document.write('<div style="border: 1px solid #ccc; background: #fff; width: 300px; min-height: 250px">');
document.write('<div style="padding: 10px; font-family: arial; font-size: 15px; color: #000; background: #eee">Quanto tempo você seria capaz de se sustentar caso parasse de trabalhar hoje?</div>');
document.write('<div style="padding: 10px; font-family: arial; font-size: 14px; color: #000">');
document.write('<form action="http://www.websitegoodies.com/vote.php" method="post">');
document.write('<input type="hidden" name="id" value="115245">');
        document.write('<div style="vertical-align: middle; padding: 3px 0"><label style="font-weight: normal"><input type="radio" name="vote" value="927284" /> &nbsp; Hoje</label></div>');
        document.write('<div style="vertical-align: middle; padding: 3px 0"><label style="font-weight: normal"><input type="radio" name="vote" value="927285" /> &nbsp; 1 a 6 meses</label></div>');
        document.write('<div style="vertical-align: middle; padding: 3px 0"><label style="font-weight: normal"><input type="radio" name="vote" value="927286" /> &nbsp; 6m a 1 ano</label></div>');
        document.write('<div style="vertical-align: middle; padding: 3px 0"><label style="font-weight: normal"><input type="radio" name="vote" value="927287" /> &nbsp; 1 a 2 anos</label></div>');
        document.write('<div style="vertical-align: middle; padding: 3px 0"><label style="font-weight: normal"><input type="radio" name="vote" value="927288" /> &nbsp; 2 a 5 anos</label></div>');
        document.write('<div style="vertical-align: middle; padding: 3px 0"><label style="font-weight: normal"><input type="radio" name="vote" value="927289" /> &nbsp; >5 anos</label></div>');
        document.write('<div style="vertical-align: middle; padding: 3px 0"><label style="font-weight: normal"><input type="radio" name="vote" value="927290" /> &nbsp; já sou FIRE</label></div>');
document.write('<div align="center" style="margin-top: 10px">');
document.write('<input type="submit" value="Submit My Vote"><br /><br />');
document.write('<a href="http://www.websitegoodies.com/pollresults.php?id=115245" target="_blank">View Results</a>');
document.write('</div>');
document.write('</form>');
document.write('</div>');
document.write('</div>');