{"title":"Quote Form (1)","description":"","labelPlacement":"top_label","descriptionPlacement":"below","button":{"type":"text","text":"Submit","imageUrl":"","width":"auto","location":"bottom","layoutGridColumnSpan":12},"fields":[{"type":"date","id":3,"formId":1,"label":"Date of birth","adminLabel":"","isRequired":true,"size":"large","errorMessage":"","visibility":"visible","inputs":[{"id":"3.1","label":"Month","name":""},{"id":"3.2","label":"Day","name":""},{"id":"3.3","label":"Year","name":""}],"dateType":"datefield","dateFormat":"mdy","dateFormatPlacement":"below","calendarIconType":"none","description":"Age is one of the many factors that determines your life insurance rates.","allowsPrepopulate":false,"inputMask":false,"inputMaskValue":"","inputMaskIsCustom":false,"maxLength":"","inputType":"","labelPlacement":"","descriptionPlacement":"","subLabelPlacement":"","placeholder":"","cssClass":"two_box","inputName":"","noDuplicates":false,"defaultValue":"","enableAutocomplete":false,"autocompleteAttribute":"","choices":"","conditionalLogic":"","calendarIconUrl":"","productField":"","layoutGridColumnSpan":"","enableEnhancedUI":0,"layoutGroupId":"8751397a","multipleFiles":false,"maxFiles":"","calculationFormula":"","calculationRounding":"","enableCalculation":"","disableQuantity":false,"displayAllCategories":false,"useRichTextEditor":false,"errors":[],"pageNumber":1,"fields":"","displayOnly":"","checkboxLabel":""},{"type":"radio","id":4,"formId":1,"label":"Gender","adminLabel":"","isRequired":true,"size":"large","errorMessage":"","visibility":"visible","validateState":true,"inputs":null,"choices":[{"text":"Female","value":"Female","isSelected":false,"price":""},{"text":"Male","value":"Male","isSelected":false,"price":""}],"description":"Most insurers do not offer a gender-neutral or nonbinary option on their applications, but if you are transgender, you can choose your actual gender, not your gender assigned at birth.","allowsPrepopulate":false,"inputMask":false,"inputMaskValue":"","inputMaskIsCustom":false,"maxLength":"","inputType":"","labelPlacement":"","descriptionPlacement":"","subLabelPlacement":"","placeholder":"","cssClass":"two_box btn_box","inputName":"","noDuplicates":false,"defaultValue":"","enableAutocomplete":false,"autocompleteAttribute":"","conditionalLogic":"","productField":"","layoutGridColumnSpan":"","enableOtherChoice":"","enablePrice":"","enableEnhancedUI":0,"layoutGroupId":"8c71f0bc","multipleFiles":false,"maxFiles":"","calculationFormula":"","calculationRounding":"","enableCalculation":"","disableQuantity":false,"displayAllCategories":false,"useRichTextEditor":false,"errors":[],"pageNumber":1,"fields":"","displayOnly":"","checkboxLabel":""},{"type":"number","id":5,"formId":1,"label":"Annual income","adminLabel":"","isRequired":true,"size":"large","errorMessage":"","visibility":"visible","inputs":null,"numberFormat":"currency","description":"Your total annual salary and\/or earnings, before taxes.","allowsPrepopulate":false,"inputMask":false,"inputMaskValue":"","inputMaskIsCustom":false,"maxLength":"","inputType":"","labelPlacement":"","descriptionPlacement":"","subLabelPlacement":"","placeholder":"","cssClass":"two_box","inputName":"","noDuplicates":false,"defaultValue":"","enableAutocomplete":false,"autocompleteAttribute":"","choices":"","conditionalLogic":"","enableCalculation":false,"rangeMin":false,"rangeMax":false,"calculationFormula":"","productField":"","layoutGridColumnSpan":"","enableEnhancedUI":0,"layoutGroupId":"4ab163e7","multipleFiles":false,"maxFiles":"","calculationRounding":"","disableQuantity":false,"displayAllCategories":false,"useRichTextEditor":false,"errors":[],"pageNumber":1,"fields":"","displayOnly":"","checkboxLabel":""},{"type":"radio","id":6,"formId":1,"label":"Do you have a spouse or partner?","adminLabel":"","isRequired":true,"size":"large","errorMessage":"","visibility":"visible","validateState":true,"inputs":null,"choices":[{"text":"Yes","value":"Yes","isSelected":false,"price":""},{"text":"No","value":"No","isSelected":false,"price":""}],"description":"","allowsPrepopulate":false,"inputMask":false,"inputMaskValue":"","inputMaskIsCustom":false,"maxLength":"","inputType":"","labelPlacement":"","descriptionPlacement":"","subLabelPlacement":"","placeholder":"","cssClass":"two_box btn_box","inputName":"","noDuplicates":false,"defaultValue":"","enableAutocomplete":false,"autocompleteAttribute":"","conditionalLogic":"","productField":"","layoutGridColumnSpan":"","enableOtherChoice":"","enablePrice":"","enableEnhancedUI":0,"layoutGroupId":"b1e81976","multipleFiles":false,"maxFiles":"","calculationFormula":"","calculationRounding":"","enableCalculation":"","disableQuantity":false,"displayAllCategories":false,"useRichTextEditor":false,"errors":[],"pageNumber":1,"fields":"","displayOnly":""},{"type":"number","id":7,"formId":1,"label":"Number of children under age 18","adminLabel":"","isRequired":true,"size":"large","errorMessage":"","visibility":"visible","inputs":null,"numberFormat":"decimal_dot","description":"We'll take the number and ages of your children into account when calculating your coverage.","allowsPrepopulate":false,"inputMask":false,"inputMaskValue":"","inputMaskIsCustom":false,"maxLength":"","inputType":"","labelPlacement":"","descriptionPlacement":"","subLabelPlacement":"","placeholder":"","cssClass":"two_box","inputName":"","noDuplicates":false,"defaultValue":"","enableAutocomplete":false,"autocompleteAttribute":"","choices":"","conditionalLogic":"","enableCalculation":false,"rangeMin":"","rangeMax":"","calculationFormula":"","productField":"","layoutGridColumnSpan":"","enableEnhancedUI":0,"layoutGroupId":"fd371e7f","multipleFiles":false,"maxFiles":"","calculationRounding":"","disableQuantity":false,"displayAllCategories":false,"useRichTextEditor":false,"errors":[],"pageNumber":1,"fields":"","displayOnly":"","checkboxLabel":""},{"type":"number","id":13,"formId":1,"label":"Age of youngest child","adminLabel":"","isRequired":false,"size":"large","errorMessage":"","visibility":"visible","inputs":null,"numberFormat":"decimal_dot","description":"","allowsPrepopulate":false,"inputMask":false,"inputMaskValue":"","inputMaskIsCustom":false,"maxLength":"","inputType":"","labelPlacement":"","descriptionPlacement":"","subLabelPlacement":"","placeholder":"","cssClass":"two_box","inputName":"","noDuplicates":false,"defaultValue":"","enableAutocomplete":false,"autocompleteAttribute":"","choices":"","conditionalLogic":{"enabled":true,"actionType":"show","logicType":"all","rules":[{"fieldId":"7","operator":">","value":"0"}]},"enableCalculation":false,"rangeMin":"","rangeMax":"","calculationFormula":"","productField":"","layoutGridColumnSpan":12,"enableEnhancedUI":0,"layoutGroupId":"9699ccdc","multipleFiles":false,"maxFiles":"","calculationRounding":"","disableQuantity":false,"displayAllCategories":false,"useRichTextEditor":false,"errors":[],"pageNumber":1,"fields":"","displayOnly":""},{"type":"radio","id":14,"formId":1,"label":"Do you want to include an additional amount to cover college costs?","adminLabel":"","isRequired":false,"size":"large","errorMessage":"","visibility":"visible","validateState":true,"inputs":null,"choices":[{"text":"Yes","value":"Yes","isSelected":false,"price":""},{"text":"No","value":"No","isSelected":false,"price":""}],"description":"We'll add an amount per child that represents the average cost of a four-year degree.","allowsPrepopulate":false,"inputMask":false,"inputMaskValue":"","inputMaskIsCustom":false,"maxLength":"","inputType":"","labelPlacement":"","descriptionPlacement":"","subLabelPlacement":"","placeholder":"","cssClass":"two_box btn_box","inputName":"","noDuplicates":false,"defaultValue":"","enableAutocomplete":false,"autocompleteAttribute":"","conditionalLogic":{"enabled":true,"actionType":"show","logicType":"all","rules":[{"fieldId":"7","operator":">","value":"0"}]},"productField":"","layoutGridColumnSpan":12,"enableOtherChoice":"","enablePrice":"","enableEnhancedUI":0,"layoutGroupId":"d63412d9","multipleFiles":false,"maxFiles":"","calculationFormula":"","calculationRounding":"","enableCalculation":"","disableQuantity":false,"displayAllCategories":false,"useRichTextEditor":false,"errors":[],"pageNumber":1,"fields":"","displayOnly":""},{"type":"number","id":8,"formId":1,"label":"Total household debt","adminLabel":"","isRequired":true,"size":"large","errorMessage":"","visibility":"visible","inputs":null,"numberFormat":"currency","description":"Include all debts, such as mortgages, student loans, car loans, credit cards, etc.","allowsPrepopulate":false,"inputMask":false,"inputMaskValue":"","inputMaskIsCustom":false,"maxLength":"","inputType":"","labelPlacement":"","descriptionPlacement":"","subLabelPlacement":"","placeholder":"","cssClass":"two_box","inputName":"","noDuplicates":false,"defaultValue":"","enableAutocomplete":false,"autocompleteAttribute":"","choices":"","conditionalLogic":"","enableCalculation":false,"rangeMin":false,"rangeMax":false,"calculationFormula":"","productField":"","layoutGridColumnSpan":12,"enableEnhancedUI":0,"layoutGroupId":"dfa19c81","multipleFiles":false,"maxFiles":"","calculationRounding":"","disableQuantity":false,"displayAllCategories":false,"useRichTextEditor":false,"errors":[],"pageNumber":1,"fields":"","displayOnly":"","checkboxLabel":""},{"type":"number","id":9,"formId":1,"label":"Total household savings","adminLabel":"","isRequired":true,"size":"large","errorMessage":"","visibility":"visible","inputs":null,"numberFormat":"currency","description":"Your total household liquid savings (i.e. the funds are accessible without taxes or other penalties whenever you need them).","allowsPrepopulate":false,"inputMask":false,"inputMaskValue":"","inputMaskIsCustom":false,"maxLength":"","inputType":"","labelPlacement":"","descriptionPlacement":"","subLabelPlacement":"","placeholder":"","cssClass":"two_box","inputName":"","noDuplicates":false,"defaultValue":"","enableAutocomplete":false,"autocompleteAttribute":"","choices":"","conditionalLogic":"","enableCalculation":false,"rangeMin":false,"rangeMax":false,"calculationFormula":"","productField":"","layoutGridColumnSpan":12,"enableEnhancedUI":0,"layoutGroupId":"571a7623","multipleFiles":false,"maxFiles":"","calculationRounding":"","disableQuantity":false,"displayAllCategories":false,"useRichTextEditor":false,"errors":[],"pageNumber":1,"fields":"","displayOnly":"","checkboxLabel":""},{"type":"name","id":10,"formId":1,"label":"Name","adminLabel":"","isRequired":true,"size":"large","errorMessage":"","visibility":"visible","nameFormat":"advanced","inputs":[{"id":"10.2","label":"Prefix","name":"","autocompleteAttribute":"honorific-prefix","choices":[{"text":"Dr.","value":"Dr."},{"text":"Miss","value":"Miss"},{"text":"Mr.","value":"Mr."},{"text":"Mrs.","value":"Mrs."},{"text":"Ms.","value":"Ms."},{"text":"Mx.","value":"Mx."},{"text":"Prof.","value":"Prof."},{"text":"Rev.","value":"Rev."}],"isHidden":true,"inputType":"radio"},{"id":"10.3","label":"First","name":"","autocompleteAttribute":"given-name","placeholder":"First"},{"id":"10.4","label":"Middle","name":"","autocompleteAttribute":"additional-name","isHidden":true},{"id":"10.6","label":"Last","name":"","autocompleteAttribute":"family-name","placeholder":"Last"},{"id":"10.8","label":"Suffix","name":"","autocompleteAttribute":"honorific-suffix","isHidden":true}],"description":"","allowsPrepopulate":false,"inputMask":false,"inputMaskValue":"","inputMaskIsCustom":false,"maxLength":"","inputType":"","labelPlacement":"","descriptionPlacement":"","subLabelPlacement":"hidden_label","placeholder":"","cssClass":"","inputName":"","noDuplicates":false,"defaultValue":"","enableAutocomplete":false,"autocompleteAttribute":"","choices":"","conditionalLogic":"","productField":"","layoutGridColumnSpan":"","enableEnhancedUI":0,"layoutGroupId":"a4dfc8ae","multipleFiles":false,"maxFiles":"","calculationFormula":"","calculationRounding":"","enableCalculation":"","disableQuantity":false,"displayAllCategories":false,"useRichTextEditor":false,"checkboxLabel":"","pageNumber":1,"fields":"","displayOnly":""},{"type":"email","id":11,"formId":1,"label":"Email","adminLabel":"","isRequired":true,"size":"large","errorMessage":"","visibility":"visible","inputs":null,"autocompleteAttribute":"email","description":"","allowsPrepopulate":false,"inputMask":false,"inputMaskValue":"","inputMaskIsCustom":false,"maxLength":"","inputType":"","labelPlacement":"","descriptionPlacement":"","subLabelPlacement":"","placeholder":"","cssClass":"","inputName":"","noDuplicates":false,"defaultValue":"","enableAutocomplete":false,"choices":"","conditionalLogic":"","productField":"","layoutGridColumnSpan":6,"emailConfirmEnabled":"","enableEnhancedUI":0,"layoutGroupId":"6f91869d","pageNumber":1,"fields":"","displayOnly":"","multipleFiles":false,"maxFiles":"","calculationFormula":"","calculationRounding":"","enableCalculation":"","disableQuantity":false,"displayAllCategories":false,"useRichTextEditor":false},{"type":"phone","id":12,"formId":1,"label":"Phone","adminLabel":"","isRequired":true,"size":"large","errorMessage":"","visibility":"visible","inputs":null,"phoneFormat":"international","autocompleteAttribute":"tel","description":"","allowsPrepopulate":false,"inputMask":false,"inputMaskValue":"","inputMaskIsCustom":false,"maxLength":"","inputType":"","labelPlacement":"","descriptionPlacement":"","subLabelPlacement":"","placeholder":"","cssClass":"","inputName":"","noDuplicates":false,"defaultValue":"","enableAutocomplete":false,"choices":"","conditionalLogic":"","productField":"","layoutGridColumnSpan":6,"enableEnhancedUI":0,"layoutGroupId":"6f91869d","pageNumber":1,"fields":"","displayOnly":"","multipleFiles":false,"maxFiles":"","calculationFormula":"","calculationRounding":"","enableCalculation":"","disableQuantity":false,"displayAllCategories":false,"useRichTextEditor":false},{"type":"number","id":15,"formId":1,"label":"Your estimated amount of insurance needed is","adminLabel":"","isRequired":false,"size":"large","errorMessage":"","visibility":"visible","inputs":null,"numberFormat":"currency","description":"","allowsPrepopulate":false,"inputMask":false,"inputMaskValue":"","inputMaskIsCustom":false,"maxLength":"","inputType":"","labelPlacement":"","descriptionPlacement":"","subLabelPlacement":"","placeholder":"","cssClass":"q_btn","inputName":"","noDuplicates":false,"defaultValue":"","enableAutocomplete":false,"autocompleteAttribute":"","choices":"","conditionalLogic":{"enabled":true,"actionType":"show","logicType":"all","rules":[{"fieldId":"5","operator":"isnot","value":""},{"fieldId":"10.3","operator":"isnot","value":""},{"fieldId":"10.6","operator":"isnot","value":""},{"fieldId":"11","operator":"isnot","value":""},{"fieldId":"12","operator":"isnot","value":""}]},"enableCalculation":true,"rangeMin":false,"rangeMax":false,"calculationFormula":"{Annual income:5} * 10","productField":"","layoutGridColumnSpan":12,"enableEnhancedUI":0,"layoutGroupId":"def0c97f","multipleFiles":false,"maxFiles":"","calculationRounding":"","disableQuantity":false,"displayAllCategories":false,"useRichTextEditor":false,"errors":[],"pageNumber":1,"fields":"","displayOnly":""}],"version":"2.7.2","id":3,"markupVersion":2,"nextFieldId":16,"useCurrentUserAsAuthor":true,"postContentTemplateEnabled":false,"postTitleTemplateEnabled":false,"postTitleTemplate":"","postContentTemplate":"","lastPageButton":null,"pagination":null,"firstPageCssClass":null,"gfpdf_form_settings":{"640d602b58e17":{"name":"Quote","template":"zadani","notification":{"64074ce3dce45":"64074ce3dce45"},"filename":"quote","conditionalLogic":null,"pdf_size":"A4","custom_pdf_size":["","","millimeters"],"orientation":"portrait","font":"dejavusanscondensed","font_size":"10","font_colour":"#000000","zadani_border_colour":"#CCCCCC","show_form_title":"Yes","enable_conditional":"Yes","background_color":"#FFF","background_image":"","header":"","first_header":"","footer":"","first_footer":"","format":"Standard","password":"","privileges":{"copy":"copy","print":"print","print-highres":"print-highres","modify":"modify","annot-forms":"annot-forms","fill-forms":"fill-forms","extract":"extract","assemble":"assemble"},"master_password":"","image_dpi":"96","save":"","conditional":"","rtl":"","security":"","public_access":"","restrict_owner":"","id":"640d602b58e17","active":true}},"is_active":"1","date_created":"2023-03-07 14:40:35","is_trash":"0","subLabelPlacement":"below","requiredIndicator":"asterisk","customRequiredIndicator":"(Required)","cssClass":"tc","saveButtonText":"Save & Continue","limitEntries":false,"limitEntriesCount":"","limitEntriesPeriod":"","limitEntriesMessage":"","scheduleForm":false,"scheduleStart":"","scheduleEnd":"","schedulePendingMessage":"","scheduleMessage":"","requireLogin":false,"requireLoginMessage":"","honeypotAction":"abort","validationSummary":false,"deprecated":"","saveEnabled":"","enableHoneypot":false,"enableAnimation":false,"save":{"enabled":false,"button":{"type":"link","text":"Save & Continue"}},"scheduleStartHour":"","scheduleStartMinute":"","scheduleStartAmpm":"","scheduleEndHour":"","scheduleEndMinute":"","scheduleEndAmpm":""}