{"id":3791,"date":"2026-01-30T14:43:29","date_gmt":"2026-01-30T14:43:29","guid":{"rendered":"https:\/\/dominionelectric.com\/?page_id=3791"},"modified":"2026-01-30T19:04:07","modified_gmt":"2026-01-30T19:04:07","slug":"credit-card-conly-account-application","status":"publish","type":"page","link":"https:\/\/dominionelectric.com\/es\/credit-card-conly-account-application\/","title":{"rendered":"Credit Card only Account Application"},"content":{"rendered":"<style>.elementor-3791 .elementor-element.elementor-element-dd46e82{--display:flex;--flex-direction:column;--container-widget-width:100%;--container-widget-height:initial;--container-widget-flex-grow:0;--container-widget-align-self:initial;--flex-wrap-mobile:wrap;--overlay-opacity:0.5;--padding-top:200px;--padding-bottom:200px;--padding-left:0px;--padding-right:0px;}.elementor-3791 .elementor-element.elementor-element-dd46e82:not(.elementor-motion-effects-element-type-background), .elementor-3791 .elementor-element.elementor-element-dd46e82 > .elementor-motion-effects-container > .elementor-motion-effects-layer{background-image:url(\"https:\/\/dominionelectric.com\/wp-content\/uploads\/2025\/07\/Both-Arlington-Buildings-copy-1024x681-1.webp\");background-position:center center;background-repeat:no-repeat;background-size:cover;}.elementor-3791 .elementor-element.elementor-element-dd46e82::before, .elementor-3791 .elementor-element.elementor-element-dd46e82 > .elementor-background-video-container::before, .elementor-3791 .elementor-element.elementor-element-dd46e82 > .e-con-inner > .elementor-background-video-container::before, .elementor-3791 .elementor-element.elementor-element-dd46e82 > .elementor-background-slideshow::before, .elementor-3791 .elementor-element.elementor-element-dd46e82 > .e-con-inner > .elementor-background-slideshow::before, .elementor-3791 .elementor-element.elementor-element-dd46e82 > .elementor-motion-effects-container > .elementor-motion-effects-layer::before{--background-overlay:'';background-color:#000000;}.elementor-3791 .elementor-element.elementor-element-8b4a70c{text-align:center;}.elementor-3791 .elementor-element.elementor-element-8b4a70c .elementor-heading-title{font-family:\"Azo Sans\", Sans-serif;font-size:48px;font-weight:700;color:#FFFFFF;}.elementor-3791 .elementor-element.elementor-element-8b4a70c > .elementor-widget-container{margin:0px 0px 0px 0px;padding:0px 0px 0px 0px;}.elementor-3791 .elementor-element.elementor-element-eadfdaf{--display:flex;--flex-direction:column;--container-widget-width:100%;--container-widget-height:initial;--container-widget-flex-grow:0;--container-widget-align-self:initial;--flex-wrap-mobile:wrap;--padding-top:0px;--padding-bottom:80px;--padding-left:0px;--padding-right:0px;}@media(min-width:768px){.elementor-3791 .elementor-element.elementor-element-eadfdaf{--content-width:1140px;}}<\/style>\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"3791\" class=\"elementor elementor-3791\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-dd46e82 e-flex e-con-boxed e-con e-parent\" data-id=\"dd46e82\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8b4a70c elementor-widget elementor-widget-heading\" data-id=\"8b4a70c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Credit Card Only Account Application<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-eadfdaf e-flex e-con-boxed e-con e-parent\" data-id=\"eadfdaf\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-01aae8b elementor-widget elementor-widget-shortcode\" data-id=\"01aae8b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><style id=\"wpforms-css-vars-3799\">\n\t\t\t\t#wpforms-3799 {\n\t\t\t\t--wpforms-field-border-color: rgba(0, 0, 0, 0.25);\n--wpforms-field-border-color-spare: rgba(0, 0, 0, 0.25);\n--wpforms-field-text-color: rgba(0, 0, 0, 0.7);\n--wpforms-label-color: rgba(0, 0, 0, 0.85);\n--wpforms-label-sublabel-color: rgba(0, 0, 0, 0.55);\n--wpforms-button-border-style: solid;\n--wpforms-button-background-color: #006648;\n--wpforms-button-border-color: #000000;\n--wpforms-background-color: rgba(0, 0, 0, 0);\n--wpforms-field-size-input-height: 43px;\n--wpforms-field-size-input-spacing: 15px;\n--wpforms-field-size-font-size: 16px;\n--wpforms-field-size-line-height: 19px;\n--wpforms-field-size-padding-h: 14px;\n--wpforms-field-size-checkbox-size: 16px;\n--wpforms-field-size-sublabel-spacing: 5px;\n--wpforms-field-size-icon-size: 1;\n--wpforms-label-size-font-size: 16px;\n--wpforms-label-size-line-height: 19px;\n--wpforms-label-size-sublabel-font-size: 14px;\n--wpforms-label-size-sublabel-line-height: 17px;\n--wpforms-button-size-font-size: 17px;\n--wpforms-button-size-height: 41px;\n--wpforms-button-size-padding-h: 15px;\n--wpforms-button-size-margin-top: 10px;\n--wpforms-container-shadow-size-box-shadow: none;\n\t\t\t}\n\t\t\t<\/style><div class=\"wpforms-container wpforms-container-full wpforms-render-modern\" id=\"wpforms-3799\"><form id=\"wpforms-form-3799\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"3799\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/es\/wp-json\/wp\/v2\/pages\/3791\" data-token=\"93cbb3b6551c6abbfb18703af6c82ba6\" data-token-time=\"1776845930\"><noscript class=\"wpforms-error-noscript\">Por favor, activa JavaScript en tu navegador para completar este formulario.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Por favor, activa JavaScript en tu navegador para completar este formulario.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-3799-field_2-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"2\"><div id=\"wpforms-3799-field_2\" class=\"wpforms-field-large wpforms-field-row\" aria-errormessage=\"wpforms-3799-field_2-error\"><h4 style=\"text-align:center\"><img decoding=\"async\" class=\"size-medium wp-image-3313 aligncenter\" src=\"https:\/\/dominionelectric.com\/wp-content\/uploads\/2023\/05\/441458621_426243253634409_8438000861081748062_n-e1715929836544-300x134.jpeg\" alt=\"Logo of Dominion Electric Supply Company, a division of Border States, displayed with green and black text on a white background.\" width=\"300\" height=\"134\" title=\"\" srcset=\"https:\/\/dominionelectric.com\/wp-content\/uploads\/2023\/05\/441458621_426243253634409_8438000861081748062_n-e1715929836544-300x134.jpeg 300w, https:\/\/dominionelectric.com\/wp-content\/uploads\/2023\/05\/441458621_426243253634409_8438000861081748062_n-e1715929836544-1024x459.jpeg 1024w, https:\/\/dominionelectric.com\/wp-content\/uploads\/2023\/05\/441458621_426243253634409_8438000861081748062_n-e1715929836544-768x344.jpeg 768w, https:\/\/dominionelectric.com\/wp-content\/uploads\/2023\/05\/441458621_426243253634409_8438000861081748062_n-e1715929836544-18x8.jpeg 18w, https:\/\/dominionelectric.com\/wp-content\/uploads\/2023\/05\/441458621_426243253634409_8438000861081748062_n-e1715929836544.jpeg 1080w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/h4>\n<p style=\"text-align:center\">5053 Langston Blvd Arlington, VA 22207<\/p>\n<p style=\"text-align:center\">Phone: (703) 536-4400; Email: <a style=\"color:#006648\" href=\"mailto:DOM-AR@borderstates.com\">DOM-AR@borderstates.com<\/a><\/p>\n<h4 style=\"text-align:center\">Cash Account Application<\/h4>\n<p style=\"text-align:left\">By signing this form you give DOMINION ELECTRIC SUPPLY - A Division of Border States permission to authorize the person below to access account activity\/information through our website <a href=\"https:\/\/dominionelectric.com\/\">www.dominionelectric.com<\/a>.<\/p>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><div id=\"wpforms-3799-field_3-container\" class=\"wpforms-field wpforms-field-date-time\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-3799-field_3\">Date <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><div class=\"wpforms-datepicker-wrap\"><input type=\"text\" id=\"wpforms-3799-field_3\" class=\"wpforms-field-date-time-date wpforms-datepicker wpforms-field-required wpforms-field-large\" data-date-format=\"m\/d\/Y\" data-disable-past-dates=\"0\" data-input=\"true\" name=\"wpforms[fields][3][date]\" aria-errormessage=\"wpforms-3799-field_3-error\" required><a title=\"Borrar fecha\" data-clear role=\"button\" tabindex=\"0\" class=\"wpforms-datepicker-clear\" aria-label=\"Borrar fecha\" style=\"display:none;\"><\/a><\/div><\/div><div id=\"wpforms-3799-field_4-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-3799-field_4\">Business Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3799-field_4\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][4]\" aria-errormessage=\"wpforms-3799-field_4-error\" required><\/div><div id=\"wpforms-3799-field_5-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"5\"><fieldset><legend class=\"wpforms-field-label\">Billing Address <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-3799-field_5\" class=\"wpforms-field-address-address1 wpforms-field-required\" name=\"wpforms[fields][5][address1]\" aria-errormessage=\"wpforms-3799-field_5-error\" required><label for=\"wpforms-3799-field_5\" class=\"wpforms-field-sublabel after\">Direcci\u00f3n (l\u00ednea 1)<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-3799-field_5-city\" class=\"wpforms-field-address-city wpforms-field-required\" name=\"wpforms[fields][5][city]\" aria-errormessage=\"wpforms-3799-field_5-city-error\" required><label for=\"wpforms-3799-field_5-city\" class=\"wpforms-field-sublabel after\">Ciudad<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-3799-field_5-state\" class=\"wpforms-field-address-state wpforms-field-required\" name=\"wpforms[fields][5][state]\" aria-errormessage=\"wpforms-3799-field_5-state-error\" required><option class=\"placeholder\" value=\"\" selected disabled>--- Selecciona state ---<\/option><option value=\"AL\" >Alabama<\/option><option value=\"AK\" >Alaska<\/option><option value=\"AZ\" >Arizona<\/option><option value=\"AR\" >Arkansas<\/option><option value=\"CA\" >California<\/option><option value=\"CO\" >Colorado<\/option><option value=\"CT\" >Connecticut<\/option><option value=\"DE\" >Delaware<\/option><option value=\"DC\" >Distrito de Columbia<\/option><option value=\"FL\" >Florida<\/option><option value=\"GA\" >Georgia<\/option><option value=\"HI\" >Hawai<\/option><option value=\"ID\" >Idaho<\/option><option value=\"IL\" >Illinois<\/option><option value=\"IN\" >Indiana<\/option><option value=\"IA\" >Iowa<\/option><option value=\"KS\" >Kansas<\/option><option value=\"KY\" >Kentucky<\/option><option value=\"LA\" >Luisiana<\/option><option value=\"ME\" >Maine<\/option><option value=\"MD\" >Maryland<\/option><option value=\"MA\" >Massachusetts<\/option><option value=\"MI\" >M\u00edchigan<\/option><option value=\"MN\" >Minnesota<\/option><option value=\"MS\" >Misisip\u00ed<\/option><option value=\"MO\" >Misuri<\/option><option value=\"MT\" >Montana<\/option><option value=\"NE\" >Nebraska<\/option><option value=\"NV\" >Nevada<\/option><option value=\"NH\" >Nuevo Hampshire<\/option><option value=\"NJ\" >Nueva Jersey<\/option><option value=\"NM\" >Nuevo M\u00e9xico<\/option><option value=\"NY\" >Nueva York<\/option><option value=\"NC\" >Carolina del norte<\/option><option value=\"ND\" >Dakota del norte<\/option><option value=\"OH\" >Ohio<\/option><option value=\"OK\" >Oklahoma<\/option><option value=\"OR\" >Oreg\u00f3n<\/option><option value=\"PA\" >Pensilvania<\/option><option value=\"RI\" >Rhode Island<\/option><option value=\"SC\" >Carolina del Sur<\/option><option value=\"SD\" >Dakota del Sur<\/option><option value=\"TN\" >Tennessee<\/option><option value=\"TX\" >Texas<\/option><option value=\"UT\" >Utah<\/option><option value=\"VT\" >Vermont<\/option><option value=\"VA\" >Virginia<\/option><option value=\"WA\" >Washington<\/option><option value=\"WV\" >Virginia Occidental<\/option><option value=\"WI\" >Wisconsin<\/option><option value=\"WY\" >Wyoming<\/option><\/select><label for=\"wpforms-3799-field_5-state\" class=\"wpforms-field-sublabel after\">Provincia<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-3799-field_5-postal\" class=\"wpforms-field-address-postal wpforms-field-required wpforms-masked-input\" data-inputmask-mask=\"(99999)|(99999-9999)\" data-inputmask-keepstatic=\"true\" data-rule-inputmask-incomplete=\"1\" name=\"wpforms[fields][5][postal]\" aria-errormessage=\"wpforms-3799-field_5-postal-error\" required><label for=\"wpforms-3799-field_5-postal\" class=\"wpforms-field-sublabel after\">C\u00f3digo Postal<\/label><\/div><\/div><\/fieldset><\/div><div id=\"wpforms-3799-field_6-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-3799-field_6\">Requested By: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3799-field_6\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][6]\" aria-errormessage=\"wpforms-3799-field_6-error\" required><\/div><div id=\"wpforms-3799-field_8-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-3799-field_8\">Phone <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-3799-field_8\" class=\"wpforms-field-large wpforms-field-required wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][8]\" aria-label=\"Phone\" aria-errormessage=\"wpforms-3799-field_8-error\" required><\/div><div id=\"wpforms-3799-field_9-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-3799-field_9\">Email <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-3799-field_9\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][9]\" spellcheck=\"false\" aria-errormessage=\"wpforms-3799-field_9-error\" required><\/div><div id=\"wpforms-3799-field_10-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"10\"><h3 id=\"wpforms-3799-field_10\" aria-errormessage=\"wpforms-3799-field_10-error\" aria-describedby=\"wpforms-3799-field_10-description\">Please complete the information below:<\/h3><div id=\"wpforms-3799-field_10-description\" class=\"wpforms-field-description\"> Your information will be kept confidential and will only be used by Dominion Electric for our internal purposes of serving you.<\/div><\/div><div id=\"wpforms-3799-field_11-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"11\"><div id=\"wpforms-3799-field_11\" class=\"wpforms-field-large wpforms-field-row\" aria-errormessage=\"wpforms-3799-field_11-error\"><h4 style=\"text-align:center\">User Information<\/h4>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><div id=\"wpforms-3799-field_13-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"13\"><label class=\"wpforms-field-label\" for=\"wpforms-3799-field_13\">Authorized Username<\/label><input type=\"text\" id=\"wpforms-3799-field_13\" class=\"wpforms-field-large\" name=\"wpforms[fields][13]\" aria-errormessage=\"wpforms-3799-field_13-error\" ><\/div><div id=\"wpforms-3799-field_14-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-3799-field_14\">Company Title<\/label><input type=\"text\" id=\"wpforms-3799-field_14\" class=\"wpforms-field-large\" name=\"wpforms[fields][14]\" aria-errormessage=\"wpforms-3799-field_14-error\" ><\/div><div id=\"wpforms-3799-field_15-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-3799-field_15\">Email<\/label><input type=\"email\" id=\"wpforms-3799-field_15\" class=\"wpforms-field-large\" name=\"wpforms[fields][15]\" spellcheck=\"false\" aria-errormessage=\"wpforms-3799-field_15-error\" ><\/div><div id=\"wpforms-3799-field_16-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-3799-field_16\">Phone<\/label><input type=\"tel\" id=\"wpforms-3799-field_16\" class=\"wpforms-field-large wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][16]\" aria-label=\"Phone\" aria-errormessage=\"wpforms-3799-field_16-error\" ><\/div><div id=\"wpforms-3799-field_17-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-3799-field_17\">Fax<\/label><input type=\"number\" id=\"wpforms-3799-field_17\" class=\"wpforms-field-large\" name=\"wpforms[fields][17]\" step=\"any\" aria-errormessage=\"wpforms-3799-field_17-error\" ><\/div><div id=\"wpforms-3799-field_18-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"18\"><label class=\"wpforms-field-label\" for=\"wpforms-3799-field_18\">Supervisor\/Manager (if applicable)<\/label><input type=\"text\" id=\"wpforms-3799-field_18\" class=\"wpforms-field-large\" name=\"wpforms[fields][18]\" aria-errormessage=\"wpforms-3799-field_18-error\" ><\/div><div id=\"wpforms-3799-field_19-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-inline\" data-field-id=\"19\"><fieldset><legend class=\"wpforms-field-label\">Access Available To USER (Please Check All That Apply) <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-3799-field_19\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-3799-field_19_1\" name=\"wpforms[fields][19][]\" value=\"Product Orders\" aria-errormessage=\"wpforms-3799-field_19_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3799-field_19_1\">Product Orders<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-3799-field_19_2\" name=\"wpforms[fields][19][]\" value=\"Product Price Availability\" aria-errormessage=\"wpforms-3799-field_19_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3799-field_19_2\">Product Price Availability<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-3799-field_19_3\" name=\"wpforms[fields][19][]\" value=\"Account Status\" aria-errormessage=\"wpforms-3799-field_19_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3799-field_19_3\">Account Status<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-3799-field_19_4\" name=\"wpforms[fields][19][]\" value=\"Account History\" aria-errormessage=\"wpforms-3799-field_19_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3799-field_19_4\">Account History<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-3799-field_20-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"20\"><fieldset><legend class=\"wpforms-field-label\">Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-3799-field_20\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][20][first]\" aria-errormessage=\"wpforms-3799-field_20-error\" required><label for=\"wpforms-3799-field_20\" class=\"wpforms-field-sublabel after\">Nombre<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-3799-field_20-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][20][last]\" aria-errormessage=\"wpforms-3799-field_20-last-error\" required><label for=\"wpforms-3799-field_20-last\" class=\"wpforms-field-sublabel after\">Apellidos<\/label><\/div><\/div><\/fieldset><\/div><div id=\"wpforms-3799-field_22-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"22\"><label class=\"wpforms-field-label\" for=\"wpforms-3799-field_22\">Title <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3799-field_22\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][22]\" aria-errormessage=\"wpforms-3799-field_22-error\" required><\/div><div id=\"wpforms-3799-field_21-container\" class=\"wpforms-field wpforms-field-signature\" data-field-id=\"21\"><label class=\"wpforms-field-label\" for=\"wpforms-3799-field_21\">Signature <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3799-field_21\" class=\"wpforms-signature-input wpforms-screen-reader-element wpforms-field-required\" data-is-wrapped-field=\"1\" name=\"wpforms[fields][21]\" autocomplete=\"off\" inputmode=\"none\" aria-errormessage=\"wpforms-3799-field_21-error\" required><div class=\"wpforms-signature-wrap wpforms-field-row wpforms-field-large\"><canvas class=\"wpforms-signature-canvas\" id=\"wpforms-3799-field_21-signature\" data-color=\"#000000\"><\/canvas><div class=\"wpforms-signature-clear\" title=\"Borrar firma\" tabindex=\"0\">\n\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"1em\" height=\"1em\" preserveAspectRatio=\"xMidYMid meet\" viewBox=\"0 0 1536 1536\">\n\t\t\t\t\t<path fill=\"var( --wpforms-field-text-color, rgba(0, 0, 0, 0.25) )\" d=\"M1149 994q0-26-19-45L949 768l181-181q19-19 19-45q0-27-19-46l-90-90q-19-19-46-19q-26 0-45 19L768 587L587 406q-19-19-45-19q-27 0-46 19l-90 90q-19 19-19 46q0 26 19 45l181 181l-181 181q-19 19-19 45q0 27 19 46l90 90q19 19 46 19q26 0 45-19l181-181l181 181q19 19 45 19q27 0 46-19l90-90q19-19 19-46zm387-226q0 209-103 385.5T1153.5 1433T768 1536t-385.5-103T103 1153.5T0 768t103-385.5T382.5 103T768 0t385.5 103T1433 382.5T1536 768z\"\/>\n\t\t\t\t<\/svg>\n\t\t\t\t<div class=\"wpforms-signature-clear-caption\">Borrar firma<\/div>\n\t\t\t<\/div><\/div><\/div><div id=\"wpforms-3799-field_23-container\" class=\"wpforms-field wpforms-field-date-time\" data-field-id=\"23\"><label class=\"wpforms-field-label\" for=\"wpforms-3799-field_23\">Date <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><div class=\"wpforms-datepicker-wrap\"><input type=\"text\" id=\"wpforms-3799-field_23\" class=\"wpforms-field-date-time-date wpforms-datepicker wpforms-field-required wpforms-field-large\" data-date-format=\"m\/d\/Y\" data-disable-past-dates=\"0\" data-input=\"true\" name=\"wpforms[fields][23][date]\" aria-errormessage=\"wpforms-3799-field_23-error\" required><a title=\"Borrar fecha\" data-clear role=\"button\" tabindex=\"0\" class=\"wpforms-datepicker-clear\" aria-label=\"Borrar fecha\" style=\"display:none;\"><\/a><\/div><\/div><div id=\"wpforms-3799-field_24-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"24\"><h3 id=\"wpforms-3799-field_24\" aria-errormessage=\"wpforms-3799-field_24-error\">Dominion Use Only<\/h3><\/div><div id=\"wpforms-3799-field_25-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"25\"><label class=\"wpforms-field-label\" for=\"wpforms-3799-field_25\">Verified By<\/label><input type=\"text\" id=\"wpforms-3799-field_25\" class=\"wpforms-field-large\" name=\"wpforms[fields][25]\" aria-errormessage=\"wpforms-3799-field_25-error\" ><\/div><div id=\"wpforms-3799-field_26-container\" class=\"wpforms-field wpforms-field-date-time\" data-field-id=\"26\"><label class=\"wpforms-field-label\" for=\"wpforms-3799-field_26\">Received Date<\/label><div class=\"wpforms-datepicker-wrap\"><input type=\"text\" id=\"wpforms-3799-field_26\" class=\"wpforms-field-date-time-date wpforms-datepicker wpforms-field-large\" data-date-format=\"m\/d\/Y\" data-disable-past-dates=\"0\" data-input=\"true\" name=\"wpforms[fields][26][date]\" aria-errormessage=\"wpforms-3799-field_26-error\" ><a title=\"Borrar fecha\" data-clear role=\"button\" tabindex=\"0\" class=\"wpforms-datepicker-clear\" aria-label=\"Borrar fecha\" style=\"display:none;\"><\/a><\/div><\/div>\t\t<div id=\"wpforms-3799-field_1-container\"\n\t\t\tclass=\"wpforms-field wpforms-field-text\"\n\t\t\tdata-field-type=\"text\"\n\t\t\tdata-field-id=\"1\"\n\t\t\t>\n\t\t\t<label class=\"wpforms-field-label\" for=\"wpforms-3799-field_1\" >Date Date information<\/label>\n\t\t\t<input type=\"text\" id=\"wpforms-3799-field_1\" class=\"wpforms-field-medium\" name=\"wpforms[fields][1]\" >\n\t\t<\/div>\n\t\t<div id=\"wpforms-3799-field_27-container\" class=\"wpforms-field wpforms-field-date-time\" data-field-id=\"27\"><label class=\"wpforms-field-label\" for=\"wpforms-3799-field_27\">Approved Date<\/label><div class=\"wpforms-datepicker-wrap\"><input type=\"text\" id=\"wpforms-3799-field_27\" class=\"wpforms-field-date-time-date wpforms-datepicker wpforms-field-large\" data-date-format=\"m\/d\/Y\" data-disable-past-dates=\"0\" data-input=\"true\" name=\"wpforms[fields][27][date]\" aria-errormessage=\"wpforms-3799-field_27-error\" ><a title=\"Borrar fecha\" data-clear role=\"button\" tabindex=\"0\" class=\"wpforms-datepicker-clear\" aria-label=\"Borrar fecha\" style=\"display:none;\"><\/a><\/div><\/div><div id=\"wpforms-3799-field_28-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"28\"><label class=\"wpforms-field-label\" for=\"wpforms-3799-field_28\">Notes<\/label><textarea id=\"wpforms-3799-field_28\" class=\"wpforms-field-medium\" name=\"wpforms[fields][28]\" aria-errormessage=\"wpforms-3799-field_28-error\" ><\/textarea><\/div><script>\n\t\t\t\t( function() {\n\t\t\t\t\tconst style = document.createElement( 'style' );\n\t\t\t\t\tstyle.appendChild( document.createTextNode( '#wpforms-3799-field_1-container { position: absolute !important; overflow: hidden !important; display: inline !important; height: 1px !important; width: 1px !important; z-index: -1000 !important; padding: 0 !important; } #wpforms-3799-field_1-container input { visibility: hidden; } #wpforms-conversational-form-page #wpforms-3799-field_1-container label { counter-increment: none; }' ) );\n\t\t\t\t\tdocument.head.appendChild( style );\n\t\t\t\t\tdocument.currentScript?.remove();\n\t\t\t\t} )();\n\t\t\t<\/script><\/div><!-- .wpforms-field-container --><div class=\"wpforms-recaptcha-container wpforms-is-hcaptcha\" ><div class=\"h-captcha\" data-sitekey=\"c228c6f2-3aa8-4ebc-9ca8-da5c78a8a3b0\"><\/div><input type=\"text\" name=\"g-recaptcha-hidden\" class=\"wpforms-recaptcha-hidden\" style=\"position:absolute!important;clip:rect(0,0,0,0)!important;height:1px!important;width:1px!important;border:0!important;overflow:hidden!important;padding:0!important;margin:0!important;\" data-rule-hcaptcha=\"1\"><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"3799\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/dominionelectric.com\/es\/wp-json\/wp\/v2\/pages\/3791\"><input type=\"hidden\" name=\"url_referer\" value=\"\">\t\t<div id=\"cf-turnstile-wpf-1775773152\"\r\n\t\tclass=\"cf-turnstile\" \t\tdata-sitekey=\"0x4AAAAAACsP_5CKbDqKdWr2\"\r\n\t\tdata-theme=\"light\"\r\n\t\tdata-language=\"auto\"\r\n\t\tdata-size=\"normal\"\r\n\t\tdata-retry=\"auto\" data-retry-interval=\"1000\"\r\n\t\tdata-refresh-expired=\"auto\"\r\n\t\tdata-action=\"wpforms-3799\"\r\n\t\t\t\tdata-appearance=\"always\"><\/div>\r\n\t\t\t<script>document.addEventListener(\"DOMContentLoaded\", function() { setTimeout(function(){ var e=document.getElementById(\"cf-turnstile-wpf-1775773152\"); e&&!e.innerHTML.trim()&&(turnstile.remove(\"#cf-turnstile-wpf-1775773152\"), turnstile.render(\"#cf-turnstile-wpf-1775773152\", {sitekey:\"0x4AAAAAACsP_5CKbDqKdWr2\"})); }, 100); });<\/script>\r\n\t\t\t<br class=\"cf-turnstile-br cf-turnstile-br-wpf-1775773152\">\r\n\t\t\t\t<style>#cf-turnstile-wpf-1775773152 { margin-left: -15px; }<\/style>\r\n\t\t<button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-3799\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><img decoding=\"async\" src=\"https:\/\/dominionelectric.com\/wp-content\/plugins\/wpforms\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Cargando\" title=\"\"><\/div><\/form><\/div>  <!-- .wpforms-container --><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Credit Card Only Account Application<\/p>","protected":false},"author":8,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-3791","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/dominionelectric.com\/es\/wp-json\/wp\/v2\/pages\/3791","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dominionelectric.com\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dominionelectric.com\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dominionelectric.com\/es\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dominionelectric.com\/es\/wp-json\/wp\/v2\/comments?post=3791"}],"version-history":[{"count":0,"href":"https:\/\/dominionelectric.com\/es\/wp-json\/wp\/v2\/pages\/3791\/revisions"}],"wp:attachment":[{"href":"https:\/\/dominionelectric.com\/es\/wp-json\/wp\/v2\/media?parent=3791"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}