<style type="text/css">
	.stripe-form label{
		font-weight:normal;
		font-size:14px;	
	}
	
	.stripe-form .form-heading {
	  font-weight: bold;
	  margin-top: 10px;
	  margin-bottom: 10px;
	  font-size: 16px;
	}
</style>

<?php
	$currencyCode=$invoice->currency;	
	$currencyIcon="$";	
?>

<div class="invoice-payment-form">
    <div class="product-delivery-option-list">
        <div class="delivery-shipping-details">
            <script type="text/javascript" src="https://js.stripe.com/v2/"></script>
    	    {!! Theme::section('invoices.stripe-js',['invoice'=>$invoice]) !!}
             
            <div class="stripe-form"> 
            	<form action="{{URL::route('community-invoice-pay',['slug'=>$invoice->community_id,'id'=>$invoice->id])}}" method="POST" id="paymentForm">    
                    {{ csrf_field() }}                       
                    <div class="form-heading">Card Details</div>
                        
                    <div class="form-group">
                        <label>Card Number <span class="text-danger">*</span></label>
                        <input type="text" name="cardNumber" id="creditcardNumber" class="form-control" placeholder="1234 5678 9012 3456" maxlength="20" onkeypress="" required="required" autocomplete="off">
                        <span id="errorCardNumber" class="text-danger"></span>
                    </div>
                        
                    <div class="form-group">
                        <div class="row crowdfunding-card-row">
                            <div class="col-sm-4 col-xs-4">
                                 <label>Expiry Month <span class="text-danger">*</span></label>
                                 <select name="cardExpMonth" id="cardExpMonth" class="form-control cards-exp-month-year-box" required="required">
                                    <option value="">Select Month</option>
                                    <option value="01">01</option>
                                    <option value="02">02</option>
                                    <option value="03">03</option>
                                    <option value="04">04</option>
                                    <option value="05">05</option>
                                    <option value="06">06</option>
                                    <option value="07">07</option>
                                    <option value="08">08</option>
                                    <option value="09">09</option>
                                    <option value="10">10</option>
                                    <option value="11">11</option>
                                    <option value="12">12</option>
                                </select>
                                
                                <span id="errorCardExpMonth" class="text-danger"></span>
                            </div>
                            
                            <div class="col-sm-4 col-xs-4">  
                                <label>Expiry Year <span class="text-danger">*</span></label>
                                <select name="cardExpYear" id="cardExpYear" class="form-control cards-exp-month-year-box" required="required">
                                    <?php 
                                        $current_year=date("Y");
                                        $last_year=date('Y', strtotime('+14 years'));
                                    ?>
                                    <option value="">Select Year</option>
                                    @for($y=$current_year;$y < $last_year;$y++)
                                        <option value="{{$y}}">{{$y}}</option>
                                    @endfor   
                                </select>
                                
                                <span id="errorCardExpYear" class="text-danger"></span>
                            </div>
                            
                            <div class="col-sm-4 col-xs-4">
                                <label>CVC <span class="text-danger">*</span></label>
                                <input type="password" name="cardCVC" id="cardCVC" class="form-control" placeholder="123" maxlength="4" onkeypress="return validateNumber(event);" required="required" autocomplete="off">
                                <span id="errorCardCvc" class="text-danger"></span>     
                            </div>    
                        </div>    

                        <div class="form-group validate-card-btn-row">
							<span class="validate-card-msg"></span>
							<input type="button" class="btn black-color-button validate-card-btn" onclick="return ValidateCard()"  value="Verify Card">
						</div>						
                    </div>
                      
                    <div class="form-heading">Customer Details</div>
                    
                    <div class="form-group">
                        <label>{{trans('product.name-of-the-receiver')}} <span class="text-danger">*</span></label>
                        <input class="form-control" type="text" name="customerName" id="customerName" placeholder="{{trans('product.provide-full-name')}}" @if(Auth::check()) value="{{\Auth::user()->fullname}}" @endif autocomplete="off"/>
                    </div>
                    
                    <div class="form-group">
                        <label>Email Address <span class="text-danger">*</span></label>
                        <input type="text" name="emailAddress" id="emailAddress" class="form-control" @if(Auth::check()) value="{{\Auth::user()->email_address}}" @endif required="required" placeholder="Provide email address" autocomplete="off">
                        <span id="errorEmailAddress" class="text-danger"></span>
                    </div>
                    
                    <div class="form-group">					
						<label>Billing Address<span class="text-danger">*</span></label>
                        <div class="searchBoxContainer1">
                             <input class="form-control social_product_billing_addr" style="width:96.5%;" type="text" name="customerBillingAddress" id="addressSearchBox1" placeholder="type your full billing address" autocomplete="off" @if($organizationDetails) value="{{$organizationDetails->address}}" @endif/>
                        </div>
					</div>
					
					<div class="form-group" style="margin-bottom:5px;">
						<label>Is your billing address same for delivery?<label>
						
						<span style="margin-left:10px;">	
							<input class="form-check-input same_billing_address" type="radio" name="same_billing_address" id="same_billing_address_yes" value="1">							
							<label class="form-check-label" for="same_billing_address_yes">Yes</label>
						</span>
						
						<span style="margin-left:10px;">
							<input class="form-check-input same_billing_address" type="radio" name="same_billing_address" id="same_billing_address_no" value="0">							  
							<label class="form-check-label" for="same_billing_address_no">No</label>
						</span>
					</div>
					
					<div class="form-group">					
                        <label>Delivery Address<span class="text-danger">*</span></label>
                        <div class="searchBoxContainer">
                             <input class="form-control social_product_mailing_addr" style="width:96.5%;" type="text" name="customerAddress" id="addressSearchBox" placeholder="type your full mailing address" autocomplete="off" @if($organizationDetails) value="{{$organizationDetails->address}}" @endif/>
                        </div>
						
						<div class="form-group">
							<label>STE/Unit/Suite #</label>
							<input type="text" name="address_unit" id="address_unit" class="form-control" placeholder="Add STE/Unit/Suite #" @if($organizationDetails and $organizationDetails->suit_number) value="{{$organizationDetails->suit_number}}" @endif autocomplete="off">
						</div>
					</div>
					
					<div class="form-group">						
						<div class="billing-address-btn-row">
							<span class="billing-address-open-btn">Show address</span>
						</div>
                    </div>
                    
					<div class="auto-billing-address-form">
					    <div class="form-group">
							<label>Street address</label>
							<input type="text" name="address_line" id="address_line" class="form-control autoaddress-street autoaddress-street1" value="" placeholder="Street address" autocomplete="off">
						</div>
					
						<div class="form-group">
							<label>{{trans('product.city-name')}}</label>							
							<input type="text" name="customerCity" id="customerCity" class="form-control autoaddress-city autoaddress-city1" placeholder="{{trans('product.provide-city-name')}}" autocomplete="off" @if($organizationDetails and $organizationDetails->city) value="{{$organizationDetails->city}}" @endif/>
						</div>
						
						<div class="form-group">
							<label>{{trans('product.zip-code')}}</label>
							<input class="form-control autoaddress-zipcode autoaddress-zipcode1" type="text" name="customerZipcode" id="customerZipcode" placeholder="{{trans('product.provide-zip-code')}}" autocomplete="off" @if($organizationDetails and $organizationDetails->zip) value="{{$organizationDetails->zip}}" @endif/>
						</div>
						
						<div class="form-group">
							<label>{{trans('product.state-province')}}</label>							
							<input type="text" class="form-control autoaddress-state autoaddress-state1" name="customerState" id="customerState" placeholder="{{trans('product.provide-state-province')}}" autocomplete="off" @if($organizationDetails and $organizationDetails->state) value="{{$organizationDetails->state}}" @endif/>
						</div>
						
						<div class="form-group">
							<label>{{trans('product.country')}}</label>						
							<input class="form-control autoaddress-country autoaddress-country1" type="text" name="customerCountry"  id="customerCountry" placeholder="{{trans('product.write-the-country')}}" autocomplete="off" @if($organizationDetails and $organizationDetails->country) value="{{$organizationDetails->country}}" @endif/>
						</div>
					</div>					
                               
                    <?php /*<div class="form-group">
                        <label>{{trans('product.mobile-number')}}</label>
                        <input class="form-control" type="text" name="delivery_mobile" id="delivery_mobile" placeholder="{{trans('product.provide-mobile-number')}}" autocomplete="off"/>
                    </div>*/?>
					
					<div class="form-group order-phone-number-box">
                        <label>{{trans('product.mobile-number')}}<span class="text-danger">*</span></label>
                        
						<input type="hidden" id="my_existing_phone_number" @if(Auth::check()) value="{{\Auth::user()->phone_number}}" @endif />
						
						<input type="hidden" id="my_carrier_country_code" @if(Auth::check()) value="{{\Auth::user()->country_iso_code}}" @endif />
						
						<div class="input-phone-number"></div>
						<div class="phone-number-custom-error-container"></div>
                    </div>
                    
                    <div class="form-group row">
                        <div class="col-sm-6">
                            <span style="color:#000">{{trans('product.total-amount')}}:</span> <span class="brand-colored-texts ">{!! $currencyIcon !!} <span class="product_subtotal_price_show">{{number_format($invoice->total_amount, 2, '.', ',')}}</span> <!--(Tax included)--></span>
                        </div>                        
                    </div>
                    
                    <div class="form-group row">
                        <div class="col-sm-12">
                            <input type="hidden" name="price" id="stripe_price" value="{{$invoice->total_amount}}">
                            <input type="hidden" name="total_amount" id="stripe_total_amount" value="{{$invoice->total_amount}}">
                            <input type="hidden" name="currency_code" value="{{$currencyCode}}">
                            <input type="hidden" name="item_details" value="Invoice">
                            <input type="hidden" name="item_number" value="<?php echo rand(111111,999999);?>">
                            <input type="hidden" name="order_number" value="<?php echo rand(111111,999999);?>">    
                            <input type="hidden" name="invoice_id" id="invoice_id" value="{{$invoice->id}}" />
                              
                            <input type="button" name="payNow" id="payNow" class="stripePayNowBtn btn red-color-button" onclick="stripeInvoicePayment(event)" value="Pay Now" style="width:100%" />
                        </div>
                    </div>       
                 </form>   
             </div>   
         </div>   
    </div>
</div>


