@extends('layouts.frontend')

@section('title', '| Last Will And Testament')

@section('content')
@include('frontend.forms.Will-Testament.stepIndicator')
 <!-- start -->
<div class="container">
   <form action="{{route('willsAndTestFormcreate')}}" method="POST" id="signUpForm">
      @csrf
      <input type="hidden" id="stepInput" name="step" value="3">
      <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">Estate assets</div>
                     @if(isset($willsAndTest->m_status) &&  $willsAndTest->m_status == "single")
                     <div class="card-sub-title">Who will receive all the assets of the testator's estate excluding any specific gifts they might give to others?</div>
                     @else
                     <div class="card-sub-title">Do you want your spouse to receive the assets of your estate excluding any specific gifts to others?</div>
                     @endif
                     <div class="card-minsub">You will be asked to list any specific gifts later.</div>
                   
                     <div class="custom-button-yn mb-5">
                      <input type="radio" id="estate-l-y" name="estate_status" value="yes" {{ empty($willsAndTest->asset_beneficiary) ? 'checked' : ''}}>
                       <label for="estate-l-y">Yes</label>
                       <input type="radio" id="estate-l-n" name="estate_status" value="no" {{ !empty($willsAndTest->asset_beneficiary) ? 'checked' : ''}}>
                       <label for="estate-l-n">No</label>
                     </div>
                     <div id="excluding-section-details">

                        <div id="beneficiary-container" style="display:block">
                           @if(!empty($willsAndTest->asset_beneficiary))
                           @foreach(json_decode($willsAndTest->asset_beneficiary, true) 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 class="beneficiary-radio" data-form="individual_form_gifts32" type="radio" id="gifts32_lb-{{$index}}" name="beneficiary_type[{{$index}}]" value="person" {{ isset($abeneficiary['type']) &&  $abeneficiary['type'] == 'person' ? 'checked' : '' }}>
                                         <label for="gifts32_lb-{{$index}}">Person</label>
                                         <input class="beneficiary-radio" data-form="charity_form_gifts32" type="radio" id="gifts32_charity_lb-{{$index}}" name="beneficiary_type[{{$index}}]" value="charity" {{ isset($abeneficiary['type']) && $abeneficiary['type'] == 'charity'   ? 'checked' : '' }}>
                                         <label for="gifts32_charity_lb-{{$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')  style="display: none" @else style="display: block" @endif>
                                     <div class="form-group mb-3">
                                        <label for="name">Name</label>
                                        <input  value="{{$abeneficiary['name'] ?? ''}}" type="text" class="form-control" name="beneficiary31_name[]" id="beneficiary31_name" aria-describedby="nameHelp" >
                                        <small id="nameHelp" class="form-text text-muted">e.g. William Timothy Smith</small>
                                     </div>
                                     <div class="form-group mb-3">
                                        <label for="beneficiary31_city">City/Town</label>
                                        <input value="{{$abeneficiary['city'] ?? ''}}" type="text" class="form-control" 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  value="{{$abeneficiary['state'] ?? ''}}" type="text" class="form-control" name="beneficiary31_state[]" id="beneficiary31_state" placeholder="State">
                                     </div>
                                 </div>
                                 <div class="beneficiary-form" data-form-name="charity_form_gifts32" id="charity_form_gifts32-{{$index}}"  @if($abeneficiary['type'] != 'charity')  style="display: none" @else style="display: block" @endif>
                                     <div class="form-group mb-3">
                                        <label for="name">Charity or Organization Name</label>
                                        <input value="{{$abeneficiary['charity_name'] ?? ''}}" type="text" class="form-control" 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">Employer Identification Number (EIN):</label>
                                        <input value="{{$abeneficiary['charity_city'] ?? ''}}" type="text" class="form-control" name="beneficiary31_charity_registration[]" id="beneficiary31_charity_registration" aria-describedby="cityHelp" placeholder="e.g. 200583415">
                                        <small id="cityHelp" class="form-text text-muted d-none">e.g. 200583415</small>
                                     </div>
                                     <div class="form-group mb-3">
                                       <label for="state">City/Town</label>
                                       <input value="{{$abeneficiary['charity_city'] ?? ''}}" type="text" class="form-control" 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" name="beneficiary31_charity_state[]" id="beneficiary31_charity_state" placeholder="State">
                                     </div>
                                 </div>

                              </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" 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" 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" 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" 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" 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" 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" 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" 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> 
                           </div>
                           @endif
                        </div>
                        <div class="add-child">
                           <a  onclick="custom_clone('beneficiary-container')"><span class="fas fa-plus"></span>Add another recipient</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>What if my spouse dies first?</p>
                       </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="button" onclick="window.location.href = '{{ route('willsAndTest.create.step.two') }}'" 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('beneficiary-container', 'beneficiary-radio','.beneficiary-form','.beneficiary-card');
   });
</script>
<script src="{{ url('frontend/assets/js/forms/wills-And-Testament-step.js?v=10.5') }}"></script>
<script src="{{ url('frontend/assets/js/forms/custom.js?v=10.3') }}"></script>

@endsection