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$('input_16').hint('ex: 11097');
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FormTranslation.init({"detectUserLanguage":"1","dictionary":"{\"en\":{\"Primer Nombre\":\"First Name\",\"Apellido\":\"Last Name\",\"Correo Electrónico\":\"E-mail\",\"Dirección de la calle\":\"Street Address\",\"Dirección de la calle Línea 2\":\"Street Address Line 2\",\"Ciudad\":\"City\",\"Estado / Provincia\":\"State / Province\",\"Codigo postal\":\"Postal / Zip Code\",\"País\":\"Country\",\"Nombre Completo\":\"Full Name\",\"Enero\":\"January\",\"Febrero\":\"February\",\"Marzo\":\"March\",\"Abril\":\"April\",\"Mayo\":\"May\",\"Junio\":\"June\",\"Julio\":\"July\",\"Agosto\":\"August\",\"Septiembre\":\"September\",\"Octubre\":\"October\",\"Noviembre\":\"November\",\"Diciembre\":\"December\",\"Cantidad\":\"Quantity\",\"Enviar\":\"Send\",\"Atras\":\"Back\",\"text_84\":\"<p>En este campo es necesario tener una contraseña como Usuario Autorizado para aprobar un credito, de no ser asi solo llene el formulario con la informacion necesaria, dirijase a la opcion ATRAS y luego ENVIAR.</p>\",\"Siguiente\":\"Next\",\"text_102\":\"<p>Si esta viendo este mensaje es por que usted aprobo el credito en este formulario, el siguiente paso es indicarle a la sede principal que procese su aprobacion.</p>\\n<p>Llene algun comentario para indicarle algun requerimiento o proceso especial a el departamento de RMA.</p>\",\"Este campo solo puede contener letras\":\"This field can only contain letters\",\"Este campo solo puede contener letras y números.\":\"This field can only contain letters and numbers.\",\"¿Está seguro de querer borra el formulario?\":\"Are you sure you want to clear the form?\",\"Correo electrónico no coincide\":\"E-mail does not match\",\"Introduzca una dirección e-mail válida\":\"Enter a valid e-mail address\",\"Existen errores en el formulario, por favor corríjalos antes de continuar.\":\"There are errors on the form. Please fix them before continuing.\",\"Hay errores en esta página. Por favor, corríjalos antes de continuar.\":\"There are errors on this page. Please fix them before continuing.\",\"El puntaje total debería ser sólo \\\"menos que\\\" o \\\"igual que\\\"\":\"Score total should only be less than or equal to\",\"Existen campos requeridos incompletos. Por favor complételos.\":\"There are incomplete required fields. Please complete them.\",\"El valor introducido no puede ser menor que el mínimo especificado:\":\"Input should not be less than the minimum value:\",\"Entrada no debe ser mas grande que el valor maximo:\":\"Input should not be greater than the maximum value:\",\"Tu cuenta debería ser menor o igual que\":\"Your score should be less than or equal to\",\"El máximo de dígitos permitido es\":\"The maximum digits allowed is\",\"El número máximo de selecciones es\":\"The maximum number of selections allowed is\",\"El número mínimo de selección requerido es\":\"The minimum required number of selections is\",\"El fichero {file} está vacío; por favor, selecciona de nuevo los ficheros sin él.\":\"{file} is empty, please select files again without it.\",\"{file} is demasiado pequeño, el tamaño mínimo de fichero es: {minSizeLimit}.\":\"{file} is too small, minimum file size is {minSizeLimit}.\",\"Se están cargando los ficheros, si cierras ahora, se cancelará dicha carga.\":\"The files are being uploaded, if you leave now the upload will be cancelled.\",\"{file} es demasiado grande; el tamaño del archivo no debe superar los {sizeLimit}.\":\"{file} is too large, maximum file size is {sizeLimit}.\",\"El fichero {file} posee una extensión no permitida. Sólo están permitidas las extensiones {extensions}.\":\"{file} has invalid extension. Only {extensions} are allowed.\",\"Este campo sólo admite valores numéricos\":\"This field can only contain numeric values\",\"La fecha debe ser futura\":\"Date must not be in the past.\",\"Por favor, espere ...\":\"Please wait...\",\"Campo requerido.\":\"This field is required.\",\"Todas las filas son obligatorias.\":\"Every row is required.\",\"Por lo menos un campo requerido\":\"At least one field required.\",\"¡Lo siento! Sólo se permite una entrada. Múltiples envíos están desactivados para este formulario.\":\"Sorry! Only one entry is allowed. Multiple submissions are disabled for this form.\",\"Solo puede subir los siguientes archivos:\":\"You can only upload following files:\",\"Tamaño del archivo no puede ser mayor que:\":\"File size cannot be bigger than:\"}}","options":"Español|English (US)","primaryLanguage":"es","showStatus":"flag-with-nation","theme":"dark-theme"});
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1px;
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width: 293px;
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<div class="dd-placeholder lang-emp">
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Español
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<li data-lang="en" class="en">
English (US)
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<ul class="form-section">
<li class="form-line" id="id_1">
<div id="cid_1" class="form-input-wide">
<div style="text-align:center;">
<img alt="" class="form-image" border="0" src="http://www.jotform.com/uploads/ricksgonz/form_files/Iconos marcas.png" height="95" width="557" />
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</li>
<li id="cid_3" class="form-input-wide">
<div class="form-header-group">
<h2 id="header_3" class="form-header">
Credito de Marcas Exclusivas RMA
</h2>
</div>
</li>
<ul class="form-section" id="section_9">
<li id="cid_9" class="form-input-wide">
<div class="form-collapse-table" id="collapse_9"><span class="form-collapse-mid" id="collapse-text_9">Datos de Empresa / Cliente:</span><span class="form-collapse-right form-collapse-right-show">&nbsp;</span>
</div>
</li>
<li class="form-line form-line-column" id="id_12">
<label class="form-label-top" id="label_12" for="input_12">
Empresa / Cliente:<span class="form-required">*</span>
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<div id="cid_12" class="form-input-wide">
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</li>
<li class="form-line form-line-column" id="id_4">
<label class="form-label-top" id="label_4" for="input_4">
Quien lo Solicita:<span class="form-required">*</span>
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<div id="cid_4" class="form-input-wide"><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q4_quienLo4[first]" id="first_4" />
<label class="form-sub-label" for="first_4" id="sublabel_first"> Primer Nombre </label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q4_quienLo4[last]" id="last_4" />
<label class="form-sub-label" for="last_4" id="sublabel_last"> Apellido </label></span>
</div>
</li>
<li class="form-line form-line-column" id="id_17">
<label class="form-label-top" id="label_17" for="input_17"> Correo Electrónico </label>
<div id="cid_17" class="form-input-wide">
<input type="email" class=" form-textbox validate[Email]" id="input_17" name="q17_correoElectronico17" size="30" value="" />
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</li>
<li class="form-line form-line-column" id="id_16">
<label class="form-label-top" id="label_16" for="input_16"> Numero de Cliente: </label>
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<li class="form-line form-line-column" id="id_13">
<label class="form-label-top" id="label_13" for="input_13"> Direccion: </label>
<div id="cid_13" class="form-input-wide">
<table summary="" class="form-address-table" border="0" cellpadding="0" cellspacing="0">
<tr>
<td colspan="2"><span class="form-sub-label-container"><input class="form-textbox form-address-line" type="text" name="q13_direccion13[addr_line1]" id="input_13_addr_line1" />
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</td>
</tr>
<tr>
<td colspan="2"><span class="form-sub-label-container"><input class="form-textbox form-address-line" type="text" name="q13_direccion13[addr_line2]" id="input_13_addr_line2" size="46" />
<label class="form-sub-label" for="input_13_addr_line2" id="sublabel_13_addr_line2"> Dirección de la calle Línea 2 </label></span>
</td>
</tr>
<tr>
<td width="50%"><span class="form-sub-label-container"><input class="form-textbox form-address-city" type="text" name="q13_direccion13[city]" id="input_13_city" size="21" />
<label class="form-sub-label" for="input_13_city" id="sublabel_13_city"> Ciudad </label></span>
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<td><span class="form-sub-label-container"><input class="form-textbox form-address-state" type="text" name="q13_direccion13[state]" id="input_13_state" size="22" />
<label class="form-sub-label" for="input_13_state" id="sublabel_13_state"> Estado / Provincia </label></span>
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</tr>
<tr>
<td width="50%" function zip() { var iterator=P rototype.K, args=$ A(arguments); if (Object.isFunction(args.last())) { iterator=a rgs.pop(); } var collections=[ this].concat(args).map($A); return this.map(function (value, index) {return iterator(collections.pluck(index));}); }><span class="form-sub-label-container"><input class="form-textbox form-address-postal" type="text" name="q13_direccion13[postal]" id="input_13_postal" size="10" />
<label class="form-sub-label" for="input_13_postal" id="sublabel_13_postal"> Codigo postal </label></span>
</td>
<td><span class="form-sub-label-container"><select class="form-dropdown form-address-country" name="q13_direccion13[country]" id="input_13_country">
<option value="" selected> Seleccione </option>
<option value="United States"> United States </option>
<option value="Afghanistan"> Afghanistan </option>
<option value="Albania"> Albania </option>
<option value="Algeria"> Algeria </option>
<option value="American Samoa"> American Samoa </option>
<option value="Andorra"> Andorra </option>
<option value="Angola"> Angola </option>
<option value="Anguilla"> Anguilla </option>
<option value="Antigua and Barbuda"> Antigua and Barbuda </option>
<option value="Argentina"> Argentina </option>
<option value="Armenia"> Armenia </option>
<option value="Aruba"> Aruba </option>
<option value="Australia"> Australia </option>
<option value="Austria"> Austria </option>
<option value="Azerbaijan"> Azerbaijan </option>
<option value="The Bahamas"> The Bahamas </option>
<option value="Bahrain"> Bahrain </option>
<option value="Bangladesh"> Bangladesh </option>
<option value="Barbados"> Barbados </option>
<option value="Belarus"> Belarus </option>
<option value="Belgium"> Belgium </option>
<option value="Belize"> Belize </option>
<option value="Benin"> Benin </option>
<option value="Bermuda"> Bermuda </option>
<option value="Bhutan"> Bhutan </option>
<option value="Bolivia"> Bolivia </option>
<option value="Bosnia and Herzegovina"> Bosnia and Herzegovina </option>
<option value="Botswana"> Botswana </option>
<option value="Brazil"> Brazil </option>
<option value="Brunei"> Brunei </option>
<option value="Bulgaria"> Bulgaria </option>
<option value="Burkina Faso"> Burkina Faso </option>
<option value="Burundi"> Burundi </option>
<option value="Cambodia"> Cambodia </option>
<option value="Cameroon"> Cameroon </option>
<option value="Canada"> Canada </option>
<option value="Cape Verde"> Cape Verde </option>
<option value="Cayman Islands"> Cayman Islands </option>
<option value="Central African Republic"> Central African Republic </option>
<option value="Chad"> Chad </option>
<option value="Chile"> Chile </option>
<option value="People's Republic of China"> People's Republic of China </option>
<option value="Republic of China"> Republic of China </option>
<option value="Christmas Island"> Christmas Island </option>
<option value="Cocos (Keeling) Islands"> Cocos (Keeling) Islands </option>
<option value="Colombia"> Colombia </option>
<option value="Comoros"> Comoros </option>
<option value="Congo"> Congo </option>
<option value="Cook Islands"> Cook Islands </option>
<option value="Costa Rica"> Costa Rica </option>
<option value="Cote d'Ivoire"> Cote d'Ivoire </option>
<option value="Croatia"> Croatia </option>
<option value="Cuba"> Cuba </option>
<option value="Cyprus"> Cyprus </option>
<option value="Czech Republic"> Czech Republic </option>
<option value="Denmark"> Denmark </option>
<option value="Djibouti"> Djibouti </option>
<option value="Dominica"> Dominica </option>
<option value="Dominican Republic"> Dominican Republic </option>
<option value="Ecuador"> Ecuador </option>
<option value="Egypt"> Egypt </option>
<option value="El Salvador"> El Salvador </option>
<option value="Equatorial Guinea"> Equatorial Guinea </option>
<option value="Eritrea"> Eritrea </option>
<option value="Estonia"> Estonia </option>
<option value="Ethiopia"> Ethiopia </option>
<option value="Falkland Islands"> Falkland Islands </option>
<option value="Faroe Islands"> Faroe Islands </option>
<option value="Fiji"> Fiji </option>
<option value="Finland"> Finland </option>
<option value="France"> France </option>
<option value="French Polynesia"> French Polynesia </option>
<option value="Gabon"> Gabon </option>
<option value="The Gambia"> The Gambia </option>
<option value="Georgia"> Georgia </option>
<option value="Germany"> Germany </option>
<option value="Ghana"> Ghana </option>
<option value="Gibraltar"> Gibraltar </option>
<option value="Greece"> Greece </option>
<option value="Greenland"> Greenland </option>
<option value="Grenada"> Grenada </option>
<option value="Guadeloupe"> Guadeloupe </option>
<option value="Guam"> Guam </option>
<option value="Guatemala"> Guatemala </option>
<option value="Guernsey"> Guernsey </option>
<option value="Guinea"> Guinea </option>
<option value="Guinea-Bissau"> Guinea-Bissau </option>
<option value="Guyana"> Guyana </option>
<option value="Haiti"> Haiti </option>
<option value="Honduras"> Honduras </option>
<option value="Hong Kong"> Hong Kong </option>
<option value="Hungary"> Hungary </option>
<option value="Iceland"> Iceland </option>
<option value="India"> India </option>
<option value="Indonesia"> Indonesia </option>
<option value="Iran"> Iran </option>
<option value="Iraq"> Iraq </option>
<option value="Ireland"> Ireland </option>
<option value="Israel"> Israel </option>
<option value="Italy"> Italy </option>
<option value="Jamaica"> Jamaica </option>
<option value="Japan"> Japan </option>
<option value="Jersey"> Jersey </option>
<option value="Jordan"> Jordan </option>
<option value="Kazakhstan"> Kazakhstan </option>
<option value="Kenya"> Kenya </option>
<option value="Kiribati"> Kiribati </option>
<option value="North Korea"> North Korea </option>
<option value="South Korea"> South Korea </option>
<option value="Kosovo"> Kosovo </option>
<option value="Kuwait"> Kuwait </option>
<option value="Kyrgyzstan"> Kyrgyzstan </option>
<option value="Laos"> Laos </option>
<option value="Latvia"> Latvia </option>
<option value="Lebanon"> Lebanon </option>
<option value="Lesotho"> Lesotho </option>
<option value="Liberia"> Liberia </option>
<option value="Libya"> Libya </option>
<option value="Liechtenstein"> Liechtenstein </option>
<option value="Lithuania"> Lithuania </option>
<option value="Luxembourg"> Luxembourg </option>
<option value="Macau"> Macau </option>
<option value="Macedonia"> Macedonia </option>
<option value="Madagascar"> Madagascar </option>
<option value="Malawi"> Malawi </option>
<option value="Malaysia"> Malaysia </option>
<option value="Maldives"> Maldives </option>
<option value="Mali"> Mali </option>
<option value="Malta"> Malta </option>
<option value="Marshall Islands"> Marshall Islands </option>
<option value="Martinique"> Martinique </option>
<option value="Mauritania"> Mauritania </option>
<option value="Mauritius"> Mauritius </option>
<option value="Mayotte"> Mayotte </option>
<option value="Mexico"> Mexico </option>
<option value="Micronesia"> Micronesia </option>
<option value="Moldova"> Moldova </option>
<option value="Monaco"> Monaco </option>
<option value="Mongolia"> Mongolia </option>
<option value="Montenegro"> Montenegro </option>
<option value="Montserrat"> Montserrat </option>
<option value="Morocco"> Morocco </option>
<option value="Mozambique"> Mozambique </option>
<option value="Myanmar"> Myanmar </option>
<option value="Nagorno-Karabakh"> Nagorno-Karabakh </option>
<option value="Namibia"> Namibia </option>
<option value="Nauru"> Nauru </option>
<option value="Nepal"> Nepal </option>
<option value="Netherlands"> Netherlands </option>
<option value="Netherlands Antilles"> Netherlands Antilles </option>
<option value="New Caledonia"> New Caledonia </option>
<option value="New Zealand"> New Zealand </option>
<option value="Nicaragua"> Nicaragua </option>
<option value="Niger"> Niger </option>
<option value="Nigeria"> Nigeria </option>
<option value="Niue"> Niue </option>
<option value="Norfolk Island"> Norfolk Island </option>
<option value="Turkish Republic of Northern Cyprus"> Turkish Republic of Northern Cyprus </option>
<option value="Northern Mariana"> Northern Mariana </option>
<option value="Norway"> Norway </option>
<option value="Oman"> Oman </option>
<option value="Pakistan"> Pakistan </option>
<option value="Palau"> Palau </option>
<option value="Palestine"> Palestine </option>
<option value="Panama"> Panama </option>
<option value="Papua New Guinea"> Papua New Guinea </option>
<option value="Paraguay"> Paraguay </option>
<option value="Peru"> Peru </option>
<option value="Philippines"> Philippines </option>
<option value="Pitcairn Islands"> Pitcairn Islands </option>
<option value="Poland"> Poland </option>
<option value="Portugal"> Portugal </option>
<option value="Puerto Rico"> Puerto Rico </option>
<option value="Qatar"> Qatar </option>
<option value="Romania"> Romania </option>
<option value="Russia"> Russia </option>
<option value="Rwanda"> Rwanda </option>
<option value="Saint Barthelemy"> Saint Barthelemy </option>
<option value="Saint Helena"> Saint Helena </option>
<option value="Saint Kitts and Nevis"> Saint Kitts and Nevis </option>
<option value="Saint Lucia"> Saint Lucia </option>
<option value="Saint Martin"> Saint Martin </option>
<option value="Saint Pierre and Miquelon"> Saint Pierre and Miquelon </option>
<option value="Saint Vincent and the Grenadines"> Saint Vincent and the Grenadines </option>
<option value="Samoa"> Samoa </option>
<option value="San Marino"> San Marino </option>
<option value="Sao Tome and Principe"> Sao Tome and Principe </option>
<option value="Saudi Arabia"> Saudi Arabia </option>
<option value="Senegal"> Senegal </option>
<option value="Serbia"> Serbia </option>
<option value="Seychelles"> Seychelles </option>
<option value="Sierra Leone"> Sierra Leone </option>
<option value="Singapore"> Singapore </option>
<option value="Slovakia"> Slovakia </option>
<option value="Slovenia"> Slovenia </option>
<option value="Solomon Islands"> Solomon Islands </option>
<option value="Somalia"> Somalia </option>
<option value="Somaliland"> Somaliland </option>
<option value="South Africa"> South Africa </option>
<option value="South Ossetia"> South Ossetia </option>
<option value="Spain"> Spain </option>
<option value="Sri Lanka"> Sri Lanka </option>
<option value="Sudan"> Sudan </option>
<option value="Suriname"> Suriname </option>
<option value="Svalbard"> Svalbard </option>
<option value="Swaziland"> Swaziland </option>
<option value="Sweden"> Sweden </option>
<option value="Switzerland"> Switzerland </option>
<option value="Syria"> Syria </option>
<option value="Taiwan"> Taiwan </option>
<option value="Tajikistan"> Tajikistan </option>
<option value="Tanzania"> Tanzania </option>
<option value="Thailand"> Thailand </option>
<option value="Timor-Leste"> Timor-Leste </option>
<option value="Togo"> Togo </option>
<option value="Tokelau"> Tokelau </option>
<option value="Tonga"> Tonga </option>
<option value="Transnistria Pridnestrovie"> Transnistria Pridnestrovie </option>
<option value="Trinidad and Tobago"> Trinidad and Tobago </option>
<option value="Tristan da Cunha"> Tristan da Cunha </option>
<option value="Tunisia"> Tunisia </option>
<option value="Turkey"> Turkey </option>
<option value="Turkmenistan"> Turkmenistan </option>
<option value="Turks and Caicos Islands"> Turks and Caicos Islands </option>
<option value="Tuvalu"> Tuvalu </option>
<option value="Uganda"> Uganda </option>
<option value="Ukraine"> Ukraine </option>
<option value="United Arab Emirates"> United Arab Emirates </option>
<option value="United Kingdom"> United Kingdom </option>
<option value="Uruguay"> Uruguay </option>
<option value="Uzbekistan"> Uzbekistan </option>
<option value="Vanuatu"> Vanuatu </option>
<option value="Vatican City"> Vatican City </option>
<option value="Venezuela"> Venezuela </option>
<option value="Vietnam"> Vietnam </option>
<option value="British Virgin Islands"> British Virgin Islands </option>
<option value="US Virgin Islands"> US Virgin Islands </option>
<option value="Wallis and Futuna"> Wallis and Futuna </option>
<option value="Western Sahara"> Western Sahara </option>
<option value="Yemen"> Yemen </option>
<option value="Zambia"> Zambia </option>
<option value="Zimbabwe"> Zimbabwe </option>
<option value="other"> Other </option>
</select>
<label class="form-sub-label" for="input_13_country" id="sublabel_13_country"> País </label></span>
</td>
</tr>
</table>
</div>
</li>
</ul>
<ul class="form-section" id="section_11">
<li id="cid_11" class="form-input-wide">
<div class="form-collapse-table" id="collapse_11"><span class="form-collapse-mid" id="collapse-text_11">Datos de Solicitante:</span><span class="form-collapse-right form-collapse-right-show">&nbsp;</span>
</div>
</li>
<li class="form-line form-line-column" id="id_14">
<label class="form-label-top" id="label_14" for="input_14">
Nombre Completo<span class="form-required">*</span>
</label>
<div id="cid_14" class="form-input-wide"><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q14_nombreCompleto14[first]" id="first_14" />
<label class="form-sub-label" for="first_14" id="sublabel_first"> Primer Nombre </label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q14_nombreCompleto14[last]" id="last_14" />
<label class="form-sub-label" for="last_14" id="sublabel_last"> Apellido </label></span>
</div>
</li>
<li class="form-line form-line-column" id="id_5">
<label class="form-label-top" id="label_5" for="input_5">
Correo Electrónico<span class="form-required">*</span>
</label>
<div id="cid_5" class="form-input-wide">
<input type="email" class=" form-textbox validate[required, Email]" id="input_5" name="q5_correoElectronico5" size="30" value="" />
<br>
<input type="email" class="form-textbox validate[required, Email, Email_Confirm]" id="input_5_confirm" style="8px;" size="30" />
</div>
</li>
</ul>
<ul class="form-section-closed" style="height: 60px;clear:both;" id="section_10">
<li id="cid_10" class="form-input-wide">
<div class="form-collapse-table" id="collapse_10"><span class="form-collapse-mid" id="collapse-text_10">Informacion de Marca y Fecha:</span><span class="form-collapse-right form-collapse-right-hide">&nbsp;</span>
</div>
</li>
<li class="form-line form-line-column" id="id_8">
<label class="form-label-top" id="label_8" for="input_8">
MARCA:<span class="form-required">*</span>
</label>
<div id="cid_8" class="form-input-wide">
<select class="form-dropdown validate[required]" style="width:150px" id="input_8" name="q8_marca">
<option value=""> </option>
<option value="KLIPXTREME"> KLIPXTREME </option>
<option value="NEXXT SOLUTIONS"> NEXXT SOLUTIONS </option>
<option value="NUQLEO"> NUQLEO </option>
<option value="FORZA"> FORZA </option>
<option value="XTECH"> XTECH </option>
</select>
</div>
</li>
<li class="form-line form-line-column" id="id_7">
<label class="form-label-top" id="label_7" for="input_7">
Correspondiente al MES:<span class="form-required">*</span>
</label>
<div id="cid_7" class="form-input-wide">
<select class="form-dropdown validate[required]" style="width:150px" id="input_7" name="q7_correspondienteAl">
<option value=""> </option>
<option value="Enero"> Enero </option>
<option value="Febrero"> Febrero </option>
<option value="Marzo"> Marzo </option>
<option value="Abril"> Abril </option>
<option value="Mayo"> Mayo </option>
<option value="Junio"> Junio </option>
<option value="Julio"> Julio </option>
<option value="Agosto"> Agosto </option>
<option value="Septiembre"> Septiembre </option>
<option value="Octubre"> Octubre </option>
<option value="Noviembre"> Noviembre </option>
<option value="Diciembre"> Diciembre </option>
</select>
</div>
</li>

</ul>

<ul class="form-section-closed" style="height: 60px;clear:both;" id="section_21">
<li id="cid_21" class="form-input-wide">
<div class="form-collapse-table" id="collapse_21"><span class="form-collapse-mid" id="collapse-text_21">NUQLEO:</span><span class="form-collapse-right form-collapse-right-hide">&nbsp;</span>
</div>

<span class="form-product-item hover-product-item"><input class="form-checkbox" type="checkbox" id="input_100_1055" name="q100_productosA[][id]" value="1055" />
<label for="input_100_1055">
NUQLEO<span class="form-product-details"><b><span class='freeCurr' style='display:none;'>&nbsp$</span><span id="input_100_1055_price">&nbspFree</span><span class='freeCurr' style='display:none;'>&nbspUSD</span>
</b></span>
</label></span>
<br /><span class="form-product-item hover-product-item"><img src="http://accvent.desk.com/customer/portal/attachments/97692" class="form-product-image" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1034" name="q100_productosA[][id]" value="1034" />
<label for="input_100_1034">
Quark<span class="form-product-details"><b>
$<span id="input_100_1034_price">11.00</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1034][item_0]" id="input_100_quantity_1034_0" />
<label class="form-sub-label" for="input_100_quantity_1034_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://www.nuqleo.com/us/media/catalog/product/cache/1/small_image/200x289/9df78eab33525d08d6e5fb8d27136e95/q/u/quark2_yellow_box.jpg" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1035" name="q100_productosA[][id]" value="1035" />
<label for="input_100_1035">
Quark 2<span class="form-product-details"><b>
$<span id="input_100_1035_price">16.99</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1035][item_0]" id="input_100_quantity_1035_0" />
<label class="form-sub-label" for="input_100_quantity_1035_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://accvent.desk.com/customer/portal/attachments/97693" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1036" name="q100_productosA[][id]" value="1036" />
<label for="input_100_1036">
Ion<span class="form-product-details"><b>
$<span id="input_100_1036_price">27.19</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1036][item_0]" id="input_100_quantity_1036_0" />
<label class="form-sub-label" for="input_100_quantity_1036_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://www.nuqleo.com/us/media/catalog/product/cache/1/small_image/200x289/9df78eab33525d08d6e5fb8d27136e95/c/e/cellphones_ion_1.jpg" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1037" name="q100_productosA[][id]" value="1037" />
<label for="input_100_1037">
Ion Lite<span class="form-product-details"><b>
$<span id="input_100_1037_price">23.11</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1037][item_0]" id="input_100_quantity_1037_0" />
<label class="form-sub-label" for="input_100_quantity_1037_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://www.nuqleo.com/us/media/catalog/product/cache/1/small_image/200x289/9df78eab33525d08d6e5fb8d27136e95/n/e/neotouch-3.jpg" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1038" name="q100_productosA[][id]" value="1038" />
<label for="input_100_1038">
Neon Touch<span class="form-product-details"><b>
$<span id="input_100_1038_price">25.97</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1038][item_0]" id="input_100_quantity_1038_0" />
<label class="form-sub-label" for="input_100_quantity_1038_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://www.nuqleo.com/us/media/catalog/product/cache/1/small_image/200x289/9df78eab33525d08d6e5fb8d27136e95/n/e/neutron-profile.png" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1039" name="q100_productosA[][id]" value="1039" />
<label for="input_100_1039">
Neutron<span class="form-product-details"><b>
$<span id="input_100_1039_price">44.19</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1039][item_0]" id="input_100_quantity_1039_0" />
<label class="form-sub-label" for="input_100_quantity_1039_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://accvent.desk.com/customer/portal/attachments/90855" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1040" name="q100_productosA[][id]" value="1040" />
<label for="input_100_1040">
Cromo<span class="form-product-details"><b>
$<span id="input_100_1040_price">56.75</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1040][item_0]" id="input_100_quantity_1040_0" />
<label class="form-sub-label" for="input_100_quantity_1040_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://accvent.desk.com/customer/portal/attachments/90858" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1041" name="q100_productosA[][id]" value="1041" />
<label for="input_100_1041">
Fusion<span class="form-product-details"><b>
$<span id="input_100_1041_price">95.19</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1041][item_0]" id="input_100_quantity_1041_0" />
<label class="form-sub-label" for="input_100_quantity_1041_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://www.nuqleo.com/us/media/catalog/product/cache/1/small_image/200x289/9df78eab33525d08d6e5fb8d27136e95/f/u/fusion2-new2.png" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1042" name="q100_productosA[][id]" value="1042" />
<label for="input_100_1042">
Fusion 2<span class="form-product-details"><b>
$<span id="input_100_1042_price">88.39</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1042][item_0]" id="input_100_quantity_1042_0" />
<label class="form-sub-label" for="input_100_quantity_1042_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://www.nuqleo.com/us/media/catalog/product/cache/1/small_image/200x289/9df78eab33525d08d6e5fb8d27136e95/e/l/eleqtron_white-new2.png" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1043" name="q100_productosA[][id]" value="1043" />
<label for="input_100_1043">
Eleqtron<span class="form-product-details"><b>
$<span id="input_100_1043_price">101.99</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1043][item_0]" id="input_100_quantity_1043_0" />
<label class="form-sub-label" for="input_100_quantity_1043_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://www.nuqleo.com/us/media/catalog/product/cache/1/small_image/200x289/9df78eab33525d08d6e5fb8d27136e95/g/a/gamma-new.png" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1044" name="q100_productosA[][id]" value="1044" />
<label for="input_100_1044">
Gamma<span class="form-product-details"><b>
$<span id="input_100_1044_price">148.91</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1044][item_0]" id="input_100_quantity_1044_0" />
<label class="form-sub-label" for="input_100_quantity_1044_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://www.nuqleo.com/us/media/catalog/product/cache/1/small_image/200x289/9df78eab33525d08d6e5fb8d27136e95/s/p/speqtra-new.png" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1045" name="q100_productosA[][id]" value="1045" />
<label for="input_100_1045">
Speqtra<span class="form-product-details"><b>
$<span id="input_100_1045_price">169.99</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1045][item_0]" id="input_100_quantity_1045_0" />
<label class="form-sub-label" for="input_100_quantity_1045_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://accvent.desk.com/customer/portal/attachments/112046" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1046" name="q100_productosA[][id]" value="1046" />
<label for="input_100_1046">
Quantum 7<span class="form-product-details"><b>
$<span id="input_100_1046_price">65.01</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1046][item_0]" id="input_100_quantity_1046_0" />
<label class="form-sub-label" for="input_100_quantity_1046_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://accvent.desk.com/customer/portal/attachments/112046" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1047" name="q100_productosA[][id]" value="1047" />
<label for="input_100_1047">
Quantum 7 8GB<span class="form-product-details"><b>
$<span id="input_100_1047_price">65.01</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1047][item_0]" id="input_100_quantity_1047_0" />
<label class="form-sub-label" for="input_100_quantity_1047_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://www.nuqleo.com/us/media/catalog/product/cache/1/small_image/200x289/9df78eab33525d08d6e5fb8d27136e95/z/i/zinq7-catalog.png" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1048" name="q100_productosA[][id]" value="1048" />
<label for="input_100_1048">
Zinq 7<span class="form-product-details"><b>
$<span id="input_100_1048_price">77.99</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1048][item_0]" id="input_100_quantity_1048_0" />
<label class="form-sub-label" for="input_100_quantity_1048_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://www.nuqleo.com/us/media/catalog/product/cache/1/small_image/200x289/9df78eab33525d08d6e5fb8d27136e95/n/u/nuqleo_zaffire785_catalog.png" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1049" name="q100_productosA[][id]" value="1049" />
<label for="input_100_1049">
Zaffire 785<span class="form-product-details"><b>
$<span id="input_100_1049_price">149.99</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1049][item_0]" id="input_100_quantity_1049_0" />
<label class="form-sub-label" for="input_100_quantity_1049_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://www.nuqleo.com/us/media/catalog/product/cache/1/small_image/200x289/9df78eab33525d08d6e5fb8d27136e95/z/a/zaffire970_front-zine_1.png" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1050" name="q100_productosA[][id]" value="1050" />
<label for="input_100_1050">
Zaffire 970<span class="form-product-details"><b>
$<span id="input_100_1050_price">181.99</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1050][item_0]" id="input_100_quantity_1050_0" />
<label class="form-sub-label" for="input_100_quantity_1050_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://www.nuqleo.com/us/media/catalog/product/cache/1/small_image/200x289/9df78eab33525d08d6e5fb8d27136e95/z/a/zaffire1010-zine_1.png" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1051" name="q100_productosA[][id]" value="1051" />
<label for="input_100_1051">
Zaffire 1010<span class="form-product-details"><b>
$<span id="input_100_1051_price">194.99</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1051][item_0]" id="input_100_quantity_1051_0" />
<label class="form-sub-label" for="input_100_quantity_1051_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://www.nuqleo.com/us/media/catalog/product/cache/1/small_image/200x289/9df78eab33525d08d6e5fb8d27136e95/q/r/qrypton7_front_zine2.png" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1052" name="q100_productosA[][id]" value="1052" />
<label for="input_100_1052">
Qrypton 7<span class="form-product-details"><b>
$<span id="input_100_1052_price">136.49</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1052][item_0]" id="input_100_quantity_1052_0" />
<label class="form-sub-label" for="input_100_quantity_1052_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://www.nuqleo.com/us/media/catalog/product/cache/1/small_image/200x289/9df78eab33525d08d6e5fb8d27136e95/q/r/qrypton1010_front-web.png" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1053" name="q100_productosA[][id]" value="1053" />
<label for="input_100_1053">
Qrypton 1010<span class="form-product-details"><b>
$<span id="input_100_1053_price">207.99</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1053][item_0]" id="input_100_quantity_1053_0" />
<label class="form-sub-label" for="input_100_quantity_1053_0"> Cantidad </label></span></span>
<br />

 


<! Ending for Nuqleo Label !>
</li>
</ul>

<ul class="form-section-closed" style="height: 60px;clear:both;" id="section_106">
<li id="cid_106" class="form-input-wide">
<div class="form-collapse-table" id="collapse_106"><span class="form-collapse-mid" id="collapse-text_106">FORZA:</span><span class="form-collapse-right form-collapse-right-hide">&nbsp;</span>
</div>

<span class="form-product-item hover-product-item"><input class="form-checkbox" type="checkbox" id="input_100_1056" name="q100_productosA[][id]" value="1056" />
<label for="input_100_1056">
FORZA<span class="form-product-details"><b><span class='freeCurr' style='display:none;'>&nbsp$</span><span id="input_100_1056_price">&nbspFree</span><span class='freeCurr' style='display:none;'>&nbspUSD</span>
</b></span>
</label></span>
<br /><span class="form-product-item hover-product-item"><img src="http://accvent.desk.com/customer/portal/attachments/180577" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1054" name="q100_productosA[][id]" value="1054" />
<label for="input_100_1054">
Elipse 3K<span class="form-product-details"><b>
$<span id="input_100_1054_price">1,000.00</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1054][item_0]" id="input_100_quantity_1054_0" />
<label class="form-sub-label" for="input_100_quantity_1054_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://accvent.desk.com/customer/portal/attachments/180082" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1057" name="q100_productosA[][id]" value="1057" />
<label for="input_100_1057">
Elipse 6K<span class="form-product-details"><b>
$<span id="input_100_1057_price">2,000.00</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1057][item_0]" id="input_100_quantity_1057_0" />
<label class="form-sub-label" for="input_100_quantity_1057_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://accvent.desk.com/customer/portal/attachments/180645" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1058" name="q100_productosA[][id]" value="1058" />
<label for="input_100_1058">
Elipse 10K<span class="form-product-details"><b>
$<span id="input_100_1058_price">3,000.00</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1058][item_0]" id="input_100_quantity_1058_0" />
<label class="form-sub-label" for="input_100_quantity_1058_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://accvent.desk.com/customer/portal/attachments/180580" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1059" name="q100_productosA[][id]" value="1059" />
<label for="input_100_1059">
ATLAS 3K<span class="form-product-details"><b>
$<span id="input_100_1059_price">2,000.00</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1059][item_0]" id="input_100_quantity_1059_0" />
<label class="form-sub-label" for="input_100_quantity_1059_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://accvent.desk.com/customer/portal/attachments/180606" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1060" name="q100_productosA[][id]" value="1060" />
<label for="input_100_1060">
ATLAS 6K<span class="form-product-details"><b>
$<span id="input_100_1060_price">3,000.00</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1060][item_0]" id="input_100_quantity_1060_0" />
<label class="form-sub-label" for="input_100_quantity_1060_0"> Cantidad </label></span></span>
<br /><span class="form-product-item hover-product-item"><img src="http://accvent.desk.com/customer/portal/attachments/180611" class="form-product-image-with-options" height="50" width="50" align="absmiddle" />
<input class="form-checkbox" type="checkbox" id="input_100_1061" name="q100_productosA[][id]" value="1061" />
<label for="input_100_1061">
ATLAS 10K<span class="form-product-details"><b>
$<span id="input_100_1061_price">4,000.00</span>
USD
</b></span>
</label>
<br />
<br /><span class="form-sub-label-container"><input type="text" size="3" onblur="if(!this.value)this.value=0" style="text-align:left; width:30px; padding-left:4px " value="0" class="form-textbox" name="q100_productosA[special_1061][item_0]" id="input_100_quantity_1061_0" />
<label class="form-sub-label" for="input_100_quantity_1061_0"> Cantidad </label></span></span>
<br />

<! Ending of Forza Label !>

</li>
</ul>

<ul class="form-section-closed" style="height: 60px;clear:both;" id="section_107">
<li id="cid_107" class="form-input-wide">
<div class="form-collapse-table" id="collapse_107"><span class="form-collapse-mid" id="collapse-text_107">KLIPXTREME:</span><span class="form-collapse-right form-collapse-right-hide">&nbsp;</span>
</div>
</li>
</ul>
<ul class="form-section-closed" style="height: 60px;clear:both;" id="section_108">
<li id="cid_108" class="form-input-wide">
<div class="form-collapse-table" id="collapse_108"><span class="form-collapse-mid" id="collapse-text_108">NEXXT:</span><span class="form-collapse-right form-collapse-right-hide">&nbsp;</span>
</div>
</li>
</ul>

<! Total at the end after all labels !>

<li class="form-line" id="id_100">
<label class="form-label-left" id="label_100" for="input_100"> Productos a Acreditar: </label>
<div id="cid_100" class="form-input">
<input type="hidden" name="simple_fpc" value="100" />
<br /><span class="form-payment-total">
<b>
Total:&nbsp;<span>$<span id="payment_total">0.00</span>
USD</span></span>
</b>
</div>
</li>


<! Closing UL for all sales list 1>
</ul>
<ul class="form-section" id="section_87">
<li id="cid_87" class="form-input-wide">
<div class="form-collapse-table" id="collapse_87"><span class="form-collapse-mid" id="collapse-text_87">Enviar Formulario:</span><span class="form-collapse-right form-collapse-right-show">&nbsp;</span>
</div>
</li>
<li class="form-line" id="id_93">
<label class="form-label-top" id="label_93" for="input_93"> Agregue Reporte Completo o Archivo de RMA </label>
<div id="cid_93" class="form-input-wide">
<div class="qq-uploader-buttonText-value">
Suba Archivos
</div>
<input class="form-upload-multiple" type="file" id="input_93" name="q93_agregueReporte93[]" multiple="multiple" file-accept="*" file-maxsize="2048" />
</div>
</li>
<li class="form-line" id="id_92">
<div id="cid_92" class="form-input-wide">
<div style="text-align:center" class="form-buttons-wrapper">
<button id="input_92" type="submit" class="form-submit-button form-submit-button-cool_grey_rounded">
Enviar
</button>
&nbsp;
<button id="input_print_92" style="25px;" class="form-submit-print form-submit-button-cool_grey_rounded" type="button">
<img src="http://cdn.jotfor.ms/images/printer.png" align="absmiddle" />
Imprimir formulario
</button>
</div>
</div>
</li>
</ul>
<li id="cid_94" class="form-input-wide">
<div class="form-pagebreak">
<div class="form-pagebreak-back-container form-label-left">
<button type="button" class="form-pagebreak-back form-submit-button-cool_grey" id="form-pagebreak-back_94">
Atras
</button>
</div>
<div class="form-pagebreak-next-container">
<button type="button" class="form-pagebreak-next form-submit-button-cool_grey" id="form-pagebreak-next_94">
Siguiente (Solo para Autorizar)
</button>
</div>
</div>
</li>
</ul>
<ul class="form-section" style="display:none;">
<ul class="form-section" id="section_83">
<li id="cid_83" class="form-input-wide">
<div class="form-collapse-table" id="collapse_83"><span class="form-collapse-mid" id="collapse-text_83">Aprobacion de Credito: (Solo para Usuarios Autorizados)</span><span class="form-collapse-right form-collapse-right-show">&nbsp;</span>
</div>
</li>
<li class="form-line" id="id_84">
<div id="cid_84" class="form-input-wide">
<div id="text_84" class="form-html">
<p>
En este campo es necesario tener una contraseña como Usuario Autorizado para aprobar un credito, de no ser asi solo llene el formulario con la informacion necesaria, dirijase a la opcion ATRAS y luego ENVIAR.
</p>
</div>
</div>
</li>
<li class="form-line" id="id_95">
<label class="form-label-left" id="label_95" for="input_95">
Usuario:<span class="form-required">*</span>
</label>
<div id="cid_95" class="form-input">
<input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_95" name="q95_usuario" size="20" value="" />
</div>
</li>
<li class="form-line" id="id_85">
<label class="form-label-left" id="label_85" for="input_85">
Contraseña de Aprobacion:<span class="form-required">*</span>
</label>
<div id="cid_85" class="form-input">
<input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_85" name="q85_contrasenaDe85" size="20" value="" />
</div>
</li>
<li class="form-line" id="id_86">
<label class="form-label-left" id="label_86" for="input_86">
Status de Aprobacion:<span class="form-required">*</span>
</label>
<div id="cid_86" class="form-input">
<div class="form-single-column"><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio validate[required]" id="input_86_0" name="q86_clickTo86" value="SI" />
<label for="input_86_0"> SI </label></span><span class="clearfix"></span><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio validate[required]" id="input_86_1" name="q86_clickTo86" value="NO" />
<label for="input_86_1"> NO </label></span><span class="clearfix"></span>
</div>
</div>
</li>
<li class="form-line" id="id_91">
<label class="form-label-left" id="label_91" for="input_91"> Comentarios: </label>
<div id="cid_91" class="form-input">
<textarea id="input_91" class="form-textarea" name="q91_comentarios" cols="40" rows="6"></textarea>
</div>
</li>
<li class="form-line" id="id_102">
<div id="cid_102" class="form-input-wide">
<div id="text_102" class="form-html">
<p>
Si esta viendo este mensaje es por que usted aprobo el credito en este formulario, el siguiente paso es indicarle a la sede principal que procese su aprobacion.
</p>
<p>
Llene algun comentario para indicarle algun requerimiento o proceso especial a el departamento de RMA.
</p>
</div>
</div>
</li>
<li class="form-line form-line-column" id="id_104">
<label class="form-label-top" id="label_104" for="input_104"> Comentarios para la sede en base a el credito dato: </label>
<div id="cid_104" class="form-input-wide">
<textarea id="input_104" class="form-textarea" name="q104_comentariosPara" cols="40" rows="6"></textarea>
</div>
</li>
<li class="form-line" id="id_96">
<div id="cid_96" class="form-input-wide">
<div style="156px" class="form-buttons-wrapper">
<button id="input_96" type="submit" class="form-submit-button form-submit-button-cool_grey_rounded">
Enviar
</button>
</div>
</div>
</li>
<li style="display:none">
Should be Empty:
<input type="text" name="website" value="" />
</li>
</ul>
</div>
<input type="hidden" id="simple_spc" name="simple_spc" value="33505416214849" />
<script type="text/javascript">
document.getElementById("si" + "mple" + "_spc").value = "33505416214849-33505416214849";
</script>
<input type="hidden" class="form-hidden" value="" id="input_89" name="q89_editLink89" />
<input type="hidden" class="form-hidden" value="" id="input_105" name="q105_creditNote" />
</form>