<style type="text/css"> A:link {color:#002a63;} A:visited {color:#002a63;} A:hover {text-decoration: none; color:#002a63;} .bodystyle { background : transparent ; } .text { font-family: Verdana; font-size: 11px; color:#494d52; text-decoration: none; } .textHF { font-family: Verdana; font-size: 11px; color:#494d52; text-decoration: none; } .celltext { font-family: Verdana; font-size: 11px; color:#494d52; text-decoration: none; } .celltextInventory { font-family: Verdana; font-size: 11px; color:#494d52; text-decoration: none; BORDER: transparent 0px solid; } .celltextcolor { font-family: Verdana; font-size: 11px; color:#494d52; text-decoration: none; background : transparent; } .textcolor { font-family: Verdana; font-size: 11px; color:#494d52; text-decoration: none; background : transparent; } .celltextBOLDcolor { font-family: Verdana; font-size: 11px; color:#494d52; text-decoration: none; font-weight: bold; background : transparent; } .agentPopup { font-family: Verdana; font-size: 11px; 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bottom:2px; FONT: 11px Verdana; color: #333333 } .title { font-family: Verdana; font-size: 14px; font-weight: bold; text-transform: uppercase; color: #002a63; } .celltitlecolor { font-family: Verdana; font-size: 14px; font-weight: bold; text-transform: uppercase; color: #494d52; background : transparent; } .brLogo[class] { background-image: url(images/black.png); background-repeat: no-repeat; width: 95px; height: 21px; } .brLogo { background-repeat: no-repeat; width: 95px; height: 21px; filter: progid:DXImageTransform.Microsoft.AlphaImageLoader(src='images/black.png') ; } .pbLogo { background-repeat: no-repeat; width: 50px; height: 54px; filter: progid:DXImageTransform.Microsoft.AlphaImageLoader(src='images/palm-beach-IDX.png') ; } .pType{ color:#FF0000; } </style> <table width="700" cellpadding="1" cellspacing="2" height="10"> <tr> <td colspan="4" class="celltext" align="right" height="25" valign="middle"> <a onclick="self.status='';return true;" onmouseover="self.status='Return to the previous page';return true;" onmouseout="self.status='';return true;" href="javascript:window.history.back()"> < Back</a> </td> </tr> <tr> <td colspan="4" height="25" class="title"> Request More Information </td> </tr> <tr> <td colspan="2" class="celltextBOLD"> Agent Info: </td> <td colspan="2" class="celltextBOLD"> Personal Information: </td> </tr> <tr> <td width="25%" class="celltextcolor"> </td> <td width="25%" class="celltext" align="left">Ryan Bassett</td> <td width="25%" class="celltextcolor"> </td> <td width="25%" class="celltext"> </td> </tr> <tr> <td width="25%" class="celltextcolor" align="right">Direct Phone:</td> <td width="25%" class="celltext" align="left">(843) 338-2120</td> <td width="25%" class="celltextcolor"> </td> <td width="25%" class="celltext"> </td> </tr> <tr> <td width="25%" class="celltextcolor" align="right">Office Phone:</td> <td width="25%" class="celltext" align="left">(843) 785-4460</td> <td class="celltextcolor"> </td> <td class="celltext"> </td> </tr> <tr> <td class="celltextcolor">&nbsp;</td> <td class="celltext">&nbsp;</td> <td class="celltextcolor"> </td> <td class="celltext"> </td> </tr> <tr> <td width="25%" class="celltextcolor" align="right">Fax Phone:</td> <td width="25%" class="celltext" align="left">(866) 357-2120</td> <td class="celltextcolor"> </td> <td class="celltext"> </td> </tr> <tr> <td class="celltextcolor">&nbsp;</td> <td class="celltext">&nbsp;</td> <td class="celltextcolor"> </td> <td class="celltext"> </td> </tr> <tr> <td width="25%" class="celltextcolor" align="right">Mobile Phone:</td> <td width="25%" class="celltext" align="left">(843) 338-2120</td> <td class="celltextcolor"> </td> <td class="celltext"> </td> </tr> </table> <table width="700" cellpadding="1" cellspacing="2" height="10" class="RequestInfoMore"> <tr> <td colspan="4" class="celltext"> <table width="100%" border="0" cellspacing="0" cellpadding="3"> <tr> <td width="63%" class="text"> Please provide me with more information about your services </td> <td width="37%" class="text"> </td> </tr> </table> </td> </tr> <tr> <td colspan="4" class="celltext"> <table width="100%" border="0" cellspacing="0" cellpadding="3"> <tr> <td width="63%" class="text"> Please provide information about surrounding areas </td> <td width="37%"> </td> </tr> </table> </td> </tr> <tr> <td colspan="4" class="celltext"> <table width="100%" border="0" cellspacing="0" cellpadding="3"> <tr> <td width="63%" class="text"> I am planning to buy or sell real estate property in </td> <td width="37%"> 1 Month 2 Months 3 Months 6 Months 8 Months 12 Months Over 12 Months </td> </tr> <tr> <td width="63%" class="text"> How did you find our website? </td> <td width="37%"> Google MSN Yahoo Other Search Engines Direct Mailing Email Advertising Newspaper Other </td> </tr> </table> </td> </tr> </table> <table width="700" cellpadding="1" cellspacing="2" height="10"> <tr> <td colspan="4" class="celltext"> &nbsp; </td> </tr> <tr> <td colspan="4" class="celltextBOLD"> Special Instructions: </td> </tr> <tr> <td colspan="4" class="celltextBOLD"> </td> </tr> <tr> <td colspan="4" class="celltext"> All personal information will be kept confidential </td> </tr> <tr> <td colspan="4" class="celltext"> * By submitting this form with your telephone number you are consenting for Charter One Realty and all authorized representatives to contact you even if your name is on the <a href="https://www.donotcall.gov/default.aspx" target="_new">Federal Do-Not-Call List</a> </td> </tr> <tr class="celltextcolor"> <td colspan="4" class="celltext"> <table width="60%" border="0" align="center" cellpadding="3" cellspacing="0"> <tr> <td width="50%"> </td> <td width="50%"> </td> </tr> </table> </td> </tr> <tr class="celltextcolor"> <td colspan="4" class="celltext"> <table width="15%" border="0" align="center" cellpadding="3" cellspacing="0"> <tr> <td width="21%"> </td> <td width="79%"> <a tabindex="13" onclick="self.status='';return true;" onmouseover="self.status='Click to reset form';return true;" onmouseout="self.status='';return true;" href="javascript:form1.reset()"> <img src="images/reset.gif" border="0"></a> </td> </tr> </table> </td> </tr> <tr> <td colspan="4" class="celltext" height="100%" valign="top"> <table width="100%" border="0" align="center" cellpadding="3" cellspacing="0"> <tr> <td colspan="4" class="text" align="right" height="100%" valign="top"> &nbsp; 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