RGS Title, LLC (451) -- RGS Title, LLC (287)

Visual Data Systems

title - Submit Title Order

FormID: 676 AccountID: 287

LEGACY Contents for config-title.php file:
<?php $AccountID = 287; $formid = 676; $pageTitle = 'Contact Us: Submit Title Order | RGS Title'; $pageHeader = 'Submit Title Order'; $introText = '<p>We would like the opportunity to provide you with more information. Please fill in the simple form below, select the <strong>Submit</strong> button, and we will get back to you shortly. </p>'; $template = $Root.'/Templates/page2.dwt'; $contactblock = "<tr><td colspan=4><table width=100%><tr><td align=right class=label>First Name:</td><td width=85%><input type='text' name='FirstName' value='".(($_POST['FirstName'] <> "") ? htmlentities(stripslashes($_POST['FirstName']), ENT_QUOTES) : "")."' size=24 maxlength=24 />$reqsymbol</td></tr> <tr><td align=right class=label>Last Name:</td><td width=85%><input type='text' name='LastName' value='".(($_POST['LastName'] <> "") ? htmlentities(stripslashes($_POST['LastName']), ENT_QUOTES) : "")."' size=32 maxlength=32 />$reqsymbol</td></tr> <tr><td align=right class=label>Email:</td><td width=85%><input type='text' name='Email' value='".(($_POST['Email'] <> "") ? htmlentities(stripslashes($_POST['Email']), ENT_QUOTES) : "")."' size=32 maxlength=64 />$reqsymbol</td></tr> <tr><td align=right class=label>Phone:</td><td width=85%><input type='text' name='Phone' value='".(($_POST['Phone'] <> "") ? htmlentities(stripslashes($_POST['Phone']), ENT_QUOTES) : "")."' size=16 maxlength=16 />$reqsymbol</td></tr> <tr><td colspan=2><table width=100%><tr><td colspan=3>Please indicate the methods by which we may contact you:</td></tr><tr><td><input type='checkbox' class=clear name='ApprovedContactEmail' value='1' ".(($_POST['ApprovedContactEmail'] == "1") ? "CHECKED" : "CHECKED")." />email</td><td><input type='checkbox' class=clear name='ApprovedContactPhone' value='1' ".(($_POST['ApprovedContactPhone'] == "1") ? "CHECKED" : "CHECKED")." />phone</td><td><input type='checkbox' class=clear name='ApprovedContactPost' value='1' ".(($_POST['ApprovedContactPost'] == "1") ? "CHECKED" : "CHECKED")." />post</td></tr></table></td></tr> </table></td></tr>"; $questionblock = "<tr><td><b>Transaction Type: </b></td><td><select class='item' name='MAID:0000003880' size='1'><option value='0000048213' ".(($_POST['MAID:0000003880'] == '0000048213') ? "selected":"").">-select one-</option><option value='0000048214' ".(($_POST['MAID:0000003880'] == '0000048214') ? "selected":"").">Sale</option><option value='0000048215' ".(($_POST['MAID:0000003880'] == '0000048215') ? "selected":"").">Refinance</option></select></td></tr> <tr><td><b>Office:</b></td><td><select class='item' name='MAID:0000003881' size='1'><option value='0000048216' ".(($_POST['MAID:0000003881'] == '0000048216') ? "selected":"").">-select one-</option></select></td></tr> <tr><td class=label><b>Sales Price:</b></td><td><input type='text' class='item' name='TEXT:0000003882' value='".(($_POST['TEXT:0000003882'] <> "") ? htmlentities($_POST['TEXT:0000003882'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Loan Amount:</b></td><td><input type='text' class='item' name='TEXT:0000003883' value='".(($_POST['TEXT:0000003883'] <> "") ? htmlentities($_POST['TEXT:0000003883'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Projected Closing Date:</b></td><td><input type='text' class='item' name='TEXT:0000003884' value='".(($_POST['TEXT:0000003884'] <> "") ? htmlentities($_POST['TEXT:0000003884'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>First/Last Name:</b></td><td><input type='text' class='item' name='TEXT:0000003885' value='".(($_POST['TEXT:0000003885'] <> "") ? htmlentities($_POST['TEXT:0000003885'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Email:</b></td><td><input type='text' class='item' name='TEXT:0000003886' value='".(($_POST['TEXT:0000003886'] <> "") ? htmlentities($_POST['TEXT:0000003886'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Phone:</b></td><td><input type='text' class='item' name='TEXT:0000003887' value='".(($_POST['TEXT:0000003887'] <> "") ? htmlentities($_POST['TEXT:0000003887'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Applicant 1 First/Last Name:</b></td><td><input type='text' class='item' name='TEXT:0000003888' value='".(($_POST['TEXT:0000003888'] <> "") ? htmlentities($_POST['TEXT:0000003888'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Applicant 1 Address:</b></td><td><input type='text' class='item' name='TEXT:0000003889' value='".(($_POST['TEXT:0000003889'] <> "") ? htmlentities($_POST['TEXT:0000003889'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Applicant 1 Email:</b></td><td><input type='text' class='item' name='TEXT:0000003890' value='".(($_POST['TEXT:0000003890'] <> "") ? htmlentities($_POST['TEXT:0000003890'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Applicant 1 Phone:</b></td><td><input type='text' class='item' name='TEXT:0000003891' value='".(($_POST['TEXT:0000003891'] <> "") ? htmlentities($_POST['TEXT:0000003891'], ENT_QUOTES) : "")."' /></td></tr> <tr><td><b>Applicant 1 Marital Status:</b></td><td><select class='item' name='MAID:0000003892' size='1'><option value='0000048227' ".(($_POST['MAID:0000003892'] == '0000048227') ? "selected":"").">-select one-</option><option value='0000048228' ".(($_POST['MAID:0000003892'] == '0000048228') ? "selected":"").">Single</option><option value='0000048229' ".(($_POST['MAID:0000003892'] == '0000048229') ? "selected":"").">Married</option><option value='0000048230' ".(($_POST['MAID:0000003892'] == '0000048230') ? "selected":"").">Divorced</option></select></td></tr> <tr><td class=label><b>Applicant 2 First/Last Name:</b></td><td><input type='text' class='item' name='TEXT:0000003893' value='".(($_POST['TEXT:0000003893'] <> "") ? htmlentities($_POST['TEXT:0000003893'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Applicant 2 Address:</b></td><td><input type='text' class='item' name='TEXT:0000003894' value='".(($_POST['TEXT:0000003894'] <> "") ? htmlentities($_POST['TEXT:0000003894'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Applicant 2 Email: </b></td><td><input type='text' class='item' name='TEXT:0000003895' value='".(($_POST['TEXT:0000003895'] <> "") ? htmlentities($_POST['TEXT:0000003895'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Applicant 2 Phone:</b></td><td><input type='text' class='item' name='TEXT:0000003896' value='".(($_POST['TEXT:0000003896'] <> "") ? htmlentities($_POST['TEXT:0000003896'], ENT_QUOTES) : "")."' /></td></tr> <tr><td><b>Applicant 2 Marital Status:</b></td><td><select class='item' name='MAID:0000003897' size='1'><option value='0000048235' ".(($_POST['MAID:0000003897'] == '0000048235') ? "selected":"").">-select one-</option><option value='0000048236' ".(($_POST['MAID:0000003897'] == '0000048236') ? "selected":"").">Single</option><option value='0000048237' ".(($_POST['MAID:0000003897'] == '0000048237') ? "selected":"").">Married</option><option value='0000048238' ".(($_POST['MAID:0000003897'] == '0000048238') ? "selected":"").">Divorced</option></select></td></tr> <tr><td class=label><b>Seller First/Last Name:</b></td><td><input type='text' class='item' name='TEXT:0000003898' value='".(($_POST['TEXT:0000003898'] <> "") ? htmlentities($_POST['TEXT:0000003898'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Seller Address:</b></td><td><input type='text' class='item' name='TEXT:0000003900' value='".(($_POST['TEXT:0000003900'] <> "") ? htmlentities($_POST['TEXT:0000003900'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Seller Email:</b></td><td><input type='text' class='item' name='TEXT:0000003899' value='".(($_POST['TEXT:0000003899'] <> "") ? htmlentities($_POST['TEXT:0000003899'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Seller Phone:</b></td><td><input type='text' class='item' name='TEXT:0000003901' value='".(($_POST['TEXT:0000003901'] <> "") ? htmlentities($_POST['TEXT:0000003901'], ENT_QUOTES) : "")."' /></td></tr> <tr><td><b>Seller Marital Status:</b></td><td><select class='item' name='MAID:0000003902' size='1'><option value='0000048243' ".(($_POST['MAID:0000003902'] == '0000048243') ? "selected":"").">-select one-</option><option value='0000048244' ".(($_POST['MAID:0000003902'] == '0000048244') ? "selected":"").">Single</option><option value='0000048245' ".(($_POST['MAID:0000003902'] == '0000048245') ? "selected":"").">Married</option><option value='0000048246' ".(($_POST['MAID:0000003902'] == '0000048246') ? "selected":"").">Divorced</option></select></td></tr> <tr><td class=label><b>Property Address:</b></td><td><input type='text' class='item' name='TEXT:0000003903' value='".(($_POST['TEXT:0000003903'] <> "") ? htmlentities($_POST['TEXT:0000003903'], ENT_QUOTES) : "")."' /></td></tr> <tr><td colspan=2><b>Property City, State, Zip, Country:</b></td></tr><tr><td colspan=2><textarea cols=60 rows=5 name='TEXT:0000003904'>".(($_POST['TEXT:0000003904'] <> "") ? htmlentities(stripslashes($_POST['TEXT:0000003904']), ENT_QUOTES) : htmlentities(stripslashes(""), ENT_QUOTES))."</textarea></td></tr> <tr><td class=label><b>Sales Contract:</b></td><td><input type='text' class='item' name='TEXT:0000003905' value='".(($_POST['TEXT:0000003905'] <> "") ? htmlentities($_POST['TEXT:0000003905'], ENT_QUOTES) : "(Upload)")."' /></td></tr> <tr><td class=label><b>Listing Agent Name:</b></td><td><input type='text' class='item' name='TEXT:0000003906' value='".(($_POST['TEXT:0000003906'] <> "") ? htmlentities($_POST['TEXT:0000003906'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Listing Agent Phone:</b></td><td><input type='text' class='item' name='TEXT:0000003907' value='".(($_POST['TEXT:0000003907'] <> "") ? htmlentities($_POST['TEXT:0000003907'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Listing Agent Email:</b></td><td><input type='text' class='item' name='TEXT:0000003908' value='".(($_POST['TEXT:0000003908'] <> "") ? htmlentities($_POST['TEXT:0000003908'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Selling Agent Name:</b></td><td><input type='text' class='item' name='TEXT:0000003909' value='".(($_POST['TEXT:0000003909'] <> "") ? htmlentities($_POST['TEXT:0000003909'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Selling Agent Phone:</b></td><td><input type='text' class='item' name='TEXT:0000003910' value='".(($_POST['TEXT:0000003910'] <> "") ? htmlentities($_POST['TEXT:0000003910'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Selling Agent Email:</b></td><td><input type='text' class='item' name='TEXT:0000003911' value='".(($_POST['TEXT:0000003911'] <> "") ? htmlentities($_POST['TEXT:0000003911'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Lender Name:</b></td><td><input type='text' class='item' name='TEXT:0000003912' value='".(($_POST['TEXT:0000003912'] <> "") ? htmlentities($_POST['TEXT:0000003912'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Loan Officer Name:</b></td><td><input type='text' class='item' name='TEXT:0000003913' value='".(($_POST['TEXT:0000003913'] <> "") ? htmlentities($_POST['TEXT:0000003913'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Loan Officer Phone:</b></td><td><input type='text' class='item' name='TEXT:0000003914' value='".(($_POST['TEXT:0000003914'] <> "") ? htmlentities($_POST['TEXT:0000003914'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Loan Officer Email:</b></td><td><input type='text' class='item' name='TEXT:0000003915' value='".(($_POST['TEXT:0000003915'] <> "") ? htmlentities($_POST['TEXT:0000003915'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label><b>Mortgagee Clause:</b></td><td><input type='text' class='item' name='TEXT:0000003916' value='".(($_POST['TEXT:0000003916'] <> "") ? htmlentities($_POST['TEXT:0000003916'], ENT_QUOTES) : "")."' /></td></tr> <tr><td class=label colspan=2><b>Please provide us with the following: </b></td></tr><tr><td colspan=2>   <input type='checkbox' class=clear name='MAID:0000003917:0' value='0000048261' ".(($_POST['MAID:0000003917:0'] == '0000048261') ? "checked='checked'":"")." />Title commitment </td></tr><tr><td colspan=2>   <input type='checkbox' class=clear name='MAID:0000003917:1' value='0000048262' ".(($_POST['MAID:0000003917:1'] == '0000048262') ? "checked='checked'":"")." />Wiring Instructions </td></tr><tr><td colspan=2>   <input type='checkbox' class=clear name='MAID:0000003917:2' value='0000048263' ".(($_POST['MAID:0000003917:2'] == '0000048263') ? "checked='checked'":"")." />Preliminary HUD </td></tr> <tr><td colspan=2><b>Additional Instructions: </b></td></tr><tr><td colspan=2><textarea cols=60 rows=5 name='TEXT:0000003918'>".(($_POST['TEXT:0000003918'] <> "") ? htmlentities(stripslashes($_POST['TEXT:0000003918']), ENT_QUOTES) : htmlentities(stripslashes(""), ENT_QUOTES))."</textarea></td></tr> "; $thanksTitle = 'Thank You'; $thanksHeader = 'Thanks for your time!'; $thanksText = '<P>Many thanks for contacting us. A representative will be responding to your on-line request shortly. We appreciate your business and will do our best to serve your needs! </p>';