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webroot/admin_RTG/Metro_1535_compliance_challenge_letter.html
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407
webroot/admin_RTG/Metro_1535_compliance_challenge_letter.html
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<!DOCTYPE html>
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<html>
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<head>
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<meta charset="utf-8">
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<meta http-equiv="X-UA-Compatible" content="IE=edge">
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<title>Metro 1535 compliance challenge letter</title>
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<!-- Tell the browser to be responsive to screen width -->
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<meta
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content="width=device-width, initial-scale=1, maximum-scale=1, user-scalable=no"
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name="viewport">
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||||
<!-- Bootstrap 3.3.6 -->
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<link rel="stylesheet" href="http://cloud-height.com/RTG/bootstrap/css/bootstrap.min.css">
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<!-- Font Awesome -->
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||||
<link rel="stylesheet"
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href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/4.5.0/css/font-awesome.min.css">
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<!-- Ionicons -->
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||||
<link rel="stylesheet"
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href="https://cdnjs.cloudflare.com/ajax/libs/ionicons/2.0.1/css/ionicons.min.css">
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||||
<!-- Theme style -->
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<link rel="stylesheet" href="http://cloud-height.com/RTG/dist/css/AdminLTE.min.css">
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<!-- AdminLTE Skins. Choose a skin from the css/skins
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folder instead of downloading all of them to reduce the load. -->
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<link rel="stylesheet" href="http://cloud-height.com/RTG/dist/css/skins/_all-skins.min.css">
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<!-- HTML5 Shim and Respond.js IE8 support of HTML5 elements and media queries -->
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<!-- WARNING: Respond.js doesn't work if you view the page via file:// -->
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<!--[if lt IE 9]>
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<script src="https://oss.maxcdn.com/html5shiv/3.7.3/html5shiv.min.js"></script>
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<script src="https://oss.maxcdn.com/respond/1.4.2/respond.min.js"></script>
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<![endif]-->
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<style>
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||||
.form-group.required .control-label:before{
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color: red;
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content: "*";
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||||
position: absolute;
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margin-left: -7px;
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}
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</style>
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</head>
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<body class="hold-transition skin-blue sidebar-mini">
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<div class="wrapper" >
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||||
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<!-- Content Wrapper. Contains page content -->
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<div class="content-wrapper">
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<!-- Content Header (Page header) -->
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<section class="content-header">
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<h1>R.T.G M.2.M. Letter generator by M.2.C Academy - V3.0</h1>
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<ol class="breadcrumb">
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<li><a href="#"><i class="fa fa-dashboard"></i> Home</a></li>
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<li class="active">Metro 1535 compliance challenge letter</li>
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</ol>
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</section>
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<!-- Main content -->
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<section class="content">
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<div class="row">
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<!-- right column -->
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<div class="col-md-12">
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<!-- Horizontal Form -->
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<div class="box box-info">
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<div class="box-header with-border">
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<h3 class="box-title"> Enter Your Information Below</h3>
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</div>
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<!-- /.box-header -->
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<!-- form start -->
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<form enctype="multipart/form-data" class="form-horizontal" method="post" action="http://localhost/rtgv4/admin_RTG/Metro_1535_compliance_challenge_letter.php">
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<div class="box-body">
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<div class="row">
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<!-- right column -->
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<div class="col-md-7">
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<div class="form-group required">
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<label class="col-sm-5 control-label">Choose The Credit bureau Your Sending Too</label>
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<div class="col-sm-7">
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<select onchange="reportFileChange(this)" name="report_file_name" class="form-control">
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<option value="">Please select</option>
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<option value="1">Experian Report</option>
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<option value="2">Equifax Confirmation Report</option>
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<option value="3">TransUnion File Report</option>
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</select>
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</div>
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</div>
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<div class="form-group required" style="display:none">
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<label class="col-sm-5 control-label">CREDIT REPORT</label>
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<div class="col-sm-7">
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<input type="text" name="credit_report" class="form-control">
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</div>
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</div>
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<div class="form-group required">
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<label class="col-sm-5 control-label">FIRST NAME</label>
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<div class="col-sm-7">
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<input type="text" name="first_name" class="form-control" required>
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</div>
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</div>
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<div class="form-group required">
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<label class="col-sm-5 control-label">LAST NAME</label>
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<div class="col-sm-7">
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<input type="text" name="last_name" class="form-control" required >
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</div>
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</div>
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<div class="form-group required">
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<label class="col-sm-5 control-label">STREET NO</label>
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<div class="col-sm-7">
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<input type="text" name="street_no" class="form-control" required>
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</div>
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</div>
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<div class="form-group required">
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<label class="col-sm-5 control-label">STREET NAME</label>
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<div class="col-sm-7">
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<input type="text" name="street_name" class="form-control" required >
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</div>
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</div>
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<div class="form-group required">
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<label class="col-sm-5 control-label">CITY</label>
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<div class="col-sm-7">
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<input type="text" name="city" class="form-control" required >
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</div>
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</div>
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<div class="form-group required">
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<label class="col-sm-5 control-label">STATE</label>
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<div class="col-sm-7">
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<input type="text" name="state" class="form-control" required >
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</div>
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</div>
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<div class="form-group required">
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<label class="col-sm-5 control-label">DATE OF BIRTH</label>
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<div class="col-sm-7">
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<input type="text" name="dob" class="form-control" required >
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</div>
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</div>
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<div class="form-group required">
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<label class="col-sm-5 control-label">SSN</label>
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<div class="col-sm-7">
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<input type="text" name="ssn" class="form-control" maxlength="20" required>
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</div>
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</div>
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<div class="form-group required">
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<label class="col-sm-5 control-label">CREDIT BUREAU & CREDIT BUREAU ADDRESS</label>
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<div class="col-sm-7">
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<textarea name="credit_bureau_name_address" class="form-control" ></textarea>
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</div>
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</div>
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<div class="form-group required">
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<label class="col-sm-5 control-label">Sincerely</label>
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<div class="col-sm-7">
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<input type="text" name="sincerely" class="form-control" required >
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</div>
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</div>
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<hr/>
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</div>
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</div>
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<div class="row">
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<!-- right column -->
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<div class="col-md-7">
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<div class="form-group">
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<div class="col-sm-12">
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ALLEGED ACCOUNT NUMBER :<br/>
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<textarea name="creditor1" class="form-control" rows="8"></textarea>
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</div>
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</div>
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<div class="form-group">
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<div class="col-sm-12">
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ALLEGED Inquiry Creditor :<br/>
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<textarea name="creditor2" class="form-control" rows="8"></textarea>
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</div>
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</div>
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<!-- <div class="form-group">
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<div class="col-sm-12">
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ALLEGED CREDITOR/ DATA FURNISHER and ALLEGED ACCOUNT #1 :<br/>
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<textarea name="creditor1" class="form-control" ></textarea>
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</div>
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</div>
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<div class="form-group">
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<div class="col-sm-12">
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ALLEGED CREDITOR/ DATA FURNISHER and ALLEGED ACCOUNT #2 :<br/>
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<textarea name="creditor2" class="form-control" ></textarea>
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</div>
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</div>
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<div class="form-group">
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<div class="col-sm-12">
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ALLEGED CREDITOR/ DATA FURNISHER and ALLEGED ACCOUNT #3 :<br/>
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<textarea name="creditor3" class="form-control" ></textarea>
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</div>
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</div>
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<div class="form-group">
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<div class="col-sm-12">
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ALLEGED CREDITOR/ DATA FURNISHER and ALLEGED ACCOUNT #4 :<br/>
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<textarea name="creditor4" class="form-control" ></textarea>
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</div>
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</div>
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<div class="form-group">
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<div class="col-sm-12">
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ALLEGED CREDITOR/ DATA FURNISHER and ALLEGED ACCOUNT #5 :<br/>
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<textarea name="creditor5" class="form-control" ></textarea>
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</div>
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</div>
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<div class="form-group">
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<div class="col-sm-12">
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ALLEGED CREDITOR/ DATA FURNISHER and ALLEGED ACCOUNT #6 :<br/>
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<textarea name="creditor6" class="form-control" ></textarea>
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</div>
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</div>
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<div class="form-group">
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<div class="col-sm-12">
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ALLEGED CREDITOR/ DATA FURNISHER and ALLEGED ACCOUNT #7 :<br/>
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<textarea name="creditor7" class="form-control" ></textarea>
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</div>
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</div>
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<div class="form-group">
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<div class="col-sm-12">
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ALLEGED CREDITOR/ DATA FURNISHER and ALLEGED ACCOUNT #8 :<br/>
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||||
<textarea name="creditor8" class="form-control" ></textarea>
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||||
</div>
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||||
</div>
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<div class="form-group">
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||||
<div class="col-sm-12">
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ALLEGED CREDITOR/ DATA FURNISHER and ALLEGED ACCOUNT #9 :<br/>
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||||
<textarea name="creditor9" class="form-control" ></textarea>
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</div>
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</div>
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<div class="form-group">
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<div class="col-sm-12">
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ALLEGED CREDITOR/ DATA FURNISHER and ALLEGED ACCOUNT #10 :<br/>
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<textarea name="creditor10" class="form-control" ></textarea>
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</div>
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</div>
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<div class="form-group">
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<div class="col-sm-12">
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ALLEGED CREDITOR/ DATA FURNISHER and ALLEGED ACCOUNT #11 :<br/>
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||||
<textarea name="creditor11" class="form-control" ></textarea>
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</div>
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||||
</div>
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<div class="form-group">
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<div class="col-sm-12">
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ALLEGED CREDITOR/ DATA FURNISHER and ALLEGED ACCOUNT #12 :<br/>
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<textarea name="creditor12" class="form-control" ></textarea>
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</div>
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</div>
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<div class="form-group">
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<div class="col-sm-12">
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ALLEGED CREDITOR/ DATA FURNISHER and ALLEGED ACCOUNT #13 :<br/>
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<textarea name="creditor13" class="form-control" ></textarea>
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</div>
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</div>
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<div class="form-group">
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<div class="col-sm-12">
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ALLEGED CREDITOR/ DATA FURNISHER and ALLEGED ACCOUNT #14 :<br/>
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<textarea name="creditor14" class="form-control" ></textarea>
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</div>
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||||
</div>
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<div class="form-group">
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||||
<div class="col-sm-12">
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||||
ALLEGED CREDITOR/ DATA FURNISHER and ALLEGED ACCOUNT #15 :<br/>
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<textarea name="creditor15" class="form-control" ></textarea>
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</div>
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||||
</div>
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<div class="form-group">
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<div class="col-sm-12">
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ALLEGED CREDITOR/ DATA FURNISHER and ALLEGED ACCOUNT #16 :<br/>
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<textarea name="creditor16" class="form-control" ></textarea>
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</div>
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</div> -->
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<div class="form-group ">
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<label class="col-sm-5 control-label">Proof of social security number<br>(PNG, JPG,BMP etc. )</label>
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<div class="col-sm-5">
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<input type="file" name="image1" id="image1" class="form-control">
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||||
</div>
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||||
<div class="col-sm-2">
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||||
<a style="cursor:hand;cursor:pointer;" onclick="clearImage('image1');" data-id="4">Clear</a>
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||||
</div>
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||||
</div>
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||||
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||||
<div class="form-group ">
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<label class="col-sm-5 control-label">Copy of State Photo ID<br>(PNG, JPG,BMP etc. )</label>
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<div class="col-sm-5">
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<input type="file" name="image2" id="image2" class="form-control">
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||||
</div>
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||||
<div class="col-sm-2">
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||||
<a style="cursor:hand;cursor:pointer;" onclick="clearImage('image2');" data-id="4">Clear</a>
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||||
</div>
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||||
</div>
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||||
<div class="form-group ">
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||||
<label class="col-sm-5 control-label">Proof of CURRENT ADDRESS<br>(PNG, JPG,BMP etc. )</label>
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||||
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||||
<div class="col-sm-5">
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||||
<input type="file" name="image3" id="image3" class="form-control">
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||||
</div>
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||||
<div class="col-sm-2">
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||||
<a style="cursor:hand;cursor:pointer;" onclick="clearImage('image3');" data-id="4">Clear</a>
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||||
</div>
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||||
</div>
|
||||
<div class="form-group">
|
||||
<div class="col-sm-offset-5 col-sm-7">
|
||||
<button type="submit" class="btn btn-info pull-left">Generate
|
||||
PDF</button>
|
||||
</div>
|
||||
</div>
|
||||
|
||||
</div>
|
||||
</div>
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||||
|
||||
|
||||
|
||||
|
||||
</div>
|
||||
<!-- /.box-body -->
|
||||
<div class="box-footer"></div>
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||||
<!-- /.box-footer -->
|
||||
</form>
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||||
</div>
|
||||
<!-- /.box -->
|
||||
|
||||
</div>
|
||||
<!--/.col (right) -->
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||||
</div>
|
||||
<!-- /.row -->
|
||||
|
||||
|
||||
</section>
|
||||
<!-- /.content -->
|
||||
</div>
|
||||
<!-- /.content-wrapper -->
|
||||
<footer class="main-footer">
|
||||
<strong>Copyright © 2021 <a href="#" >R.T.G M.2.M. Letter generator by M.2.C Academy - V3.0</a>.
|
||||
</strong> All rights reserved.
|
||||
</footer>
|
||||
<!-- Add the sidebar's background. This div must be placed
|
||||
immediately after the control sidebar -->
|
||||
<div class="control-sidebar-bg"></div>
|
||||
</div>
|
||||
<!-- ./wrapper -->
|
||||
|
||||
<!-- jQuery 2.2.0 -->
|
||||
<script src="http://cloud-height.com/RTG/plugins/jQuery/jQuery-2.2.0.min.js"></script>
|
||||
<!-- Bootstrap 3.3.6 -->
|
||||
<script src="http://cloud-height.com/RTG/bootstrap/js/bootstrap.min.js"></script>
|
||||
<!-- FastClick -->
|
||||
<script src="http://cloud-height.com/RTG/plugins/fastclick/fastclick.js"></script>
|
||||
<!-- AdminLTE App -->
|
||||
<script src="http://cloud-height.com/RTG/dist/js/app.min.js"></script>
|
||||
<!-- AdminLTE for demo purposes -->
|
||||
<script src="http://cloud-height.com/RTG/dist/js/demo.js"></script>
|
||||
<script>
|
||||
|
||||
function clearImage(imageId){
|
||||
|
||||
document.getElementById(imageId).value = null;
|
||||
}
|
||||
|
||||
function resetForm(){
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||||
document.getElementById("inputformId").reset();
|
||||
//
|
||||
}
|
||||
|
||||
|
||||
function reportFileChange(elem){
|
||||
var report_file_name = $('select[name=report_file_name]').val();
|
||||
$('textarea[name=credit_bureau_name_address]').parents('div.form-group').first().show();
|
||||
$('textarea[name=credit_bureau_name_address]').attr('required',true)
|
||||
$('input[name=credit_report]').parents('div.form-group').first().hide();
|
||||
$('input[name=credit_report]').attr('required',false)
|
||||
if(report_file_name > 0){
|
||||
$('textarea[name=credit_bureau_name_address]').parents('div.form-group').first().hide();
|
||||
$('input[name=credit_report]').parents('div.form-group').first().show();
|
||||
$('input[name=credit_report]').attr('required',true)
|
||||
$('textarea[name=credit_bureau_name_address]').attr('required',false);
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||||
}
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||||
}
|
||||
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||||
</script>
|
||||
</body>
|
||||
</html>
|
||||
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