function init(){	
	document.getElementById('name').value='';
	document.getElementById('address').value='';
	document.getElementById('city').value='';
	document.getElementById('hphone').value='';
	document.getElementById('email').value='';
	document.getElementById('bodInjLimit').selectedIndex=0;
	document.getElementById('carrier').selectedIndex=0;
	document.getElementById('current').value='';
	document.getElementById('vehicle_1').style.display='block';
		document.getElementById('vehicle_year_1').selectedIndex=0;
	document.getElementById('vehicle_make_1').selectedIndex=0;
	document.getElementById('vehicle_model_1').value='';
	document.getElementById('vehicle_coll_1').selectedIndex=0;
	document.getElementById('vehicle_comp_1').selectedIndex=0;
	document.getElementById('ticket_info_1').style.display='none';
			document.getElementById('a1').selectedIndex=0;
		document.getElementById('ticket_1').selectedIndex=0;
		document.getElementById('d1').selectedIndex=0;
				document.getElementById('vehicle_year_2').selectedIndex=0;
	document.getElementById('vehicle_make_2').selectedIndex=0;
	document.getElementById('vehicle_model_2').value='';
	document.getElementById('vehicle_coll_2').selectedIndex=0;
	document.getElementById('vehicle_comp_2').selectedIndex=0;
	document.getElementById('ticket_info_2').style.display='none';
			document.getElementById('a2').selectedIndex=0;
		document.getElementById('ticket_2').selectedIndex=0;
		document.getElementById('d2').selectedIndex=0;
				document.getElementById('driver_2').style.display='none';
		document.getElementById('vehicle_2').style.display='none';
			document.getElementById('vehicle_year_3').selectedIndex=0;
	document.getElementById('vehicle_make_3').selectedIndex=0;
	document.getElementById('vehicle_model_3').value='';
	document.getElementById('vehicle_coll_3').selectedIndex=0;
	document.getElementById('vehicle_comp_3').selectedIndex=0;
	document.getElementById('ticket_info_3').style.display='none';
			document.getElementById('a3').selectedIndex=0;
		document.getElementById('ticket_3').selectedIndex=0;
		document.getElementById('d3').selectedIndex=0;
				document.getElementById('driver_3').style.display='none';
		document.getElementById('vehicle_3').style.display='none';
			document.getElementById('vehicle_year_4').selectedIndex=0;
	document.getElementById('vehicle_make_4').selectedIndex=0;
	document.getElementById('vehicle_model_4').value='';
	document.getElementById('vehicle_coll_4').selectedIndex=0;
	document.getElementById('vehicle_comp_4').selectedIndex=0;
	document.getElementById('ticket_info_4').style.display='none';
			document.getElementById('a4').selectedIndex=0;
		document.getElementById('ticket_4').selectedIndex=0;
		document.getElementById('d4').selectedIndex=0;
				document.getElementById('driver_4').style.display='none';
		document.getElementById('vehicle_4').style.display='none';
			document.getElementById('vehicle_year_5').selectedIndex=0;
	document.getElementById('vehicle_make_5').selectedIndex=0;
	document.getElementById('vehicle_model_5').value='';
	document.getElementById('vehicle_coll_5').selectedIndex=0;
	document.getElementById('vehicle_comp_5').selectedIndex=0;
	document.getElementById('ticket_info_5').style.display='none';
			document.getElementById('a5').selectedIndex=0;
		document.getElementById('ticket_5').selectedIndex=0;
		document.getElementById('d5').selectedIndex=0;
				document.getElementById('driver_5').style.display='none';
		document.getElementById('vehicle_5').style.display='none';
			document.getElementById('vehicle_year_6').selectedIndex=0;
	document.getElementById('vehicle_make_6').selectedIndex=0;
	document.getElementById('vehicle_model_6').value='';
	document.getElementById('vehicle_coll_6').selectedIndex=0;
	document.getElementById('vehicle_comp_6').selectedIndex=0;
	document.getElementById('ticket_info_6').style.display='none';
			document.getElementById('a6').selectedIndex=0;
		document.getElementById('ticket_6').selectedIndex=0;
		document.getElementById('d6').selectedIndex=0;
				document.getElementById('driver_6').style.display='none';
		document.getElementById('vehicle_6').style.display='none';
			document.getElementById('vehicle_year_7').selectedIndex=0;
	document.getElementById('vehicle_make_7').selectedIndex=0;
	document.getElementById('vehicle_model_7').value='';
	document.getElementById('vehicle_coll_7').selectedIndex=0;
	document.getElementById('vehicle_comp_7').selectedIndex=0;
	document.getElementById('ticket_info_7').style.display='none';
			document.getElementById('a7').selectedIndex=0;
		document.getElementById('ticket_7').selectedIndex=0;
		document.getElementById('d7').selectedIndex=0;
				document.getElementById('driver_7').style.display='none';
		document.getElementById('vehicle_7').style.display='none';
			document.getElementById('vehicle_year_8').selectedIndex=0;
	document.getElementById('vehicle_make_8').selectedIndex=0;
	document.getElementById('vehicle_model_8').value='';
	document.getElementById('vehicle_coll_8').selectedIndex=0;
	document.getElementById('vehicle_comp_8').selectedIndex=0;
	document.getElementById('ticket_info_8').style.display='none';
			document.getElementById('a8').selectedIndex=0;
		document.getElementById('ticket_8').selectedIndex=0;
		document.getElementById('d8').selectedIndex=0;
				document.getElementById('driver_8').style.display='none';
		document.getElementById('vehicle_8').style.display='none';
			document.getElementById('vehicle_year_9').selectedIndex=0;
	document.getElementById('vehicle_make_9').selectedIndex=0;
	document.getElementById('vehicle_model_9').value='';
	document.getElementById('vehicle_coll_9').selectedIndex=0;
	document.getElementById('vehicle_comp_9').selectedIndex=0;
	document.getElementById('ticket_info_9').style.display='none';
			document.getElementById('a9').selectedIndex=0;
		document.getElementById('ticket_9').selectedIndex=0;
		document.getElementById('d9').selectedIndex=0;
				document.getElementById('driver_9').style.display='none';
		document.getElementById('vehicle_9').style.display='none';
			document.getElementById('vehicle_year_10').selectedIndex=0;
	document.getElementById('vehicle_make_10').selectedIndex=0;
	document.getElementById('vehicle_model_10').value='';
	document.getElementById('vehicle_coll_10').selectedIndex=0;
	document.getElementById('vehicle_comp_10').selectedIndex=0;
	document.getElementById('ticket_info_10').style.display='none';
				document.getElementById('driver_10').style.display='none';
		document.getElementById('vehicle_10').style.display='none';
			document.getElementById('comments').value='';	
	document.getElementById('buttons').style.display='block';			
	document.getElementById('response').innerHTML = '&nbsp;<div class="required">&bull;</div>Required Fields';
	document.getElementById('validation_image').src='img/server.php?'+Math.random();
}
function clearAll(){
	init();
	document.getElementById('name').value='';
	document.getElementById('address').value='';
	document.getElementById('city').value='';
	document.getElementById('hphone').value='';
	document.getElementById('wphone').value='';
	document.getElementById('email').value='';
}

function check_veh(layer, value){
	if(value==1){
		document.getElementById('vehicle_' + layer).style.display='block';
	}else{
		for(myLayer=layer;myLayer<=10;myLayer++){
			document.getElementById('vehicle_' + myLayer).style.display='none';
			document.getElementById('a' + (myLayer - 1)).selectedIndex=0;
			document.getElementById('vehicle_year_' + myLayer).selectedIndex=0;
			document.getElementById('vehicle_make_' + myLayer).selectedIndex=0;
			document.getElementById('vehicle_model_' + myLayer).value='';
			document.getElementById('vehicle_coll_' + myLayer).selectedIndex=0;
			document.getElementById('vehicle_comp_' + myLayer).selectedIndex=0;
		}
	}
}

function check_driver(layer, value){
	if(value==1){
		document.getElementById('driver_' + layer).style.display='block';
	}else{
		for(myLayer=layer;myLayer<=10;myLayer++){
			document.getElementById('driver_' + myLayer).style.display='none';
			document.getElementById('ticket_info_' + myLayer).style.display='none';
			document.getElementById('ticket_' + myLayer).selectedIndex=0;
			document.getElementById('driver_' + myLayer + '_ticket_info_claim_1').value='';
			document.getElementById('driver_' + myLayer + '_ticket_info_type_1').selectedIndex=0;
			document.getElementById('driver_' + myLayer + '_ticket_info_date_1').value='';
			document.getElementById('driver_' + myLayer + '_ticket_info_claim_2').value='';
			document.getElementById('driver_' + myLayer + '_ticket_info_type_2').selectedIndex=0;
			document.getElementById('driver_' + myLayer + '_ticket_info_date_2').value='';
			document.getElementById('driver_' + myLayer + '_ticket_info_claim_3').value='';
			document.getElementById('driver_' + myLayer + '_ticket_info_type_3').selectedIndex=0;
			document.getElementById('driver_' + myLayer + '_ticket_info_date_3').value='';
			if(myLayer!=10){
				document.getElementById('d' + myLayer).selectedIndex=0;
			}
		}
	}
}

function ticketDetails(layer, value){
	if(value==1){
		document.getElementById('ticket_info_' + layer).style.display='block';
	}else{
		document.getElementById('ticket_info_' + layer).style.display='none';
		document.getElementById('driver_' + layer + '_ticket_info_claim_1').value='';
		document.getElementById('driver_' + layer + '_ticket_info_type_1').selectedIndex=0;
		document.getElementById('driver_' + layer + '_ticket_info_date_1').value='';
		document.getElementById('driver_' + layer + '_ticket_info_claim_2').value='';
		document.getElementById('driver_' + layer + '_ticket_info_type_2').selectedIndex=0;
		document.getElementById('driver_' + layer + '_ticket_info_date_2').value='';
		document.getElementById('driver_' + layer + '_ticket_info_claim_3').value='';
		document.getElementById('driver_' + layer + '_ticket_info_type_3').selectedIndex=0;
		document.getElementById('driver_' + layer + '_ticket_info_date_3').value='';
	}
}
function getHTTPObject(){
if (window.ActiveXObject){ 
		return new ActiveXObject("Microsoft.XMLHTTP"); 
	}else if (window.XMLHttpRequest){ 
		return new XMLHttpRequest(); 
	}else{
		alert("Your browser does not support AJAX.");
		return null;
	}
}
function process(){
	scroll(0,0);
	document.getElementById('response').innerHTML = '<div style="float:left">&nbsp;Validating Form</div><img src="img/LoadingProgressBar.gif" style="float:right">';
	document.getElementById('buttons').style.display='none';
	var httpObject = null;
	httpObject = getHTTPObject();
	if (httpObject !== null) {
		var querystring='inc/process/auto.php?name=' + document.getElementById('name').value;
		querystring+='&address=' + document.getElementById('address').value;
		querystring+='&city=' + document.getElementById('city').value;
		querystring+='&hphone=' + document.getElementById('hphone').value;
		querystring+='&email=' + document.getElementById('email').value;
		querystring+='&bodInjLimit=' + document.getElementById('bodInjLimit').options[document.getElementById('bodInjLimit').selectedIndex].value;
		querystring+='&carrier=' + document.getElementById('carrier').options[document.getElementById('carrier').selectedIndex].value;
		querystring+='&current=' + document.getElementById('current').value;
		querystring+='&comments=' + document.getElementById('comments').value;
				querystring+='&vehicle_year_1=' + document.getElementById('vehicle_year_1').options[document.getElementById('vehicle_year_1').selectedIndex].value;
		querystring+='&vehicle_make_1=' + document.getElementById('vehicle_make_1').options[document.getElementById('vehicle_make_1').selectedIndex].value;
		querystring+='&vehicle_model_1=' + document.getElementById('vehicle_model_1').value;
		querystring+='&vehicle_coll_1=' + document.getElementById('vehicle_coll_1').options[document.getElementById('vehicle_coll_1').selectedIndex].value;
		querystring+='&vehicle_comp_1=' + document.getElementById('vehicle_comp_1').options[document.getElementById('vehicle_comp_1').selectedIndex].value;
				querystring+='&a1=' + document.getElementById('a1').options[document.getElementById('a1').selectedIndex].value;
				querystring+='&vehicle_year_2=' + document.getElementById('vehicle_year_2').options[document.getElementById('vehicle_year_2').selectedIndex].value;
		querystring+='&vehicle_make_2=' + document.getElementById('vehicle_make_2').options[document.getElementById('vehicle_make_2').selectedIndex].value;
		querystring+='&vehicle_model_2=' + document.getElementById('vehicle_model_2').value;
		querystring+='&vehicle_coll_2=' + document.getElementById('vehicle_coll_2').options[document.getElementById('vehicle_coll_2').selectedIndex].value;
		querystring+='&vehicle_comp_2=' + document.getElementById('vehicle_comp_2').options[document.getElementById('vehicle_comp_2').selectedIndex].value;
				querystring+='&a2=' + document.getElementById('a2').options[document.getElementById('a2').selectedIndex].value;
				querystring+='&vehicle_year_3=' + document.getElementById('vehicle_year_3').options[document.getElementById('vehicle_year_3').selectedIndex].value;
		querystring+='&vehicle_make_3=' + document.getElementById('vehicle_make_3').options[document.getElementById('vehicle_make_3').selectedIndex].value;
		querystring+='&vehicle_model_3=' + document.getElementById('vehicle_model_3').value;
		querystring+='&vehicle_coll_3=' + document.getElementById('vehicle_coll_3').options[document.getElementById('vehicle_coll_3').selectedIndex].value;
		querystring+='&vehicle_comp_3=' + document.getElementById('vehicle_comp_3').options[document.getElementById('vehicle_comp_3').selectedIndex].value;
				querystring+='&a3=' + document.getElementById('a3').options[document.getElementById('a3').selectedIndex].value;
				querystring+='&vehicle_year_4=' + document.getElementById('vehicle_year_4').options[document.getElementById('vehicle_year_4').selectedIndex].value;
		querystring+='&vehicle_make_4=' + document.getElementById('vehicle_make_4').options[document.getElementById('vehicle_make_4').selectedIndex].value;
		querystring+='&vehicle_model_4=' + document.getElementById('vehicle_model_4').value;
		querystring+='&vehicle_coll_4=' + document.getElementById('vehicle_coll_4').options[document.getElementById('vehicle_coll_4').selectedIndex].value;
		querystring+='&vehicle_comp_4=' + document.getElementById('vehicle_comp_4').options[document.getElementById('vehicle_comp_4').selectedIndex].value;
				querystring+='&a4=' + document.getElementById('a4').options[document.getElementById('a4').selectedIndex].value;
				querystring+='&vehicle_year_5=' + document.getElementById('vehicle_year_5').options[document.getElementById('vehicle_year_5').selectedIndex].value;
		querystring+='&vehicle_make_5=' + document.getElementById('vehicle_make_5').options[document.getElementById('vehicle_make_5').selectedIndex].value;
		querystring+='&vehicle_model_5=' + document.getElementById('vehicle_model_5').value;
		querystring+='&vehicle_coll_5=' + document.getElementById('vehicle_coll_5').options[document.getElementById('vehicle_coll_5').selectedIndex].value;
		querystring+='&vehicle_comp_5=' + document.getElementById('vehicle_comp_5').options[document.getElementById('vehicle_comp_5').selectedIndex].value;
				querystring+='&a5=' + document.getElementById('a5').options[document.getElementById('a5').selectedIndex].value;
				querystring+='&vehicle_year_6=' + document.getElementById('vehicle_year_6').options[document.getElementById('vehicle_year_6').selectedIndex].value;
		querystring+='&vehicle_make_6=' + document.getElementById('vehicle_make_6').options[document.getElementById('vehicle_make_6').selectedIndex].value;
		querystring+='&vehicle_model_6=' + document.getElementById('vehicle_model_6').value;
		querystring+='&vehicle_coll_6=' + document.getElementById('vehicle_coll_6').options[document.getElementById('vehicle_coll_6').selectedIndex].value;
		querystring+='&vehicle_comp_6=' + document.getElementById('vehicle_comp_6').options[document.getElementById('vehicle_comp_6').selectedIndex].value;
				querystring+='&a6=' + document.getElementById('a6').options[document.getElementById('a6').selectedIndex].value;
				querystring+='&vehicle_year_7=' + document.getElementById('vehicle_year_7').options[document.getElementById('vehicle_year_7').selectedIndex].value;
		querystring+='&vehicle_make_7=' + document.getElementById('vehicle_make_7').options[document.getElementById('vehicle_make_7').selectedIndex].value;
		querystring+='&vehicle_model_7=' + document.getElementById('vehicle_model_7').value;
		querystring+='&vehicle_coll_7=' + document.getElementById('vehicle_coll_7').options[document.getElementById('vehicle_coll_7').selectedIndex].value;
		querystring+='&vehicle_comp_7=' + document.getElementById('vehicle_comp_7').options[document.getElementById('vehicle_comp_7').selectedIndex].value;
				querystring+='&a7=' + document.getElementById('a7').options[document.getElementById('a7').selectedIndex].value;
				querystring+='&vehicle_year_8=' + document.getElementById('vehicle_year_8').options[document.getElementById('vehicle_year_8').selectedIndex].value;
		querystring+='&vehicle_make_8=' + document.getElementById('vehicle_make_8').options[document.getElementById('vehicle_make_8').selectedIndex].value;
		querystring+='&vehicle_model_8=' + document.getElementById('vehicle_model_8').value;
		querystring+='&vehicle_coll_8=' + document.getElementById('vehicle_coll_8').options[document.getElementById('vehicle_coll_8').selectedIndex].value;
		querystring+='&vehicle_comp_8=' + document.getElementById('vehicle_comp_8').options[document.getElementById('vehicle_comp_8').selectedIndex].value;
				querystring+='&a8=' + document.getElementById('a8').options[document.getElementById('a8').selectedIndex].value;
				querystring+='&vehicle_year_9=' + document.getElementById('vehicle_year_9').options[document.getElementById('vehicle_year_9').selectedIndex].value;
		querystring+='&vehicle_make_9=' + document.getElementById('vehicle_make_9').options[document.getElementById('vehicle_make_9').selectedIndex].value;
		querystring+='&vehicle_model_9=' + document.getElementById('vehicle_model_9').value;
		querystring+='&vehicle_coll_9=' + document.getElementById('vehicle_coll_9').options[document.getElementById('vehicle_coll_9').selectedIndex].value;
		querystring+='&vehicle_comp_9=' + document.getElementById('vehicle_comp_9').options[document.getElementById('vehicle_comp_9').selectedIndex].value;
				querystring+='&a9=' + document.getElementById('a9').options[document.getElementById('a9').selectedIndex].value;
				querystring+='&vehicle_year_10=' + document.getElementById('vehicle_year_10').options[document.getElementById('vehicle_year_10').selectedIndex].value;
		querystring+='&vehicle_make_10=' + document.getElementById('vehicle_make_10').options[document.getElementById('vehicle_make_10').selectedIndex].value;
		querystring+='&vehicle_model_10=' + document.getElementById('vehicle_model_10').value;
		querystring+='&vehicle_coll_10=' + document.getElementById('vehicle_coll_10').options[document.getElementById('vehicle_coll_10').selectedIndex].value;
		querystring+='&vehicle_comp_10=' + document.getElementById('vehicle_comp_10').options[document.getElementById('vehicle_comp_10').selectedIndex].value;
						querystring+='&driver_name_1=' + document.getElementById('driver_name_1').value;
		querystring+='&driver_dob_1=' + document.getElementById('driver_dob_month_1').options[document.getElementById('driver_dob_month_1').selectedIndex].value + '/' + document.getElementById('driver_dob_day_1').options[document.getElementById('driver_dob_day_1').selectedIndex].value + '/' + document.getElementById('driver_dob_year_1').options[document.getElementById('driver_dob_year_1').selectedIndex].value;
		querystring+='&driver_marital_1=' + document.getElementById('driver_marital_1').options[document.getElementById('driver_marital_1').selectedIndex].value;
		querystring+='&ticket_1=' + document.getElementById('ticket_1').options[document.getElementById('ticket_1').selectedIndex].value;
		querystring+='&driver_1_ticket_info_claim_1=' + document.getElementById('driver_1_ticket_info_claim_1').value;
		querystring+='&driver_1_ticket_info_type_1=' + document.getElementById('driver_1_ticket_info_type_1').options[document.getElementById('driver_1_ticket_info_type_1').selectedIndex].value;
		querystring+='&driver_1_ticket_info_date_1=' + document.getElementById('driver_1_ticket_info_date_1').value;
		querystring+='&driver_1_ticket_info_claim_2=' + document.getElementById('driver_1_ticket_info_claim_2').value;
		querystring+='&driver_1_ticket_info_type_2=' + document.getElementById('driver_1_ticket_info_type_2').options[document.getElementById('driver_1_ticket_info_type_2').selectedIndex].value;
		querystring+='&driver_1_ticket_info_date_2=' + document.getElementById('driver_1_ticket_info_date_2').value;
		querystring+='&driver_1_ticket_info_claim_3=' + document.getElementById('driver_1_ticket_info_claim_3').value;
		querystring+='&driver_1_ticket_info_type_3=' + document.getElementById('driver_1_ticket_info_type_3').options[document.getElementById('driver_1_ticket_info_type_3').selectedIndex].value;
		querystring+='&driver_1_ticket_info_date_3=' + document.getElementById('driver_1_ticket_info_date_3').value;
				querystring+='&d1=' + document.getElementById('d1').options[document.getElementById('d1').selectedIndex].value;
				querystring+='&driver_name_2=' + document.getElementById('driver_name_1').value;
		querystring+='&driver_dob_2=' + document.getElementById('driver_dob_month_2').options[document.getElementById('driver_dob_month_2').selectedIndex].value + '/' + document.getElementById('driver_dob_day_2').options[document.getElementById('driver_dob_day_2').selectedIndex].value + '/' + document.getElementById('driver_dob_year_2').options[document.getElementById('driver_dob_year_2').selectedIndex].value;
		querystring+='&driver_marital_2=' + document.getElementById('driver_marital_2').options[document.getElementById('driver_marital_2').selectedIndex].value;
		querystring+='&ticket_2=' + document.getElementById('ticket_2').options[document.getElementById('ticket_2').selectedIndex].value;
		querystring+='&driver_2_ticket_info_claim_1=' + document.getElementById('driver_2_ticket_info_claim_1').value;
		querystring+='&driver_2_ticket_info_type_1=' + document.getElementById('driver_2_ticket_info_type_1').options[document.getElementById('driver_2_ticket_info_type_1').selectedIndex].value;
		querystring+='&driver_2_ticket_info_date_1=' + document.getElementById('driver_2_ticket_info_date_1').value;
		querystring+='&driver_2_ticket_info_claim_2=' + document.getElementById('driver_2_ticket_info_claim_2').value;
		querystring+='&driver_2_ticket_info_type_2=' + document.getElementById('driver_2_ticket_info_type_2').options[document.getElementById('driver_2_ticket_info_type_2').selectedIndex].value;
		querystring+='&driver_2_ticket_info_date_2=' + document.getElementById('driver_2_ticket_info_date_2').value;
		querystring+='&driver_2_ticket_info_claim_3=' + document.getElementById('driver_2_ticket_info_claim_3').value;
		querystring+='&driver_2_ticket_info_type_3=' + document.getElementById('driver_2_ticket_info_type_3').options[document.getElementById('driver_2_ticket_info_type_3').selectedIndex].value;
		querystring+='&driver_2_ticket_info_date_3=' + document.getElementById('driver_2_ticket_info_date_3').value;
				querystring+='&d2=' + document.getElementById('d2').options[document.getElementById('d2').selectedIndex].value;
				querystring+='&driver_name_3=' + document.getElementById('driver_name_1').value;
		querystring+='&driver_dob_3=' + document.getElementById('driver_dob_month_3').options[document.getElementById('driver_dob_month_3').selectedIndex].value + '/' + document.getElementById('driver_dob_day_3').options[document.getElementById('driver_dob_day_3').selectedIndex].value + '/' + document.getElementById('driver_dob_year_3').options[document.getElementById('driver_dob_year_3').selectedIndex].value;
		querystring+='&driver_marital_3=' + document.getElementById('driver_marital_3').options[document.getElementById('driver_marital_3').selectedIndex].value;
		querystring+='&ticket_3=' + document.getElementById('ticket_3').options[document.getElementById('ticket_3').selectedIndex].value;
		querystring+='&driver_3_ticket_info_claim_1=' + document.getElementById('driver_3_ticket_info_claim_1').value;
		querystring+='&driver_3_ticket_info_type_1=' + document.getElementById('driver_3_ticket_info_type_1').options[document.getElementById('driver_3_ticket_info_type_1').selectedIndex].value;
		querystring+='&driver_3_ticket_info_date_1=' + document.getElementById('driver_3_ticket_info_date_1').value;
		querystring+='&driver_3_ticket_info_claim_2=' + document.getElementById('driver_3_ticket_info_claim_2').value;
		querystring+='&driver_3_ticket_info_type_2=' + document.getElementById('driver_3_ticket_info_type_2').options[document.getElementById('driver_3_ticket_info_type_2').selectedIndex].value;
		querystring+='&driver_3_ticket_info_date_2=' + document.getElementById('driver_3_ticket_info_date_2').value;
		querystring+='&driver_3_ticket_info_claim_3=' + document.getElementById('driver_3_ticket_info_claim_3').value;
		querystring+='&driver_3_ticket_info_type_3=' + document.getElementById('driver_3_ticket_info_type_3').options[document.getElementById('driver_3_ticket_info_type_3').selectedIndex].value;
		querystring+='&driver_3_ticket_info_date_3=' + document.getElementById('driver_3_ticket_info_date_3').value;
				querystring+='&d3=' + document.getElementById('d3').options[document.getElementById('d3').selectedIndex].value;
				querystring+='&driver_name_4=' + document.getElementById('driver_name_1').value;
		querystring+='&driver_dob_4=' + document.getElementById('driver_dob_month_4').options[document.getElementById('driver_dob_month_4').selectedIndex].value + '/' + document.getElementById('driver_dob_day_4').options[document.getElementById('driver_dob_day_4').selectedIndex].value + '/' + document.getElementById('driver_dob_year_4').options[document.getElementById('driver_dob_year_4').selectedIndex].value;
		querystring+='&driver_marital_4=' + document.getElementById('driver_marital_4').options[document.getElementById('driver_marital_4').selectedIndex].value;
		querystring+='&ticket_4=' + document.getElementById('ticket_4').options[document.getElementById('ticket_4').selectedIndex].value;
		querystring+='&driver_4_ticket_info_claim_1=' + document.getElementById('driver_4_ticket_info_claim_1').value;
		querystring+='&driver_4_ticket_info_type_1=' + document.getElementById('driver_4_ticket_info_type_1').options[document.getElementById('driver_4_ticket_info_type_1').selectedIndex].value;
		querystring+='&driver_4_ticket_info_date_1=' + document.getElementById('driver_4_ticket_info_date_1').value;
		querystring+='&driver_4_ticket_info_claim_2=' + document.getElementById('driver_4_ticket_info_claim_2').value;
		querystring+='&driver_4_ticket_info_type_2=' + document.getElementById('driver_4_ticket_info_type_2').options[document.getElementById('driver_4_ticket_info_type_2').selectedIndex].value;
		querystring+='&driver_4_ticket_info_date_2=' + document.getElementById('driver_4_ticket_info_date_2').value;
		querystring+='&driver_4_ticket_info_claim_3=' + document.getElementById('driver_4_ticket_info_claim_3').value;
		querystring+='&driver_4_ticket_info_type_3=' + document.getElementById('driver_4_ticket_info_type_3').options[document.getElementById('driver_4_ticket_info_type_3').selectedIndex].value;
		querystring+='&driver_4_ticket_info_date_3=' + document.getElementById('driver_4_ticket_info_date_3').value;
				querystring+='&d4=' + document.getElementById('d4').options[document.getElementById('d4').selectedIndex].value;
				querystring+='&driver_name_5=' + document.getElementById('driver_name_1').value;
		querystring+='&driver_dob_5=' + document.getElementById('driver_dob_month_5').options[document.getElementById('driver_dob_month_5').selectedIndex].value + '/' + document.getElementById('driver_dob_day_5').options[document.getElementById('driver_dob_day_5').selectedIndex].value + '/' + document.getElementById('driver_dob_year_5').options[document.getElementById('driver_dob_year_5').selectedIndex].value;
		querystring+='&driver_marital_5=' + document.getElementById('driver_marital_5').options[document.getElementById('driver_marital_5').selectedIndex].value;
		querystring+='&ticket_5=' + document.getElementById('ticket_5').options[document.getElementById('ticket_5').selectedIndex].value;
		querystring+='&driver_5_ticket_info_claim_1=' + document.getElementById('driver_5_ticket_info_claim_1').value;
		querystring+='&driver_5_ticket_info_type_1=' + document.getElementById('driver_5_ticket_info_type_1').options[document.getElementById('driver_5_ticket_info_type_1').selectedIndex].value;
		querystring+='&driver_5_ticket_info_date_1=' + document.getElementById('driver_5_ticket_info_date_1').value;
		querystring+='&driver_5_ticket_info_claim_2=' + document.getElementById('driver_5_ticket_info_claim_2').value;
		querystring+='&driver_5_ticket_info_type_2=' + document.getElementById('driver_5_ticket_info_type_2').options[document.getElementById('driver_5_ticket_info_type_2').selectedIndex].value;
		querystring+='&driver_5_ticket_info_date_2=' + document.getElementById('driver_5_ticket_info_date_2').value;
		querystring+='&driver_5_ticket_info_claim_3=' + document.getElementById('driver_5_ticket_info_claim_3').value;
		querystring+='&driver_5_ticket_info_type_3=' + document.getElementById('driver_5_ticket_info_type_3').options[document.getElementById('driver_5_ticket_info_type_3').selectedIndex].value;
		querystring+='&driver_5_ticket_info_date_3=' + document.getElementById('driver_5_ticket_info_date_3').value;
				querystring+='&d5=' + document.getElementById('d5').options[document.getElementById('d5').selectedIndex].value;
				querystring+='&driver_name_6=' + document.getElementById('driver_name_1').value;
		querystring+='&driver_dob_6=' + document.getElementById('driver_dob_month_6').options[document.getElementById('driver_dob_month_6').selectedIndex].value + '/' + document.getElementById('driver_dob_day_6').options[document.getElementById('driver_dob_day_6').selectedIndex].value + '/' + document.getElementById('driver_dob_year_6').options[document.getElementById('driver_dob_year_6').selectedIndex].value;
		querystring+='&driver_marital_6=' + document.getElementById('driver_marital_6').options[document.getElementById('driver_marital_6').selectedIndex].value;
		querystring+='&ticket_6=' + document.getElementById('ticket_6').options[document.getElementById('ticket_6').selectedIndex].value;
		querystring+='&driver_6_ticket_info_claim_1=' + document.getElementById('driver_6_ticket_info_claim_1').value;
		querystring+='&driver_6_ticket_info_type_1=' + document.getElementById('driver_6_ticket_info_type_1').options[document.getElementById('driver_6_ticket_info_type_1').selectedIndex].value;
		querystring+='&driver_6_ticket_info_date_1=' + document.getElementById('driver_6_ticket_info_date_1').value;
		querystring+='&driver_6_ticket_info_claim_2=' + document.getElementById('driver_6_ticket_info_claim_2').value;
		querystring+='&driver_6_ticket_info_type_2=' + document.getElementById('driver_6_ticket_info_type_2').options[document.getElementById('driver_6_ticket_info_type_2').selectedIndex].value;
		querystring+='&driver_6_ticket_info_date_2=' + document.getElementById('driver_6_ticket_info_date_2').value;
		querystring+='&driver_6_ticket_info_claim_3=' + document.getElementById('driver_6_ticket_info_claim_3').value;
		querystring+='&driver_6_ticket_info_type_3=' + document.getElementById('driver_6_ticket_info_type_3').options[document.getElementById('driver_6_ticket_info_type_3').selectedIndex].value;
		querystring+='&driver_6_ticket_info_date_3=' + document.getElementById('driver_6_ticket_info_date_3').value;
				querystring+='&d6=' + document.getElementById('d6').options[document.getElementById('d6').selectedIndex].value;
				querystring+='&driver_name_7=' + document.getElementById('driver_name_1').value;
		querystring+='&driver_dob_7=' + document.getElementById('driver_dob_month_7').options[document.getElementById('driver_dob_month_7').selectedIndex].value + '/' + document.getElementById('driver_dob_day_7').options[document.getElementById('driver_dob_day_7').selectedIndex].value + '/' + document.getElementById('driver_dob_year_7').options[document.getElementById('driver_dob_year_7').selectedIndex].value;
		querystring+='&driver_marital_7=' + document.getElementById('driver_marital_7').options[document.getElementById('driver_marital_7').selectedIndex].value;
		querystring+='&ticket_7=' + document.getElementById('ticket_7').options[document.getElementById('ticket_7').selectedIndex].value;
		querystring+='&driver_7_ticket_info_claim_1=' + document.getElementById('driver_7_ticket_info_claim_1').value;
		querystring+='&driver_7_ticket_info_type_1=' + document.getElementById('driver_7_ticket_info_type_1').options[document.getElementById('driver_7_ticket_info_type_1').selectedIndex].value;
		querystring+='&driver_7_ticket_info_date_1=' + document.getElementById('driver_7_ticket_info_date_1').value;
		querystring+='&driver_7_ticket_info_claim_2=' + document.getElementById('driver_7_ticket_info_claim_2').value;
		querystring+='&driver_7_ticket_info_type_2=' + document.getElementById('driver_7_ticket_info_type_2').options[document.getElementById('driver_7_ticket_info_type_2').selectedIndex].value;
		querystring+='&driver_7_ticket_info_date_2=' + document.getElementById('driver_7_ticket_info_date_2').value;
		querystring+='&driver_7_ticket_info_claim_3=' + document.getElementById('driver_7_ticket_info_claim_3').value;
		querystring+='&driver_7_ticket_info_type_3=' + document.getElementById('driver_7_ticket_info_type_3').options[document.getElementById('driver_7_ticket_info_type_3').selectedIndex].value;
		querystring+='&driver_7_ticket_info_date_3=' + document.getElementById('driver_7_ticket_info_date_3').value;
				querystring+='&d7=' + document.getElementById('d7').options[document.getElementById('d7').selectedIndex].value;
				querystring+='&driver_name_8=' + document.getElementById('driver_name_1').value;
		querystring+='&driver_dob_8=' + document.getElementById('driver_dob_month_8').options[document.getElementById('driver_dob_month_8').selectedIndex].value + '/' + document.getElementById('driver_dob_day_8').options[document.getElementById('driver_dob_day_8').selectedIndex].value + '/' + document.getElementById('driver_dob_year_8').options[document.getElementById('driver_dob_year_8').selectedIndex].value;
		querystring+='&driver_marital_8=' + document.getElementById('driver_marital_8').options[document.getElementById('driver_marital_8').selectedIndex].value;
		querystring+='&ticket_8=' + document.getElementById('ticket_8').options[document.getElementById('ticket_8').selectedIndex].value;
		querystring+='&driver_8_ticket_info_claim_1=' + document.getElementById('driver_8_ticket_info_claim_1').value;
		querystring+='&driver_8_ticket_info_type_1=' + document.getElementById('driver_8_ticket_info_type_1').options[document.getElementById('driver_8_ticket_info_type_1').selectedIndex].value;
		querystring+='&driver_8_ticket_info_date_1=' + document.getElementById('driver_8_ticket_info_date_1').value;
		querystring+='&driver_8_ticket_info_claim_2=' + document.getElementById('driver_8_ticket_info_claim_2').value;
		querystring+='&driver_8_ticket_info_type_2=' + document.getElementById('driver_8_ticket_info_type_2').options[document.getElementById('driver_8_ticket_info_type_2').selectedIndex].value;
		querystring+='&driver_8_ticket_info_date_2=' + document.getElementById('driver_8_ticket_info_date_2').value;
		querystring+='&driver_8_ticket_info_claim_3=' + document.getElementById('driver_8_ticket_info_claim_3').value;
		querystring+='&driver_8_ticket_info_type_3=' + document.getElementById('driver_8_ticket_info_type_3').options[document.getElementById('driver_8_ticket_info_type_3').selectedIndex].value;
		querystring+='&driver_8_ticket_info_date_3=' + document.getElementById('driver_8_ticket_info_date_3').value;
				querystring+='&d8=' + document.getElementById('d8').options[document.getElementById('d8').selectedIndex].value;
				querystring+='&driver_name_9=' + document.getElementById('driver_name_1').value;
		querystring+='&driver_dob_9=' + document.getElementById('driver_dob_month_9').options[document.getElementById('driver_dob_month_9').selectedIndex].value + '/' + document.getElementById('driver_dob_day_9').options[document.getElementById('driver_dob_day_9').selectedIndex].value + '/' + document.getElementById('driver_dob_year_9').options[document.getElementById('driver_dob_year_9').selectedIndex].value;
		querystring+='&driver_marital_9=' + document.getElementById('driver_marital_9').options[document.getElementById('driver_marital_9').selectedIndex].value;
		querystring+='&ticket_9=' + document.getElementById('ticket_9').options[document.getElementById('ticket_9').selectedIndex].value;
		querystring+='&driver_9_ticket_info_claim_1=' + document.getElementById('driver_9_ticket_info_claim_1').value;
		querystring+='&driver_9_ticket_info_type_1=' + document.getElementById('driver_9_ticket_info_type_1').options[document.getElementById('driver_9_ticket_info_type_1').selectedIndex].value;
		querystring+='&driver_9_ticket_info_date_1=' + document.getElementById('driver_9_ticket_info_date_1').value;
		querystring+='&driver_9_ticket_info_claim_2=' + document.getElementById('driver_9_ticket_info_claim_2').value;
		querystring+='&driver_9_ticket_info_type_2=' + document.getElementById('driver_9_ticket_info_type_2').options[document.getElementById('driver_9_ticket_info_type_2').selectedIndex].value;
		querystring+='&driver_9_ticket_info_date_2=' + document.getElementById('driver_9_ticket_info_date_2').value;
		querystring+='&driver_9_ticket_info_claim_3=' + document.getElementById('driver_9_ticket_info_claim_3').value;
		querystring+='&driver_9_ticket_info_type_3=' + document.getElementById('driver_9_ticket_info_type_3').options[document.getElementById('driver_9_ticket_info_type_3').selectedIndex].value;
		querystring+='&driver_9_ticket_info_date_3=' + document.getElementById('driver_9_ticket_info_date_3').value;
				querystring+='&d9=' + document.getElementById('d9').options[document.getElementById('d9').selectedIndex].value;
				querystring+='&driver_name_10=' + document.getElementById('driver_name_1').value;
		querystring+='&driver_dob_10=' + document.getElementById('driver_dob_month_10').options[document.getElementById('driver_dob_month_10').selectedIndex].value + '/' + document.getElementById('driver_dob_day_10').options[document.getElementById('driver_dob_day_10').selectedIndex].value + '/' + document.getElementById('driver_dob_year_10').options[document.getElementById('driver_dob_year_10').selectedIndex].value;
		querystring+='&driver_marital_10=' + document.getElementById('driver_marital_10').options[document.getElementById('driver_marital_10').selectedIndex].value;
		querystring+='&ticket_10=' + document.getElementById('ticket_10').options[document.getElementById('ticket_10').selectedIndex].value;
		querystring+='&driver_10_ticket_info_claim_1=' + document.getElementById('driver_10_ticket_info_claim_1').value;
		querystring+='&driver_10_ticket_info_type_1=' + document.getElementById('driver_10_ticket_info_type_1').options[document.getElementById('driver_10_ticket_info_type_1').selectedIndex].value;
		querystring+='&driver_10_ticket_info_date_1=' + document.getElementById('driver_10_ticket_info_date_1').value;
		querystring+='&driver_10_ticket_info_claim_2=' + document.getElementById('driver_10_ticket_info_claim_2').value;
		querystring+='&driver_10_ticket_info_type_2=' + document.getElementById('driver_10_ticket_info_type_2').options[document.getElementById('driver_10_ticket_info_type_2').selectedIndex].value;
		querystring+='&driver_10_ticket_info_date_2=' + document.getElementById('driver_10_ticket_info_date_2').value;
		querystring+='&driver_10_ticket_info_claim_3=' + document.getElementById('driver_10_ticket_info_claim_3').value;
		querystring+='&driver_10_ticket_info_type_3=' + document.getElementById('driver_10_ticket_info_type_3').options[document.getElementById('driver_10_ticket_info_type_3').selectedIndex].value;
		querystring+='&driver_10_ticket_info_date_3=' + document.getElementById('driver_10_ticket_info_date_3').value;
				querystring+='&validation=' + document.getElementById('validation').value;
		httpObject.open("GET", querystring, true);
		httpObject.send(null);
		httpObject.onreadystatechange = function(){
			if(httpObject.readyState == 4){
				if(httpObject.responseText!='valid'){
					document.getElementById('response').innerHTML = '<div class="required">&nbsp;'+httpObject.responseText+'</div>';
					document.getElementById('buttons').style.display='block';			
					document.getElementById('validation_image').src='img/server.php?'+Math.random();
				}else{
					document.getElementById('response').innerHTML = '<div style="color:#006600">Thank you for your inquiry. We will be contacting you shortly.</div>';
					setTimeout("clearAll()", 7000);
				}
			}
		};
	}
}