@extends('layouts.frontend')

@section('title', '| Pour-Over Will Form')

@section('content')
@include('frontend.forms.Pour-Over-Will.stepIndicator')
 <!-- start -->

<div class="container">
    <form action="{{route('pourOverWillFormcreate')}}" method="POST" id="signUpForm">
      @csrf
      <input type="hidden" id="stepInput" name="step" value="2">
      <div class="card">
         <div class="card-body">
            <!-- step 1 -->
            <div class="step" style="display: block">
                <div class="row">
                    <div class="col-md-10 col-lg-8 order-1 order-md-1 order-lg-1">
                        <div class="card-title">Gifts</div>
                        <div class="card-sub-title">Do you want to leave any specific gifts in your Pour-Over Will?</div>
                        <div class="custom-button-yn mb-5">
                           <input id="gifts-y" name="gift" type="radio" value="yes" {{ !empty($pourOverWillForm->gift) ? 'checked' : '' }}>
                           <label for="gifts-y">Yes</label>
                           <input id="gifts-n" name="gift" type="radio" value="no" {{ empty($pourOverWillForm->gift) ? 'checked' : '' }}>
                           <label for="gifts-n">No</label>
                        </div>
                        <div id="add-gifts-container-card">
                           <div id="gifts-container">
                              @php
                                 $pourOverWillFormGiftArray = json_decode($pourOverWillForm->gift, true)
                              @endphp

                              @if(!empty($pourOverWillForm->gift) && count($pourOverWillFormGiftArray) > 0 )
                              @foreach($pourOverWillFormGiftArray as $index => $abeneficiary)                              
                                 <div class="card list mb-3 beneficiary-card" id="child">
                                    <div class="card-header d-flex justify-content-between">
                                       <div class="card-title m-0">Beneficiary Details</div>
                                       <a class="r-button" onclick="removetList(this)"><span class="fas fa-times"></span><span class="remove">Remove</span></a>
                                    </div>
                                    <div class="card-body">
                                       <div class="long-btn-card">
                                          <div class="custom-button-yn">
                                             <input type="radio" class="beneficiary-radio" data-form="individual_form_gifts32" id="gifts32_lb-{{$index}}" name="beneficiary_type[{{$index}}]" value="person" {{ $abeneficiary['type'] == 'person' && isset($abeneficiary['type']) ? 'checked' : '' }}>
                                             <label for="gifts32_lb-{{$index}}">Person</label>
                                             <input type="radio" class="beneficiary-radio" data-form="charity_form_gifts32" id="gifts32_charity_lb-{{$index}}" name="beneficiary_type[{{$index}}]" value="charity" {{ $abeneficiary['type'] == 'charity' && isset($abeneficiary['type']) ? 'checked' : '' }}>
                                             <label for="gifts32_charity_lb-{{$index}}">Charity or Organization</label>
                                          </div>
                                       </div>
      
                                       <div class="beneficiary-form" data-form-name="individual_form_gifts32" id="individual_form_gifts32-{{$index}}" @if($abeneficiary['type'] == 'person' && isset($abeneficiary['type'])) style="display: block;" @else style="display: none;" @endif>
                                          <div class="form-group mb-3">
                                             <label for="name">Name</label>
                                             <input  value="{{$abeneficiary['name'] ?? ""}}" type="text" class="form-control modified-input" name="beneficiary31_name[]" id="beneficiary31_name" aria-describedby="nameHelp" >
                                             <small id="nameHelp" class="form-text text-muted">e.g. William Timothy Smith</small>
                                          </div>
                                          <div class="form-group mb-3">
                                             <label for="city">City/Town</label>
                                             <input value="{{$abeneficiary['city'] ?? ""}}" type="text" class="form-control modified-input" name="beneficiary31_city[]"  aria-describedby="cityHelp" placeholder="Any City">
                                             <small id="cityHelp" class="form-text text-muted d-none">city</small>
                                          </div>
                                          <div class="form-group mb-3">
                                             <label for="state">State</label>
                                             <input  value="{{$abeneficiary['state'] ?? ""}}" type="text" class="form-control modified-input" name="beneficiary31_state[]" id="beneficiary31_state" placeholder="State">
                                          </div>
                                       </div>
                                       <div  class="beneficiary-form" data-form-name="charity_form_gifts32"  id="charity_form_gifts32-{{$index}}" @if($abeneficiary['type'] == 'charity' && isset($abeneficiary['type'])) style="display: block;" @else style="display: none;" @endif>
                                          <div class="form-group mb-3">
                                             <label for="name">Charity or Organization Name</label>
                                             <input value="{{$abeneficiary['charity_name']}}" type="text" class="form-control modified-input" name="beneficiary31_charity_name[]" id="beneficiary31_recipient_name" aria-describedby="nameHelp" >
                                             <small id="nameHelp" class="form-text text-muted">e.g. United Way Worldwide, Feeding America</small>
                                          </div>
                                          <div class="form-group mb-3">
                                             <label for="city">Charity Registration</label>
                                             <input value="{{$abeneficiary['charity_registration'] ?? ""}}" type="text" class="form-control modified-input" name="beneficiary31_charity_registration[]" id="beneficiary31_charity_registration" aria-describedby="cityHelp" placeholder="">
                                             <small id="cityHelp" class="form-text text-muted d-none">e.g. 200583415</small>
                                          </div>
                                          <div class="form-group mb-3">
                                             <label for="City">City</label>
                                             <input value="{{$abeneficiary['charity_city'] ?? ""}}" type="text" class="form-control modified-input" name="beneficiary31_charity_city[]" id="beneficiary31_charity_city"placeholder="Any City">
                                          </div>
                                          <div class="form-group mb-3">
                                             <label for="state">State</label>
                                             <input value="{{$abeneficiary['charity_state'] ?? ""}}" type="text" class="form-control modified-input" name="beneficiary31_charity_state[]" id="beneficiary31_charity_state" placeholder="State">
                                          </div>
                                          <div class="form-group mb-3">
                                             <label for="g_gift">Describe the gift</label>
                                             <input  value="{{$abeneficiary['describe_gift'] ??  ""}}" type="text" class="form-control modified-input" name="beneficiary31_charity_describe_gift[]" id="beneficiary31_charity_describe_gift">
                                             <small id="cityHelp" class="form-text text-muted d-none">e.g. $500 donation</small>
                                          </div>
                                       </div>

                                       <div class="form-check my-5">
                                          <input class="form-check-input alternate_gift-checkbox" data-index="{{$index}}" name="alternate_gift[{{$index}}]" type="checkbox" value="no" id="alternate_gift" {{ $abeneficiary['alternate_name'] || $abeneficiary['alternate_city'] || $abeneficiary['alternate_state'] ? 'checked' : '' }}>
                                          <label class="form-check-label" for="flexCheckDefault">Name an alternate gift recipient</label>
                                       </div>
                                       
                                       {{-- alternate gift holder --}}
                                       <div id="alternate_gift_holder" 
                                       {!! $abeneficiary['alternate_name'] || $abeneficiary['alternate_city'] || $abeneficiary['alternate_state'] ? 'style="display: block"' : 'style="display: none"' !!}>
                                          <div class="form-group mb-3">
                                             <label for="name">Name</label>
                                             <input type="text" value="{{$abeneficiary['alternate_name'] ?? ""}}" class="form-control modified-input" name="alternate_gift_name[]" id="alternate_gift_name" aria-describedby="nameHelp" >
                                             <small id="nameHelp" class="form-text text-muted">e.g. William Timothy Smith</small>
                                          </div>
                                          <div class="form-group mb-3">
                                             <label for="city">City/Town</label>
                                             <input type="text" value="{{$abeneficiary['alternate_city'] ?? ""}}" class="form-control modified-input" name="alternate_gift_city[]" id="alternate_gift_city"  aria-describedby="cityHelp" placeholder="Any City">
                                             <small id="cityHelp" class="form-text text-muted d-none">city</small>
                                          </div>
                                          <div class="form-group mb-3">
                                             <label for="state">State</label>
                                             <input type="text" value="{{$abeneficiary['alternate_state'] ?? ""}}" class="form-control modified-input" name="alternate_gift_state[]" id="alternate_gift_state" placeholder="State">
                                          </div>
                                       </div>
                                       {{-- alternate gift holder end--}}
      
                                    </div> 
                              
                                 </div>
                              @endforeach
                              @else
                              <div class="card list mb-3 beneficiary-card" id="child">
                                 <div class="card-header d-flex justify-content-between">
                                    <div class="card-title m-0">Beneficiary Details</div>
                                    <a class="r-button" onclick="removeBeneficiary(this)"><span class="fas fa-times"></span><span class="remove">Remove</span></a>
                                 </div>
                                 <div class="card-body">
                                    <div class="long-btn-card">
                                        <div class="custom-button-yn">
                                            <input type="radio" class="beneficiary-radio" data-form="individual_form_gifts32" id="gifts32_lb" name="beneficiary_type[]" value="person" checked>
                                            <label for="gifts32_lb">Person</label>
                                            <input type="radio" class="beneficiary-radio" data-form="charity_form_gifts32" id="gifts32_charity_lb" name="beneficiary_type[]" value="charity">
                                            <label for="gifts32_charity_lb">Charity or Organization</label>
                                        </div>
                                    </div>
                                    <div class="beneficiary-form" data-form-name="individual_form_gifts32" id="individual_form_gifts32" style="display: block;">
                                        <div class="form-group mb-3">
                                           <label for="name">Name</label>
                                           <input type="text" class="form-control modified-input" name="beneficiary31_name[]" id="beneficiary31_name" aria-describedby="nameHelp" >
                                           <small id="nameHelp" class="form-text text-muted">e.g. William Timothy Smith</small>
                                        </div>
                                        <div class="form-group mb-3">
                                           <label for="city">City/Town</label>
                                           <input type="text" class="form-control modified-input" name="beneficiary31_city[]" id="beneficiary31_city" aria-describedby="cityHelp" placeholder="Any City">
                                           <small id="cityHelp" class="form-text text-muted d-none">city</small>
                                        </div>
                                        <div class="form-group mb-3">
                                           <label for="state">State</label>
                                           <input type="text" class="form-control modified-input" name="beneficiary31_state[]" id="beneficiary31_state" placeholder="State">
                                        </div>
                                    </div>
                                    <div class="beneficiary-form" data-form-name="charity_form_gifts32" id="charity_form_gifts32" style="display: none;">
                                        <div class="form-group mb-3">
                                           <label for="name">Charity or Organization Name</label>
                                           <input type="text" class="form-control modified-input" name="beneficiary31_charity_name[]" id="beneficiary31_recipient_name" aria-describedby="nameHelp" >
                                           <small id="nameHelp" class="form-text text-muted">e.g. United Way Worldwide, Feeding America</small>
                                        </div>
                                        <div class="form-group mb-3">
                                           <label for="city">Charity Registration</label>
                                           <input type="text" class="form-control modified-input" name="beneficiary31_charity_registration[]" id="beneficiary31_charity_registration" aria-describedby="cityHelp" placeholder="Any City">
                                           <small id="cityHelp" class="form-text text-muted d-none">e.g. 200583415</small>
                                        </div>
                                        <div class="form-group mb-3">
                                          <label for="City">City</label>
                                          <input type="text" class="form-control modified-input" name="beneficiary31_charity_city[]" id="beneficiary31_charity_city"placeholder="Any City">
                                          <small id="cityHelp" class="form-text text-muted d-none">e.g. Boston</small>
                                       </div>
                                        <div class="form-group mb-3">
                                           <label for="state">State</label>
                                           <input type="text" class="form-control modified-input" name="beneficiary31_charity_state[]" id="beneficiary31_charity_state" placeholder="State">
                                        </div>
                                        <div class="form-group mb-3">
                                          <label for="g_gift">Describe the gift</label>
                                          <input type="text" class="form-control modified-input" name="beneficiary31_charity_describe_gift[]" id="beneficiary31_charity_describe_gift">
                                          <small id="cityHelp" class="form-text text-muted d-none">e.g. $500 donation</small>
                                       </div>
                                    </div>

                                    <div class="form-check my-5">
                                       <input class="form-check-input alternate_gift-checkbox" name="alternate_gift[]" type="checkbox" value="no" id="alternate_gift">
                                       <label class="form-check-label" for="alternate_gift">Name an alternate gift recipient</label>
                                    </div>
                                    {{-- alternate gift holder --}}
                                    <div id="alternate_gifts_holder" style="display: none">
                                       <div class="form-group mb-3">
                                          <label for="name">Name</label>
                                          <input type="text" class="form-control modified-input" name="alternate_gift_name[]" id="alternate_gift_name" aria-describedby="nameHelp" >
                                          <small id="nameHelp" class="form-text text-muted">e.g. William Timothy Smith</small>
                                       </div>
                                       <div class="form-group mb-3">
                                          <label for="city">City/Town</label>
                                          <input type="text" class="form-control modified-input" name="alternate_gift_city[]" id="alternate_gift_city"  aria-describedby="cityHelp" placeholder="Any City">
                                          <small id="cityHelp" class="form-text text-muted d-none">city</small>
                                       </div>
                                       <div class="form-group mb-3">
                                          <label for="state">State</label>
                                          <input type="text" class="form-control modified-input" name="alternate_gift_state[]" id="alternate_gift_state" placeholder="State">
                                       </div>
                                    </div>
                                    {{-- alternate gift holder end--}}
   
                                 </div> 
                              </div>
                              @endif

                           </div>
                           <div class="add-child">
                              <a onclick="custom_clone('gifts-container')"><span class="fas fa-plus"></span>Add Another Gift</a>
                           </div>
                        </div>
                        
                     </div>
                     <div class="col-md-8 col-lg-4 order-3 order-md-3 order-lg-2">
                        <div class="faq-box">
                           <div class="title">FAQ’s</div>
                           <div class="tooltip">
                           <p>Is there anything I can't give away?</p>
                           <span class="tooltiptext">Yes, there are limitations on what you can give away in your will. Laws may vary by jurisdiction, but generally, you cannot give away property or assets you do not own at your death. Additionally, investments such as life insurance proceeds with a designated beneficiary, retirement accounts, and joint tenancy property may not be subject to your will. It's essential to consult with an attorney to understand the specific rules in your area.</span>
                           </div>
                        </div>
                     </div>
                     <!-- start previous / next buttons -->
                     <div class="col-md-12 order-2 order-md-2 order-lg-3">
                        <div id="buttonsection">
                           <div class="form-footer d-flex justify-content-between">
                           <div>
                              <button onclick="window.location.href = '{{ route('pourOverWillForm.create.step.one') }}'" type="button" class="btn btn-light btn-lg back-btn">Back</button>
                              <button type="submit" class="btn btn-light btn-lg">Save and Continue</button>
                           </div>
                           <button type="submit" class="btn btn-light btn-lg" name="preview_submit" value="preview">{{env('PREVIEW_BUTTON_TEXT')}}</button>
                              <button type="button" class="btn btn-light btn-lg skip-btn d-none">Skip Step</button>
                           </div>
                        </div>
                     </div>
                     <!-- end previous / next buttons -->
                </div>
             </div>
         </div>
      </div>
   </form>

</div>

@endsection
@section('page-js')
<script>
   document.addEventListener("DOMContentLoaded", function () {
   setupFormToggle('gifts-container', 'beneficiary-radio','.beneficiary-form','.beneficiary-card')
   setupAlternateGiftToggle('alternate_gift','beneficiary-card')

});
   </script>
<script src="{{ url('frontend/assets/js/forms/pour-over-will-multi-stepform.js?v=10.4') }}"></script>
<script src="{{ url('frontend/assets/js/forms/custom.js?v=10.3') }}"></script>

@endsection