@extends('layouts/microfin_layout') @section('title', '| Add One Time Loan') @section('content')
New One Time Loan
{!! Form::open(array('name' => 'memberForm', 'url' => '', 'role' => 'form', 'id' => 'rootwizard', 'files' => 'true', 'class' => 'form-wizard validate', 'novalidate' => '')) !!}
Member and Loan Details
{!! Form::label('member', 'Member:*', ['class' => 'control-label']) !!}
{!! Form::select('memberIdFk', array('' => 'Select'), null, array('class'=>'form-control', 'id' => 'select-to', 'data-validate' => 'required')) !!}
{!! Form::label('disbursement date', 'Disbursement Date:*', ['class' => 'control-label']) !!}
{!! Form::text('disbursementDate', $value = $damageData['disbursementDate'], ['class' => 'form-control', 'id' => 'disbursementDate', 'type' => 'text', 'readonly' => 'readonly', 'data-validate' => 'required, minlength[5]']) !!}
{!! Form::label('product', 'Product:*', ['class' => 'control-label']) !!}
{!! Form::select('productIdFk', array('' => 'Select'), null, array('class'=>'form-control', 'id' => 'productIdFk', 'data-validate' => 'required')) !!}
{!! Form::label('loan code', 'Loan Code:*', ['class' => 'control-label']) !!}
{!! Form::text('loanCode', $value = null, ['class' => 'form-control', 'id' => 'loanCode', 'type' => 'text', 'readonly' => 'readonly', 'data-validate' => 'required']) !!}
Loan Configuration
{!! Form::label('loan application no', 'Loan Application No:', ['class' => 'control-label']) !!}
{!! Form::text('loanApplicationNo', $value = null, ['class' => 'form-control', 'id' => 'loanApplicationNo', 'type' => 'text']) !!}
{!! Form::label('loan amount', 'Loan Amount:*', ['class' => 'control-label']) !!}
{!! Form::text('loanAmount', $value = null, ['class' => 'form-control', 'id' => 'loanAmount', 'type' => 'text', 'data-validate' => 'required']) !!} {!! Form::text('', $value = null, ['class' => 'form-control hidden', 'id' => 'maxLoanAmount', 'type' => 'hidden']) !!} {!! Form::text('', $value = null, ['class' => 'form-control hidden', 'id' => 'minLoanAmount', 'type' => 'hidden']) !!}
{!! Form::label('loan repay period', 'Loan Repay Period:*', ['class' => 'control-label']) !!}
{!! Form::select('loanRepayPeriodInMonth', array(''=>'Select'), null, array('class'=>'form-control', 'id' => 'loanRepayPeriodInMonth', 'data-validate' => 'required')) !!}
{!! Form::label('repay date', 'Repay Date:*', ['class' => 'control-label']) !!}
{!! Form::text('repayDate', $value = null, ['class' => 'form-control', 'id' => 'repayDate', 'type' => 'text', 'readonly' => 'readonly', 'data-validate' => 'required']) !!}
{{--
{!! Form::label('loan purpose', 'Loan Purpose:*', ['class' => 'control-label']) !!}
{!! Form::select('loanSubPurposeIdFk', ($damageData['loanPurpose']), null, array('class'=>'form-control', 'id' => 'loanSubPurposeIdFk', 'data-validate' => 'required')) !!}
--}}
{!! Form::label('insurance amount', 'Insurance Amount:', ['class' => 'control-label']) !!}
{!! Form::text('insuranceAmount', $value = null, ['class' => 'form-control', 'id' => 'insuranceAmount', 'type' => 'text', 'readonly' => 'readonly']) !!}
{!! Form::label('loan cycle', 'Loan Cycle:', ['class' => 'control-label']) !!}
{!! Form::text('loanCycle', $value = null, ['class' => 'form-control', 'id' => 'loanCycle', 'type' => 'text', 'readonly' => 'readonly', 'data-validate' => 'required']) !!}
{!! Form::label('folio number', 'Folio Number:', ['class' => 'control-label']) !!}
{!! Form::text('folioNum', $value = null, ['class' => 'form-control', 'id' => 'folioNum', 'type' => 'text']) !!}
{!! Form::label('loan_purpose_code_level_1', 'Loan Purpose (Layer-1):*', ['class' => 'control-label']) !!}
{!! Form::select('loan_purpose_code_level_1', $damageData['loan_purpose_level_1_list'], null, array('class'=>'form-control', 'id' => 'loan_purpose_code_level_1', 'data-validate' => 'required')) !!}
{!! Form::label('loan_purpose_code_level_2', 'Loan Purpose (Layer-2):*', ['class' => 'control-label']) !!}
{!! Form::select('loan_purpose_code_level_2', $damageData['loan_purpose_level_2_list'], null, array('class'=>'form-control', 'id' => 'loan_purpose_code_level_2', 'data-validate' => 'required')) !!}
{!! Form::label('loan_purpose_code_level_3', 'Loan Purpose (Layer-3):*', ['class' => 'control-label']) !!}
{!! Form::select('loan_purpose_code_level_3', $damageData['loan_purpose_level_3_list'], null, array('class'=>'form-control', 'id' => 'loan_purpose_code_level_3', 'data-validate' => 'required')) !!}
{!! Form::label('loan_purpose_code_level_4', 'Loan Purpose (Layer-4):*', ['class' => 'control-label']) !!}
{!! Form::select('loan_purpose_code_level_4', $damageData['loan_purpose_level_4_list'], null, array('class'=>'form-control', 'id' => 'loan_purpose_code_level_4', 'data-validate' => 'required')) !!}
Interest Calculation
{!! Form::label('interest calculation method', 'Interest Calculation Method:*', ['class' => 'control-label']) !!}
{!! Form::text('interestCalculationMethod', $value = null, ['class' => 'form-control', 'id' => 'interestCalculationMethod', 'type' => 'text', 'readonly' => 'readonly', 'data-validate' => 'required, minlength[1]']) !!}
{!! Form::label('interest rate', 'Interest Rate:*', ['class' => 'control-label']) !!}
{!! Form::text('interestRate', $value = null, ['class' => 'form-control', 'id' => 'interestRate', 'type' => 'text', 'readonly' => 'readonly', 'data-validate' => 'required, minlength[1]']) !!}
Payments
{!! Form::label('total repay amount', 'Total Repay Amount:*', ['class' => 'control-label']) !!}
{!! Form::text('totalRepayAmount', $value = null, ['class' => 'form-control', 'id' => 'totalRepayAmount', 'type' => 'text', 'readonly' => 'readonly', 'data-validate' => 'required']) !!}
{!! Form::label('interest amount', 'Interest Amount:', ['class' => 'control-label']) !!}
{!! Form::text('interestAmount', $value = null, ['class' => 'form-control', 'id' => 'interestAmount', 'type' => 'text', 'readonly' => 'readonly']) !!}
{!! Form::label('installment amount', 'Installment Amount:*', ['class' => 'control-label']) !!}
{!! Form::text('installmentAmount', $value = null, ['class' => 'form-control', 'id' => 'installmentAmount', 'type' => 'text', 'readonly' => 'readonly', 'data-validate' => 'required']) !!}
{!! Form::label('payment type', 'Payment Type:', ['class' => 'control-label']) !!}
{!! Form::select('paymentTypeIdFk', ($damageData['paymentType']), null, array('class'=>'form-control', 'id' => 'paymentTypeIdFk', 'data-validate' => 'required')) !!}
{!! Form::label('additional fee', 'Additional Fee:', ['class' => 'control-label']) !!}
{!! Form::text('additionalFee', $value = null, ['class' => 'form-control', 'id' => 'additionalFee', 'type' => 'text', 'readonly' => 'readonly']) !!}
{!! Form::label('loan form fee', 'Loan Form Fee:', ['class' => 'control-label']) !!}
{!! Form::text('loanFormFee', $value = null, ['class' => 'form-control', 'id' => 'loanFormFee', 'type' => 'text', 'readonly' => 'readonly']) !!}
{!! Form::label('note', 'Note:', ['class' => 'control-label']) !!}
{!! Form::textarea('note', $value = null, ['class' => 'form-control', 'id' => 'note', 'type' => 'textarea', 'rows' => '5', 'cols' => '50']) !!}
Guarantor's Details
{!! Form::label('guarantor#1 name', 'Guarantor#1 Name:*', ['class' => 'control-label']) !!}
{!! Form::text('firstGuarantorName', $value = null, ['class' => 'form-control', 'id' => 'firstGuarantorName', 'type' => 'text', 'data-validate' => 'required']) !!}
{!! Form::label('relation', 'Relation:*', ['class' => 'control-label']) !!}
{!! Form::text('firstGuarantorRelation', $value = null, ['class' => 'form-control', 'id' => 'firstGuarantorRelation', 'type' => 'text', 'data-validate' => 'required']) !!}
{!! Form::label('address', 'Address:*', ['class' => 'control-label']) !!}
{!! Form::text('firstGuarantorAddress', $value = null, ['class' => 'form-control', 'id' => 'firstGuarantorAddress', 'type' => 'text', 'data-validate' => 'required']) !!}
{!! Form::label('contact', 'Contact:*', ['class' => 'control-label']) !!}
{!! Form::text('firstGuarantorContact', $value = null, ['class' => 'form-control', 'id' => 'firstGuarantorContact', 'type' => 'text', 'data-validate' => 'required']) !!}
{!! Form::label('guarantor#2 name', 'Guarantor#2 Name:', ['class' => 'control-label']) !!}
{!! Form::text('secondGuarantorName', $value = null, ['class' => 'form-control', 'id' => 'secondGuarantorName', 'type' => 'text']) !!}
{!! Form::label('relation', 'Relation:', ['class' => 'control-label']) !!}
{!! Form::text('secondGuarantorRelation', $value = null, ['class' => 'form-control', 'id' => 'secondGuarantorRelation', 'type' => 'text']) !!}
{!! Form::label('address', 'Address:', ['class' => 'control-label']) !!}
{!! Form::text('secondGuarantorAddress', $value = null, ['class' => 'form-control', 'id' => 'secondGuarantorAddress', 'type' => 'text']) !!}
{!! Form::label('contact', 'Contact:', ['class' => 'control-label']) !!}
{!! Form::text('secondGuarantorContact', $value = null, ['class' => 'form-control', 'id' => 'secondGuarantorContact', 'type' => 'text']) !!}
Employment related Information

Self-Employment / Family Employment

Full Time Employment
Part Time Employment
{!! Form::label('Male', 'Male:*', ['class' => 'control-label']) !!}
{!! Form::text('FEFullTimeMale', $value = null, ['class' => 'form-control', 'id' => 'FEFullTimeMale', 'type' => 'number', 'autocomplete' => 'off', 'data-validate' => 'required', 'min' => 0, 'max' => 99 ]) !!}
{!! Form::label('Female', 'Female:*', ['class' => 'control-label']) !!}
{!! Form::text('FEFullTimeFemale', $value = null, ['class' => 'form-control', 'id' => 'FEFullTimeFemale', 'type' => 'number', 'autocomplete' => 'off', 'data-validate' => 'required', 'min' => 0, 'max' => 99 ]) !!}
{!! Form::label('Male', 'Male:', ['class' => 'control-label']) !!}
{!! Form::text('FEPartTimeMale', $value = null, ['class' => 'form-control', 'id' => 'FEPartTimeMale', 'type' => 'number', 'autocomplete' => 'off', 'min' => 0, 'max' => 99 ]) !!}
{!! Form::label('Female', 'Female:', ['class' => 'control-label']) !!}
{!! Form::text('FEPartTimeFemale', $value = null, ['class' => 'form-control', 'id' => 'FEPartTimeFemale', 'type' => 'number', 'autocomplete' => 'off', 'min' => 0, 'max' => 99 ]) !!}

Wage-Based Employment

Full Time Employment
Part Time Employment
{!! Form::label('Male', 'Male:*', ['class' => 'control-label']) !!}
{!! Form::text('FEFullTimeMaleWage', $value = null, ['class' => 'form-control', 'id' => 'FEFullTimeMaleWage', 'type' => 'number', 'autocomplete' => 'off', 'min' => 0, 'max' => 99 ]) !!}
{!! Form::label('Female', 'Female:*', ['class' => 'control-label']) !!}
{!! Form::text('FEFullTimeFemaleWage', $value = null, ['class' => 'form-control', 'id' => 'FEFullTimeFemaleWage', 'type' => 'number', 'autocomplete' => 'off', 'min' => 0, 'max' => 99 ]) !!}
{!! Form::label('Male', 'Male:*', ['class' => 'control-label']) !!}
{!! Form::text('OFEPartTimeMaleWage', $value = null, ['class' => 'form-control', 'id' => 'OFEPartTimeMaleWage', 'type' => 'number', 'autocomplete' => 'off', 'min' => 0, 'max' => 99 ]) !!}
{!! Form::label('Female', 'Female:*', ['class' => 'control-label']) !!}
{!! Form::text('OFEPartTimeFemaleWage', $value = null, ['class' => 'form-control', 'id' => 'OFEPartTimeFemaleWage', 'type' => 'number', 'autocomplete' => 'off', 'min' => 0, 'max' => 99 ]) !!}
Upload Member Pictures

Member Profile Picture



{!! Form::label('profile picture', 'Profile Picture:', ['class' => 'control-label']) !!}
Your captured image will appear here...
{!! Form::file('profileImage', array('class' => 'profileImage', 'id' => 'profileImage', 'onchange' => 'loadProfileImageFile(event)', 'disabled' => 'true')) !!}

Member National ID Signature



Your captured image will appear here...
{!! Form::file('memberNidImage', array('class' => 'signature', 'id' => 'memberNidImage', 'onchange' => 'loadMemberNidImageFile(event)')) !!}
Upload Guarantor Pictures

Member's Guarantor Picture




Your captured image will appear here...
{!! Form::file('guarantorImage', array('class' => 'guarantorImage', 'id' => 'guarantorImage', 'onchange' => 'loadGuarantorImageFile(event)')) !!}

Member's Guarantor National ID Signature



Your captured image will appear here...
{!! Form::file('guarantorNidImage', array('class' => 'signature', 'id' => 'guarantorNidImage', 'onchange' => 'loadGuarantorNidImageFile(event)')) !!}
{!! Form::close() !!}