function writeSuccess(){
		var str='';
		str+='				<center><h3 ><em>Thank you!<\/em><\/h3></center>';
		str+='				<p>Your information has been forwarded to a financial payment specialist who will contact you soon.</p>';
		document.write(str);
	}
	function writeJS(){
		var str='<div id="freeanalysisform"><span style="display:none;">_<\/span>&nbsp;&nbsp;';
		
		str2='				<fieldset>';
		str2+='				<legend>Request A Free Analysis Today<\/legend>';
		str2+='				<div style="font-size:x-small;text-align:center;">Required fields marked with a \'*\'</div>';
		str2+='				<input type="hidden" name="ss" value="0.628620100229">';
		str2+='				<input type="hidden" name="PageNo" value="62">';
		str2+='				<input type="hidden" name="hash" value="5848BC7B822BB26AD731219DD62F3A2D">';
		str2+='				<input type="hidden" name="returnpage" value="">';
		str2+='				<table cellpadding="3" cellspacing="1" border="0">';
		str2+='				<TR>';
		str2+='					<TD class="desc" align="right" >Business Name (DBA) <span style="color:red;">*<\/span><\/TD>';
		str2+='					<TD ><INPUT size=30 value="" name=MerchantName id=MerchantName class="clsinput"><\/TD>';
		str2+='				<\/TR>';
		str2+='				<TR>';
		str2+='					<TD class="desc" align="right" >Contact Name <span style="color:red;">*<\/span><\/TD>';
		str2+='					<TD ><INPUT size=30 value="" id=ContactPerson name=ContactPerson class="clsinput"><\/TD>';
		str2+='					<TD rowspan="11" valign="bottom">&nbsp;<\/TD>';
		str2+='				<\/TR>';
		str2+='				<TR>';
		str2+='					<TD class="desc" align="right">E-mail Address <span style="color:red;">*<\/span><\/TD>';
		str2+='					<TD ><INPUT size=30 value="" id=EmailAddress name=EmailAddress class="clsinput"> <\/TD>';
		str2+='				<\/TR>';
		str2+='				<tr style="display:none;">';
		str2+='					<td class="desc" align="right">Structure<\/td>';
		str2+='					<td align="left">';
		str2+='						<SELECT	name="Business" class="clsinput">';
		str2+='							<OPTION selected value="">Choose one...<\/option>';
		str2+='							<OPTION>Sole Proprietorship<\/OPTION>';
		str2+='							<OPTION>Partnership<\/OPTION>';
		str2+='							<OPTION>Corporation<\/OPTION>';
		str2+='							<OPTION>Non-Profit<\/OPTION>';
		str2+='							<OPTION>LLC.<\/OPTION>';
		str2+='							<OPTION>Closely Held Corp.<\/OPTION>';
		str2+='							<OPTION>Publicly Held Corp.<\/OPTION>';
		str2+='							<OPTION>Sub Chapter S<\/OPTION>';
		str2+='						<\/SELECT>';
		str2+='					<\/td>';
		str2+='				<\/tr>';
		str2+='				<TR>';
		str2+='					<TD align="right" class="desc" >Phone <span style="color:red;">*<\/span><\/TD>';
		str2+='					<TD align="left"><INPUT size=18 value="" id=BusinessPhone name=BusinessPhone class="clsinput"><\/td>';
		str2+='				<\/tr>';
		str2+='				<TR>';
		str2+='				<TD align="right" class="desc" >Fax<\/TD>';
		str2+='				<TD  align="left"> <INPUT size=18 value=" " name=BusinessFax class="clsinput"><\/td>';
		str2+='				<tr>';
		str2+='				<TR style="display:none;">';
		str2+='				<TD class="desc" align="right">Address<\/TD>';
		str2+='				<TD  align="left"><INPUT size=30 value=""  name=BusinessPhysicalAddress class="clsinput"><\/TD>';
		str2+='				<\/TR>';
		str2+='				<TR>';
		str2+='				<TD class="desc" align="right">City, State<\/TD>';
		str2+='				<TD  align="left"><INPUT size=30 value=" " name=BusinessCityStateZip class="clsinput"><\/TD><\/TR>';
		str2+='				<TR style="display:none;">';
		str2+='				<TD class="desc" align="right">Owner\'s Name<\/TD>';
		str2+='				<TD  align="left"><INPUT size=30 value="" name=OwnersName class="clsinput"><\/TD><\/TR>';
		str2+='				<TR style="display:none;">';
		str2+='				<TD class="desc" align="right">% of Ownership<\/TD>';
		str2+='				<TD  align="left"><INPUT size=30 value="" name=OwnerAmount class="clsinput"><\/TD><\/TR>';
		str2+='				<TR style="display:none;">';
		str2+='				<TD class="desc" align="right">Corporate Name<\/TD>';
		str2+='				<TD  align="left" ><INPUT size=30 value="" name=CorporateName class="clsinput"><\/TD>';
		str2+='				<\/TR>';
		str2+='				<TR>';
		str2+='					<TD class="desc" align="right" >Service \/ Products<\/TD>';
		str2+='					<TD align="left"><INPUT size=30 value="" name=ServiceProducts class="clsinput"><\/TD>';
		str2+='				<\/TR>';
		str2+='				<TR>';
		str2+='				<TD class="desc" valign="top" align="right">Additional Comments<\/TD>';
		str2+='				<TD  align="left"><Textarea rows=3 cols=25	 name=Comments class="clsinput"><\/textArea><\/TD>';
		str2+='					<TD valign="bottom"><a href="http:\/\/www.nxgen.com\/"><img src="http:\/\/www.nxgen.com\/images\/logosmall.gif" border="0"/></a><\/TD>';
		str2+='				<\/TR>';
		str2+='				<TR>';
		str2+='				<TD class="desc" valign="top" align="center" colspan="2"><input type="button" class="button" value = "Submit An Information Request" OnClick="javascript:sendme();"  >   <\/TD>';
		str2+='				<\/TR>';
		str2+='				<\/table>';
		str2+='				<\/fieldset>';
		str3='';
		str3+='				<script type="text\/javascript">';
		str3+='				function sendme()';
		str3+='				{';
		str3+='					if (document.getElementById(\'ContactPerson\').value =="" || document.getElementById(\'EmailAddress\').value =="" || document.getElementById(\'BusinessPhone\').value =="" || document.getElementById(\'MerchantName\').value =="")';
		str3+='					{';
		str3+='						alert("Oops! Missing required fields. All fields marked \'*\' are required.");';
		str3+='						return;';
		str3+='					}';
		str3+='					document.getElementById(\'homeform\').submit();';
		str3+='				}';
		str3+='				<\/script>';
		str3+='				</div>';
		document.write(str);
		homeform = document.createElement("form");
		homeform.id="homeform";
		homeform.method="post";
		homeform.action="http:\/\/www.nxgen.com\/forms\/freeanalysis\/A09BF147CE5FB53571A1C5F6AF927641/";
		homeform.innerHTML = str2;
		testele = document.createElement("input");
		testele.type="hidden";
		testele.value="george";
		homeform.appendChild(testele);
		document.getElementById('freeanalysisform').appendChild(homeform);
		document.write(str3);
	}
	
			writeJS();