forms.swiftsmsgateway.com
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136.143.190.199
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Submitted URL: https://zfrmz.com/6mezjMszU53wsztWwW0N
Effective URL: https://forms.swiftsmsgateway.com/swiftsmsgateway/form/10DLCApplicationForm/formperma/0zDv-I-S3QD9x_S2piuJHQr82N8TtsQBEFvg9ZQjfL8
Submission Tags: falconsandbox
Submission: On September 19 via api from US — Scanned from DE
Effective URL: https://forms.swiftsmsgateway.com/swiftsmsgateway/form/10DLCApplicationForm/formperma/0zDv-I-S3QD9x_S2piuJHQr82N8TtsQBEFvg9ZQjfL8
Submission Tags: falconsandbox
Submission: On September 19 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
Name: test —
<form name="test" id="test"><input type="hidden" name="formName" value="10DLCApplicationForm" id="formName"><input type="hidden" name="verifyPerma" value="" id="verifyPerma"><!-- Form Perma will be sent only for PermaUrls -->
<input type="hidden" name="formPerma" value="0zDv-I-S3QD9x_S2piuJHQr82N8TtsQBEFvg9ZQjfL8" id="formPerma"><input type="hidden" name="referrerName" id="referrerName" value="null"><input type="hidden" name="isPaymentForm" value="false"
id="isPaymentForm"><input type="hidden" name="formType" value="0" id="formType">
<input type="hidden" id="zf_date_format" datelocale="en-GB" name="date_format" value="MM/dd/yyyy"><input type="hidden" name="isDocsPublicForm" value="false" id="isDocsPublicForm">
<input type="hidden" name="formrid" value="" id="formrid">
<input type="hidden" name="resizeform" value="0" id="resizeform">
<div id="zf_utmTrack" style="display: none;"></div>
<div class="templateWrapper" id="formRedirectURL">
<ul class="tempHeadBdr formRelative">
<li class="tempHeadContBdr fLogoLt">
<span id="logo-formheader" class="formLogo"><img id="logo-formheader-img" src="/swiftsmsgateway/downloadlogoperma?filepath=/swiftsmsgateway/zf-customthemes-zf/1643405931357_Swift_logo.png"></span>
<h2 class="frmTitle"><em>10DLC Brand Registration Form</em></h2>
<p class="frmDesc"></p>
<div class="clearBoth"></div>
</li>
</ul>
<!-- 'FieldElement' class is imported in order to get the key for display name of the component of 'Address' field.
'FormField' class is used to get field type of Zoho CRM field.-->
<div id="formBodyDiv" class="formRelative subContWrap topAlign"><!-- <button elname="openPopUpSubForm" onclick="openPopUp();event.preventDefault()"> Open subform pop up </button> -->
<!-- formFieldWrapper class is used to differantiate form fields and subform fields in themes. Direct children (li) are considered as form fields. Dont change the order of class used. -->
<ul elname="formBodyULName" class="ulNoStyle formFieldWrapper" page_no="1" needpagedata="true">
<!-- i) Private form, ii) Perma, iii) Shared form, iv) Theme preview, v) Current Theme -->
<!-- "isVisible"="false": This 'Admin Only' field must not be shown to user. -->
<!-- "isVisible"="true": Case 1: This is not an 'Admin Only' field. Case 2: This 'Admin Only' field must be shown to user. -->
<!-- Theme Preview, Current Theme - Admin Only fields will be shown. Formula won't be calculated. Field Rules won't be executed. -->
<!-- formMetaData.key=Field link name -->
<!-- Zoho CRM field : "FIELD_LIST" key won't be present. -->
<li elname="livefield-elem" comptype="1" id="SingleLine5-li" needdata="true" compname="SingleLine5" linkname="SingleLine5" isvisible="true" class="tempFrmWrapper small" mandatory="true" page_no="1" page_link_name="Page" showlabel="true">
<label class="labelName">
<span>Current Swift Company Name</span>
<em class="important">*</em>
</label>
<div class="tempContDiv">
<span><input onkeyup="ZFLive.configureInputMask(this);" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="off" type="text" maxlength="255" name="SingleLine5" value="" placeholder=""></span>
<p class="errorMessage" elname="error" id="error-SingleLine5"></p>
<p class="instruction instrSpace" elname="hint" id="hint-SingleLine5"> Enter the company name of your Swift SMS Gateway account. This can be found in the dashboard or on your invoice. </p>
</div>
<div class="clearBoth"></div>
</li>
<li class="tempFrmWrapper small" style="display:none;" elname="livefield-elem" comptype="3" id="Number-li" needdata="true" compname="Number" linkname="Number" isvisible="false" mandatory="false" unit_position="2" page_no="1"
page_link_name="Page" summary_type="0" showlabel="true">
<label class="labelName">
<span>Account ID</span>
</label>
<div elname="tempContDiv" class="tempContDiv">
<span><input onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="off" type="text" maxlength="18" name="Number" value="" placeholder=""> </span>
<span class="symbol" name="field_unit_after" elname="field_unit_span"></span>
<p class="errorMessage" elname="error" id="error-Number"></p>
</div>
<div class="clearBoth"></div>
</li>
<li elname="livefield-elem" comptype="1" id="SingleLine-li" needdata="true" compname="SingleLine" linkname="SingleLine" isvisible="true" class="tempFrmWrapper small" mandatory="true" page_no="1" page_link_name="Page" showlabel="true">
<label class="labelName">
<span>Legal Company Name</span>
<em class="important">*</em>
</label>
<div class="tempContDiv">
<span><input onkeyup="ZFLive.configureInputMask(this);" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="off" type="text" maxlength="255" name="SingleLine" value="" placeholder=""></span>
<p class="errorMessage" elname="error" id="error-SingleLine"></p>
<p class="instruction instrSpace" elname="hint" id="hint-SingleLine"> Enter the legal name of the entity that owns the business </p>
</div>
<div class="clearBoth"></div>
</li>
<li elname="livefield-elem" comptype="1" id="SingleLine6-li" needdata="true" compname="SingleLine6" linkname="SingleLine6" isvisible="true" class="tempFrmWrapper small" mandatory="true" page_no="1" page_link_name="Page" showlabel="true">
<label class="labelName">
<span>DBA (Doing Business As)</span>
<em class="important">*</em>
</label>
<div class="tempContDiv">
<span><input onkeyup="ZFLive.configureInputMask(this);" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="off" type="text" maxlength="255" name="SingleLine6" value="" placeholder=""></span>
<p class="errorMessage" elname="error" id="error-SingleLine6"></p>
<p class="instruction instrSpace" elname="hint" id="hint-SingleLine6"> Enter your operating name </p>
</div>
<div class="clearBoth"></div>
</li>
<li class="tempFrmWrapper dropdown small" elname="livefield-elem" comptype="12" id="Dropdown3-li" needdata="true" compname="Dropdown3" linkname="Dropdown3" isvisible="true" mandatory="true" page_no="1" page_link_name="Page" showlabel="true">
<label class="labelName">
<span>Country of Registration</span>
<em class="important">*</em>
</label>
<div class="tempContDiv">
<div class="form_sBox">
<div class="customArrow"></div><select name="Dropdown3" onchange="ZFLive.prefillFieldLabel(this); ZFLive.hideClosestFieldElemErrorDiv(this); ZFLive.checkUniqueChoiceFld(this);
">
<option selected="true" value="-Select-">-Select-</option>
<option value="CA" formula_val="">CA</option>
<option value="US" formula_val="">US</option>
</select>
</div>
<div elname="liveFieldTempChoiceCont" style="display: none;"></div>
<p class="errorMessage" elname="error" id="error-Dropdown3"></p>
<p class="instruction instrSpace" elname="hint" id="hint-Dropdown3"> Select the country of registration of your Legal Company</p>
</div>
<div class="clearBoth"></div>
</li>
<li class="tempFrmWrapper dropdown small" elname="livefield-elem" comptype="12" id="Dropdown4-li" needdata="true" compname="Dropdown4" linkname="Dropdown4" isvisible="true" mandatory="true" page_no="1" page_link_name="Page" showlabel="true">
<label class="labelName">
<span>Entity Type</span>
<em class="important">*</em>
</label>
<div class="tempContDiv">
<div class="form_sBox">
<div class="customArrow"></div><select name="Dropdown4" onchange="ZFLive.prefillFieldLabel(this); ZFLive.hideClosestFieldElemErrorDiv(this); ZFLive.checkUniqueChoiceFld(this);
">
<option selected="true" value="-Select-">-Select-</option>
<option value="Publicly Traded Company" formula_val="">Publicly Traded Company</option>
<option value="Private Company" formula_val="">Private Company</option>
<option value="Non-Profit Organization" formula_val="">Non-Profit Organization</option>
<option value="Government" formula_val="">Government</option>
<option value="Sole Proprietor" formula_val="">Sole Proprietor</option>
</select>
</div>
<div elname="liveFieldTempChoiceCont" style="display: none;"></div>
<p class="errorMessage" elname="error" id="error-Dropdown4"></p>
<p class="instruction instrSpace" elname="hint" id="hint-Dropdown4"> Select the legal structure of your organization</p>
</div>
<div class="clearBoth"></div>
</li>
<li class="tempFrmWrapper dropdown small" elname="livefield-elem" comptype="12" id="Dropdown2-li" needdata="true" compname="Dropdown2" linkname="Dropdown2" isvisible="true" mandatory="true" page_no="1" page_link_name="Page" showlabel="true">
<label class="labelName">
<span>Business Vertical</span>
<em class="important">*</em>
</label>
<div class="tempContDiv">
<div class="form_sBox">
<div class="customArrow"></div><select name="Dropdown2" onchange="ZFLive.prefillFieldLabel(this); ZFLive.hideClosestFieldElemErrorDiv(this); ZFLive.checkUniqueChoiceFld(this);
">
<option selected="true" value="-Select-">-Select-</option>
<option value="Agriculture" formula_val="">Agriculture</option>
<option value="Communication" formula_val="">Communication</option>
<option value="Construction/Material" formula_val="">Construction/Material</option>
<option value="Education" formula_val="">Education</option>
<option value="Energy" formula_val="">Energy</option>
<option value="Entertainment" formula_val="">Entertainment</option>
<option value="Finance" formula_val="">Finance</option>
<option value="Gambling" formula_val="">Gambling</option>
<option value="Government" formula_val="">Government</option>
<option value="Healthcare" formula_val="">Healthcare</option>
<option value="Hospitality" formula_val="">Hospitality</option>
<option value="HR" formula_val="">HR</option>
<option value="Insurance" formula_val="">Insurance</option>
<option value="Legal" formula_val="">Legal</option>
<option value="Manufacturing" formula_val="">Manufacturing</option>
<option value="Non-Profit" formula_val="">Non-Profit</option>
<option value="Political" formula_val="">Political</option>
<option value="Delivery" formula_val="">Delivery</option>
<option value="Professional Service" formula_val="">Professional Service</option>
<option value="Retail" formula_val="">Retail</option>
<option value="Technology" formula_val="">Technology</option>
<option value="Transportation" formula_val="">Transportation</option>
</select>
</div>
<div elname="liveFieldTempChoiceCont" style="display: none;"></div>
<p class="errorMessage" elname="error" id="error-Dropdown2"></p>
</div>
<div class="clearBoth"></div>
</li>
<li elname="livefield-elem" comptype="1" id="SingleLine7-li" needdata="true" compname="SingleLine7" linkname="SingleLine7" isvisible="true" class="tempFrmWrapper small" mandatory="true" page_no="1" page_link_name="Page" showlabel="true">
<label class="labelName">
<span>EIN Number / Corporation Number</span>
<em class="important">*</em>
</label>
<div class="tempContDiv">
<span><input onkeyup="ZFLive.configureInputMask(this);" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="off" type="text" maxlength="255" name="SingleLine7" value="" placeholder=""></span>
<p class="errorMessage" elname="error" id="error-SingleLine7"></p>
<p class="instruction instrSpace" elname="hint" id="hint-SingleLine7"> For US Entities enter your EIN number. For Canadian organizations enter your Federal or Provincial corporation number only, not your business number/GST number. </p>
</div>
<div class="clearBoth"></div>
</li>
<li class="tempFrmWrapper dropdown small" elname="livefield-elem" comptype="12" id="Dropdown5-li" needdata="true" compname="Dropdown5" linkname="Dropdown5" isvisible="true" mandatory="true" page_no="1" page_link_name="Page" showlabel="true">
<label class="labelName">
<span>EIN Number / Corporation Country</span>
<em class="important">*</em>
</label>
<div class="tempContDiv">
<div class="form_sBox">
<div class="customArrow"></div><select name="Dropdown5" onchange="ZFLive.prefillFieldLabel(this); ZFLive.hideClosestFieldElemErrorDiv(this); ZFLive.checkUniqueChoiceFld(this);
">
<option selected="true" value="-Select-">-Select-</option>
<option value="CA" formula_val="">CA</option>
<option value="US" formula_val="">US</option>
</select>
</div>
<div elname="liveFieldTempChoiceCont" style="display: none;"></div>
<p class="errorMessage" elname="error" id="error-Dropdown5"></p>
<p class="instruction instrSpace" elname="hint" id="hint-Dropdown5"> Select the country that has issued the EIN Number or Corporation Number</p>
</div>
<div class="clearBoth"></div>
</li>
<li class="tempFrmWrapper dropdown small" elname="livefield-elem" comptype="12" id="Dropdown7-li" needdata="true" compname="Dropdown7" linkname="Dropdown7" isvisible="true" mandatory="false" page_no="1" page_link_name="Page" showlabel="true">
<label class="labelName">
<span>DUNS/GIIN/LEI</span>
</label>
<div class="tempContDiv">
<div class="form_sBox">
<div class="customArrow"></div><select name="Dropdown7" onchange="ZFLive.prefillFieldLabel(this); ZFLive.hideClosestFieldElemErrorDiv(this); ZFLive.checkUniqueChoiceFld(this);
">
<option selected="true" value="-Select-">-Select-</option>
<option value="DUNS" formula_val="">DUNS</option>
<option value="GIIN" formula_val="">GIIN</option>
<option value="LEI" formula_val="">LEI</option>
</select>
</div>
<div elname="liveFieldTempChoiceCont" style="display: none;"></div>
<p class="errorMessage" elname="error" id="error-Dropdown7"></p>
<p class="instruction instrSpace" elname="hint" id="hint-Dropdown7"> Optional - DUNS number is helpful in identifying non-US Brands</p>
</div>
<div class="clearBoth"></div>
</li>
<li elname="livefield-elem" comptype="1" id="SingleLine9-li" needdata="true" compname="SingleLine9" linkname="SingleLine9" isvisible="true" class="tempFrmWrapper small" mandatory="false" page_no="1" page_link_name="Page" showlabel="true">
<label class="labelName">
<span>DUNS/GIIN/LEI Number</span>
</label>
<div class="tempContDiv">
<span><input onkeyup="ZFLive.configureInputMask(this);" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="off" type="text" maxlength="255" name="SingleLine9" value="" placeholder=""></span>
<p class="errorMessage" elname="error" id="error-SingleLine9"></p>
<p class="instruction instrSpace" elname="hint" id="hint-SingleLine9"> Optional - DUNS number is helpful in identifying non-US Brands </p>
</div>
<div class="clearBoth"></div>
</li>
<li elname="livefield-elem" comptype="1" id="SingleLine2-li" needdata="true" compname="SingleLine2" linkname="SingleLine2" isvisible="true" class="tempFrmWrapper small" mandatory="true" page_no="1" page_link_name="Page" showlabel="true">
<label class="labelName">
<span>Address</span>
<em class="important">*</em>
</label>
<div class="tempContDiv">
<span><input onkeyup="ZFLive.configureInputMask(this);" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="off" type="text" maxlength="255" name="SingleLine2" value="" placeholder=""></span>
<p class="errorMessage" elname="error" id="error-SingleLine2"></p>
<p class="instruction instrSpace" elname="hint" id="hint-SingleLine2"> Enter your legal address of your registered organization, not your mailing address </p>
</div>
<div class="clearBoth"></div>
</li>
<li elname="livefield-elem" comptype="1" id="SingleLine4-li" needdata="true" compname="SingleLine4" linkname="SingleLine4" isvisible="true" class="tempFrmWrapper small" mandatory="true" page_no="1" page_link_name="Page" showlabel="true">
<label class="labelName">
<span>City</span>
<em class="important">*</em>
</label>
<div class="tempContDiv">
<span><input onkeyup="ZFLive.configureInputMask(this);" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="off" type="text" maxlength="255" name="SingleLine4" value="" placeholder=""></span>
<p class="errorMessage" elname="error" id="error-SingleLine4"></p>
</div>
<div class="clearBoth"></div>
</li>
<li class="tempFrmWrapper dropdown small" elname="livefield-elem" comptype="12" id="Dropdown-li" needdata="true" compname="Dropdown" linkname="Dropdown" isvisible="true" mandatory="true" page_no="1" page_link_name="Page" showlabel="true">
<label class="labelName">
<span>State/Province</span>
<em class="important">*</em>
</label>
<div class="tempContDiv">
<div class="form_sBox">
<div class="customArrow"></div><select name="Dropdown" onchange="ZFLive.prefillFieldLabel(this); ZFLive.hideClosestFieldElemErrorDiv(this); ZFLive.checkUniqueChoiceFld(this);
">
<option selected="true" value="-Select-">-Select-</option>
<option value="AL" formula_val="">AL</option>
<option value="AK" formula_val="">AK</option>
<option value="AZ" formula_val="">AZ</option>
<option value="AR" formula_val="">AR</option>
<option value="CA" formula_val="">CA</option>
<option value="CO" formula_val="">CO</option>
<option value="CT" formula_val="">CT</option>
<option value="DE" formula_val="">DE</option>
<option value="FL" formula_val="">FL</option>
<option value="GA" formula_val="">GA</option>
<option value="HI" formula_val="">HI</option>
<option value="ID" formula_val="">ID</option>
<option value="IL" formula_val="">IL</option>
<option value="IN" formula_val="">IN</option>
<option value="IA" formula_val="">IA</option>
<option value="KS" formula_val="">KS</option>
<option value="KY" formula_val="">KY</option>
<option value="LA" formula_val="">LA</option>
<option value="MA" formula_val="">MA</option>
<option value="MD" formula_val="">MD</option>
<option value="ME" formula_val="">ME</option>
<option value="MI" formula_val="">MI</option>
<option value="MN" formula_val="">MN</option>
<option value="MS" formula_val="">MS</option>
<option value="MO" formula_val="">MO</option>
<option value="MT" formula_val="">MT</option>
<option value="NE" formula_val="">NE</option>
<option value="NV" formula_val="">NV</option>
<option value="NH" formula_val="">NH</option>
<option value="NJ" formula_val="">NJ</option>
<option value="NM" formula_val="">NM</option>
<option value="NY" formula_val="">NY</option>
<option value="NC" formula_val="">NC</option>
<option value="ND" formula_val="">ND</option>
<option value="OH" formula_val="">OH</option>
<option value="OK" formula_val="">OK</option>
<option value="OR" formula_val="">OR</option>
<option value="PA" formula_val="">PA</option>
<option value="RI" formula_val="">RI</option>
<option value="SC" formula_val="">SC</option>
<option value="SD" formula_val="">SD</option>
<option value="TN" formula_val="">TN</option>
<option value="TX" formula_val="">TX</option>
<option value="UT" formula_val="">UT</option>
<option value="VT" formula_val="">VT</option>
<option value="VA" formula_val="">VA</option>
<option value="WA" formula_val="">WA</option>
<option value="WI" formula_val="">WI</option>
<option value="WV" formula_val="">WV</option>
<option value="WY" formula_val="">WY</option>
<option value="BC" formula_val="">BC</option>
<option value="AB" formula_val="">AB</option>
<option value="MB" formula_val="">MB</option>
<option value="SK" formula_val="">SK</option>
<option value="ON" formula_val="">ON</option>
<option value="QC" formula_val="">QC</option>
<option value="NL" formula_val="">NL</option>
<option value="NB" formula_val="">NB</option>
<option value="NS" formula_val="">NS</option>
<option value="PE" formula_val="">PE</option>
<option value="NV" formula_val="">NV</option>
<option value="NU" formula_val="">NU</option>
<option value="YT" formula_val="">YT</option>
</select>
</div>
<div elname="liveFieldTempChoiceCont" style="display: none;"></div>
<p class="errorMessage" elname="error" id="error-Dropdown"></p>
</div>
<div class="clearBoth"></div>
</li>
<li elname="livefield-elem" comptype="1" id="SingleLine3-li" needdata="true" compname="SingleLine3" linkname="SingleLine3" isvisible="true" class="tempFrmWrapper small" mandatory="true" page_no="1" page_link_name="Page" showlabel="true">
<label class="labelName">
<span>Zip/Postal Code</span>
<em class="important">*</em>
</label>
<div class="tempContDiv">
<span><input onkeyup="ZFLive.configureInputMask(this);" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="off" type="text" maxlength="255" name="SingleLine3" value="" placeholder=""></span>
<p class="errorMessage" elname="error" id="error-SingleLine3"></p>
</div>
<div class="clearBoth"></div>
</li>
<li class="tempFrmWrapper dropdown small" elname="livefield-elem" comptype="12" id="Dropdown1-li" needdata="true" compname="Dropdown1" linkname="Dropdown1" isvisible="true" mandatory="true" page_no="1" page_link_name="Page" showlabel="true">
<label class="labelName">
<span>Country</span>
<em class="important">*</em>
</label>
<div class="tempContDiv">
<div class="form_sBox">
<div class="customArrow"></div><select name="Dropdown1" onchange="ZFLive.prefillFieldLabel(this); ZFLive.hideClosestFieldElemErrorDiv(this); ZFLive.checkUniqueChoiceFld(this);
">
<option selected="true" value="-Select-">-Select-</option>
<option value="CA" formula_val="">CA</option>
<option value="US" formula_val="">US</option>
</select>
</div>
<div elname="liveFieldTempChoiceCont" style="display: none;"></div>
<p class="errorMessage" elname="error" id="error-Dropdown1"></p>
</div>
<div class="clearBoth"></div>
</li>
<li class="tempFrmWrapper dropdown small" elname="livefield-elem" comptype="12" id="Dropdown6-li" needdata="true" compname="Dropdown6" linkname="Dropdown6" isvisible="true" mandatory="false" page_no="1" page_link_name="Page" showlabel="true">
<label class="labelName">
<span>Stock Exchange</span>
</label>
<div class="tempContDiv">
<div class="form_sBox">
<div class="customArrow"></div><select name="Dropdown6" onchange="ZFLive.prefillFieldLabel(this); ZFLive.hideClosestFieldElemErrorDiv(this); ZFLive.checkUniqueChoiceFld(this);
">
<option selected="true" value="-Select-">-Select-</option>
<option value="NASDAQ" formula_val="">NASDAQ</option>
<option value="NYSE" formula_val="">NYSE</option>
<option value="AMEX" formula_val="">AMEX</option>
<option value="AMX" formula_val="">AMX</option>
<option value="ASX" formula_val="">ASX</option>
<option value="B3" formula_val="">B3</option>
<option value="BME" formula_val="">BME</option>
<option value="BSE" formula_val="">BSE</option>
<option value="FRA" formula_val="">FRA</option>
<option value="ICEX" formula_val="">ICEX</option>
<option value="JPX" formula_val="">JPX</option>
<option value="JSE" formula_val="">JSE</option>
<option value="KRX" formula_val="">KRX</option>
<option value="LON" formula_val="">LON</option>
<option value="NSE" formula_val="">NSE</option>
<option value="OMX" formula_val="">OMX</option>
<option value="SEHK" formula_val="">SEHK</option>
<option value="SGX" formula_val="">SGX</option>
<option value="SSE" formula_val="">SSE</option>
<option value="STO" formula_val="">STO</option>
<option value="SWX" formula_val="">SWX</option>
<option value="SZSE" formula_val="">SZSE</option>
<option value="TSX" formula_val="">TSX</option>
<option value="TWSE" formula_val="">TWSE</option>
<option value="VSE" formula_val="">VSE</option>
<option value="Other" formula_val="">Other</option>
</select>
</div>
<div elname="liveFieldTempChoiceCont" style="display: none;"></div>
<p class="errorMessage" elname="error" id="error-Dropdown6"></p>
<p class="instruction instrSpace" elname="hint" id="hint-Dropdown6"> Required when entity type is "Publically Traded Company"</p>
</div>
<div class="clearBoth"></div>
</li>
<li elname="livefield-elem" comptype="1" id="SingleLine8-li" needdata="true" compname="SingleLine8" linkname="SingleLine8" isvisible="true" class="tempFrmWrapper small" mandatory="false" page_no="1" page_link_name="Page" showlabel="true">
<label class="labelName">
<span>Stock Symbol</span>
</label>
<div class="tempContDiv">
<span><input onkeyup="ZFLive.configureInputMask(this);" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="off" type="text" maxlength="255" name="SingleLine8" value="" placeholder=""></span>
<p class="errorMessage" elname="error" id="error-SingleLine8"></p>
<p class="instruction instrSpace" elname="hint" id="hint-SingleLine8"> Required when entity type is "Publicly Traded Company" </p>
</div>
<div class="clearBoth"></div>
</li>
<li class="tempFrmWrapper name namemedium" elname="livefield-elem" comptype="7" needdata="true" id="Name-li" compname="Name" linkname="Name" isvisible="true" mandatory="false" page_no="1" page_link_name="Page" regex_type="0" showlabel="true">
<label class="labelName">
<span>Name</span>
</label>
<div class="tempContDiv twoType">
<div class="nameWrapper">
<span> <input onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="auto-off" type="text" maxlength="255" elname="First" name="Name" complink="Name_First" value="" mandatory="false" placeholder="">
<label class="formSubInfoText">First</label>
</span>
<span> <input onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="auto-off" type="text" maxlength="255" elname="Last" name="Name" complink="Name_Last" value="" mandatory="false" placeholder="">
<label class="formSubInfoText">Last</label>
</span>
<div class="clearBoth"></div>
</div>
<p class="errorMessage" elname="error" id="error-Name"></p>
<p class="instruction instrLeftSpace" elname="hint" id="hint-Name"> Required if Entity type is Sole Proprietor</p>
</div>
<div class="clearBoth"></div>
</li>
<li class="tempFrmWrapper email small" elname="livefield-elem" comptype="9" id="Email-li" needdata="true" compname="Email" linkname="Email" isvisible="true" mandatory="true" page_no="1" page_link_name="Page" showlabel="true" domain_option="0"
need_reconf="false">
<label class="labelName">
<span>Email</span>
<em class="important">*</em>
</label>
<div class="tempContDiv">
<span elname="livefield-email-elem"><input onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="off" type="text" maxlength="255" name="Email" value="" placeholder="">
<p class="errorMessage" elname="error" id="error-Email"></p>
</span>
<p class="instruction instrSpace" elname="hint" id="hint-Email"> Support Email Address for the organization</p>
</div>
<div class="clearBoth"></div>
</li>
<li class="tempFrmWrapper phone small" elname="livefield-elem" comptype="11" id="PhoneNumber-li" needdata="true" compname="PhoneNumber" linkname="PhoneNumber" isvisible="true" mandatory="true" page_no="1" page_link_name="Page"
showlabel="true" need_reconf="false">
<label class="labelName">
<span>Phone</span>
<em class="important">*</em>
</label>
<div class="tempContDiv" elname="phoneFormatElem" phoneformat="INTERNATIONAL">
<div elname="phoneFld" name="phone-elements">
<div class="intl-tel-input allow-dropdown separate-dial-code phCodeWrapper">
<div class="flag-container">
<div class="selected-flag" tabindex="0" title="Unknown">
<div class="iti-flag undefined"></div>
<div class="selected-dial-code"></div>
<div class="iti-arrow"></div>
</div>
</div><input name="PhoneNumber" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="off" id="PhoneNumber" type="text" elname="countrycode" maxlength="20" value="" iscodeenabled="true" phoneformattype="2" placeholder=""
initcountry="auto" countrylist="ca,us" style="padding-left: 52px;">
</div>
</div>
<p class="errorMessage" elname="error" id="error-PhoneNumber"></p>
<script type="module">
if (true == true && (true)) {
var allowedCountryList = [137, 331];
var ipBasedCurrentCountry = null;
ipBasedCurrentCountry = "DE"; // check null value
ipBasedCurrentCountry = ipBasedCurrentCountry.toLowerCase();
var defaultCountry = ""; // No I18N
var keyId = $("#PhoneNumber");
var keyIdConf = ("#" + "PhoneNumber" + "-reconf"); // No I18N
var listofcountries = [],
hasCode = false;
var initialCountry = "auto"; // No I18N
var countryCodeProps = jQuery.extend(true, {}, ZFPhone.countryCodeProps);
var isRtlEnabled = false;
var txtDir = "1"; // No I18N
if (txtDir != null && txtDir != undefined) {
if (txtDir == 2) {
isRtlEnabled = true;
}
}
countryCodeProps.isRtl = isRtlEnabled;
if (defaultCountry != "") {
defaultCountry = countryUniqueCode[""]; // No I18N
}
if (allowedCountryList.length > 0) {
var phoneVal = ""; // No I18N
var codeVal = ""; // No I18N
for (var itr = 0; itr < allowedCountryList.length; itr++) {
if (codeVal != "" && codelist[allowedCountryList[itr]] == codeVal && !hasCode) {
phoneVal = codeVal + phoneVal;
hasCode = true;
}
listofcountries[itr] = countryUniqueCode[allowedCountryList[itr]];
}
countryCodeProps.onlyCountries = listofcountries;
if ("live" == 'live') {
if (jQuery.inArray(defaultCountry, listofcountries) !== -1) {
initialCountry = defaultCountry;
} else if (ipBasedCurrentCountry !== null && ipBasedCurrentCountry != "null" && ipBasedCurrentCountry != "-" && jQuery.inArray(ipBasedCurrentCountry, listofcountries) != -1) { // No I18N
initialCountry = ipBasedCurrentCountry;
}
} else {
$("#PhoneNumber").val(phoneVal);
if ("false" == "true") {
$(keyIdConf).val(phoneVal); // No I18N
}
}
} else if ("live" == 'live') { // No I18N
if (defaultCountry != "") {
initialCountry = defaultCountry;
} else if (ipBasedCurrentCountry !== null && ipBasedCurrentCountry != "null" && ipBasedCurrentCountry != "-") { // No I18N
initialCountry = ipBasedCurrentCountry;
}
}
if ($(keyId).parents("ul").attr("elname") != "subFormFieldsCloneUl") {
countryCodeProps.initialCountry = initialCountry;
$(keyId).intlTelInput(countryCodeProps);
$(keyIdConf).intlTelInput(countryCodeProps); // No I18N
if ("live" == 'live') {
$(keyId).intlTelInput("setNumber", ""); // No I18N
}
}
$(keyId).attr({
"initCountry": initialCountry,
"countryList": listofcountries
}); // No I18N
//$("#PhoneNumber") is used instead of variable keyId, since event get attached only to the last dom element instead of all elements.
setCountryCodePropsForFlds(("#" + "PhoneNumber"), isRtlEnabled); // No I18N
if ("false" == "true") {
setCountryCodePropsForFlds(("#" + "PhoneNumber" + "-reconf"), isRtlEnabled); // No I18N
}
}
</script>
<p class="instruction instrSpace" elname="hint" id="hint-PhoneNumber"> Support phone number for the organization</p>
</div>
<div class="clearBoth"></div>
</li>
<li class="tempFrmWrapper small" elname="livefield-elem" comptype="10" id="Website-li" needdata="true" compname="Website" linkname="Website" isvisible="true" mandatory="false" page_no="1" page_link_name="Page" showlabel="true">
<label class="labelName">
<span>Website</span>
</label>
<div class="tempContDiv">
<span> <input autocomplete="off" onfocusout="ZFLive.validateFieldConstraint(this);" type="text" maxlength="2083" name="Website" value="" placeholder=""></span>
<p class="errorMessage" elname="error" id="error-Website"></p>
<p class="instruction instrSpace" elname="hint" id="hint-Website"> Optional</p>
</div>
<div class="clearBoth"></div>
</li>
</ul>
</div>
<ul elname="footer" class="footerWrapper formRelative" page_no="1" page_count="1" page_link_name="Page">
<li style="overflow:visible; position: relative;" class="btnAllign fmFooter" id="formAccess" elname="0">
<div class="pageFotDef">
<div class="alignSubmit">
<div class="formRelative inlineBlock reviewBtnCont"><button class="fmSmtButton reviewBtn" elname="review" value="review">
<em>Review</em>
</button></div>
<div class="formRelative inlineBlock submitBtnCont"><button class="fmSmtButton submitColor submitWrapper fmSmtButtom" elname="submit" value="submit">
<em>Submit</em>
</button></div>
</div>
</div>
<div class="clearBoth"></div>
</li>
</ul>
<!-- Uncomment the following Code to enable automation location based value filling for GeoLocation Fields -->
<!-- Set the mapquestURL from zohoforms.properties -->
<!-- -->
<!--Div to show error for unconfirmed users -->
<div id="errorDiv" style="display:none" class="errorMsgWrapper">
<div class="flLeft errorIcon"></div>
<div class="errorMsgCont">
<h2>Error Occurred!</h2>
<span id="errorMsgSpan">You haven't verified your email yet, click<a href="javascript:;" onclick="ZFUtil.resendMail('0');"> here </a> to receive a verification email.</span>
</div>
<div class="clearBoth"></div>
</div>
</div><!-- 'formRedirectURL' ends -->
<div id="popupdiv" class="dim-div2" style="display:none;">
<div id="imageChoiceDiv-cont" class="popUpOuter imageTypeZoom">
<div class="popUpInnerWrapper">
<div class="popupHeader removeBdr"><a class="flRight ppDeleteIcon" onclick="ZFLive.hideZoomedImage();" href="javascript:;"></a>
<div class="clearBoth"></div>
</div>
<div class="popupMainCont"><img src=""></div>
</div>
</div>
</div>
</form>Text Content
* 10DLC BRAND REGISTRATION FORM * Current Swift Company Name * Enter the company name of your Swift SMS Gateway account. This can be found in the dashboard or on your invoice. * Account ID * Legal Company Name * Enter the legal name of the entity that owns the business * DBA (Doing Business As) * Enter your operating name * Country of Registration * -Select- CA US Select the country of registration of your Legal Company * Entity Type * -Select- Publicly Traded Company Private Company Non-Profit Organization Government Sole Proprietor Select the legal structure of your organization * Business Vertical * -Select- Agriculture Communication Construction/Material Education Energy Entertainment Finance Gambling Government Healthcare Hospitality HR Insurance Legal Manufacturing Non-Profit Political Delivery Professional Service Retail Technology Transportation * EIN Number / Corporation Number * For US Entities enter your EIN number. For Canadian organizations enter your Federal or Provincial corporation number only, not your business number/GST number. * EIN Number / Corporation Country * -Select- CA US Select the country that has issued the EIN Number or Corporation Number * DUNS/GIIN/LEI -Select- DUNS GIIN LEI Optional - DUNS number is helpful in identifying non-US Brands * DUNS/GIIN/LEI Number Optional - DUNS number is helpful in identifying non-US Brands * Address * Enter your legal address of your registered organization, not your mailing address * City * * State/Province * -Select- AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA MA MD ME MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WI WV WY BC AB MB SK ON QC NL NB NS PE NV NU YT * Zip/Postal Code * * Country * -Select- CA US * Stock Exchange -Select- NASDAQ NYSE AMEX AMX ASX B3 BME BSE FRA ICEX JPX JSE KRX LON NSE OMX SEHK SGX SSE STO SWX SZSE TSX TWSE VSE Other Required when entity type is "Publically Traded Company" * Stock Symbol Required when entity type is "Publicly Traded Company" * Name First Last Required if Entity type is Sole Proprietor * Email * Support Email Address for the organization * Phone * Support phone number for the organization * Website Optional * Review Submit ERROR OCCURRED! You haven't verified your email yet, click here to receive a verification email. OK OK Retry Cancel That CAPTCHA was incorrect. Your form has been deactivated. Contact support@zohoforms.com for further information. Submitting... Please Wait... Saving... Redirecting to Merchant Website.. Verifying Credit Card Details... Please wait... Verification Code Enter the text in the box below Continue Verification mail sent. LINK TO RESUME THIS FORM LATER: Email Link to Send Please enter a valid email address to configure Zoho Sign settings. Copy Link Copied to clipboard. * * * Done FORM SUMMARY TURN ON THE CAMERA PERMISSION IN YOUR BROWSER TO CONTINUE FURTHER