
<!--
function MM_swapImgRestore() { //v3.0
  var i,x,a=document.MM_sr; for(i=0;a&&i<a.length&&(x=a[i])&&x.oSrc;i++) x.src=x.oSrc;
}

function MM_preloadImages() { //v3.0
  var d=document; if(d.images){ if(!d.MM_p) d.MM_p=new Array();
    var i,j=d.MM_p.length,a=MM_preloadImages.arguments; for(i=0; i<a.length; i++)
    if (a[i].indexOf("#")!=0){ d.MM_p[j]=new Image; d.MM_p[j++].src=a[i];}}
}

function MM_findObj(n, d) { //v4.01
  var p,i,x;  if(!d) d=document; if((p=n.indexOf("?"))>0&&parent.frames.length) {
    d=parent.frames[n.substring(p+1)].document; n=n.substring(0,p);}
  if(!(x=d[n])&&d.all) x=d.all[n]; for (i=0;!x&&i<d.forms.length;i++) x=d.forms[i][n];
  for(i=0;!x&&d.layers&&i<d.layers.length;i++) x=MM_findObj(n,d.layers[i].document);
  if(!x && d.getElementById) x=d.getElementById(n); return x;
}

function MM_swapImage() { //v3.0
  var i,j=0,x,a=MM_swapImage.arguments; document.MM_sr=new Array; for(i=0;i<(a.length-2);i+=3)
   if ((x=MM_findObj(a[i]))!=null){document.MM_sr[j++]=x; if(!x.oSrc) x.oSrc=x.src; x.src=a[i+2];}
}

function getPicture(num) {
	var order = ((Math.round(Math.random()*50) % 3)+1);
	document.write('<img src="images/right_photos/wp'+num+'.'+order+'R.jpg" width="194" height="180">');
}

/*******************************************************************
// Clear functions for STEP 1
********************************************************************/
function clear_dob_fni() { if (document.form1.dob_fni.value == 'MM/DD/YYYY') document.form1.dob_fni.value = ''; }
function clear_ssn_fni() { if (document.form1.ssn_fni.value == '(no spaces or dashes)') document.form1.ssn_fni.value = ''; }
function clear_dob_sni() { if (document.form1.dob_sni.value == 'MM/DD/YYYY') document.form1.dob_sni.value = ''; }
function clear_ssn_sni() { if (document.form1.ssn_sni.value == '(no spaces or dashes)') document.form1.ssn_sni.value = ''; }

/*******************************************************************
// Check functions for STEP 1
********************************************************************/
function check_form_1() { 
	if (document.form1.dob_fni.value == '') document.form1.dob_fni.value = 'MM/DD/YYYY'; 
	if (document.form1.ssn_fni.value == '') document.form1.ssn_fni.value = '(no spaces or dashes)';
	if (document.form1.dob_sni.value == '') document.form1.dob_sni.value = 'MM/DD/YYYY';
	if (document.form1.ssn_sni.value == '') document.form1.ssn_sni.value = '(no spaces or dashes)';
}

/*******************************************************************
// Disable functions for STEP 2 (Automotive)
********************************************************************/
function check_v1_other_than_collision() {
	if (document.form1.v1_other_than_collision.value == 'No') {
		document.form1.v1_other_than_collision_deductable.value='0';
		document.form1.v1_other_than_collision_deductable.disabled=true;
	}
	if (document.form1.v1_other_than_collision.value == 'Yes') document.form1.v1_other_than_collision_deductable.disabled=false;
}

function check_v1_collision() {
	if (document.form1.v1_collision.value == 'No') {
		document.form1.v1_collision_deductable.value='0';
		document.form1.v1_collision_deductable.disabled=true;
	}
	if (document.form1.v1_collision.value == 'Yes') document.form1.v1_collision_deductable.disabled=false;
}

function check_v2_other_than_collision() {
	if (document.form1.v2_other_than_collision.value == 'No') {
		document.form1.v2_other_than_collision_deductable.value='0';
		document.form1.v2_other_than_collision_deductable.disabled=true;
	}
	if (document.form1.v2_other_than_collision.value == 'Yes') document.form1.v2_other_than_collision_deductable.disabled=false;
}

function check_v2_collision() {
	if (document.form1.v2_collision.value == 'No') {
		document.form1.v2_collision_deductable.value='0';
		document.form1.v2_collision_deductable.disabled=true;
	}
	if (document.form1.v2_collision.value == 'Yes') document.form1.v2_collision_deductable.disabled=false;
}

function check_v3_other_than_collision() {
	if (document.form1.v3_other_than_collision.value == 'No') {
		document.form1.v3_other_than_collision_deductable.value='0';
		document.form1.v3_other_than_collision_deductable.disabled=true;
	}
	if (document.form1.v3_other_than_collision.value == 'Yes') document.form1.v3_other_than_collision_deductable.disabled=false;
}

function check_v3_collision() {
	if (document.form1.v3_collision.value == 'No') {
		document.form1.v3_collision_deductable.value='0';
		document.form1.v3_collision_deductable.disabled=true;
	}
	if (document.form1.v3_collision.value == 'Yes') document.form1.v3_collision_deductable.disabled=false;
}

function check_v4_other_than_collision() {
	if (document.form1.v4_other_than_collision.value == 'No') {
		document.form1.v4_other_than_collision_deductable.value='0';
		document.form1.v4_other_than_collision_deductable.disabled=true;
	}
	if (document.form1.v4_other_than_collision.value == 'Yes') document.form1.v4_other_than_collision_deductable.disabled=false;
}

function check_v4_collision() {
	if (document.form1.v4_collision.value == 'No') {
		document.form1.v4_collision_deductable.value='0';
		document.form1.v4_collision_deductable.disabled=true;
	}
	if (document.form1.v4_collision.value == 'Yes') document.form1.v4_collision_deductable.disabled=false;
}
//---------------------------------------------------------------------
function check_v1_vehicle_use() {
	if ((document.form1.v1_vehicle_use.value == 'To/From Work') || (document.form1.v1_vehicle_use.value == 'To/From School')) {
		document.form1.v1_miles_one_way.disabled=false;
		document.form1.v1_num_days_week.disabled=false;
		document.form1.v1_num_weeks_month.disabled=false;
	}
	else { 
		document.form1.v1_miles_one_way.value=''; document.form1.v1_miles_one_way.disabled=true;
		document.form1.v1_num_days_week.value=''; document.form1.v1_num_days_week.disabled=true;
		document.form1.v1_num_weeks_month.value=''; document.form1.v1_num_weeks_month.disabled=true;
	}
}

function check_v2_vehicle_use() {
	if ((document.form1.v2_vehicle_use.value == 'To/From Work') || (document.form1.v2_vehicle_use.value == 'To/From School')) {
		document.form1.v2_miles_one_way.disabled=false;
		document.form1.v2_num_days_week.disabled=false;
		document.form1.v2_num_weeks_month.disabled=false;
	}
	else { 
		document.form1.v2_miles_one_way.value=''; document.form1.v2_miles_one_way.disabled=true;
		document.form1.v2_num_days_week.value=''; document.form1.v2_num_days_week.disabled=true;
		document.form1.v2_num_weeks_month.value=''; document.form1.v2_num_weeks_month.disabled=true;
	}
}

function check_v3_vehicle_use() {
	if ((document.form1.v3_vehicle_use.value == 'To/From Work') || (document.form1.v3_vehicle_use.value == 'To/From School')) {
		document.form1.v3_miles_one_way.disabled=false;
		document.form1.v3_num_days_week.disabled=false;
		document.form1.v3_num_weeks_month.disabled=false;
	}
	else { 
		document.form1.v3_miles_one_way.value=''; document.form1.v3_miles_one_way.disabled=true;
		document.form1.v3_num_days_week.value=''; document.form1.v3_num_days_week.disabled=true;
		document.form1.v3_num_weeks_month.value=''; document.form1.v3_num_weeks_month.disabled=true;
	}
}

function check_v4_vehicle_use() {
	if ((document.form1.v4_vehicle_use.value == 'To/From Work') || (document.form1.v4_vehicle_use.value == 'To/From School')) {
		document.form1.v4_miles_one_way.disabled=false;
		document.form1.v4_num_days_week.disabled=false;
		document.form1.v4_num_weeks_month.disabled=false;
	}
	else { 
		document.form1.v4_miles_one_way.value=''; document.form1.v4_miles_one_way.disabled=true;
		document.form1.v4_num_days_week.value=''; document.form1.v4_num_days_week.disabled=true;
		document.form1.v4_num_weeks_month.value=''; document.form1.v4_num_weeks_month.disabled=true;
	}
}
//------------------------------------------------------------------------------------
function check_ad_first_party_benefits() {
	if (document.form1.ad_first_party_benefits.value == 'None') {
		document.form1.ad_additional_benefits.value='None'; document.form1.ad_additional_benefits.disabled=true;
		document.form1.ad_accidental_death.value='None'; document.form1.ad_accidental_death.disabled=true;
		document.form1.ad_funeral_expense.value='None'; document.form1.ad_funeral_expense.disabled=true;
		document.form1.ad_extra_medical_expense.value='None'; document.form1.ad_extra_medical_expense.disabled=true;
	}
	else {
		if (document.form1.ad_first_party_benefits.value == '**Additional Benefits') { 
			document.form1.ad_additional_benefits.disabled=false;
			document.form1.ad_accidental_death.disabled=false;
			document.form1.ad_funeral_expense.disabled=false;
			document.form1.ad_extra_medical_expense.value='None'; document.form1.ad_extra_medical_expense.disabled=true;
		}
		else {
			if ((document.form1.ad_first_party_benefits.value == '***Combined First Party Benefits - $50,000') ||
				 (document.form1.ad_first_party_benefits.value == '***Combined First Party Benefits - $100,000') ||
				 (document.form1.ad_first_party_benefits.value == '***Combined First Party Benefits - $177,500')) { 
				document.form1.ad_additional_benefits.value='None'; document.form1.ad_additional_benefits.disabled=true;
				document.form1.ad_accidental_death.value='None'; document.form1.ad_accidental_death.disabled=true;
				document.form1.ad_funeral_expense.value='None'; document.form1.ad_funeral_expense.disabled=true;
				document.form1.ad_extra_medical_expense.disabled=false;
			}
		}
	}
}

/*******************************************************************
// Clear functions for STEP 2 (Homeowners)
********************************************************************/
function clear_bhi_total_living_space() { if (document.form1.bhi_total_living_space.value == 'L x W x # of Stories') document.form1.bhi_total_living_space.value = ''; }
function clear_bhi_bathrooms() { if (document.form1.bhi_bathrooms.value == '0.0') document.form1.bhi_bathrooms.value = ''; }
function clear_bhi_miles_fire_station() { if (document.form1.bhi_miles_fire_station.value == '# of Miles') document.form1.bhi_miles_fire_station.value = ''; }
function clear_bhi_fire_protection_provider() { if (document.form1.bhi_fire_protection_provider.value == 'Provider\'s Name') document.form1.bhi_fire_protection_provider.value = ''; }
function clear_bhi_year_built() { if (document.form1.bhi_year_built.value == 'YYYY') document.form1.bhi_year_built.value = ''; }
function clear_bhi_purchase_date() { if (document.form1.bhi_purchase_date.value == 'YYYY') document.form1.bhi_purchase_date.value = ''; }
function clear_bhi_date_loss() { if (document.form1.bhi_date_loss.value == 'MM/DD/YYYY') document.form1.bhi_date_loss.value = ''; }
function clear_bhi_amount_paid() { if (document.form1.bhi_amount_paid.value == '$0.00') document.form1.bhi_amount_paid.value = ''; }
function clear_ri_wiring_year() { if (document.form1.ri_wiring_year.value == 'YYYY') document.form1.ri_wiring_year.value = ''; }
function clear_ri_plumbing_year() { if (document.form1.ri_plumbing_year.value == 'YYYY') document.form1.ri_plumbing_year.value = ''; }
function clear_ri_heating_year() { if (document.form1.ri_heating_year.value == 'YYYY') document.form1.ri_heating_year.value = ''; }
function clear_ri_roof_year() { if (document.form1.ri_roof_year.value == 'YYYY') document.form1.ri_roof_year.value = ''; }
function clear_vcpd_home_value() { if (document.form1.vcpd_home_value.value == '$0,000,000') document.form1.vcpd_home_value.value = ''; }

/*******************************************************************
// Check functions for STEP 2 (Homeowners)
********************************************************************/
function check_form_2_homeowners() { 
	if (document.form1.bhi_total_living_space.value == '') document.form1.bhi_total_living_space.value = 'L x W x # of Stories'; 
	if (document.form1.bhi_bathrooms.value == '') document.form1.bhi_bathrooms.value = '0.0';
	if (document.form1.bhi_miles_fire_station.value == '') document.form1.bhi_miles_fire_station.value = '# of Miles';
	if (document.form1.bhi_fire_protection_provider.value == '') document.form1.bhi_fire_protection_provider.value = 'Provider\'s Name';
	if (document.form1.bhi_year_built.value == '') document.form1.bhi_year_built.value = 'YYYY';
	if (document.form1.bhi_purchase_date.value == '') document.form1.bhi_purchase_date.value = 'YYYY';
	if (document.form1.bhi_date_loss.value == '') document.form1.bhi_date_loss.value = 'MM/DD/YYYY'; 
	if (document.form1.bhi_amount_paid.value == '') document.form1.bhi_amount_paid.value = '$0.00';
	if (document.form1.ri_wiring_year.value == '') document.form1.ri_wiring_year.value = 'YYYY';
	if (document.form1.ri_plumbing_year.value == '') document.form1.ri_plumbing_year.value = 'YYYY';
	if (document.form1.ri_heating_year.value == '') document.form1.ri_heating_year.value = 'YYYY'; 
	if (document.form1.ri_roof_year.value == '') document.form1.ri_roof_year.value = 'YYYY';
	if (document.form1.vcpd_home_value.value == '') document.form1.vcpd_home_value.value = '$0,000,000';
}
function check_bhi_finished_basement() {
	if (document.form1.bhi_finished_basement.value == 'Yes') {
		document.form1.bhi_basement_size.disabled=false;
	}
	else { 
		if (document.form1.bhi_finished_basement.value == 'No') {
			document.form1.bhi_basement_size.value=''; document.form1.bhi_basement_size.disabled=true;
		}
	}
}
function check_bhi_losses_3_years() {
	if (document.form1.bhi_losses_3_years.value == 'Yes') {
		document.form1.bhi_date_loss.disabled=false;
		document.form1.bhi_amount_paid.disabled=false;
		document.form1.bhi_describe_loss.disabled=false;
	}
	else { 
		if (document.form1.bhi_losses_3_years.value == 'No') {
			document.form1.bhi_date_loss.value='MM/DD/YYYY'; document.form1.bhi_date_loss.disabled=true;
			document.form1.bhi_amount_paid.value='$0.00'; document.form1.bhi_amount_paid.disabled=true;
			document.form1.bhi_describe_loss.value=''; document.form1.bhi_describe_loss.disabled=true;
		}
	}
}

function check_pd_none() {
	if (document.form1.pd_none.value == '0') {
		document.form1.pd_smoke_alarm.disabled=false;
		document.form1.pd_dead_bolt_lock.disabled=false;
		document.form1.pd_burglar_alarm.disabled=false;
		document.form1.pd_fire_alarm.disabled=false;
		document.form1.pd_sprinkler_system.disabled=false;
	}
	else { 
		if (document.form1.pd_none.value == 'None') {
			document.form1.pd_smoke_alarm.value='No'; document.form1.pd_smoke_alarm.disabled=true;
			document.form1.pd_dead_bolt_lock.value='No'; document.form1.pd_dead_bolt_lock.disabled=true;
			document.form1.pd_burglar_alarm.value='0'; document.form1.pd_burglar_alarm.disabled=true;
			document.form1.pd_fire_alarm.value='0'; document.form1.pd_fire_alarm.disabled=true;
			document.form1.pd_sprinkler_system.value='0'; document.form1.pd_sprinkler_system.disabled=true;
		}
	}
}

/*******************************************************************
// Clear functions for STEP 2 (Automotive)
********************************************************************/
function clear_v1_odometer_dt() { if (document.form1.v1_odometer_dt.value == 'MM/DD/YYYY') document.form1.v1_odometer_dt.value = ''; }
function clear_v2_odometer_dt() { if (document.form1.v2_odometer_dt.value == 'MM/DD/YYYY') document.form1.v2_odometer_dt.value = ''; }
function clear_v3_odometer_dt() { if (document.form1.v3_odometer_dt.value == 'MM/DD/YYYY') document.form1.v3_odometer_dt.value = ''; }
function clear_v4_odometer_dt() { if (document.form1.v4_odometer_dt.value == 'MM/DD/YYYY') document.form1.v4_odometer_dt.value = ''; }
function clear_fd_dob() { if (document.form1.fd_dob.value == 'MM/DD/YYYY') document.form1.fd_dob.value = ''; }
function clear_sd_dob() { if (document.form1.sd_dob.value == 'MM/DD/YYYY') document.form1.sd_dob.value = ''; }
function clear_td_dob() { if (document.form1.td_dob.value == 'MM/DD/YYYY') document.form1.td_dob.value = ''; }
function clear_fd4_dob() { if (document.form1.fd4_dob.value == 'MM/DD/YYYY') document.form1.fd4_dob.value = ''; }
function clear_fd_license_num() { if (document.form1.fd_license_num.value == '(no spaces or dashes)') document.form1.fd_license_num.value = ''; }
function clear_td_license_num() { if (document.form1.td_license_num.value == '(no spaces or dashes)') document.form1.td_license_num.value = ''; }
function clear_sd_license_num() { if (document.form1.sd_license_num.value == '(no spaces or dashes)') document.form1.sd_license_num.value = ''; }
function clear_fd4_license_num() { if (document.form1.fd4_license_num.value == '(no spaces or dashes)') document.form1.fd4_license_num.value = ''; }
function clear_effective_date() { if (document.form1.effective_date.value == 'MM/DD/YYYY') document.form1.effective_date.value = ''; }
function clear_carrier_effective_date() { if (document.form1.fd_current_carrier_effective_date.value == 'MM/DD/YYYY') document.form1.fd_current_carrier_effective_date.value = ''; }

/*******************************************************************
// Check functions for STEP 2 (Automotive)
********************************************************************/
function check_form_2_automotive() { 
	if (document.form1.v1_odometer_dt.value == '') document.form1.v1_odometer_dt.value = 'MM/DD/YYYY'; 
	if (document.form1.v2_odometer_dt.value == '') document.form1.v2_odometer_dt.value = 'MM/DD/YYYY';
	if (document.form1.v3_odometer_dt.value == '') document.form1.v3_odometer_dt.value = 'MM/DD/YYYY';
	if (document.form1.v4_odometer_dt.value == '') document.form1.v4_odometer_dt.value = 'MM/DD/YYYY';
	if (document.form1.fd_dob.value == '') document.form1.fd_dob.value = 'MM/DD/YYYY'; 
	if (document.form1.sd_dob.value == '') document.form1.sd_dob.value = 'MM/DD/YYYY';
	if (document.form1.td_dob.value == '') document.form1.td_dob.value = 'MM/DD/YYYY';
	if (document.form1.fd4_dob.value == '') document.form1.fd4_dob.value = 'MM/DD/YYYY';
	if (document.form1.fd_license_num.value == '') document.form1.fd_license_num.value = '(no spaces or dashes)';
	if (document.form1.td_license_num.value == '') document.form1.td_license_num.value = '(no spaces or dashes)'; 
	if (document.form1.sd_license_num.value == '') document.form1.sd_license_num.value = '(no spaces or dashes)';
	if (document.form1.fd4_license_num.value == '') document.form1.fd4_license_num.value = '(no spaces or dashes)';
	if (document.form1.effective_date.value == '') document.form1.effective_date.value = 'MM/DD/YYYY';
	if (document.form1.fd_current_carrier_effective_date.value == '') document.form1.fd_current_carrier_effective_date.value = 'MM/DD/YYYY';
}

/*******************************************************************
// Validate form (Initial)
********************************************************************/
function validate(form_type) {
	// Relationship
	var message='';
	var sRel=false;
	first_name_fni = document.form1.first_name_fni.value;
	last_name_fni = document.form1.last_name_fni.value;
	dob_fni = document.form1.dob_fni.value;
	fni_house_num = document.form1.fni_house_num.value;
	fni_street = document.form1.fni_street.value;
	fni_city = document.form1.fni_city.value;
	fni_state = document.form1.fni_state.value;
	fni_zip = document.form1.fni_zip.value;
	fni_home_phone = document.form1.fni_home_phone.value;
	
	if (first_name_fni=='') { message += 'First Name is a required field.\n'; }
	if (last_name_fni=='') { message += 'Last Name is a required field.\n'; }
	if ((dob_fni=='') || (dob_fni=='MM/DD/YYYY')) { message += 'Date of Birth is a required field.\n'; }
	if (fni_house_num=='') { message += 'House Number is a required field.\n'; }
	if (fni_street=='') { message += 'Street Name is a required field.\n'; }
	if (fni_city=='') { message += 'City is a required field.\n'; }
	if (fni_state=='') { message += 'State is a required field.\n'; }
	if (fni_zip=='') { message += 'Zip Code is a required field.\n'; }
	if (fni_home_phone=='') { message += 'Home phone number is a required field.\n'; }
	
	if (message=='') { sRel=true; }
	
	// Print error messages
	if (!sRel) {
		alert(message);
		message = '';
	}
	else { 
		document.form1.form_type.value = form_type; 
		submit_form();
	}
}

/*******************************************************************
// Validate form (Homeowners)
********************************************************************/
function validate_homeowners() {
	// Relationship
	var message='';
	var sRel=false;
	bhi_num_stories = document.form1.bhi_num_stories.value;
	bhi_total_living_space = document.form1.bhi_total_living_space.value;
	bhi_bathrooms = document.form1.bhi_bathrooms.value;
	bhi_full_bathrooms = document.form1.bhi_full_bathrooms.value;
	bhi_half_bathrooms = document.form1.bhi_half_bathrooms.value;
	bhi_miles_fire_station = document.form1.bhi_miles_fire_station.value;
	bhi_fire_protection_provider = document.form1.bhi_fire_protection_provider.value;
	bhi_year_built = document.form1.bhi_year_built.value;
	ri_roof_year = document.form1.ri_roof_year.value;
	vcpd_home_value = document.form1.vcpd_home_value.value;
	current_carrier_name = document.form1.current_carrier_name.value;
	
	if (bhi_num_stories=='') { message += 'Number of Stories is a required field.\n'; }
	if ((bhi_total_living_space=='') || (bhi_total_living_space=='L x W x # of Stories')) { message += 'Total Living space is a required field.\n'; }
	if ((bhi_bathrooms=='') || (bhi_bathrooms=='0.0')) { message += 'Bathrooms is a required field.\n'; }
	if ((bhi_full_bathrooms=='') ) { message += 'Full Bathrooms is a required field.\n'; }
	if ((bhi_half_bathrooms=='') ) { message += 'Half Bathrooms is a required field.\n'; }
	if ((bhi_miles_fire_station=='') || (bhi_miles_fire_station=='# of Miles')) { message += 'Miles from Fire Station is a required field.\n'; }
	if ((bhi_fire_protection_provider=='') || (bhi_fire_protection_provider=='Provider\'s Name')) { message += 'Fire Protection Provider is a required field.\n'; }
	if ((bhi_year_built=='') || (bhi_year_built=='YYYY')) { message += 'Year Built is a required field.\n'; }
	if ((ri_roof_year=='') || (ri_roof_year=='YYYY')) { message += 'Roof Year is a required field.\n'; }
	if ((vcpd_home_value=='') || (vcpd_home_value=='$0,000,000')) { message += 'Home Value is a required field.\n'; }
	if (current_carrier_name=='') { message += 'Name of Current Carrier is a required field.\n'; }
	
	if (message=='') { sRel=true; }
	
	// Print error messages
	if (!sRel) {
		alert(message);
		message = '';
	}
	else { submit_form(); }
}

/*******************************************************************
// Validate form (Automotive)
********************************************************************/
function validate_automotive() {
	// Relationship
	var message='';
	var sRel=false;
	v1_vin = document.form1.v1_vin.value;
	v1_type = document.form1.v1_type.value;
	v1_year = document.form1.v1_year.value;
	v1_make = document.form1.v1_make.value;
	v1_model = document.form1.v1_model.value;
	
	if (v1_vin=='') {
		if (v1_type=='0') {
			message += 'Vin # or Vehicle Type are required fields.\n';
		}
		else {
			if (v1_year=='') { message += 'Vehicle Year is a required field.\n'; }
			if (v1_make=='') { message += 'Vehicle Make is a required field.\n'; }
			if (v1_model=='') { message += 'Vehicle Model is a required field.\n'; }
		}
	}
	
	fd_first_name = document.form1.fd_first_name.value;
	fd_last_name = document.form1.fd_last_name.value;
	fd_dob = document.form1.fd_dob.value;
	//fd_age_licensed = document.form1.fd_age_licensed.value;
	fd_license_state = document.form1.fd_license_state.value;
	fd_license_num = document.form1.fd_license_num.value;
	fd_current_carrier = document.form1.fd_current_carrier.value;
	fd_current_carrier_effective_date = document.form1.fd_current_carrier_effective_date.value;
	fd_current_carrier_premium = document.form1.fd_current_carrier_premium.value;
	fd_current_carrier_years = document.form1.fd_current_carrier_years.value;
	//sd_current_carrier = document.form1.sd_current_carrier.value;
	sd_first_name = document.form1.sd_first_name.value;
	
	if (fd_first_name=='') { message += 'First Name is a required field.\n'; }
	if (fd_last_name=='') { message += 'Last Name is a required field.\n'; }
	if ((fd_dob=='') || (fd_dob=='MM/DD/YYYY')) { message += 'Date of Birth is a required field.\n'; }
	//if (fd_age_licensed=='') { message += 'Age Licensed is a required field.\n'; }
	if (fd_license_state=='') { message += 'License State is a required field.\n'; }
	if ((fd_license_num=='') || (fd_license_num=='(no dashes or spaces)')) { message += 'License Number is a required field.\n'; }
	if (fd_current_carrier=='') { message += 'First Driver\'s Current Carrier is a required field.\n'; }
	if (fd_current_carrier_premium=='') { message += 'First Driver\'s Current Carrier Premium is a required field.\n'; }
	if (fd_current_carrier_effective_date=='') { message += 'First Driver\'s Current Carrier Effective Date is a required field.\n'; }
	if (fd_current_carrier_years=='') { message += 'First Driver\'s  Years with Current Carrier is a required field.\n'; }
	//if ((sd_current_carrier=='') && (sd_first_name!='')) { message += 'Second Driver\'s Current Carrier is a required field.\n'; }
	
	if (message=='') { sRel=true; }
	
	// Print error messages
	if (!sRel) {
		alert(message);
		message = '';
	}
	else { submit_form(); }
}

function submit_form() { document.form1.submit(); }


//-->