<script language="javascript" type="text/javascript">
function SubmitForm() {
 var st_error = "";
   var flag = false;
    var var_result = document.getElementById("txtResult");
  if (var_result.value == "")
   {
      flag = true;
       st_error += "The spam code is required.";
   }
 if (flag)
  {
      alert(st_error);
    }
    else
    {
 document.forms.form2.action = "FormBlight_Complaint_FormExcute.aspx?formCode=Blight_Complaint_Form&url=" + location.href;
   document.forms.form2.submit();
    }
}
 
 </script> <div align="center"> <fieldset style="width: 90%; padding: 10px">   <form id="form2" name="paypal.com"  action="" method="post"> <div>
<table>
<tr><td align="right"><strong>Name</strong></td><td align="left"><input type="text" id="textbox01" name="textbox01" style = "" class="MANAGEWEBSITE_140" maxlength="255"/></td></tr><tr><td align="right"><strong>Blighted Property Information. Please include address or parcel number</strong></td><td align="left"><textarea cols="35"  class="CommentMANAGEWEBSITE" rows="5"  id="textarea01" name="textarea01" style = ""  maxlength="255"></textarea></td></tr><tr><td align="right"><strong>Add Pictures</strong></td><td align="left"><input type="file" id="uploadbox01" name="uploadbox01" style = "" class="MANAGEWEBSITE_UPLOAD" /></td></tr>
<tr>
    <td align="right">
       <strong>Anti-spam code<span style="color: Red">*</span></strong>
    </td>
    <td align="left" valign="top">
       <table border="0" cellpadding="0" cellspacing="0">
        <tr>
           <td colspan="2">
                <table border="0" cellpadding="0" cellspacing="0">
                    <tr>
                        <td>
         <img src="CustomFormCaptcharHandler.ashx" id="imgCaptcha" alt="" />
                            <script type="text/javascript">
 RefreshCaptcha();
                                  function RefreshCaptcha() {
                                   var img = document.getElementById("imgCaptcha");
                                    img.src = "CustomFormCaptcharHandler.ashx?query=" + Math.random() + "&act=ref";
                                   }
                            </script>
         </td>
                <td align="right" style="width: 20px;">
                  <a name="ref" style="cursor: pointer;"  onclick="javascript:RefreshCaptcha();">
                    <img alt="" src="images/Refresh_s.png" /></a>
                        </td>
                       </tr>
                    </table>
                    </td>
                            </tr>
                  <tr>
                     <td>
                   <input style="margin-top: 5px;"  id="txtResult" name="txtResult" class="MANAGEWEBSITE_140"
                        maxlength="255" type="text" />
                      </td>
                     <td>
                  </td>
                          </tr>
                  </table>
      </td>
    </tr>
<tr><td > <input type="hidden" id="hdAction" style = "" name="hdAction"/>  <input type="hidden" id="hdID" style = "" name="hdID"/>  <input type="hidden" id="hdFormCode" style = "" name="hdFormCode" value="Blight_Complaint_Form"/></td><td><input type="button"  value="Submit" style="cursor:pointer;" class="buttonSearch" id="Submit"  onclick="return SubmitForm();" /> <label><input style="cursor:pointer;" type="reset" name="Reset" value="Reset"  class="buttonSearch"  /></label> </td>   </tr></table></div></form> </fieldset> </div>