function Form_Validator(d,c){var a=document.getElementById(c+"AEHome"),b="Living Expenses While dependents are at home";if(isEmpty(a,b)||isBiggerThan(a,b,10)||!isValidCurrency(a,b))return!1;a=document.getElementById(c+"NYHome");b="Years While dependents are at home";if(isEmpty(a,b)||isBiggerThan(a,b,2)||!isValidNumber(a,b))return!1;a=document.getElementById(c+"AEAfter");b="Living Expenses After dependents leave";if(isEmpty(a,b)||isBiggerThan(a,b,10)||!isValidCurrency(a,b))return!1;a=document.getElementById(c+
"NYAfter");b="Years After dependents leave";if(isEmpty(a,b)||isBiggerThan(a,b,2)||!isValidNumber(a,b))return!1;for(i=1;4>=i;i++){a=document.getElementById(c+"AEChild"+i);b="Educational Expenses for Child "+i;if(isEmpty(a,b)||isBiggerThan(a,b,10)||!isValidCurrency(a,b))return!1;a=document.getElementById(c+"NYChild"+i);b="Years for Child "+i;if(isEmpty(a,b)||isBiggerThan(a,b,2)||!isValidNumber(a,b))return!1}a=document.getElementById(c+"HomeLoan");b="Home Loan";if(isEmpty(a,b)||isBiggerThan(a,b,10)||
!isValidCurrency(a,b))return!1;a=document.getElementById(c+"CarLoan");b="Car Loan";if(isEmpty(a,b)||isBiggerThan(a,b,10)||!isValidCurrency(a,b))return!1;a=document.getElementById(c+"HomeEquity");b="Home Equity";if(isEmpty(a,b)||isBiggerThan(a,b,10)||!isValidCurrency(a,b))return!1;a=document.getElementById(c+"CreditCards");b="Credit Card";if(isEmpty(a,b)||isBiggerThan(a,b,10)||!isValidCurrency(a,b))return!1;a=document.getElementById(c+"OtherDebt");b="Other outstanding debt";if(isEmpty(a,b)||isBiggerThan(a,
b,10)||!isValidCurrency(a,b))return!1;a=document.getElementById(c+"Funeral");b="Funeral Expenses";if(isEmpty(a,b)||isBiggerThan(a,b,10)||!isValidCurrency(a,b))return!1;a=document.getElementById(c+"Medical");b="Medical Expenses";if(isEmpty(a,b)||isBiggerThan(a,b,10)||!isValidCurrency(a,b))return!1;a=document.getElementById(c+"Probate");b="Probate";if(isEmpty(a,b)||isBiggerThan(a,b,10)||!isValidCurrency(a,b))return!1;a=document.getElementById(c+"ATWages");b="Annual after tax wages";if(isEmpty(a,b)||
isBiggerThan(a,b,10)||!isValidCurrency(a,b))return!1;a=document.getElementById(c+"NYWages");b="Annual wages years";if(isEmpty(a,b)||isBiggerThan(a,b,10)||!isValidCurrency(a,b))return!1;a=document.getElementById(c+"NYWages");b="Annual wages years";if(isEmpty(a,b)||isBiggerThan(a,b,10)||!isValidCurrency(a,b))return!1;a=document.getElementById(c+"SSBenefits");b="Social Security Benefits";if(isEmpty(a,b)||isBiggerThan(a,b,10)||!isValidCurrency(a,b))return!1;a=document.getElementById(c+"NYSSBenefits");
b="Social Security Years";if(isEmpty(a,b)||isBiggerThan(a,b,2)||!isValidNumber(a,b))return!1;a=document.getElementById(c+"OtherIncome");b="Other Income";if(isEmpty(a,b)||isBiggerThan(a,b,10)||!isValidCurrency(a,b))return!1;a=document.getElementById(c+"NYOtherIncome");b="Other Income Years";if(isEmpty(a,b)||isBiggerThan(a,b,2)||!isValidNumber(a,b))return!1;a=document.getElementById(c+"CurrentCoverage");b="Current Coverage";return isEmpty(a,b)||isBiggerThan(a,b,10)||!isValidCurrency(a,b)?!1:!0}
function isEmpty(d,c){if(""==d.value&&""==d.defaultValue)return!1}function isBiggerThan(d,c,a){if(d.value.length>a)return alert('Please enter at most 10 characters in the "'+c+'" field.'),theForm.CurrentCoverage.focus(),!0}function isValidCurrency(d,c){var a=/(?=.)^\$?(([1-9][0-9]{0,2}(,[0-9]{3})*)|0)?(\.[0-9]{1,2})?$/,b=/^\d*$/;return""==d.value||""==d.defaultValue||a.test(d.value)||b.test(d.value)?!0:(alert('Please enter only digit characters in the "'+c+'" field.'),d.focus(),!1)}
function isValidNumber(d,c){var a=/^\d*$/;return""==d.value||""==d.defaultValue||a.test(d.value)?!0:(alert('Please enter only digit characters in the "'+c+'" field.'),d.focus(),!1)}jQuery(document).ready(function(){$(function(){$("[placeholder]").blur().parents("form").submit(function(){$(this).find("[placeholder]").each(function(){var d=$(this);d.val()==d.attr("placeholder")&&d.val("")})})})});