@extends('layouts.frontend')

@section('title', '| Revocable Living Trust')

@section('content')
@include('frontend.forms.Revocable-Living-Trust.stepIndicator')
<!-- start -->
<div class="container">
   <form action="{{route('RevocableLivingTrustFormcreate')}}" method="POST" id="signUpForm">
      @csrf
      <input type="hidden" id="stepInput" name="step" value="6">
      <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">Beneficiary Details</div>
                     <div class="card-sub-title">Who are your beneficiaries?</div>

                     <div id="beneficiary-section-details">
                        <input type="hidden" id="beneficiary-container-hidden" data-index="0" value="0">
                        <div id="beneficiary-container">
                           @if(count($RevocableTrustData['beneficiaries']) > 0)
                              @foreach( $RevocableTrustData['beneficiaries'] as $beneficiary)
                              <div class="card list mb-3" id="child">
                                 <div class="card-header d-flex justify-content-between">
                                    <div class="card-title m-0">Beneficiary</div>
                                    <a class="r-button" onclick="removetList(this)"><span class="fas fa-times"></span><span class="remove">Remove</span></a>
                                 </div>
                                 <div class="card-body">
                                    <div class="form-group mb-3">
                                       <label for="name">Name</label>
                                       <input type="text" oninput="filterString(this);" class="form-control modified-input" name="beneficiaries[{{$loop->index}}][name]" id="beneficiary_name_{{$loop->index}}" value="{{$beneficiary['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" oninput="filterString(this);" class="form-control modified-input" name="beneficiaries[{{$loop->index}}][city]" id="beneficiary_city_{{$loop->index}}" value="{{$beneficiary['city']}}" aria-describedby="cityHelp">
                                       <small id="cityHelp" class="form-text text-muted">e.g. Northridge</small>
                                    </div>
                                    <div class="form-group mb-3">
                                       <label for="state">State</label>
                                       <input type="text" oninput="filterString(this);" class="form-control modified-input" name="beneficiaries[{{$loop->index}}][state]" id="beneficiary_state_{{$loop->index}}" value="{{$beneficiary['state']}}" aria-describedby="stateHelp">
                                       <small id="stateHelp" class="form-text text-muted">e.g. California</small>
                                    </div>
                                    <!-- <div class="card-sub-title">How much of the estate will you give to this beneficiary?</div> -->
                                    <div class="form-group mb-3">
                                       <input type="checkbox" class="form-check-input" name="beneficiaries[{{$loop->index}}][is_minor]" id="is_minor_on_{{$loop->index}}" value="1" @if((!empty($beneficiary['is_minor'])) && $beneficiary['is_minor'] == 1) checked @endif> Beneficiary is a minor
                                    </div>
                                    <div class="form-group mb-3">   
                                       <input type="checkbox" class="form-check-input" name="beneficiaries[{{$loop->index}}][is_alternate_beneficiary]" id="alternate_beneficiary_on_{{$loop->index}}" value="1" onclick="hideShowCheckBoxContainer(this,'alternate_beneficiary_recipient')" @if((!empty($beneficiary['is_alternate_beneficiary'])) && $beneficiary['is_alternate_beneficiary'] == 1) checked @endif> Name an alternate beneficiary
                                       <div id="alternate_beneficiary_recipient"  @if(!isset($beneficiary['is_alternate_beneficiary'])) style="display: none;" @endif>
                                          <div class="form-group mb-3 alternate_beneficiary_recipient">
                                             <label for="name">Name</label>
                                             <input type="text" oninput="filterString(this);" class="form-control modified-input" name="beneficiaries[{{$loop->index}}][alternate_beneficiaries][name]" value="{{$beneficiary['alternate_beneficiaries']['name']}}" id="alternate_beneficiary_recipient_name_{{$loop->index}}" aria-describedby="nameHelp">
                                             <small id="nameHelp" class="form-text text-muted">e.g. William Timothy Smith</small>
                                          </div>
                                          <div class="form-group mb-3 alternate_beneficiary_recipient">
                                             <label for="city">City/Town</label>
                                             <input type="text" oninput="filterString(this);" class="form-control modified-input" name="beneficiaries[{{$loop->index}}][alternate_beneficiaries][city]" value="{{$beneficiary['alternate_beneficiaries']['city']}}" id="alternate_beneficiary_recipient_city_{{$loop->index}}" aria-describedby="cityHelp">
                                             <small id="cityHelp" class="form-text text-muted">e.g. Northridge</small>
                                          </div>
                                          <div class="form-group mb-3  alternate_beneficiary_recipient">
                                             <label for="state">State</label>
                                             <input type="text" oninput="filterString(this);" class="form-control modified-input" name="beneficiaries[{{$loop->index}}][alternate_beneficiaries][state]" value="{{$beneficiary['alternate_beneficiaries']['state']}}" id="alternate_beneficiary_recipient_state_{{$loop->index}}" aria-describedby="stateHelp">
                                             <small id="stateHelp" class="form-text text-muted">e.g. California</small>
                                          </div>
                                       </div>
                                    </div>

                                 </div>
                              </div>
                              @endforeach
                           @else   
                              <div class="card list mb-3" id="child">
                                 <div class="card-header d-flex justify-content-between">
                                    <div class="card-title m-0">Beneficiary</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="form-group mb-3">
                                       <label for="name">Name</label>
                                       <input type="text" oninput="filterString(this);" class="form-control modified-input" name="beneficiaries[0][name]" id="beneficiary_name_0" 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" oninput="filterString(this);" class="form-control modified-input" name="beneficiaries[0][city]" id="beneficiary_city_0" aria-describedby="cityHelp">
                                       <small id="cityHelp" class="form-text text-muted">e.g. Northridge</small>
                                    </div>
                                    <div class="form-group mb-3">
                                       <label for="state">State</label>
                                       <input type="text" oninput="filterString(this);" class="form-control modified-input" name="beneficiaries[0][state]" id="beneficiary_state_0" aria-describedby="stateHelp">
                                       <small id="stateHelp" class="form-text text-muted">e.g. California</small>
                                    </div>
                                    <div class="card-sub-title">How much of the estate will you give to this beneficiary?</div>
                                    <div class="form-group mb-3">
                                       <input type="checkbox" class="form-check-input" name="beneficiaries[0][is_minor]" id="is_minor_on_0" value="1"> Beneficiary is a minor
                                    </div>
                                    <div class="form-group mb-3">   
                                       <input type="checkbox" class="form-check-input" name="beneficiaries[0][is_alternate_beneficiary]" id="alternate_beneficiary_on_0" value="1" onclick="hideShowCheckBoxContainer(this,'alternate_beneficiary_recipient')"> Name an alternate beneficiary
                                       <div id="alternate_beneficiary_recipient">
                                          <div class="form-group mb-3 alternate_beneficiary_recipient">
                                             <label for="name">Name</label>
                                             <input type="text" oninput="filterString(this);" class="form-control modified-input" name="beneficiaries[0][alternate_beneficiaries][name]" id="alternate_beneficiary_recipient_name_0" aria-describedby="nameHelp">
                                             <small id="nameHelp" class="form-text text-muted">e.g. William Timothy Smith</small>
                                          </div>
                                          <div class="form-group mb-3 alternate_beneficiary_recipient">
                                             <label for="city">City/Town</label>
                                             <input type="text" oninput="filterString(this);" class="form-control modified-input" name="beneficiaries[0][alternate_beneficiaries][city]" id="alternate_beneficiary_recipient_city_0" aria-describedby="cityHelp">
                                             <small id="cityHelp" class="form-text text-muted">e.g. Northridge</small>
                                          </div>
                                          <div class="form-group mb-3  alternate_beneficiary_recipient">
                                             <label for="state">State</label>
                                             <input type="text" oninput="filterString(this);" class="form-control modified-input" name="beneficiaries[0][alternate_beneficiaries][state]" id="alternate_beneficiary_recipient_state_0" aria-describedby="stateHelp">
                                             <small id="stateHelp" class="form-text text-muted">e.g. California</small>
                                          </div>
                                       </div>
                                    </div>
                                 </div>
                              </div>
                           @endif   
                        </div>
                        <div class="add-child">
                           <a onclick="custom_clone_for_revocable('beneficiary-container')"><span class="fas fa-plus"></span>Add beneficiary details</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>Who can I name as a beneficiary?</p>
                        <span class="tooltiptext">You can name an individual, charity, or business entity, such as a partnership or corporation, as a beneficiary.<br><br>If you name a person with a disability, make sure you understand the possible impact on their eligibility for Supplemental Security Income and Medicaid.</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 type="submit" name="back" value="1" class="btn btn-light btn-lg back-btn">Back</button>
                           <button type="submit" name="forward" value="1" class="btn btn-light btn-lg">Save and Continue</button>
                           <button type="button" class="btn btn-light btn-lg skip-btn d-none">Skip Step</button>
                           </div>
                           <button type="submit" class="btn btn-light btn-lg" name="preview_submit" value="preview">Save and Preview</button>   
                        </div>
                     </div>
                  </div>
                  <!-- end previous / next buttons -->
               </div>
            </div>
         </div>
      </div>
   </form>   
</div>

@endsection
@section('page-js')
<script src="{{ url('frontend/assets/js/forms/revocable-living-trust-step.js?v=10.2') }}"></script>
<script src="{{ url('frontend/assets/js/forms/custom.js?v=10.1') }}"></script>
<script src="{{ url('frontend/assets/js/common.js?v=10.1') }}"></script>
@endsection