@extends('layouts.v2.frontend-user-backend')

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

@section('content')
@include('frontend.forms.v2.Will-Testament.stepIndicator')
    <form action="{{route('willsAndTestFormcreate')}}" method="POST" id="signUpForm">
      @csrf
      <input type="hidden" id="stepInput" name="step" value="3-1">
      <div class="multiple-form dashboard-radio">
         <h4>If no living beneficiaries</h4>
         <p>How will the estate be distributed if the testator's beneficiaries pass away first or no longer exist when the testator dies?</p>
         <div class="form">
            <div class="row">
               <div class="col-12">
                  <div class="dashboard-radio-form">
                     <div class="form-check">
                        <input type="radio" class="form-check-input" id="beneficiaries-on" name="beneficiaries" value="spouse" {{ $willsAndTest->beneficiaries == 'spouse' && isset($willsAndTest->beneficiaries) ? 'checked' : '' }}>
                        <label for="beneficiaries-on"><p>Divided equally among your parents/ sibling</p></label>
                     </div>
                     <div class="form-check">
                        <input type="radio" class="form-check-input" id="beneficiaries-off" name="beneficiaries" value="someone_else" {{ $willsAndTest->beneficiaries == 'someone_else' && isset($willsAndTest->beneficiaries) ? 'checked' : '' }}>
                        <label for="beneficiaries-off"><p>Given to someone else</p></label>
                     </div>
                  </div>
               </div>
            </div>
            <div class="row my-5">
               <div id="add-beneficiary-container-card" class="child-card-holder">
                  <div class="sub-title mb-5">Who will receive the estate?</div>
                  <div id="beneficiary-container31">
                     @php
                        $wipeout_beneficiarytArray = json_decode($willsAndTest->wipeout_beneficiary, true)
                     @endphp
                     @if(!empty($willsAndTest->wipeout_beneficiary) && count($wipeout_beneficiarytArray) > 0)
                     @foreach($wipeout_beneficiarytArray  as $index => $wbeneficiary)
                     <div class="card list mb-3 beneficiary33-card" id="child">
                        <div class="card-header">
                           <div class="card-title m-0">Wipeout Beneficiary</div>
                           <a class="r-button" onclick="removetList(this)"><span class="fas fa-times"></span><span class="remove">Remove</span></a>
                        </div>
                        <div class="card-body">
                           <div class="long-btn-card">
                              <div class="dashboard-radio-form">
                                 <div class="form-check">
                                   <input class="form-check-input" data-form="gifts32_lbm" type="radio" id="gifts32_lb-{{$index}}" name="beneficiary_type[{{$index}}]" value="person" {{ $wbeneficiary['type'] == 'person' && isset($wbeneficiary['type']) ? 'checked' : '' }}>
                                   <label for="gifts32_lb-{{$index}}"><p>Person</p></label>
                                 </div>
                                 <div class="form-check">
                                   <input class="form-check-input" data-form="gifts32_charity_lbm"  type="radio" id="gifts32_charity_lb-{{$index}}" name="beneficiary_type[{{$index}}]" value="charity" {{ $wbeneficiary['type'] == 'charity' && isset($wbeneficiary['type']) ? 'checked' : '' }}>
                                   <label for="gifts32_charity_lb-{{$index}}"><p>Charity or Organization</p></label>
                                 </div>
                               </div>
                           </div>
                           <div  class="beneficiary-form-x" data-form-name="gifts32_lbm" id="individual_form_gifts32-{{$index}}" @if($wbeneficiary['type'] != 'person')  style="display: none" @else style="display: block" @endif>
                               <div class="form-group mb-3">
                                  <label for="name">Name</label>
                                  <input  value="{{$wbeneficiary['name'] ?? ''}}" type="text"  name="beneficiary31_name[]" id="beneficiary31_name_{{$index}}" aria-describedby="nameHelp" >
                                  <small id="nameHelp" class="form-text text-muted">e.g. William Timothy Smith</small>
                               </div>
                               <div class="row">
                                 <div class="col-md-6">
                                    <div class="form-group mb-3">
                                       <label for="city">City/Town</label>
                                       <input value="{{$wbeneficiary['city'] ?? ''}}" type="text"  name="beneficiary31_city[]" id="beneficiary31_city_{{$index}}" aria-describedby="cityHelp">
                                       <small id="cityHelp" class="form-text text-muted d-none">city</small>
                                    </div>
                                 </div>
                                 <div class="col-md-6">
                                    <div class="form-group mb-3">
                                       <label for="state">State</label>
                                       <input  value="{{$wbeneficiary['state'] ?? ''}}" type="text"  name="beneficiary31_state[]" id="beneficiary31_state_{{$index}}">
                                    </div>
                                 </div>
                               </div>
                           </div>
                           <div class="beneficiary-form-x" data-form-name="gifts32_charity_lbm"  id="charity_form_gifts32-{{$index}}" @if($wbeneficiary['type'] != 'charity')  style="display: none" @else style="display: block" @endif>
                               <div class="form-group mb-3">
                                  <label for="name">Charity or Organization Name</label>
                                  <input value="{{$wbeneficiary['charity_name'] ?? ''}}" type="text"  name="beneficiary31_charity_name[]" id="beneficiary31_recipient_name_{{$index}}" aria-describedby="nameHelp" >
                                  <small id="nameHelp" class="form-text text-muted">e.g. United Way Worldwide, Feeding America</small>
                               </div>
                               <div class="form-group mb-3">
                                 <label for="city">Employer Identification Number (EIN):</label>
                                 <input value="{{$wbeneficiary['registration'] ?? ''}}" type="text"  name="beneficiary31_charity_registration[]" id="beneficiary31_charity_registration_{{$index}}" aria-describedby="cityHelp" placeholder="e.g. 200583415">
                                 <small id="cityHelp" class="form-text text-muted d-none">e.g. 200583415</small>
                              </div>
                              <div class="row">
                                 <div class="col-md-6">
                                    <div class="form-group mb-3">
                                       <label for="state">City/Town</label>
                                       <input value="{{$wbeneficiary['charity_city'] ?? ''}}" type="text"  name="beneficiary31_charity_city[]" id="beneficiary31_charity_city_{{$index}}">
                                    </div>
                                 </div>
                                 <div class="col-md-6">
                                    <div class="form-group mb-3">
                                       <label for="state">State</label>
                                       <input value="{{$wbeneficiary['charity_state'] ?? ''}}" type="text"  name="beneficiary31_charity_state[]" id="beneficiary31_charity_state_{{$index}}">
                                    </div>
                                 </div>
                              </div>
                           </div>
                        </div> 
                     </div>
      


                     @endforeach
                     @else
                     <div class="card list mb-3 beneficiary33-card" id="child">
                        <div class="card-header">
                           <div class="card-title m-0">Wipeout Beneficiary</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="dashboard-radio-form">
                                 <div class="form-check">
                                   <input class="form-check-input beneficiary32-radio" class="form-check-input" data-form="gifts32_lbm" type="radio" id="gifts32_lb" name="beneficiary_type[]" value="person" checked>
                                   <label for="gifts32_lb"><p>Person</p></label>
                                 </div>
                                 <div class="form-check">
                                   <input class="form-check-input beneficiary32-radio" class="form-check-input" data-form="gifts32_charity_lbm" type="radio" id="gifts32_charity_lb" name="beneficiary_type[]" value="charity">
                                   <label for="gifts32_charity_lb"><p>Charity or Organization</p></label>
                                 </div>
                              </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"  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="row">
                                 <div class="col-md-6">
                                    <div class="form-group mb-3">
                                       <label for="city">City/Town</label>
                                       <input type="text"  name="beneficiary31_city[]" id="beneficiary31_city" aria-describedby="cityHelp">
                                       <small id="cityHelp" class="form-text text-muted d-none">city</small>
                                    </div>
                                 </div>
                                 <div class="col-md-6">
                                    <div class="form-group mb-3">
                                       <label for="state">State</label>
                                       <input type="text"  name="beneficiary31_state[]" id="beneficiary31_state">
                                    </div>
                                 </div>
                               </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"  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"  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="row">
                                 <div class="col-md-6">
                                    <div class="form-group mb-3">
                                       <label for="state">City/Town</label>
                                       <input  type="text"  name="beneficiary31_charity_city[]" id="beneficiary31_charity_city">
                                     </div>
                                 </div>
                                 <div class="col-md-6">
                                    <div class="form-group mb-3">
                                       <label for="state">State</label>
                                       <input type="text"  name="beneficiary31_charity_state[]" id="beneficiary31_charity_state">
                                    </div>
                                 </div>
                              </div>

                           </div>

                        </div> 
                     </div>
                     @endif
                  </div>
                  <div class="add-child">
                        <a class="add-another"  onclick="custom_clone('beneficiary-container31')">Add beneficiary details</a>
                  </div>
               </div>
            </div>
         </div>
         <!-- start previous / next buttons -->
         <div id="buttonsection" class="submit-button-multiple">
            <button type="button" onclick="window.location.href = '{{ route('willsAndTest.create.step.three') }}'">Back</button>
            <button type="submit" class="submit-btn">Save and Continue</button>
            <button type="submit" class="d-none" name="preview_submit" value="preview">{{env('PREVIEW_BUTTON_TEXT')}}</button>
            <button type="button" class="skip-btn d-none">Skip Step</button>
         </div>
         <!-- end previous / next buttons -->
      </div>
    </form>


<div class="faq-box d-none">
   <div class="title">FAQ’s</div>
   <div class="tooltip">
      <p>What is a Wipe-out beneficiary?</p>
      <span class="tooltiptext">A Wipe-out beneficiary is a term used in estate planning to describe a situation where a beneficiary has predeceased the testator, and there are no contingent beneficiaries or alternative instructions. In such cases, the gift or bequest may "wipe out" and not distributed as intended.</span>
   </div>
</div>


@endsection
@section('page-js')
<script>
   document.addEventListener("DOMContentLoaded", function () {
      const container = document.getElementById("beneficiary-container31");

      container.addEventListener("change", function (e) {
         const radio = e.target;

         if (!radio.matches('input[type="radio"][name^="beneficiary_type"]')) return;

         // Get the card block where the clicked radio belongs
         const card = radio.closest('.beneficiary33-card');

         if (!card) return;

         const individualForm = card.querySelector('[data-form-name="gifts32_lbm"]');
         const charityForm = card.querySelector('[data-form-name="gifts32_charity_lbm"]');

         if (!individualForm || !charityForm) return;

         if (radio.value === "person") {
               individualForm.style.display = "block";
               charityForm.style.display = "none";
         } else if (radio.value === "charity") {
               individualForm.style.display = "none";
               charityForm.style.display = "block";
         }
      });
   });
</script>
<script>
   document.addEventListener("DOMContentLoaded", function () {
      setupFormToggle('beneficiary-container31', 'beneficiary32-radio','.beneficiary-form-x','.beneficiary33-card');
   });
</script>
<script src="{{ url('frontend/assets/js/forms/wills-And-Testament-step.js') }}?v={{ time() }}"></script>
<script src="{{ url('v2/js/form-validation.js') }}?v={{ time() }}"></script>
<script src="{{ url('frontend/assets/js/forms/custom.js?v=10.3') }}"></script>
@endsection