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11230 College Blvd, Overland Park, KS 66210
Accounting & Billing
POSIM LLC, PO Box 37, Hurricane, UT 84737
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<div class='gform_body gform-body'><ul id='gform_fields_17' class='gform_fields top_label form_sublabel_below description_below'><li id="field_17_6" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_6' id='input_17_6' type='hidden' class='gform_hidden' aria-invalid="false" value='https://app-3QNL6WU154.marketingautomation.services/webforms/receivePostback/MzawMDG3NDO0AAA/' /></div></li><li id="field_17_7" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_7' id='input_17_7' type='hidden' class='gform_hidden' aria-invalid="false" value='0994ba05-06b3-460d-b11c-4f3b11093ec9' /></div></li><li id="field_17_8" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_8' id='input_17_8' type='hidden' class='gform_hidden' aria-invalid="false" value='POSIM' /></div></li><li id="field_17_11" class="gfield gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" ><label class='gfield_label' for='input_17_11' >First<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_17_11' type='text' value='' class='large' tabindex='88' placeholder='First Name' aria-required="true" aria-invalid="false" /> </div></li><li id="field_17_10" class="gfield gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" ><label class='gfield_label' for='input_17_10' >Last<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_17_10' type='text' value='' class='large' tabindex='89' placeholder='Last Name' aria-required="true" aria-invalid="false" /> </div></li><li id="field_17_2" class="gfield posim-email gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" ><label class='gfield_label' for='input_17_2' >Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'>
<input name='input_2' id='input_17_2' type='text' value='' class='large' tabindex='90' placeholder='Email' aria-required="true" aria-invalid="false" />
</div></li><li id="field_17_3" class="gfield posim-phone gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" ><label class='gfield_label' for='input_17_3' >Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_17_3' type='text' value='' class='large' tabindex='91' placeholder='Phone' aria-required="true" aria-invalid="false" /></div></li><li id="field_17_5" class="gfield posim-industry gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" ><label class='gfield_label' for='input_17_5' >Your Industry<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_5' id='input_17_5' class='large gfield_select' tabindex='92' aria-required="true" aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>Your Industry</option><option value='Apparel' >Apparel</option><option value='Hobby' >Hobby</option><option value='Household' >Household</option><option value='Liquor_Wine_Beer' >Liquor, Wine & Beer</option><option value='Needlearts' >Needlearts</option><option value='Quilt_Fabric_Sewing' >Quilt, Fabric & Sewing</option><option value='Outdoor' >Outdoor</option><option value='Other' >Other</option></select></div></li><li id="field_17_12" class="gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_17_12' >Name</label><div class='ginput_container'><input name='input_12' id='input_17_12' type='text' value='' /></div><div class='gfield_description' id='gfield_description_17_12'>This field is for validation purposes and should be left unchanged.</div></li></ul></div>
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<input type='hidden' class='gform_hidden' name='state_17' value='WyJbXSIsIjFmYmJkMmM5NDAyMGYzNTJmZGM3MmU0ODNlNDM2YjBmIl0=' />
<input type='hidden' class='gform_hidden' name='gform_target_page_number_17' id='gform_target_page_number_17' value='0' />
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<input type='hidden' name='gform_field_values' value='' />
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<iframe style='display:none;width:0px;height:0px;' src='about:blank' name='gform_ajax_frame_17' id='gform_ajax_frame_17' title='This iframe contains the logic required to handle Ajax powered Gravity Forms.'></iframe>
<script type="text/javascript">
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