@if($errors->count()>0)
@endif
@if(Session::has('failed'))
@endif
-
@foreach($errors->all() as $error)
- {{ $error }} @endforeach
{{ Session::get('failed') }}
{{ Form::open(['route'=>['order.lienhoaboth.store'], 'files'=>true, 'class'=>'form-horizontal row-border'])}}
@include ('helpers.lienSelections')
@include ('helpers.uploadDoc')
Basic Information
Requested By:
{{ Form::text('RequestedBy', Input::old('RequestedBy', Auth::user()->fullname), ['id'=>'requested-by-both', 'class'=>"form-control", 'maxlength'=>"50"]) }} {{Form::hidden('ClientID', Auth::user()->lien_client_id)}}File Number:
{{ Form::text('FileNo', Input::old('FileNo'), ['id'=>'file-number-both', 'class'=>"form-control center", 'maxlength'=>"50"]) }}Closing Date:
{{-- Form::input('date', 'ClosingDate', Input::old('ClosingDate'), ['id'=>'closing-date-both', 'class'=>"form-control center", 'placeholder'=>"MM/DD/YYYY"]) --}}
{{ Form::text('ClosingDate', Input::old('ClosingDate'), ['id'=>'closing-date-both', 'class'=>"form-control center", 'placeholder'=>"MM/DD/YYYY"]) }}
Property Information
Number:
{{ Form::text('StreetNo',false, ['class'=>'form-control-especial center', 'maxlength'=>"50"] )}}{{ Form::select('StreetDirectionID',($select + $streetDirection), Input::old('StreetDirectionID'), ['class'=>'form-control center-especial StreetDirectionID']) }}
Street Name:
{{ Form::text('StreetName',false, ['class'=>'form-control center', 'maxlength'=>"100"] )}}Type:
{{ Form::select('StreetTypeID',(['-1'=>'Select'] + $streetType), Input::old('StreetTypeID'), ['class'=>'form-control center StreetTypeID']) }}Unit Number:
{{ Form::text('StreetUnitNo',false, ['class'=>'form-control center', 'maxlength'=>"50"] )}}City:
{{ Form::select('CityID',($select + $cities), Input::old('CityID'), ['id'=>'city-lien', 'class'=>'form-control center']) }}Zip:
{{ Form::text('ZipCode',Input::get('ZipCode'), ['class'=>'form-control center', 'maxlength'=>"10"] )}}County:
{{ Form::select('CountyID',($select + $counties), Input::old('CountyID'), ['id'=>'county-lien', 'class'=>'form-control center']) }}Folio Number:
{{ Form::text('FolioNo',Input::get('FolioNo'), ['class'=>'form-control center', 'maxlength'=>"100"] )}}Legal Description:
{{ Form::textarea('LegalDescription',Input::get('LegalDescription'), ['class'=>'form-control', 'size'=>'3x5', 'maxlength'=>"1000"] )}}Buyer:
{{ Form::text('BuyerName',Input::get('BuyerName'), ['class'=>'form-control center', 'maxlength'=>"100"] )}}Seller:
{{ Form::text('SellerName',Input::get('SellerName'), ['class'=>'form-control center', 'maxlength'=>"100"] )}}Specific Instructions:
{{ Form::textarea('SpecialInstruction',Input::get('SpecialInstruction'), ['class'=>'form-control','size'=>'3x5', 'maxlength'=>"2000"] )}}
HOA Information
HOA Name:
{{ Form::text('HOAName',Input::old('HOAName'), ['class'=>'form-control center', 'maxlength'=>"255"] )}}Phone:
{{ Form::text('hoa_tel[0]',Input::get('hoa_tel.0'), ['class'=>'form-control-especial', 'id'=>'tel1', 'size'=>'3', 'maxlength'=>'3']) }}{{ Form::text('hoa_tel[1]',Input::get('hoa_tel.1'), ['class'=>'form-control-especial', 'id'=>'tel2', 'size'=>'3', 'maxlength'=>'3']) }}
{{ Form::text('hoa_tel[2]',Input::get('hoa_tel.2'), ['class'=>'form-control-especial', 'id'=>'tel3', 'size'=>'4', 'maxlength'=>'4']) }}
Listing Agent/ Realtor:
{{ Form::text('ListingAgentName',Input::get('ListingAgentName'), ['class'=>'form-control center', 'maxlength'=>"255"] )}}Phone:
{{ Form::text('agent_tel[0]',Input::get('agent_tel.0'), ['class'=>'form-control-especial', 'id'=>'tel1', 'size'=>'3', 'maxlength'=>'3'] )}}{{ Form::text('agent_tel[1]',Input::get('agent_tel.0'), ['class'=>'form-control-especial', 'id'=>'tel2', 'size'=>'3', 'maxlength'=>'3'] )}}
{{ Form::text('agent_tel[2]',Input::get('agent_tel.0'), ['class'=>'form-control-especial', 'id'=>'tel2', 'size'=>'4', 'maxlength'=>'4'] )}}
Search Response Delivery
@include('site.EmailFax')
@include('site.buttonsSubmit')
@if(Session::has('message'))
{{ Session::get('message')}}
@endif