simplehome-quotes.com Open in urlscan Pro
172.67.212.177 Public Scan

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Submitted URL:
https://bit.ly/3DZKmgq#c13860aCmZV2821543XgOV20595KXi1581byLJ1792/YLVTZM20XW.6O4TUL5MYEZMUV75DHBF.NSSMO2OBN9VP3...
Effective URL:
https://simplehome-quotes.com/roofing/lp12/v2?aff_id=21&sub_id=822607&s2=662332276&s3=&s4=&s5=49295c657a27415eafa5d69eb7c82018
Submission: On October 19 via api (October 19th 2021, 4:30:18 am UTC) from BE — Scanned from DE

Form analysis
1 forms found in the DOM

roofing/thank-you

<form id="msform" class="form" action="roofing/thank-you" novalidate="novalidate">
  <input id="leadid_token" name="universal_leadid" type="hidden" value="F524B4DA-3F8C-E25F-98C5-2C056DA4B456">
  <input type="hidden" id="session_id" name="session_id" value="ODA9TbhVvklzBkMbFyUEwUGR6h3NpboD2qe6FoPU">
  <input type="hidden" id="completed" name="completed" value="0">
  <input type="hidden" id="token" name="token" value="6dac05668a2f5a5b12c69278aad244a6943d38d690b5bdce">
  <input type="hidden" id="aff_id" name="aff_id" value="21">
  <input type="hidden" id="transaction_id" name="transaction_id" value="">
  <input type="hidden" id="sub_id" name="sub_id" value="822607">
  <input type="hidden" id="s2" name="s2" value="662332276">
  <input type="hidden" id="s3" name="s3" value="">
  <input type="hidden" id="s4" name="s4" value="">
  <input type="hidden" id="s5" name="s5" value="49295c657a27415eafa5d69eb7c82018">
  <input type="hidden" id="tcpa_text" name="tcpa_text" value="

By clicking &quot;Continue
&quot;, I authorize up to 4 home improvement services companies, their
contractors and partner companies to contact
me about home improvement offers by phone calls and SMS messages to the number I provided. I authorize that
these marketing communications may be delivered to me using an automatic telephone dialing system or by
prerecorded message. I understand that my consent is not a condition of purchase. I also have read and agree to
the Terms and Conditions and Privacy Policy of this website. Message
and Data rates may apply.
">
  <input type="hidden" id="lotame_profile_data" name="lotame_profile_data" value="">
  <input type="hidden" id="time_spent_on_page" name="time_spent_on_page" value="0">
  <input type="hidden" id="address_short" value=""> <input type="hidden" id="post_url" value="https://marble.logiq.com/api/lead/simplehome-quotes.com/leadspedia_roofing">
  <input type="hidden" id="city" name="city" value="">
  <input type="hidden" id="state" name="state" value="">
  <input type="hidden" name="own_rented" id="own_rented" value="Own">
  <fieldset data-step="1">
    <legend hidden="true">homeowner</legend>
    <h3 class="form_box-question">What is your zip code?</h3>
    <div class="form-group">
      <label style="visibility: hidden; position: absolute;" for="zip">Zip Code</label>
      <input id="zip" class="form-control zipcode" type="tel" name="zip_code" pattern="^[0-9]{5}(?:-[0-9]{4})?$" onkeyup="this.value=this.value.replace(/[^\d]/,'')" maxlength="5" placeholder="Enter your zip code" required="">
      <div class="form-error-message">Please enter a valid zip code. (i.e. 90210)</div>
    </div>
    <div class="form-btns ml-auto">
      <button class="btn btn-next form-btn" id="btnzip" type="button"><span class="btn-text">Next</span>
      </button>
    </div>
  </fieldset>
  <fieldset data-step="2">
    <legend hidden="true">windows</legend>
    <h3 class="form_box-question">What type of roof are you looking&nbsp;for?</h3>
    <div class="form-group radio-next">
      <div class="radio-btn">
        <input id="mat-01" type="radio" name="material" value="Asphalt Shingle" required="">
        <label for="mat-01"><span>Asphalt</span></label>
      </div>
      <div class="radio-btn">
        <input id="mat-02" type="radio" name="material" value="Tile" required="">
        <label for="mat-02"><span>Clay</span></label>
      </div>
      <div class="radio-btn">
        <input id="mat-03" type="radio" name="material" value="Natural Slate" required="">
        <label for="mat-03"><span>Slate</span></label>
      </div>
      <div class="radio-btn">
        <input id="mat-04" type="radio" name="material" value="Cedar Shake" required="">
        <label for="mat-04"><span>Wood</span></label>
      </div>
      <div class="radio-btn">
        <input id="mat-05" type="radio" name="material" value="Metal" required="">
        <label for="mat-05"><span>Metal</span></label>
      </div>
      <div class="radio-btn">
        <input id="mat-06" type="radio" name="material" value="Tar Torchdown" required="">
        <label for="mat-06"><span>Other</span></label>
      </div>
      <div class="form-error-message">Please select an option.</div>
    </div>
    <div class="row">
      <div class="col colback"><a class="btn btn-link btn-back">Back</a></div>
      <div class="col">
        <div class="form-btns ml-auto text-center">
          <button class="btn form-btn btn-next" type="button"><span class="btn-text">Next</span>
          </button>
        </div>
      </div>
    </div>
  </fieldset>
  <fieldset data-step="3">
    <legend hidden="true">windows</legend>
    <h3 class="form_box-question">How soon do you want to begin this project?</h3>
    <div class="form-group radio-next">
      <div class="radio-btn">
        <input id="t1" class="img-radio" type="radio" name="timeline" value="Immediately" required="">
        <label class="radio-label" for="t1"><span>Immediately</span></label>
      </div>
      <div class="radio-btn">
        <input id="t2" class="img-radio" type="radio" name="timeline" value="Within 6 months" required="">
        <label class="radio-label" for="t2"><span>Within 6 months</span></label>
      </div>
      <div class="radio-btn">
        <input id="t3" class="img-radio" type="radio" name="timeline" value="Not sure" required="">
        <label class="radio-label" for="t3"><span>Not sure</span></label>
      </div>
      <div class="form-error-message">Please select an option.</div>
    </div>
    <div class="row">
      <div class="col colback"><a class="btn btn-link btn-back">Back</a></div>
      <div class="col">
        <div class="form-btns ml-auto text-center">
          <button class="btn form-btn btn-next" type="button"><span class="btn-text">Next</span>
          </button>
        </div>
      </div>
    </div>
  </fieldset>
  <fieldset data-step="4">
    <legend hidden="true">address</legend>
    <h3 class="form_box-question">Where do you live?</h3>
    <div class="form-cont">
      <div class="form-group" id="street_address">
        <label for="address" class="label">Street Address*</label>
        <input id="address" class="form-control pac-target-input" name="address" type="text" placeholder="Enter Street Address" data-geocomplete="street address" required="" autocomplete="off">
        <div class="form-error-message"> Please complete this field</div>
        <div class="address_loc address_change mb-3" id="add-change" style=" display: none;">
          <div class="address_string address_change d-inline " style=" font-weight: 700;">
            <span class="street_span"></span> <span class="city_span"></span>,&nbsp;<span class="state_span"></span>
          </div>
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col colback"><a class="btn btn-link btn-back">Back</a></div>
      <div class="col">
        <div class="form-btns ml-auto text-center">
          <button class="btn form-btn btn-next" type="button"><span class="btn-text">Next</span>
          </button>
        </div>
      </div>
    </div>
  </fieldset>
  <fieldset data-step="5" id="phoneContainer">
    <legend hidden="true">Email</legend>
    <center>
      <h3 class="form_box-question mb-1 last"><b>Congratulations!</b> <br> We found matching pros in your area!</h3>
      <p class="form_box-desc">Enter your info so we can personalize your results.</p>
    </center>
    <div class="form-group">
      <label class="label" for="first_name">First Name</label>
      <input id="first_name" pattern="[a-zA-Z]+" minlength="3" class="form-control" type="text" name="first_name" placeholder="Enter First Name" required="">
      <div class="form-error-message"> Please complete this field</div>
    </div>
    <div class="form-group ">
      <label class="label" for="last_name">Last Name</label>
      <input id="last_name" pattern="[a-zA-Z]+" minlength="3" class="form-control" type="text" name="last_name" placeholder="Enter Last Name" required="">
      <div class="form-error-message"> Please complete this field</div>
    </div>
    <div class="form-group">
      <label class="label" for="email">Email</label>
      <input id="email" pattern="[a-z0-9._%+-]+@[a-z0-9.-]+\.[a-z]{2,4}$" class="form-control" type="email" name="email_address" placeholder="Email Address" required="">
      <p class="form-error-message">Please enter your email address.</p>
    </div>
    <div class="form-group ">
      <label class="label" for="homePhone"> Phone </label>
      <input id="homePhone" class="form-control" type="tel" name="phone_home" pattern="\d?[\(]\d{3}[\)][\-]\d{3}[\-]\d{4}" placeholder="Enter Phone Number" required="" maxlength="15">
      <div class="form-error-message phone-valid-error">Please enter a valid phone.</div>
    </div>
    <div class="form-btns mx-auto sbmt">
      <button class="btn form-btn btn-next" type="submit"><span class="btn-text">Continue</span>
      </button>
    </div>
    <center><img src="img/roofing/lp12/v1/trusted.svg" alt="trusted site" class="trusted mt-3"></center>
  </fieldset>
  <input type="hidden" id="original_url" name="original_url" value="https://simplehome-quotes.com/roofing/lp12/v2?aff_id=21&amp;sub_id=822607&amp;s2=662332276&amp;s3=&amp;s4=&amp;s5=49295c657a27415eafa5d69eb7c82018"><input type="hidden"
    name="xxTrustedFormToken" id="xxTrustedFormToken_0" value="https://cert.trustedform.com/3984fb5796bfa9b2dc1f3eaadbe4bdbf2f0c56f8"><input type="hidden" name="xxTrustedFormCertUrl" id="xxTrustedFormCertUrl_0"
    value="https://cert.trustedform.com/3984fb5796bfa9b2dc1f3eaadbe4bdbf2f0c56f8"><input type="hidden" name="xxTrustedFormPingUrl" id="xxTrustedFormPingUrl_0"
    value="https://ping.trustedform.com/0.7Aw5Xvvqd8Ad3wg_N2o4tHAiCX5hMO1C1MEUhTzoKzb71ffYq4Isk9lsuNyNZKyiEFU1hWjJ.liSqt-n-u2mplDzqAMdm0Q.fMwdMFre1XsDDbCvqZDSqg">
</form>

Text Content

SIMPLE ROOFING SURVEY


FIND TOP-RATED ROOFING PROS AND SAVE!

Takes less than 30 seconds!


Question 1
homeowner


WHAT IS YOUR ZIP CODE?

Zip Code
Please enter a valid zip code. (i.e. 90210)
Next
windows


WHAT TYPE OF ROOF ARE YOU LOOKING FOR?

Asphalt
Clay
Slate
Wood
Metal
Other
Please select an option.
Back
Next
windows


HOW SOON DO YOU WANT TO BEGIN THIS PROJECT?

Immediately
Within 6 months
Not sure
Please select an option.
Back
Next
address


WHERE DO YOU LIVE?

Street Address*
Please complete this field
, 
Back
Next
Email


CONGRATULATIONS!
WE FOUND MATCHING PROS IN YOUR AREA!

Enter your info so we can personalize your results.

First Name
Please complete this field
Last Name
Please complete this field
Email

Please enter your email address.

Phone
Please enter a valid phone.
Continue

By clicking "Continue ", I authorize up to 4 home improvement services
companies, their contractors and partner companies to contact me about home
improvement offers by phone calls and SMS messages to the number I provided. I
authorize that these marketing communications may be delivered to me using an
automatic telephone dialing system or by prerecorded message. I understand that
my consent is not a condition of purchase. I also have read and agree to the
Terms and Conditions and Privacy Policy of this website. Message and Data rates
may apply.

This Website is an advertising marketplace for individuals and companies who are
seeking consumer referrals for services or products. We are not a provider,
manufacturer, or installer. The information provided by you to us will be sent
to a manufacturer and/or installer in your area. We do not endorse, warrant, or
guarantee any service or products of any individual or company you choose. While
any information shared with you is believed to be accurate and reliable, the
owners/operators of this Website specifically disclaim all warranties, express,
implied or statutory, regarding the accuracy, timeliness, and/or completeness of
the information provided. The content of any information or service contained
thereon (the “Content”) are provided on an "as is" basis. Federal and State tax
credits or incentives are not available in all locations and not available to
all individuals.

Simple Home Quotes

Copyright © 2021

 * Privacy Policy
 * Terms of Use
 * Contact
 * Join Our Network!

 * Do Not Sell My Information
 * Email Preferences


WE ARE CURRENTLY MATCHING YOU WITH OUR PARTNERS.



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simplehome-quotes.com Open in urlscan Pro 172.67.212.177 Public Scan

Form analysis 1 forms found in the DOM

roofing/thank-you

Text Content

simplehome-quotes.com Open in urlscan Pro
172.67.212.177 Public Scan

Form analysis
1 forms found in the DOM