Please provide your first name.'; if ($formLastName == '') $msgValidation .= '
  • Please provide your last name.
  • '; if ($formPhone == '' && $formEmail == '') $msgValidation .= '
  • Please provide your email and/or phone number.
  • '; if ($formCity == '') $msgValidation .= '
  • Please state your city.
  • '; if ($formPostal == '') $msgValidation .= '
  • Please provide your zipcode.
  • '; if ($msgValidation == '') { // Send the email $message = 'Received ' . $currentTime . "\r\n\r\n"; // --- Customizable part of message starts here --- $message .= 'Section I - Causes:' . "\r\n"; $message .= '===================================' . "\r\n"; $message .= 'Why are you considering bankruptcy?' . "\r\n"; $i = 101; foreach ($cbWhy as $fieldVal) { $fieldVar = 'formWhyConsidering'.$i; if ($$fieldVar == $fieldVal) { $message .= '- ' . $$fieldVar . "\r\n"; } $i++; } if ($formWhyConsidering199 != '') { $message .= '- ' . $formWhyConsidering199 . ' ' . $formWhyConsideringOther . "\r\n"; } $message .= "\r\n"; $message .= 'Section II - Debts:' . "\r\n"; $message .= '===================================' . "\r\n"; $message .= 'What debts do you have?' . "\r\n"; $i = 201; foreach ($cbDebts as $fieldVal) { $fieldVar = 'formWhatDebts'.$i; if ($$fieldVar == $fieldVal) { $message .= '- ' . $$fieldVar . "\r\n"; } $i++; } if ($formWhatDebts299 != '') { $message .= '- ' . $formWhatDebts299 . ' ' . $formWhatDebtsOther . "\r\n"; } $message .= 'Approximate Total Debts: ' . $formApproxTotalDebts . "\r\n\r\n"; $message .= 'Section III - Assets:' . "\r\n"; $message .= '===================================' . "\r\n"; $message .= 'Please describe your assets:' . "\r\n"; $i = 301; foreach ($ynAssets as $fieldVal) { $fieldVar = 'formAssets'.$i; $message .= $fieldVal . ' [' . $$fieldVar . "]\r\n"; $i++; } $message .= 'If so, please describe them: ' . $formAssetsOver1000 . "\r\n\r\n"; $message .= 'Section IV - Income:' . "\r\n"; $message .= '===================================' . "\r\n"; $message .= 'What are your sources of income?' . "\r\n"; $i = 401; foreach ($cbIncome as $fieldVal) { $fieldVar = 'formIncomeSource'.$i; if ($$fieldVar == $fieldVal) { $message .= '- ' . $$fieldVar . "\r\n"; } $i++; } if ($formIncomeSource499 != '') { $message .= '- ' . $formIncomeSource499 . ' ' . $formIncomeSourceOther . "\r\n"; } $message .= 'Est. Total Monthly Net Income: ' . $formEstTotalIncome . "\r\n\r\n"; $message .= 'Section V - Contact:' . "\r\n"; $message .= '===================================' . "\r\n"; $message .= 'Name: ' . $formFirstName . ' ' . $formLastName . "\r\n"; $message .= 'Phone: ' . $formPhone . "\r\n"; $message .= 'Best time to call: ' . $formBestTime . "\r\n"; $message .= 'Email: ' . $formEmail . "\r\n"; $message .= 'State: ' . $formState . "\r\n"; $message .= 'City: ' . $formCity . "\r\n"; $message .= 'Postal: ' . $formPostal . "\r\n"; $message .= 'Message: ' . $formMessage . "\r\n"; // --- Customizable part of message ends here --- if (preg_match('/^[A-Z0-9._-]+@[A-Z0-9][A-Z0-9.-]{0,61}[A-Z0-9]\.[A-Z.]{2,6}$/i', $formEmail)) $sender = $formEmail; $mailHeader = 'From: ' . $sender . "\r\n"; mail($recipient, $subject, $message, $mailHeader); logReferral($sys['var']['contactid'], 'evaluation', $formFirstName.' '.$formLastName, $formEmail, $formPhone); $seqSection = 99; } } } elseif ($seqSection == 4) { // Section 4 Processing if (isset($_POST['Back'])) { $seqSection = 3; } else { $msgValidation = '
  • Please select at least one field below.
  • '; $i = 401; foreach ($cbIncome as $fieldVal) { $fieldVar = 'formIncomeSource'.$i; if ($$fieldVar == $fieldVal) $msgValidation = ''; $i++; } if ($formIncomeSource499 != '' && $formIncomeSourceOther == '') { $msgValidation = '
  • Please provide details for "Other".
  • '; } else if ($formIncomeSource499 != '') { $msgValidation = ''; } if ($msgValidation == '') $seqSection = 5; } } elseif ($seqSection == 3) { // Section 3 Processing if (isset($_POST['Back'])) { $seqSection = 2; } else { if ($formAssets301 == 'Yes' && $formAssets302 == '') { $msgValidation = '
  • Please state if your mortgage payments are in arrears.
  • '; } if ($formAssets303 == 'Yes' && $formAssets304 == '') { $msgValidation .= '
  • Please state if your car/truck loan payments are in arrears.
  • '; } if ($formAssets305 == 'Yes' && $formAssetsOver1000 == '') { $msgValidation .= '
  • Please describe your assets over $1,000.
  • '; } if ($msgValidation == '') $seqSection = 4; } } elseif ($seqSection == 2) { // Section 2 Processing if (isset($_POST['Back'])) { $seqSection = 1; } else { $msgValidation = '
  • Please select at least one field below.
  • '; $i = 201; foreach ($cbDebts as $fieldVal) { $fieldVar = 'formWhatDebts'.$i; if ($$fieldVar == $fieldVal) $msgValidation = ''; $i++; } if ($formWhatDebts299 != '' && $formWhatDebtsOther == '') { $msgValidation = '
  • Please provide details for "Other".
  • '; } else if ($formWhatDebts299 != '') { $msgValidation = ''; } if ($msgValidation == '') $seqSection = 3; } } elseif ($seqSection == 1) { // Section 1 Processing $msgValidation = '
  • Please select at least one field below.
  • '; $i = 101; foreach ($cbWhy as $fieldVal) { $fieldVar = 'formWhyConsidering'.$i; if ($$fieldVar == $fieldVal) $msgValidation = ''; $i++; } if ($formWhyConsidering199 != '' && $formWhyConsideringOther == '') { $msgValidation = '
  • Please provide details for "Other".
  • '; } else if ($formWhyConsidering199 != '') { $msgValidation = ''; } if ($msgValidation == '') $seqSection = 2; } else { $seqSection = 1; } ?> Bankruptcy Attorney Evaluation - Filing Chapter 13 Bankruptcy & Chapter 7 Bankruptcy Lawyers

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    The following corrections are required:

      '.$msgValidation."
    \r\n"; if ($seqSection == 99) { ?>

    Thank You!

    Your information has been sent to .

    Please include your email and/or phone number so we can reply to you. Other required fields are marked *

    How would you like us to contact you?

    What are your sources of income? (Check all that apply)

    * At least one field is required

      '."\r\n"; $i++; } ?>
    • value="Other:" onchange="autoClearTBviaCB(this.id,'tb499');">
      Other:

    Please describe your assets:

    '.$fieldVal.'

    '."\r\n"; $i++; } ?>

    If so, please describe them:

    What debts do you have? (Check all that apply)

    * At least one field is required

      '."\r\n"; $i++; } ?>
    • value="Other:" onchange="autoClearTBviaCB(this.id,'tb299');">
      Other:

    * Required

    Why are you considering bankruptcy? (Check all that apply)

    * At least one field is required

      '."\r\n"; $i++; } ?>
    • value="Other:" onchange="autoClearTBviaCB(this.id,'tb199');">
      Other:
    '."\r\n"; $i++; } echo ''."\r\n"; echo ''."\r\n"; } if ($seqSection != 2) { $i = 201; foreach ($cbDebts as $fieldVal) { $fieldName = 'WhatDebts'.$i; $fieldVar = 'formWhatDebts'.$i; echo ''."\r\n"; $i++; } echo ''."\r\n"; echo ''."\r\n"; echo ''."\r\n"; } if ($seqSection != 3) { $i = 301; foreach ($ynAssets as $fieldVal) { $fieldName = 'Assets'.$i; $fieldVar = 'formAssets'.$i; echo ''."\r\n"; $i++; } echo ''."\r\n"; } if ($seqSection != 4) { $i = 401; foreach ($cbIncome as $fieldVal) { $fieldName = 'IncomeSource'.$i; $fieldVar = 'formIncomeSource'.$i; echo ''."\r\n"; $i++; } echo ''."\r\n"; echo ''."\r\n"; echo ''."\r\n"; } if ($seqSection != 5) { echo ''."\r\n"; echo ''."\r\n"; echo ''."\r\n"; echo ''."\r\n"; echo ''."\r\n"; echo ''."\r\n"; echo ''."\r\n"; echo ''."\r\n"; echo ''."\r\n"; } ?>

    This free case evaluation will be performed by a bankruptcy lawyer. All information will be held in the strictest of confidence.

     

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