{"id":510,"date":"2018-02-10T18:39:51","date_gmt":"2018-02-11T01:39:51","guid":{"rendered":"http:\/\/www.nwacpa.com\/dev\/?page_id=510"},"modified":"2018-02-10T18:39:51","modified_gmt":"2018-02-11T01:39:51","slug":"newclientform","status":"publish","type":"page","link":"http:\/\/www.nwacpa.com\/dev\/newclientform\/","title":{"rendered":"New Client Form"},"content":{"rendered":"<div class=\"caldera-grid\" id=\"caldera_form_1\" data-cf-ver=\"1.5.9.1\" data-cf-form-id=\"CF5a77a1c46f8bf\"><div id=\"caldera_notices_1\" data-spinner=\"http:\/\/www.nwacpa.com\/dev\/wp-admin\/images\/spinner.gif\"><\/div><form data-instance=\"1\" class=\"CF5a77a1c46f8bf caldera_forms_form cfajax-trigger\" method=\"POST\" enctype=\"multipart\/form-data\" id=\"CF5a77a1c46f8bf_1\" data-form-id=\"CF5a77a1c46f8bf\" aria-label=\"New Client Tax Form\" data-target=\"#caldera_notices_1\" data-template=\"#cfajax_CF5a77a1c46f8bf-tmpl\" data-cfajax=\"CF5a77a1c46f8bf\" data-load-element=\"_parent\" data-load-class=\"cf_processing\" data-post-disable=\"0\" data-action=\"cf_process_ajax_submit\" data-request=\"http:\/\/www.nwacpa.com\/dev\/cf-api\/CF5a77a1c46f8bf\" data-hiderows=\"true\">\r\n<input type=\"hidden\" id=\"_cf_verify_CF5a77a1c46f8bf\" name=\"_cf_verify\" value=\"5b3e4d6a7c\"  data-nonce-time=\"1775927322\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/dev\/wp-json\/wp\/v2\/pages\/510\" \/><input type=\"hidden\" name=\"_cf_frm_id\" value=\"CF5a77a1c46f8bf\">\r\n<input type=\"hidden\" name=\"_cf_frm_ct\" value=\"1\">\r\n<input type=\"hidden\" name=\"cfajax\" value=\"CF5a77a1c46f8bf\">\r\n<input type=\"hidden\" name=\"_cf_cr_pst\" value=\"510\">\r\n<div class=\"hide\" style=\"display:none; overflow:hidden;height:0;width:0;\">\r\n<label>Web Site<\/label><input type=\"text\" name=\"web_site\" value=\"\" autocomplete=\"off\">\r\n<\/div><div id=\"CF5a77a1c46f8bf_1-row-1\"  class=\"row  first_row\"><div  class=\"col-sm-12  single\">\n<div data-field-wrapper=\"fld_8223427\" class=\"form-group\" id=\"fld_8223427_1-wrap\">\r\n\t<label id=\"fld_8223427Label\" for=\"fld_8223427_1\" class=\"control-label\">Today's Date <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input  type=\"text\" data-provide=\"cfdatepicker\" name=\"fld_8223427\" value=\"\" id=\"fld_8223427_1\" data-field=\"fld_8223427\" class=\"form-control cfdatepicker is-cfdatepicker\" data-date-format=\"mm-dd-yyyy\" required=\"1\" data-date-start-view=\"month\"   aria-labelledby=\"fld_8223427Label\" required  \/>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-2\"  class=\"row \"><div  class=\"col-sm-12  single\"><hr id=\"fld_7361317_1\" class=\"\" style=\"width: 100%\" \/><\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-3\"  class=\"row \"><div  class=\"col-sm-4  first_col\"><div data-field-wrapper=\"fld_3472162\" class=\"form-group\" id=\"fld_3472162_1-wrap\">\r\n\t<label id=\"fld_3472162Label\" for=\"fld_3472162_1\" class=\"control-label\">Taxpayer Title<\/label>\r\n\t<div class=\"\">\r\n\t\t<select name=\"fld_3472162\" value=\"\" data-field=\"fld_3472162\" class=\"form-control\" id=\"fld_3472162_1\"    aria-labelledby=\"fld_3472162Label\" >\n\t\t<option value=\"\"><\/option>\r\n\t\t\t\t\t<option value=\"- None - \"  data-calc-value=\"- None - \" >\n\t\t\t\t\t\t- None - \t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Mr. \"  data-calc-value=\"Mr. \" >\n\t\t\t\t\t\tMr. \t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Mrs.\"  data-calc-value=\"Mrs.\" >\n\t\t\t\t\t\tMrs.\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Ms. \"  data-calc-value=\"Ms. \" >\n\t\t\t\t\t\tMs. \t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Dr.\"  data-calc-value=\"Dr.\" >\n\t\t\t\t\t\tDr.\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  class=\"col-sm-4 \"><div data-field-wrapper=\"fld_4618014\" class=\"form-group\" id=\"fld_4618014_1-wrap\">\r\n\t<label id=\"fld_4618014Label\" for=\"fld_4618014_1\" class=\"control-label\">Taxpayer 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_4618014\" class=\" form-control\" id=\"fld_4618014_1\" name=\"fld_4618014\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_4618014Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-4  last_col\"><div data-field-wrapper=\"fld_8633682\" class=\"form-group\" id=\"fld_8633682_1-wrap\">\r\n\t<label id=\"fld_8633682Label\" for=\"fld_8633682_1\" class=\"control-label\">Taxpayer 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_8633682\" class=\" form-control\" id=\"fld_8633682_1\" name=\"fld_8633682\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_8633682Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-4\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_5956981\" class=\"form-group\" id=\"fld_5956981_1-wrap\">\r\n\t<label id=\"fld_5956981Label\" for=\"fld_5956981_1\" class=\"control-label\">Taxpayer 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_5956981\" class=\" form-control\" id=\"fld_5956981_1\" name=\"fld_5956981\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_5956981Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-5\"  class=\"row \"><div  class=\"col-sm-12  single\">\n<div data-field-wrapper=\"fld_9408463\" class=\"form-group\" id=\"fld_9408463_1-wrap\">\r\n\t<label id=\"fld_9408463Label\" for=\"fld_9408463_1\" class=\"control-label\">Taxpayer Date of Birth <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input  type=\"text\" data-provide=\"cfdatepicker\" name=\"fld_9408463\" value=\"\" id=\"fld_9408463_1\" data-field=\"fld_9408463\" class=\"form-control cfdatepicker is-cfdatepicker\" data-date-format=\"mm-dd-yyyy\" required=\"1\" data-date-start-view=\"decade\" data-date-autoclose=\"true\"   aria-labelledby=\"fld_9408463Label\" required  \/>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-6\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_3920559\" class=\"form-group\" id=\"fld_3920559_1-wrap\">\r\n\t<label id=\"fld_3920559Label\" for=\"fld_3920559_1\" class=\"control-label\">Taxpayer Home Phone<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"tel\" data-field=\"fld_3920559\" class=\" form-control\" id=\"fld_3920559_1\" name=\"fld_3920559\" value=\"\" data-type=\"phone_better\"   aria-labelledby=\"fld_3920559Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-7\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_948219\" class=\"form-group\" id=\"fld_948219_1-wrap\">\r\n\t<label id=\"fld_948219Label\" for=\"fld_948219_1\" class=\"control-label\">Taxpayer Cell Phone <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=\"tel\" data-field=\"fld_948219\" class=\" form-control\" id=\"fld_948219_1\" name=\"fld_948219\" value=\"\" data-type=\"phone_better\" aria-required=\"true\"   aria-labelledby=\"fld_948219Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-8\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_3919946\" class=\"form-group\" id=\"fld_3919946_1-wrap\">\r\n\t<label id=\"fld_3919946Label\" for=\"fld_3919946_1\" class=\"control-label\">Taxpayer 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_3919946\" class=\" form-control\" id=\"fld_3919946_1\" name=\"fld_3919946\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_3919946Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-9\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_7531663\" class=\"form-group\" id=\"fld_7531663_1-wrap\">\r\n\t<label id=\"fld_7531663Label\" for=\"fld_7531663_1\" class=\"control-label\">Taxpayer City <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_7531663\" class=\" form-control\" id=\"fld_7531663_1\" name=\"fld_7531663\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_7531663Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3 \"><div data-field-wrapper=\"fld_866352\" class=\"form-group\" id=\"fld_866352_1-wrap\">\r\n\t<label id=\"fld_866352Label\" for=\"fld_866352_1\" class=\"control-label\">Taxpayer State <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_866352\" class=\" form-control\" id=\"fld_866352_1\" name=\"fld_866352\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_866352Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3  last_col\"><div data-field-wrapper=\"fld_2274999\" class=\"form-group\" id=\"fld_2274999_1-wrap\">\r\n\t<label id=\"fld_2274999Label\" for=\"fld_2274999_1\" class=\"control-label\">Taxpayer Zip <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_2274999\" class=\" form-control\" id=\"fld_2274999_1\" name=\"fld_2274999\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_2274999Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-10\"  class=\"row \"><div  class=\"col-sm-12  single\"><hr id=\"fld_7045783_1\" class=\"\" style=\"width: 100%\" \/><\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-11\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_3607557\" class=\"form-group\" id=\"fld_3607557_1-wrap\">\r\n\t<label id=\"fld_3607557Label\" for=\"fld_3607557_1\" class=\"control-label\">Spouse Title<\/label>\r\n\t<div class=\"\">\r\n\t\t<select name=\"fld_3607557\" value=\"\" data-field=\"fld_3607557\" class=\"form-control\" id=\"fld_3607557_1\"    aria-labelledby=\"fld_3607557Label\" >\n\t\t<option value=\"\"><\/option>\r\n\t\t\t\t\t<option value=\"- None - \"  data-calc-value=\"- None - \" >\n\t\t\t\t\t\t- None - \t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Mr.\"  data-calc-value=\"Mr.\" >\n\t\t\t\t\t\tMr.\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Mrs.\"  data-calc-value=\"Mrs.\" >\n\t\t\t\t\t\tMrs.\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Ms.\"  data-calc-value=\"Ms.\" >\n\t\t\t\t\t\tMs.\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Dr.\"  data-calc-value=\"Dr.\" >\n\t\t\t\t\t\tDr.\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  class=\"col-sm-3 \"><div data-field-wrapper=\"fld_7257941\" class=\"form-group\" id=\"fld_7257941_1-wrap\">\r\n\t<label id=\"fld_7257941Label\" for=\"fld_7257941_1\" class=\"control-label\">Spouse First Name<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_7257941\" class=\" form-control\" id=\"fld_7257941_1\" name=\"fld_7257941\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_7257941Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3  last_col\"><div data-field-wrapper=\"fld_7197426\" class=\"form-group\" id=\"fld_7197426_1-wrap\">\r\n\t<label id=\"fld_7197426Label\" for=\"fld_7197426_1\" class=\"control-label\">Spouse Last Name<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_7197426\" class=\" form-control\" id=\"fld_7197426_1\" name=\"fld_7197426\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_7197426Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-12\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_3388906\" class=\"form-group\" id=\"fld_3388906_1-wrap\">\r\n\t<label id=\"fld_3388906Label\" for=\"fld_3388906_1\" class=\"control-label\">Spouse Occupation<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_3388906\" class=\" form-control\" id=\"fld_3388906_1\" name=\"fld_3388906\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_3388906Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-13\"  class=\"row \"><div  class=\"col-sm-12  single\">\n<div data-field-wrapper=\"fld_6990143\" class=\"form-group\" id=\"fld_6990143_1-wrap\">\r\n\t<label id=\"fld_6990143Label\" for=\"fld_6990143_1\" class=\"control-label\">Spouse Date of Birth<\/label>\r\n\t<div class=\"\">\r\n\t\t<input  type=\"text\" data-provide=\"cfdatepicker\" name=\"fld_6990143\" value=\"\" id=\"fld_6990143_1\" data-field=\"fld_6990143\" class=\"form-control cfdatepicker is-cfdatepicker\" data-date-format=\"mm-dd-yyyy\" data-date-start-view=\"decade\" data-date-autoclose=\"true\"   aria-labelledby=\"fld_6990143Label\"   \/>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-14\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_7892260\" class=\"form-group\" id=\"fld_7892260_1-wrap\">\r\n\t<label id=\"fld_7892260Label\" for=\"fld_7892260_1\" class=\"control-label\">Spouse Cell Phone<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"tel\" data-field=\"fld_7892260\" class=\" form-control\" id=\"fld_7892260_1\" name=\"fld_7892260\" value=\"\" data-type=\"phone_better\"   aria-labelledby=\"fld_7892260Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<hr id=\"fld_3335256_1\" class=\"\" style=\"width: 100%\" \/><\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-15\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_3553987\" class=\"form-group\" id=\"fld_3553987_1-wrap\">\r\n\t<label id=\"fld_3553987Label\" for=\"fld_3553987_1\" class=\"control-label\">Dependent 1 Name<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_3553987\" class=\" form-control\" id=\"fld_3553987_1\" name=\"fld_3553987\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_3553987Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-16\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_9382298\" class=\"form-group\" id=\"fld_9382298_1-wrap\">\r\n\t<label id=\"fld_9382298Label\" for=\"fld_9382298_1\" class=\"control-label\">Dependent 1 Relationship<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_9382298\" class=\" form-control\" id=\"fld_9382298_1\" name=\"fld_9382298\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_9382298Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\">\n<div data-field-wrapper=\"fld_6278128\" class=\"form-group\" id=\"fld_6278128_1-wrap\">\r\n\t<label id=\"fld_6278128Label\" for=\"fld_6278128_1\" class=\"control-label\">Dependent 1 Date of Birth<\/label>\r\n\t<div class=\"\">\r\n\t\t<input  type=\"text\" data-provide=\"cfdatepicker\" name=\"fld_6278128\" value=\"\" id=\"fld_6278128_1\" data-field=\"fld_6278128\" class=\"form-control cfdatepicker is-cfdatepicker\" data-date-format=\"mm-dd-yyyy\" data-date-start-view=\"decade\" data-date-autoclose=\"true\"   aria-labelledby=\"fld_6278128Label\"   \/>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-17\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_1039214\" class=\"form-group\" id=\"fld_1039214_1-wrap\">\r\n\t<label id=\"fld_1039214Label\" for=\"fld_1039214_1\" class=\"control-label\">Dependent 1 Time Lived With You<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_1039214\" class=\" form-control\" id=\"fld_1039214_1\" name=\"fld_1039214\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_1039214Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-18\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_1404540\" class=\"form-group\" id=\"fld_1404540_1-wrap\">\r\n\t<label id=\"fld_1404540Label\" for=\"fld_1404540_1\" class=\"control-label\">Dependent 2 Name<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_1404540\" class=\" form-control\" id=\"fld_1404540_1\" name=\"fld_1404540\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_1404540Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-19\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_9871607\" class=\"form-group\" id=\"fld_9871607_1-wrap\">\r\n\t<label id=\"fld_9871607Label\" for=\"fld_9871607_1\" class=\"control-label\">Dependent 2 Relationship<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_9871607\" class=\" form-control\" id=\"fld_9871607_1\" name=\"fld_9871607\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_9871607Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\">\n<div data-field-wrapper=\"fld_5466044\" class=\"form-group\" id=\"fld_5466044_1-wrap\">\r\n\t<label id=\"fld_5466044Label\" for=\"fld_5466044_1\" class=\"control-label\">Dependent 2 Date of Birth<\/label>\r\n\t<div class=\"\">\r\n\t\t<input  type=\"text\" data-provide=\"cfdatepicker\" name=\"fld_5466044\" value=\"\" id=\"fld_5466044_1\" data-field=\"fld_5466044\" class=\"form-control cfdatepicker is-cfdatepicker\" data-date-format=\"mm-dd-yyyy\" data-date-start-view=\"decade\" data-date-autoclose=\"true\"   aria-labelledby=\"fld_5466044Label\"   \/>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-20\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_1213502\" class=\"form-group\" id=\"fld_1213502_1-wrap\">\r\n\t<label id=\"fld_1213502Label\" for=\"fld_1213502_1\" class=\"control-label\">Dependent 2 Time Lived With You<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_1213502\" class=\" form-control\" id=\"fld_1213502_1\" name=\"fld_1213502\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_1213502Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-21\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_6189016\" class=\"form-group\" id=\"fld_6189016_1-wrap\">\r\n\t<label id=\"fld_6189016Label\" for=\"fld_6189016_1\" class=\"control-label\">Dependent 3 Name<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_6189016\" class=\" form-control\" id=\"fld_6189016_1\" name=\"fld_6189016\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_6189016Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-22\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_2509434\" class=\"form-group\" id=\"fld_2509434_1-wrap\">\r\n\t<label id=\"fld_2509434Label\" for=\"fld_2509434_1\" class=\"control-label\">Dependent 3 Relationship<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_2509434\" class=\" form-control\" id=\"fld_2509434_1\" name=\"fld_2509434\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_2509434Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\">\n<div data-field-wrapper=\"fld_1499922\" class=\"form-group\" id=\"fld_1499922_1-wrap\">\r\n\t<label id=\"fld_1499922Label\" for=\"fld_1499922_1\" class=\"control-label\">Dependent 3 Date of Birth<\/label>\r\n\t<div class=\"\">\r\n\t\t<input  type=\"text\" data-provide=\"cfdatepicker\" name=\"fld_1499922\" value=\"\" id=\"fld_1499922_1\" data-field=\"fld_1499922\" class=\"form-control cfdatepicker is-cfdatepicker\" data-date-format=\"mm-dd-yyyy\" data-date-start-view=\"decade\" data-date-autoclose=\"true\"   aria-labelledby=\"fld_1499922Label\"   \/>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-23\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_1502198\" class=\"form-group\" id=\"fld_1502198_1-wrap\">\r\n\t<label id=\"fld_1502198Label\" for=\"fld_1502198_1\" class=\"control-label\">Dependent 3 Time Lived With You<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_1502198\" class=\" form-control\" id=\"fld_1502198_1\" name=\"fld_1502198\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_1502198Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-24\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_4396487\" class=\"form-group\" id=\"fld_4396487_1-wrap\">\r\n\t<label id=\"fld_4396487Label\" for=\"fld_4396487_1\" class=\"control-label\">Dependent 4 Name<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_4396487\" class=\" form-control\" id=\"fld_4396487_1\" name=\"fld_4396487\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_4396487Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-25\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_9427010\" class=\"form-group\" id=\"fld_9427010_1-wrap\">\r\n\t<label id=\"fld_9427010Label\" for=\"fld_9427010_1\" class=\"control-label\">Dependent 4 Relationship<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_9427010\" class=\" form-control\" id=\"fld_9427010_1\" name=\"fld_9427010\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_9427010Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\">\n<div data-field-wrapper=\"fld_1175412\" class=\"form-group\" id=\"fld_1175412_1-wrap\">\r\n\t<label id=\"fld_1175412Label\" for=\"fld_1175412_1\" class=\"control-label\">Dependent 4 Date of Birth<\/label>\r\n\t<div class=\"\">\r\n\t\t<input  type=\"text\" data-provide=\"cfdatepicker\" name=\"fld_1175412\" value=\"\" id=\"fld_1175412_1\" data-field=\"fld_1175412\" class=\"form-control cfdatepicker is-cfdatepicker\" data-date-format=\"mm-dd-yyyy\" data-date-start-view=\"decade\" data-date-autoclose=\"true\"   aria-labelledby=\"fld_1175412Label\"   \/>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-26\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_636427\" class=\"form-group\" id=\"fld_636427_1-wrap\">\r\n\t<label id=\"fld_636427Label\" for=\"fld_636427_1\" class=\"control-label\">Dependent 4 Time Lived With You<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_636427\" class=\" form-control\" id=\"fld_636427_1\" name=\"fld_636427\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_636427Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-27\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_5618787\" class=\"form-group\" id=\"fld_5618787_1-wrap\">\r\n\t<label id=\"fld_5618787Label\" for=\"fld_5618787_1\" class=\"control-label\">Dependent 5 Name<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_5618787\" class=\" form-control\" id=\"fld_5618787_1\" name=\"fld_5618787\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_5618787Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-28\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_2552304\" class=\"form-group\" id=\"fld_2552304_1-wrap\">\r\n\t<label id=\"fld_2552304Label\" for=\"fld_2552304_1\" class=\"control-label\">Dependent 5 Relationship<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_2552304\" class=\" form-control\" id=\"fld_2552304_1\" name=\"fld_2552304\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_2552304Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\">\n<div data-field-wrapper=\"fld_5106723\" class=\"form-group\" id=\"fld_5106723_1-wrap\">\r\n\t<label id=\"fld_5106723Label\" for=\"fld_5106723_1\" class=\"control-label\">Dependent 5 Date of Birth<\/label>\r\n\t<div class=\"\">\r\n\t\t<input  type=\"text\" data-provide=\"cfdatepicker\" name=\"fld_5106723\" value=\"\" id=\"fld_5106723_1\" data-field=\"fld_5106723\" class=\"form-control cfdatepicker is-cfdatepicker\" data-date-format=\"mm-dd-yyyy\" data-date-start-view=\"decade\" data-date-autoclose=\"true\"   aria-labelledby=\"fld_5106723Label\"   \/>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-29\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_8113541\" class=\"form-group\" id=\"fld_8113541_1-wrap\">\r\n\t<label id=\"fld_8113541Label\" for=\"fld_8113541_1\" class=\"control-label\">Dependent 5 Time Lived With You<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_8113541\" class=\" form-control\" id=\"fld_8113541_1\" name=\"fld_8113541\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_8113541Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-30\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_6675177\" class=\"form-group\" id=\"fld_6675177_1-wrap\">\r\n\t<label id=\"fld_6675177Label\" for=\"fld_6675177_1\" class=\"control-label\">Are any of your dependents over 18 and a full time student?<\/label>\r\n\t<div class=\"\">\r\n\t\t<select name=\"fld_6675177\" value=\"\" data-field=\"fld_6675177\" class=\"form-control\" id=\"fld_6675177_1\"    aria-labelledby=\"fld_6675177Label\" >\n\t\t<option value=\"\"><\/option>\r\n\t\t\t\t\t<option value=\"- None - \"  data-calc-value=\"- None - \" >\n\t\t\t\t\t\t- None - \t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Yes\"  data-calc-value=\"Yes\" >\n\t\t\t\t\t\tYes\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"No\"  data-calc-value=\"No\" >\n\t\t\t\t\t\tNo\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 data-field-wrapper=\"fld_5235907\" class=\"form-group\" id=\"fld_5235907_1-wrap\">\r\n\t<label id=\"fld_5235907Label\" for=\"fld_5235907_1\" class=\"control-label\">If Yes, Did you pay tuition?<\/label>\r\n\t<div class=\"\">\r\n\t\t<select name=\"fld_5235907\" value=\"\" data-field=\"fld_5235907\" class=\"form-control\" id=\"fld_5235907_1\"    aria-labelledby=\"fld_5235907Label\" >\n\t\t<option value=\"\"><\/option>\r\n\t\t\t\t\t<option value=\"- None - \"  data-calc-value=\"- None - \" >\n\t\t\t\t\t\t- None - \t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Yes\"  data-calc-value=\"Yes\" >\n\t\t\t\t\t\tYes\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"No\"  data-calc-value=\"No\" >\n\t\t\t\t\t\tNo\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=\"CF5a77a1c46f8bf_1-row-31\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_9732963\" class=\"form-group\" id=\"fld_9732963_1-wrap\">\r\n\t<label id=\"fld_9732963Label\" for=\"fld_9732963_1\" class=\"control-label\">How many years has the student been in college?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_9732963\" class=\" form-control\" id=\"fld_9732963_1\" name=\"fld_9732963\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_9732963Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-32\"  class=\"row \"><div  class=\"col-sm-12  single\"><hr id=\"fld_764899_1\" class=\"\" style=\"width: 100%\" \/><\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-33\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_7796377\" class=\"form-group\" id=\"fld_7796377_1-wrap\">\r\n\t<label id=\"fld_7796377Label\" for=\"fld_7796377_1\" class=\"control-label\">INCOME: (check all that apply) <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_7796377_1_opt136851\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_7796377_1\" data-parsley-multiple=\"fld_7796377_1\" type=\"checkbox\" data-label=\"W2\" data-field=\"fld_7796377\" id=\"fld_7796377_1_opt136851\" class=\"fld_7796377_1 option-required\" name=\"fld_7796377[opt136851]\" value=\"W2\"  data-type=\"checkbox\" data-checkbox-field=\"fld_7796377_1\"  data-calc-value=\"W2\" > W2<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_7796377_1_opt1330223\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_7796377_1\" data-parsley-multiple=\"fld_7796377_1\" type=\"checkbox\" data-label=\"Interest\/Dividends\" data-field=\"fld_7796377\" id=\"fld_7796377_1_opt1330223\" class=\"fld_7796377_1 option-required\" name=\"fld_7796377[opt1330223]\" value=\"Interest\/Dividends\"  data-type=\"checkbox\" data-checkbox-field=\"fld_7796377_1\"  data-calc-value=\"Interest\/Dividends\" > Interest\/Dividends<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_7796377_1_opt2496390\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_7796377_1\" data-parsley-multiple=\"fld_7796377_1\" type=\"checkbox\" data-label=\"Farm\" data-field=\"fld_7796377\" id=\"fld_7796377_1_opt2496390\" class=\"fld_7796377_1 option-required\" name=\"fld_7796377[opt2496390]\" value=\"Farm\"  data-type=\"checkbox\" data-checkbox-field=\"fld_7796377_1\"  data-calc-value=\"Farm\" > Farm<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_7796377_1_opt3534115\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_7796377_1\" data-parsley-multiple=\"fld_7796377_1\" type=\"checkbox\" data-label=\"1099 MISC\" data-field=\"fld_7796377\" id=\"fld_7796377_1_opt3534115\" class=\"fld_7796377_1 option-required\" name=\"fld_7796377[opt3534115]\" value=\"1099 MISC\"  data-type=\"checkbox\" data-checkbox-field=\"fld_7796377_1\"  data-calc-value=\"1099 MISC\" > 1099 MISC<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_7796377_1_opt4522397\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_7796377_1\" data-parsley-multiple=\"fld_7796377_1\" type=\"checkbox\" data-label=\"Retirement or Unemployment\" data-field=\"fld_7796377\" id=\"fld_7796377_1_opt4522397\" class=\"fld_7796377_1 option-required\" name=\"fld_7796377[opt4522397]\" value=\"Retirement or Unemployment\"  data-type=\"checkbox\" data-checkbox-field=\"fld_7796377_1\"  data-calc-value=\"Retirement or Unemployment\" > Retirement or Unemployment<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_7796377_1_opt6257467\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_7796377_1\" data-parsley-multiple=\"fld_7796377_1\" type=\"checkbox\" data-label=\"Self Employment\/1099\" data-field=\"fld_7796377\" id=\"fld_7796377_1_opt6257467\" class=\"fld_7796377_1 option-required\" name=\"fld_7796377[opt6257467]\" value=\"Self Employment\/1099\"  data-type=\"checkbox\" data-checkbox-field=\"fld_7796377_1\"  data-calc-value=\"Self Employment\/1099\" > Self Employment\/1099<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_7796377_1_opt6659027\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_7796377_1\" data-parsley-multiple=\"fld_7796377_1\" type=\"checkbox\" data-label=\"Business Ownerships\" data-field=\"fld_7796377\" id=\"fld_7796377_1_opt6659027\" class=\"fld_7796377_1 option-required\" name=\"fld_7796377[opt6659027]\" value=\"Business Ownerships\"  data-type=\"checkbox\" data-checkbox-field=\"fld_7796377_1\"  data-calc-value=\"Business Ownerships\" > Business Ownerships<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_7796377_1_opt8026662\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_7796377_1\" data-parsley-multiple=\"fld_7796377_1\" type=\"checkbox\" data-label=\"Rental Property\" data-field=\"fld_7796377\" id=\"fld_7796377_1_opt8026662\" class=\"fld_7796377_1 option-required\" name=\"fld_7796377[opt8026662]\" value=\"Rental Property\"  data-type=\"checkbox\" data-checkbox-field=\"fld_7796377_1\"  data-calc-value=\"Rental Property\" > Rental Property<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_7796377_1_opt9043247\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_7796377_1\" data-parsley-multiple=\"fld_7796377_1\" type=\"checkbox\" data-label=\"Sale Assets\/Stock (capital gains)\" data-field=\"fld_7796377\" id=\"fld_7796377_1_opt9043247\" class=\"fld_7796377_1 option-required\" name=\"fld_7796377[opt9043247]\" value=\"Sale Assets\/Stock (capital gains)\"  data-type=\"checkbox\" data-checkbox-field=\"fld_7796377_1\"  data-calc-value=\"Sale Assets\/Stock (capital gains)\" > Sale Assets\/Stock (capital gains)<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_7796377_1_opt9797671\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_7796377_1\" data-parsley-multiple=\"fld_7796377_1\" type=\"checkbox\" data-label=\"Gambling\" data-field=\"fld_7796377\" id=\"fld_7796377_1_opt9797671\" class=\"fld_7796377_1 option-required\" name=\"fld_7796377[opt9797671]\" value=\"Gambling\"  data-type=\"checkbox\" data-checkbox-field=\"fld_7796377_1\"  data-calc-value=\"Gambling\" > Gambling<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_7796377_1_opt11176728\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_7796377_1\" data-parsley-multiple=\"fld_7796377_1\" type=\"checkbox\" data-label=\"K-1\" data-field=\"fld_7796377\" id=\"fld_7796377_1_opt11176728\" class=\"fld_7796377_1 option-required\" name=\"fld_7796377[opt11176728]\" value=\"K-1\"  data-type=\"checkbox\" data-checkbox-field=\"fld_7796377_1\"  data-calc-value=\"K-1\" > K-1<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_7796377_1_opt12205453\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_7796377_1\" data-parsley-multiple=\"fld_7796377_1\" type=\"checkbox\" data-label=\"IRA\" data-field=\"fld_7796377\" id=\"fld_7796377_1_opt12205453\" class=\"fld_7796377_1 option-required\" name=\"fld_7796377[opt12205453]\" value=\"IRA\"  data-type=\"checkbox\" data-checkbox-field=\"fld_7796377_1\"  data-calc-value=\"IRA\" > IRA<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_7796377_1_opt12650361\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_7796377_1\" data-parsley-multiple=\"fld_7796377_1\" type=\"checkbox\" data-label=\"Social Security\" data-field=\"fld_7796377\" id=\"fld_7796377_1_opt12650361\" class=\"fld_7796377_1 option-required\" name=\"fld_7796377[opt12650361]\" value=\"Social Security\"  data-type=\"checkbox\" data-checkbox-field=\"fld_7796377_1\"  data-calc-value=\"Social Security\" > Social Security<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-34\"  class=\"row \"><div  class=\"col-sm-12  single\"><hr id=\"fld_7442627_1\" class=\"\" style=\"width: 100%\" \/><\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-35\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_3025131\" class=\"form-group\" id=\"fld_3025131_1-wrap\">\r\n\t<label id=\"fld_3025131Label\" for=\"fld_3025131_1\" class=\"control-label\">ITEMIZED DEDUCTIONS: (check all that apply) <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_3025131_1_opt748137\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_3025131_1\" data-parsley-multiple=\"fld_3025131_1\" type=\"checkbox\" data-label=\"Real Estate Tax\" data-field=\"fld_3025131\" id=\"fld_3025131_1_opt748137\" class=\"fld_3025131_1 option-required\" name=\"fld_3025131[opt748137]\" value=\"Real Estate Tax\"  data-type=\"checkbox\" data-checkbox-field=\"fld_3025131_1\"  data-calc-value=\"Real Estate Tax\" > Real Estate Tax<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_3025131_1_opt1510358\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_3025131_1\" data-parsley-multiple=\"fld_3025131_1\" type=\"checkbox\" data-label=\"Personal Property Tax\" data-field=\"fld_3025131\" id=\"fld_3025131_1_opt1510358\" class=\"fld_3025131_1 option-required\" name=\"fld_3025131[opt1510358]\" value=\"Personal Property Tax\"  data-type=\"checkbox\" data-checkbox-field=\"fld_3025131_1\"  data-calc-value=\"Personal Property Tax\" > Personal Property Tax<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_3025131_1_opt2776461\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_3025131_1\" data-parsley-multiple=\"fld_3025131_1\" type=\"checkbox\" data-label=\"Dues, License, Uniform\" data-field=\"fld_3025131\" id=\"fld_3025131_1_opt2776461\" class=\"fld_3025131_1 option-required\" name=\"fld_3025131[opt2776461]\" value=\"Dues, License, Uniform\"  data-type=\"checkbox\" data-checkbox-field=\"fld_3025131_1\"  data-calc-value=\"Dues, License, Uniform\" > Dues, License, Uniform<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_3025131_1_opt3400652\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_3025131_1\" data-parsley-multiple=\"fld_3025131_1\" type=\"checkbox\" data-label=\"Mortgage Interest\" data-field=\"fld_3025131\" id=\"fld_3025131_1_opt3400652\" class=\"fld_3025131_1 option-required\" name=\"fld_3025131[opt3400652]\" value=\"Mortgage Interest\"  data-type=\"checkbox\" data-checkbox-field=\"fld_3025131_1\"  data-calc-value=\"Mortgage Interest\" > Mortgage Interest<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_3025131_1_opt5119296\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_3025131_1\" data-parsley-multiple=\"fld_3025131_1\" type=\"checkbox\" data-label=\"Employment Business Expense\" data-field=\"fld_3025131\" id=\"fld_3025131_1_opt5119296\" class=\"fld_3025131_1 option-required\" name=\"fld_3025131[opt5119296]\" value=\"Employment Business Expense\"  data-type=\"checkbox\" data-checkbox-field=\"fld_3025131_1\"  data-calc-value=\"Employment Business Expense\" > Employment Business Expense<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_3025131_1_opt5426196\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_3025131_1\" data-parsley-multiple=\"fld_3025131_1\" type=\"checkbox\" data-label=\"RX\" data-field=\"fld_3025131\" id=\"fld_3025131_1_opt5426196\" class=\"fld_3025131_1 option-required\" name=\"fld_3025131[opt5426196]\" value=\"RX\"  data-type=\"checkbox\" data-checkbox-field=\"fld_3025131_1\"  data-calc-value=\"RX\" > RX<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_3025131_1_opt7300197\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_3025131_1\" data-parsley-multiple=\"fld_3025131_1\" type=\"checkbox\" data-label=\"Medical \" data-field=\"fld_3025131\" id=\"fld_3025131_1_opt7300197\" class=\"fld_3025131_1 option-required\" name=\"fld_3025131[opt7300197]\" value=\"Medical \"  data-type=\"checkbox\" data-checkbox-field=\"fld_3025131_1\"  data-calc-value=\"Medical \" > Medical <\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_3025131_1_opt8359840\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_3025131_1\" data-parsley-multiple=\"fld_3025131_1\" type=\"checkbox\" data-label=\"Medical Insurance\" data-field=\"fld_3025131\" id=\"fld_3025131_1_opt8359840\" class=\"fld_3025131_1 option-required\" name=\"fld_3025131[opt8359840]\" value=\"Medical Insurance\"  data-type=\"checkbox\" data-checkbox-field=\"fld_3025131_1\"  data-calc-value=\"Medical Insurance\" > Medical Insurance<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_3025131_1_opt8986799\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_3025131_1\" data-parsley-multiple=\"fld_3025131_1\" type=\"checkbox\" data-label=\"Medical Miles\" data-field=\"fld_3025131\" id=\"fld_3025131_1_opt8986799\" class=\"fld_3025131_1 option-required\" name=\"fld_3025131[opt8986799]\" value=\"Medical Miles\"  data-type=\"checkbox\" data-checkbox-field=\"fld_3025131_1\"  data-calc-value=\"Medical Miles\" > Medical Miles<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_3025131_1_opt9539633\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_3025131_1\" data-parsley-multiple=\"fld_3025131_1\" type=\"checkbox\" data-label=\"Cash Donations\" data-field=\"fld_3025131\" id=\"fld_3025131_1_opt9539633\" class=\"fld_3025131_1 option-required\" name=\"fld_3025131[opt9539633]\" value=\"Cash Donations\"  data-type=\"checkbox\" data-checkbox-field=\"fld_3025131_1\"  data-calc-value=\"Cash Donations\" > Cash Donations<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_3025131_1_opt11210214\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_3025131_1\" data-parsley-multiple=\"fld_3025131_1\" type=\"checkbox\" data-label=\"Other Donations\" data-field=\"fld_3025131\" id=\"fld_3025131_1_opt11210214\" class=\"fld_3025131_1 option-required\" name=\"fld_3025131[opt11210214]\" value=\"Other Donations\"  data-type=\"checkbox\" data-checkbox-field=\"fld_3025131_1\"  data-calc-value=\"Other Donations\" > Other Donations<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_3025131_1_opt12026301\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_3025131_1\" data-parsley-multiple=\"fld_3025131_1\" type=\"checkbox\" data-label=\"Charity Miles\" data-field=\"fld_3025131\" id=\"fld_3025131_1_opt12026301\" class=\"fld_3025131_1 option-required\" name=\"fld_3025131[opt12026301]\" value=\"Charity Miles\"  data-type=\"checkbox\" data-checkbox-field=\"fld_3025131_1\"  data-calc-value=\"Charity Miles\" > Charity Miles<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_3025131_1_opt13042316\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_3025131_1\" data-parsley-multiple=\"fld_3025131_1\" type=\"checkbox\" data-label=\"Safe Deposit Box\" data-field=\"fld_3025131\" id=\"fld_3025131_1_opt13042316\" class=\"fld_3025131_1 option-required\" name=\"fld_3025131[opt13042316]\" value=\"Safe Deposit Box\"  data-type=\"checkbox\" data-checkbox-field=\"fld_3025131_1\"  data-calc-value=\"Safe Deposit Box\" > Safe Deposit Box<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_3025131_1_opt14245215\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_3025131_1\" data-parsley-multiple=\"fld_3025131_1\" type=\"checkbox\" data-label=\"Gambling\" data-field=\"fld_3025131\" id=\"fld_3025131_1_opt14245215\" class=\"fld_3025131_1 option-required\" name=\"fld_3025131[opt14245215]\" value=\"Gambling\"  data-type=\"checkbox\" data-checkbox-field=\"fld_3025131_1\"  data-calc-value=\"Gambling\" > Gambling<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_3025131_1_opt15406760\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_3025131_1\" data-parsley-multiple=\"fld_3025131_1\" type=\"checkbox\" data-label=\"Tax Preparation Fee\" data-field=\"fld_3025131\" id=\"fld_3025131_1_opt15406760\" class=\"fld_3025131_1 option-required\" name=\"fld_3025131[opt15406760]\" value=\"Tax Preparation Fee\"  data-type=\"checkbox\" data-checkbox-field=\"fld_3025131_1\"  data-calc-value=\"Tax Preparation Fee\" > Tax Preparation Fee<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n\t\t\t\t  <label for=\"fld_3025131_1_opt16719121\"><input data-parsley-required=\"true\" data-parsley-group=\"fld_3025131_1\" data-parsley-multiple=\"fld_3025131_1\" type=\"checkbox\" data-label=\"Home Office\" data-field=\"fld_3025131\" id=\"fld_3025131_1_opt16719121\" class=\"fld_3025131_1 option-required\" name=\"fld_3025131[opt16719121]\" value=\"Home Office\"  data-type=\"checkbox\" data-checkbox-field=\"fld_3025131_1\"  data-calc-value=\"Home Office\" > Home Office<\/label>\n\n\t\t\t\t  \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5a77a1c46f8bf_1-row-36\"  class=\"row  last_row\"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_3299097\" class=\"form-group\" id=\"fld_3299097_1-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default\" type=\"submit\" name=\"fld_3299097\" id=\"fld_3299097_1\" value=\"Submit\" data-field=\"fld_3299097\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_1\" type=\"hidden\" name=\"fld_3299097\" id=\"fld_3299097_1_btn\" value=\"\" data-field=\"fld_3299097\"  \/>\n<\/div><\/div><\/form>\r\n<\/div>\r\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"http:\/\/www.nwacpa.com\/dev\/wp-json\/wp\/v2\/pages\/510"}],"collection":[{"href":"http:\/\/www.nwacpa.com\/dev\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/www.nwacpa.com\/dev\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/www.nwacpa.com\/dev\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.nwacpa.com\/dev\/wp-json\/wp\/v2\/comments?post=510"}],"version-history":[{"count":1,"href":"http:\/\/www.nwacpa.com\/dev\/wp-json\/wp\/v2\/pages\/510\/revisions"}],"predecessor-version":[{"id":511,"href":"http:\/\/www.nwacpa.com\/dev\/wp-json\/wp\/v2\/pages\/510\/revisions\/511"}],"wp:attachment":[{"href":"http:\/\/www.nwacpa.com\/dev\/wp-json\/wp\/v2\/media?parent=510"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}