@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="3-2">
      <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 Will?</div>
                      <div class="custom-button-yn">
                        <input id="gifts32-y" name="gift" type="radio" value="yes" {{ $willsAndTest->specific_gifts == 'yes' || !isset($willsAndTest->specific_gifts) ? 'checked' : '' }}>
                        <label for="gifts32-y">Yes</label>
                        <input id="gifts32-n" name="gift" type="radio" value="no" {{ $willsAndTest->specific_gifts == 'no' && isset($willsAndTest->specific_gifts) ? 'checked' : '' }}>
                        <label for="gifts32-n">No</label>
                     </div>
                    <div id="gifts32-container-card">
                        <div class="card-sub-title">Who will receive gifts in the Will?</div>
                        <div id="gifts32-container">
                        @php
                           $willsAndTestGiftArray = json_decode($willsAndTest->specific_gifts_details, true)
                        @endphp

                        @if(!empty($willsAndTest->specific_gifts_details) && count($willsAndTestGiftArray) > 0 )
                           @foreach($willsAndTestGiftArray as $index => $gift)
                              <div class="card list mb-3 beneficiary32-card" id="child">
                                 <div class="card-header d-flex justify-content-between">
                                    <div class="card-title m-0">Gift recipient</div>
                                    <a class="r-button" onclick="removetList(this)"><span class="fas fa-times"></span><span class="remove">Remove</span></a>
                                 </div>
                                 <div class="card-body">
                                    <div class="long-btn-card">
                                       <div class="custom-button-yn">
                                          <input class="beneficiary32-radio" data-form="gifts32_lbm" type="radio" id="gifts32_lb-{{$index}}" name="beneficiary_type[{{$index}}]" value="person" {{ $gift['type'] == 'person' && isset($gift['type']) ? 'checked' : '' }}>
                                          <label for="gifts32_lb-{{$index}}">Person</label>
                                          <input class="beneficiary32-radio" data-form="gifts32_charity_lbm" type="radio" id="gifts32_charity_lb-{{$index}}" name="beneficiary_type[{{$index}}]" value="charity" {{ $gift['type'] == 'charity' && isset($gift['type']) ? 'checked' : '' }}>
                                          <label for="gifts32_charity_lb-{{$index}}">Charity or Organization</label>
                                       </div>
                                    </div>

                                    <div class="beneficiary-form-x" data-form-name="gifts32_lbm" id="individual_form_gifts32" @if($gift['type'] == 'person' && isset($gift['type'])) style="display: block;" @else style="display: none;" @endif>
                                       <div class="form-group mb-3">
                                          <label for="name">Name</label>
                                          <input  value="{{$gift['name'] ?? ''}}" type="text" class="form-control modified-input" name="beneficiary31_name[]" id="beneficiary31_name" aria-describedby="nameHelp" >
                                          <small id="nameHelp" class="form-text text-muted">e.g. William Timothy Smith</small>
                                       </div>
                                       <div class="form-group mb-3">
                                          <label for="city">City/Town</label>
                                          <input value="{{$gift['city'] ?? ''}}" 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  value="{{$gift['state'] ?? ''}}" type="text" class="form-control modified-input" name="beneficiary31_state[]" id="beneficiary31_state" placeholder="State">
                                       </div>
                                       <div class="form-group mb-3">
                                          <label for="leaving">What are you leaving to this person?</label>
                                          <input value="{{$gift['leaving'] ?? ''}} " type="text" class="form-control modified-input" name="beneficiary31_leaving[]" id="beneficiary31_leaving">
                                       </div>
                                    </div>
                                    <div class="beneficiary-form-x" data-form-name="gifts32_charity_lbm" id="charity_form_gifts32" @if($gift['type'] == 'charity' && isset($gift['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="{{$gift['charity_name'] ?? ''}}" type="text" class="form-control modified-input" name="beneficiary31_charity_name[]" id="beneficiary31_recipient_name" aria-describedby="nameHelp" >
                                          <small id="nameHelp" class="form-text text-muted">e.g. United Way Worldwide, Feeding America</small>
                                       </div>
                                       <div class="form-group mb-3">
                                          <label for="city">Employer Identification Number (EIN)</label>
                                          <input value="{{$gift['charity_registration'] ?? ''}}" type="text" class="form-control modified-input" name="beneficiary31_charity_registration[]" id="beneficiary31_charity_registration" aria-describedby="cityHelp">
                                          <small id="cityHelp" class="form-text text-muted">e.g. 200583415</small>
                                       </div>
                                       <div class="form-group mb-3">
                                          <label for="state">City</label>
                                          <input value="{{$gift['charity_city'] ?? ''}}" type="text" class="form-control modified-input" name="beneficiary31_charity_city[]" id="beneficiary31_charity_City" placeholder="City">
                                       </div>
                                       <div class="form-group mb-3">
                                          <label for="state">State</label>
                                          <input value="{{$gift['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="leaving">What are you leaving to this charity/organization?</label>
                                          <input value="{{$gift['charity_leaving'] ?? ''}}" type="text" class="form-control modified-input" name="beneficiary31_charity_leaving[]" id="beneficiary31_charity_leaving">
                                       </div>
                                    </div>

                                 </div> 
                              </div>
                           @endforeach
                           @else
                           <div class="card list mb-3 beneficiary32-card" id="child">
                              <div class="card-header d-flex justify-content-between">
                                 <div class="card-title m-0">Gift recipient</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 class="beneficiary32-radio" data-form="gifts32_lbm" type="radio" id="gifts32_lb" name="beneficiary_type[]" value="person" checked>
                                         <label  for="gifts32_lb">Person</label>
                                         <input class="beneficiary32-radio" data-form="gifts32_charity_lbm" type="radio" id="gifts32_charity_lb" name="beneficiary_type[]" value="charity">
                                         <label for="gifts32_charity_lb">Charity or Organization</label>
                                     </div>
                                 </div>


                                 <div class="beneficiary-form-x" data-form-name="gifts32_lbm" 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 class="form-group mb-3">
                                       <label for="leaving">What are you leaving to this person?</label>
                                       <input type="text" class="form-control modified-input" name="beneficiary31_leaving[]" id="beneficiary31_leaving">
                                    </div>
                                 </div>
                                 <div class="beneficiary-form-x" data-form-name="gifts32_charity_lbm" 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">Employer Identification Number (EIN)</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">e.g. 200583415</small>
                                     </div>
                                     <div class="form-group mb-3">
                                        <label for="state">City</label>
                                        <input type="text" class="form-control modified-input" name="beneficiary31_charity_city[]" id="beneficiary31_charity_city" placeholder="City">
                                     </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="leaving">What are you leaving to this charity/organization?</label>
                                       <input type="text" class="form-control modified-input" name="beneficiary31_charity_leaving[]" id="beneficiary31_charity_leaving">
                                    </div>
                                 </div>

                              </div> 
                           </div>
                           @endif


                        </div>
                        <div class="add-child">
                              <a  onclick="custom_clone('gifts32-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>Is there anything i cannot give away?</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.three_1') }}'" 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>
</div>

@endsection
@section('page-js')
<script>
   document.addEventListener("DOMContentLoaded", function () {
      setupFormToggle('gifts32-container', 'beneficiary32-radio','.beneficiary-form-x','.beneficiary32-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