\n                                data-field=\"fld_615274\"\n                                id=\"fld_615274_2_opt1325016\"\n                                class=\"fld_615274_2\"\n                                name=\"fld_615274[opt1325016]\"\n                                value=\"Yes\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_615274_2\"\n                                                                data-calc-value=\"Yes\"\n                            >\n                    Yes                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_615274_2_opt1569635\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"No\"\n                                data-field=\"fld_615274\"\n                                id=\"fld_615274_2_opt1569635\"\n                                class=\"fld_615274_2\"\n                                name=\"fld_615274[opt1569635]\"\n                                value=\"No\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_615274_2\"\n                                                                data-calc-value=\"No\"\n                            >\n                    No                <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-18\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_5381046\" class=\"form-group\" id=\"fld_5381046_2-wrap\">\r\n\t<label id=\"fld_5381046Label\" for=\"fld_5381046_2\" class=\"control-label\">Names and birth dates of children<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_5381046\" value=\"\" data-field=\"fld_5381046\" class=\"form-control\" id=\"fld_5381046_2\" rows=\"4\" maxlength=\"500\"    aria-labelledby=\"fld_5381046Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-19\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_6335582\" class=\"form-group\" id=\"fld_6335582_2-wrap\">\r\n\t<label id=\"fld_6335582Label\" for=\"fld_6335582_2\" class=\"control-label\">Who do the children reside with ?<\/label>\r\n\t<div class=\"\">\r\n\t\t<select name=\"fld_6335582\" value=\"\" data-field=\"fld_6335582\" class=\"form-control\" id=\"fld_6335582_2\"    aria-labelledby=\"fld_6335582Label\" >\n\t\t<option value=\"\"><\/option>\r\n\t\t\t\t\t<option value=\"Me\"  data-calc-value=\"Me\" >\n\t\t\t\t\t\tMe\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Opposing Party\"  data-calc-value=\"Opposing Party\" >\n\t\t\t\t\t\tOpposing Party\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Shared\"  data-calc-value=\"Shared\" >\n\t\t\t\t\t\tShared\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-20\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_3496537\" class=\"form-group\" id=\"fld_3496537_2-wrap\">\r\n\t<label id=\"fld_3496537Label\" for=\"fld_3496537_2\" class=\"control-label\">Please provide a list of known assets belonging to you or the other party<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_3496537\" value=\"\" data-field=\"fld_3496537\" class=\"form-control\" id=\"fld_3496537_2\" rows=\"7\" maxlength=\"500\"    aria-labelledby=\"fld_3496537Label\" aria-describedby=\"fld_3496537Caption\" ><\/textarea>\n\t\t<span id=\"fld_3496537Caption\" class=\"help-block\">(real estate (addresses), bank accounts, RRSP\u2019s, investments, vehicles, boats, art work, jewelry or precious metals, investments, etc.) <\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-21\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_3665422\" class=\"form-group\" id=\"fld_3665422_2-wrap\">\r\n\t<label id=\"fld_3665422Label\" for=\"fld_3665422_2\" class=\"control-label\">Estimated net value of assets<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_3665422\" class=\" form-control\" id=\"fld_3665422_2\" name=\"fld_3665422\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_3665422Label\" aria-describedby=\"fld_3665422Caption\" >\t\t<span id=\"fld_3665422Caption\" class=\"help-block\">(after debts, e.g., mortgages, loans, credit card debt, etc.)<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_4567588\" class=\"form-group\" id=\"fld_4567588_2-wrap\">\r\n\t<label id=\"fld_4567588Label\" for=\"fld_4567588_2\" class=\"control-label\">Do either you or the other party have an interest in or own a business?<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4567588_2_opt1567080\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Yes\"\n                                data-field=\"fld_4567588\"\n                                id=\"fld_4567588_2_opt1567080\"\n                                class=\"fld_4567588_2\"\n                                name=\"fld_4567588[opt1567080]\"\n                                value=\"Yes\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4567588_2\"\n                                                                data-calc-value=\"Yes\"\n                            >\n                    Yes                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4567588_2_opt1560813\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"No\"\n                                data-field=\"fld_4567588\"\n                                id=\"fld_4567588_2_opt1560813\"\n                                class=\"fld_4567588_2\"\n                                name=\"fld_4567588[opt1560813]\"\n                                value=\"No\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4567588_2\"\n                                                                data-calc-value=\"No\"\n                            >\n                    No                <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-22\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_2377231\" class=\"form-group\" id=\"fld_2377231_2-wrap\">\r\n\t<label id=\"fld_2377231Label\" for=\"fld_2377231_2\" class=\"control-label\">Estimated value of businesses<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_2377231\" class=\" form-control\" id=\"fld_2377231_2\" name=\"fld_2377231\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_2377231Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-23\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_9006779\" class=\"form-group\" id=\"fld_9006779_2-wrap\">\r\n\t<label id=\"fld_9006779Label\" for=\"fld_9006779_2\" class=\"control-label\">Please provide some brief details as to your matter<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_9006779\" value=\"\" data-field=\"fld_9006779\" class=\"form-control\" id=\"fld_9006779_2\" rows=\"7\" maxlength=\"500\"    aria-labelledby=\"fld_9006779Label\" aria-describedby=\"fld_9006779Caption\" ><\/textarea>\n\t\t<span id=\"fld_9006779Caption\" class=\"help-block\">maximum of 500 words<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-24\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_9775732\" class=\"form-group\" id=\"fld_9775732_2-wrap\">\r\n\t<label id=\"fld_9775732Label\" for=\"fld_9775732_2\" class=\"control-label\">Are there any questions you would specifically like addressed at an initial consultation?<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_9775732\" value=\"\" data-field=\"fld_9775732\" class=\"form-control\" id=\"fld_9775732_2\" rows=\"7\" maxlength=\"500\"    aria-labelledby=\"fld_9775732Label\" aria-describedby=\"fld_9775732Caption\" ><\/textarea>\n\t\t<span id=\"fld_9775732Caption\" class=\"help-block\">(please provide some brief details )<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-25\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_1051862\" class=\"form-group\" id=\"fld_1051862_2-wrap\">\r\n\t<label id=\"fld_1051862Label\" for=\"fld_1051862_2\" class=\"control-label\">Please check the box below to confirm you understand that this is an inquiry only and does not form an agreement for representation by Pettit & Co.<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_1051862_2_opt1466871\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Yes\"\n                                data-field=\"fld_1051862\"\n                                id=\"fld_1051862_2_opt1466871\"\n                                class=\"fld_1051862_2\"\n                                name=\"fld_1051862[opt1466871]\"\n                                value=\"Yes\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_1051862_2\"\n                                                                data-calc-value=\"Yes\"\n                            >\n                    Yes                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_1051862_2_opt1506842\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"No\"\n                                data-field=\"fld_1051862\"\n                                id=\"fld_1051862_2_opt1506842\"\n                                class=\"fld_1051862_2\"\n                                name=\"fld_1051862[opt1506842]\"\n                                value=\"No\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_1051862_2\"\n                                                                data-calc-value=\"No\"\n                            >\n                    No                <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5ea1e7eeec40c_2-row-26\"  class=\"row  last_row\"><div  class=\"col-sm-12  single\"><span class=\"caldera-forms-conditional-field\" role=\"region\" aria-live=\"polite\" id=\"conditional_fld_2424226_2\" data-field-id=\"fld_2424226_2\"><\/span><\/div><\/div><\/form>\r\n<\/div>\r\n<script type=\"text\/javascript\">\r\nif( typeof caldera_conditionals === \"undefined\" ){ var caldera_conditionals = {}; }caldera_conditionals.CF5ea1e7eeec40c_2 = 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