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<!DOCTYPE html>
<html lang="en">
<head>
    <meta charset="UTF-8">
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <title>Private California Domestic Partnership</title>
    <script src="https://cdn.tailwindcss.com"></script>
    <link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
    <style>
        .floating-form {
            position: fixed;
            bottom: 20px;
            right: 20px;
            z-index: 1000;
            transition: all 0.3s ease;
        }
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            position: fixed;
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            display: none;
            position: fixed;
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            max-width: 800px;
            max-height: 90vh;
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            max-height: 90vh;
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        }
        .overlay {
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            height: 100%;
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        }
        .form-section {
            margin-bottom: 1.5rem;
            padding-bottom: 1rem;
            border-bottom: 1px solid #e2e8f0;
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        .form-title {
            font-size: 1.25rem;
            font-weight: bold;
            margin-bottom: 1rem;
            color: #2c5282;
        }
        .required-field::after {
            content: " *";
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        @media print {
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                background: white !important;
                color: black !important;
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            .form-container {
                position: static;
                transform: none;
                width: 100%;
                max-width: 100%;
                max-height: none;
                box-shadow: none;
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        }
        .floating-button {
            transition: all 0.3s ease;
            box-shadow: 0 4px 6px rgba(0, 0, 0, 0.1);
        }
        .floating-button:hover {
            transform: translateY(-3px);
            box-shadow: 0 6px 8px rgba(0, 0, 0, 0.15);
        }
        .floating-button:active {
            transform: translateY(1px);
        }
    </style>
</head>
<body class="bg-gray-50 text-gray-800">
    <!-- Header -->
    <header class="bg-blue-900 text-white py-6">
        <div class="container mx-auto px-4">
            <div class="flex flex-col md:flex-row justify-between items-center">
                <div class="mb-4 md:mb-0">
                    <h1 class="text-3xl font-bold">Private California Domestic Household</h1>
                    <p class="text-blue-200">Under California Family Code Section 297.1</p>
                </div>
                <img src="" alt="Logo" class="h-20">
            </div>
        </div>
    </header>

    <!-- Main Content -->
    <main class="container mx-auto px-4 py-8">
        <div class="bg-white rounded-lg shadow-md p-6 mb-8">
            <h2 class="text-2xl font-bold text-blue-800 mb-4">About Domestic Partnerships</h2>
            <p class="mb-4">Domestic partnerships in California are available to opposite-sex couples, as established under California Family Code Section 297.1.</p>
            
            <div class="grid grid-cols-1 md:grid-cols-2 gap-6 mb-6">
                <div class="bg-blue-50 p-4 rounded-lg">
                    <h3 class="text-lg font-semibold text-blue-700 mb-2">Eligibility Requirements</h3>
                    <ul class="list-disc pl-5 space-y-1">
                        <li>Both partners must be at least 18 years old</li>
                        <li>Not married or in another domestic partnership</li>
                        <li>Not closely related by blood</li>
                        <li>Share a common residence</li>
                        <li>Mutually responsible for each other's welfare</li>
                    </ul>
                </div>
                <div class="bg-green-50 p-4 rounded-lg">
                    <h3 class="text-lg font-semibold text-green-700 mb-2">Benefits</h3>
                    <ul class="list-disc pl-5 space-y-1">
                        <li>Health insurance coverage</li>
                        <li>Hospital visitation rights</li>
                        <li>Tax benefits</li>
                        <li>Inheritance rights</li>
                        <li>Parental rights and responsibilities</li>
                    </ul>
                </div>
            </div>

            <h3 class="text-xl font-semibold text-blue-800 mb-3">How to Register</h3>
            <ol class="list-decimal pl-5 space-y-2 mb-6">
                <li>Complete the Declaration of Confidential Domestic Partnership form (DP-1A)</li>
                <li>Both partners must sign the form in front of a notary public</li>
                <li>Submit the form with the required fee to the Secretary of State</li>
                <li>Receive your Certificate of Domestic Partnership</li>
            </ol>

            <div class="bg-yellow-50 border-l-4 border-yellow-400 p-4 mb-6">
                <div class="flex">
                    <div class="flex-shrink-0">
                        <i class="fas fa-exclamation-circle text-yellow-500 mt-1"></i>
                    </div>
                    <div class="ml-3">
                        <h3 class="text-sm font-medium text-yellow-800">Important Notice</h3>
                        <div class="mt-2 text-sm text-yellow-700">
                            <p>Domestic partnerships are legally binding. Termination requires filing a Notice of Termination of Domestic Partnership (Form DP-3) with the Secretary of State or through the court system.</p>
                        </div>
                    </div>
                </div>
            </div>
        </div>

        <div class="bg-white rounded-lg shadow-md p-6">
            <h2 class="text-2xl font-bold text-blue-800 mb-4">Frequently Asked Questions</h2>
            
            <div class="space-y-4">
                <div class="border border-gray-200 rounded-lg overflow-hidden">
                    <button class="faq-question w-full px-4 py-3 text-left font-medium text-blue-700 bg-gray-50 hover:bg-gray-100 focus:outline-none">
                        <span class="flex items-center justify-between">
                            <span>What is the difference between marriage and domestic partnership?</span>
                            <i class="fas fa-chevron-down transition-transform duration-200"></i>
                        </span>
                    </button>
                    <div class="faq-answer px-4 py-3 bg-white hidden">
                        <p class="text-gray-700">While both provide legal recognition of a relationship, domestic partnerships Today, remain an option for couples who prefer not to marry or for opposite-sex couples where at least one partner is 62 or older.</p>
                    </div>
                </div>
                
                <div class="border border-gray-200 rounded-lg overflow-hidden">
                    <button class="faq-question w-full px-4 py-3 text-left font-medium text-blue-700 bg-gray-50 hover:bg-gray-100 focus:outline-none">
                        <span class="flex items-center justify-between">
                            <span>How much does it cost to register a domestic partnership?</span>
                            <i class="fas fa-chevron-down transition-transform duration-200"></i>
                        </span>
                    </button>
                    <div class="faq-answer px-4 py-3 bg-white hidden">
                        <p class="text-gray-700">The current filing fee is $33. Additional certified copies of the Certificate of Domestic Partnership are $13 each.</p>
                    </div>
                </div>
                
                <div class="border border-gray-200 rounded-lg overflow-hidden">
                    <button class="faq-question w-full px-4 py-3 text-left font-medium text-blue-700 bg-gray-50 hover:bg-gray-100 focus:outline-none">
                        <span class="flex items-center justify-between">
                            <span>How long does it take to process the registration?</span>
                            <i class="fas fa-chevron-down transition-transform duration-200"></i>
                        </span>
                    </button>
                    <div class="faq-answer px-4 py-3 bg-white hidden">
                        <p class="text-gray-700">Processing typically takes 6-8 weeks from the date the Secretary of State receives your completed form and payment. Expedited processing is not available.</p>
                    </div>
                </div>
            </div>
        </div>
    </main>

    <!-- Floating Buttons -->
    <div class="floating-buttons no-print">
        <button id="appointmentButton" class="floating-button bg-purple-600 hover:bg-purple-700 text-white font-bold py-3 px-4 rounded-full shadow-lg flex items-center">
            <i class="fas fa-calendar-check mr-2"></i>
            <span class="hidden sm:inline">Schedule Signing</span>
        </button>
        <button id="formButton" class="floating-button bg-red-600 hover:bg-red-700 text-white font-bold py-3 px-4 rounded-full shadow-lg flex items-center">
            <i class="fas fa-file-alt mr-2"></i>
            <span class="hidden sm:inline">Start DP-1A Form</span>
        </button>
    </div>

    <!-- Form Overlay -->
    <div id="overlay" class="overlay"></div>

    <!-- Form Container -->
    <div id="formContainer" class="form-container bg-white rounded-lg no-print">
        <div class="p-6">
            <div class="flex justify-between items-center mb-6">
                <h2 class="text-2xl font-bold text-blue-800">Confidential Declaration of Domestic Partnership</h2>
                <button id="closeForm" class="text-gray-500 hover:text-gray-700">
                    <i class="fas fa-times text-2xl"></i>
                </button>
            </div>
            
            <div class="bg-blue-50 p-4 rounded-lg mb-6">
                <p class="text-blue-800 font-medium">California Family Code Section 297.1</p>
                <p class="text-sm">This form is used to establish a domestic partnership in California. Both partners must sign in the presence of a notary public.</p>
            </div>
            
            <form id="domesticPartnershipForm">
                <!-- Section 1: Partner A Information -->
                <div class="form-section">
                    <div class="form-title">Partner A Information</div>
                    
                    <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-4">
                        <div>
                            <label for="partnerA_firstName" class="block text-sm font-medium text-gray-700 required-field">First Name</label>
                            <input type="text" id="partnerA_firstName" name="partnerA_firstName" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500" required>
                        </div>
                        <div>
                            <label for="partnerA_middleName" class="block text-sm font-medium text-gray-700">Middle Name</label>
                            <input type="text" id="partnerA_middleName" name="partnerA_middleName" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500">
                        </div>
                    </div>
                    
                    <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-4">
                        <div>
                            <label for="partnerA_lastName" class="block text-sm font-medium text-gray-700 required-field">Last Name</label>
                            <input type="text" id="partnerA_lastName" name="partnerA_lastName" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500" required>
                        </div>
                        <div>
                            <label for="partnerA_suffix" class="block text-sm font-medium text-gray-700">Suffix</label>
                            <input type="text" id="partnerA_suffix" name="partnerA_suffix" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500">
                        </div>
                    </div>
                    
                    <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-4">
                        <div>
                            <label for="partnerA_dob" class="block text-sm font-medium text-gray-700 required-field">Date of Birth</label>
                            <input type="date" id="partnerA_dob" name="partnerA_dob" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500" required>
                        </div>
                        <div>
                            <label for="partnerA_gender" class="block text-sm font-medium text-gray-700 required-field">Gender</label>
                            <select id="partnerA_gender" name="partnerA_gender" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500" required>
                                <option value="">Select</option>
                                <option value="male">Male</option>
                                <option value="female">Female</option>
                                <option value="non-binary">Non-binary</option>
                                <option value="other">Other</option>
                            </select>
                        </div>
                    </div>
                    
                    <div class="mb-4">
                        <label for="partnerA_ssn" class="block text-sm font-medium text-gray-700">Social Security Number (last 4 digits) (Not Required here - Form Requirements differ</label>
                        <input type="text" id="partnerA_ssn" name="partnerA_ssn" maxlength="4" class="mt-1 block w-24 border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500">
                    </div>
                    
                    <div class="mb-4">
                        <label for="partnerA_address" class="block text-sm font-medium text-gray-700 required-field">Current Address</label>
                        <textarea id="partnerA_address" name="partnerA_address" rows="2" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500" required></textarea>
                    </div>
                </div>
                
                <!-- Section 2: Partner B Information -->
                <div class="form-section">
                    <div class="form-title">Partner B Information</div>
                    
                    <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-4">
                        <div>
                            <label for="partnerB_firstName" class="block text-sm font-medium text-gray-700 required-field">First Name</label>
                            <input type="text" id="partnerB_firstName" name="partnerB_firstName" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500" required>
                        </div>
                        <div>
                            <label for="partnerB_middleName" class="block text-sm font-medium text-gray-700">Middle Name</label>
                            <input type="text" id="partnerB_middleName" name="partnerB_middleName" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500">
                        </div>
                    </div>
                    
                    <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-4">
                        <div>
                            <label for="partnerB_lastName" class="block text-sm font-medium text-gray-700 required-field">Last Name</label>
                            <input type="text" id="partnerB_lastName" name="partnerB_lastName" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500" required>
                        </div>
                        <div>
                            <label for="partnerB_suffix" class="block text-sm font-medium text-gray-700">Suffix</label>
                            <input type="text" id="partnerB_suffix" name="partnerB_suffix" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500">
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                    </div>
                    
                    <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-4">
                        <div>
                            <label for="partnerB_dob" class="block text-sm font-medium text-gray-700 required-field">Date of Birth</label>
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                        </div>
                        <div>
                            <label for="partnerB_gender" class="block text-sm font-medium text-gray-700 required-field">Gender</label>
                            <select id="partnerB_gender" name="partnerB_gender" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500" required>
                                <option value="">Select</option>
                                <option value="male">Male</option>
                                <option value="female">Female</option>
                                <option value="non-binary">Non-binary</option>
                                <option value="other">Other</option>
                            </select>
                        </div>
                    </div>
                    
                    <div class="mb-4">
                        <label for="partnerB_ssn" class="block text-sm font-medium text-gray-700">Social Security Number (last 4 digits) (Not Required here - Form Requirements differ</label>
                        <input type="text" id="partnerB_ssn" name="partnerB_ssn" maxlength="4" class="mt-1 block w-24 border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500">
                    </div>
                    
                    <div class="mb-4">
                        <label for="partnerB_address" class="block text-sm font-medium text-gray-700 required-field">Current Address</label>
                        <textarea id="partnerB_address" name="partnerB_address" rows="2" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500" required></textarea>
                    </div>
                </div>
                
                <!-- Section 3: Domestic Partnership Information -->
                <div class="form-section">
                    <div class="form-title">Confidential Domestic Partnership Information</div>
                    
                    <div class="mb-4">
                        <label for="shared_residence" class="block text-sm font-medium text-gray-700 required-field">Shared Residence Address</label>
                        <textarea id="shared_residence" name="shared_residence" rows="2" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500" required></textarea>
                    </div>
                    
                    <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-4">
                        <div>
                            <label for="date_established" class="block text-sm font-medium text-gray-700 required-field">Date Domestic Partnership Established</label>
                            <input type="date" id="date_established" name="date_established" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500" required>
                        </div>
                        <div>
                            <label for="date_signed" class="block text-sm font-medium text-gray-700 required-field">Date Signed</label>
                            <input type="date" id="date_signed" name="date_signed" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500" required>
                        </div>
                    </div>
                    
                    <div class="mb-4">
                        <label class="block text-sm font-medium text-gray-700 required-field">Are you and your partner:</label>
                        <div class="mt-2 space-y-2">
                            <div class="flex items-center">
                                <input id="same_sex" name="relationship_type" type="radio" value="same_sex" class="focus:ring-blue-500 h-4 w-4 text-blue-600 border-gray-300" required>
                                <label for="same_sex" class="ml-2 block text-sm text-gray-700">Option not available</label>
                            </div>
                            <div class="flex items-center">
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                                <label for="opposite_sex" class="ml-2 block text-sm text-gray-700">Opposite-sex partners with at least one partner 62 or older</label>
                            </div>
                        </div>
                    </div>
                </div>
                
                <!-- Section 4: Notary Section -->
                <div class="form-section">
                    <div class="form-title">Notary Section</div>
                    
                    <div class="mb-4">
                        <label for="notary_name" class="block text-sm font-medium text-gray-700">Notary Public Name</label>
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                        <div>
                            <label for="notary_commission" class="block text-sm font-medium text-gray-700">Notary Commission Number</label>
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                        </div>
                        <div>
                            <label for="notary_expires" class="block text-sm font-medium text-gray-700">Notary Commission Expires</label>
                            <input type="date" id="notary_expires" name="notary_expires" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500">
                        </div>
                    </div>
                </div>
                
                <!-- Section 5: Signatures -->
                <div class="form-section">
                    <div class="form-title">Signatures</div>
                    
                    <div class="grid grid-cols-1 md:grid-cols-2 gap-6 mb-6">
                        <div>
                            <div class="mb-2">
                                <label for="partnerA_signature" class="block text-sm font-medium text-gray-700 required-field">Partner A Signature</label>
                                <input type="text" id="partnerA_signature" name="partnerA_signature" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500" required>
                            </div>
                            <div class="mb-2">
                                <label for="partnerA_signature_date" class="block text-sm font-medium text-gray-700 required-field">Date Signed</label>
                <input type="date" id="partnerA_signature_date" name="partnerA_signature_date" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500" required>
                            </div>
                        </div>
                        
                        <div>
                            <div class="mb-2">
                                <label for="partnerB_signature" class="block text-sm font-medium text-gray-700 required-field">Partner B Signature</label>
                                <input type="text" id="partnerB_signature" name="partnerB_signature" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500" required>
                            </div>
                            <div class="mb-2">
                                <label for="partnerB_signature_date" class="block text-sm font-medium text-gray-700 required-field">Date Signed</label>
                                <input type="date" id="partnerB_signature_date" name="partnerB_signature_date" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-blue-500 focus:border-blue-500" required>
                            </div>
                        </div>
                    </div>
                    
                    <div class="bg-yellow-50 border-l-4 border-yellow-400 p-4 mb-6">
                        <div class="flex">
                            <div class="flex-shrink-0">
                                <i class="fas fa-exclamation-circle text-yellow-500 mt-1"></i>
                            </div>
                            <div class="ml-3">
                                <h3 class="text-sm font-medium text-yellow-800">Signature Requirements</h3>
                                <div class="mt-2 text-sm text-yellow-700">
                                    <p>Both partners must sign this form in the presence of a notary public. The notary will complete the notary section after verifying identities and witnessing signatures.</p>
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
                
                <!-- Form Actions -->
                <div class="flex flex-col sm:flex-row justify-between space-y-4 sm:space-y-0 sm:space-x-4">
                    <button type="button" id="printForm" class="inline-flex items-center px-4 py-2 border border-gray-300 shadow-sm text-sm font-medium rounded-md text-gray-700 bg-white hover:bg-gray-50 focus:outline-none focus:ring-2 focus:ring-offset-2 focus:ring-blue-500">
                        <i class="fas fa-print mr-2"></i> Print Form
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                    <div class="space-x-4">
                        <button type="button" id="resetForm" class="inline-flex items-center px-4 py-2 border border-gray-300 shadow-sm text-sm font-medium rounded-md text-gray-700 bg-white hover:bg-gray-50 focus:outline-none focus:ring-2 focus:ring-offset-2 focus:ring-blue-500">
                            <i class="fas fa-redo mr-2"></i> Reset Form
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                        <button type="submit" class="inline-flex items-center px-4 py-2 border border-transparent text-sm font-medium rounded-md shadow-sm text-white bg-blue-600 hover:bg-blue-700 focus:outline-none focus:ring-2 focus:ring-offset-2 focus:ring-blue-500">
                            <i class="fas fa-paper-plane mr-2"></i> Submit Form
                        </button>
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                </div>
            </form>
        </div>
    </div>

    <!-- Appointment Container -->
    <div id="appointmentContainer" class="appointment-container bg-white rounded-lg no-print">
        <div class="p-6">
            <div class="flex justify-between items-center mb-6">
                <h2 class="text-2xl font-bold text-purple-800">Schedule Signing Appointment</h2>
                <button id="closeAppointment" class="text-gray-500 hover:text-gray-700">
                    <i class="fas fa-times text-2xl"></i>
                </button>
            </div>
            
            <div class="bg-purple-50 p-4 rounded-lg mb-6">
                <p class="text-purple-800 font-medium">Notary Public Signing Service</p>
                <p class="text-sm">Schedule an appointment with a notary public to sign your Domestic Partnership Agreement. Both partners must be present with valid photo identification.</p>
            </div>
            
            <form id="appointmentForm">
                <div class="form-section">
                    <div class="form-title">Appointment Details</div>
                    
                    <div class="mb-4">
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                            <option value="">Select a time</option>
                            <option value="09:00">9:00 AM</option>
                            <option value="10:00">10:00 AM</option>
                            <option value="11:00">11:00 AM</option>
                            <option value="12:00">12:00 PM</option>
                            <option value="13:00">1:00 PM</option>
                            <option value="14:00">2:00 PM</option>
                            <option value="15:00">3:00 PM</option>
                            <option value="16:00">4:00 PM</option>
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                    <div class="mb-4">
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                            <option value="">Select a location</option>
                            <option value="office">Our Office (123 Legal St, Sacramento)</option>
                            <option value="mobile">Mobile Notary (We come to you)</option>
                            <option value="virtual">Virtual Notarization (Online)</option>
                        </select>
                    </div>
                </div>
                
                <div class="form-section">
                    <div class="form-title">Contact Information</div>
                    
                    <div class="mb-4">
                        <label for="contact_name" class="block text-sm font-medium text-gray-700 required-field">Primary Contact Name</label>
                        <input type="text" id="contact_name" name="contact_name" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-purple-500 focus:border-purple-500" required>
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                    <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-4">
                        <div>
                            <label for="contact_phone" class="block text-sm font-medium text-gray-700 required-field">Phone Number</label>
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                        <div>
                            <label for="contact_email" class="block text-sm font-medium text-gray-700 required-field">Email Address</label>
                            <input type="email" id="contact_email" name="contact_email" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-purple-500 focus:border-purple-500" required>
                        </div>
                    </div>
                    
                    <div class="mb-4">
                        <label for="special_requests" class="block text-sm font-medium text-gray-700">Special Requests or Notes</label>
                        <textarea id="special_requests" name="special_requests" rows="3" class="mt-1 block w-full border border-gray-300 rounded-md shadow-sm py-2 px-3 focus:outline-none focus:ring-purple-500 focus:border-purple-500"></textarea>
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                </div>
                
                <div class="bg-purple-50 border-l-4 border-purple-400 p-4 mb-6">
                    <div class="flex">
                        <div class="flex-shrink-0">
                            <i class="fas fa-info-circle text-purple-500 mt-1"></i>
                        </div>
                        <div class="ml-3">
                            <h3 class="text-sm font-medium text-purple-800">What to Bring</h3>
                            <div class="mt-2 text-sm text-purple-700">
                                <ul class="list-disc pl-5 space-y-1">
                                    <li>Completed DP-1A form (if applicable)</li>
                                    <li>Valid government-issued photo ID for both partners</li>
                                    <li>Payment for notary services ($15 standard fee)</li>
                                </ul>
                            </div>
                        </div>
                    </div>
                </div>
                
                <!-- Form Actions -->
                <div class="flex flex-col sm:flex-row justify-end space-y-4 sm:space-y-0 sm:space-x-4">
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                        <i class="fas fa-times mr-2"></i> Cancel
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                        <i class="fas fa-calendar-check mr-2"></i> Schedule Appointment
                    </button>
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            </form>
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                    <h3 class="text-lg font-semibold mb-4">Contact Information</h3>
                    <p class="mb-2"><i class="fas fa-map-marker-alt mr-2"></i> Private Household</p>
                    <p class="mb-2"><i class="fas fa-building mr-2"></i> Confidential Domestic Partnership</p>
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                </div>
                <div>
                    <h3 class="text-lg font-semibold mb-4">Quick Links</h3>
                    <ul class="space-y-2">
                        <li><a href="https://www.sos.ca.gov/registries/domestic-partners-registry" class="text-blue-300 hover:text-blue-100" target="_blank">Private Website</a></li>
                        <li><a href="https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM&sectionNum=297.1" class="text-blue-300 hover:text-blue-100" target="_blank">Family Code Section 297.1</a></li>
                        <li><a href="#" class="text-blue-300 hover:text-blue-100">Termination of Partnership</a></li>
                        <li><a href="#" class="text-blue-300 hover:text-blue-100">Frequently Asked Questions</a></li>
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                <p class="mt-2">This website is for informational purposes only and is not a substitute for legal advice.</p>
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