@if ($client)
{{ $client->getDisplayName() }}
@if(isset($invoiceNumber))
{{ trans('texts.invoice') . ' ' . $invoiceNumber }}| {{ trans('texts.amount_due') }}: {{ $account->formatMoney($amount, $client, true) }}
@endif
@elseif ($paymentTitle)
{{ $paymentTitle }}
{{ $paymentSubtitle }}
@endif
@if (Request::secure() || Utils::isNinjaDev())
{{ trans('texts.secure_payment') }}
{{ trans('texts.256_encryption') }}
@endif
{{ trans('texts.contact_information') }}
{!! Former::text('first_name')
->placeholder(trans('texts.first_name'))
->autocomplete('given-name')
->label('') !!}
{!! Former::text('last_name')
->placeholder(trans('texts.last_name'))
->autocomplete('family-name')
->label('') !!}
@if (isset($paymentTitle))
{!! Former::text('email')
->placeholder(trans('texts.email'))
->autocomplete('email')
->label('') !!}
@endif
@if ($showAddress)
{{ trans('texts.billing_address') }}
@if($paymentType != PAYMENT_TYPE_STRIPE_ACH)
{{ trans('texts.payment_footer1') }}
@endif
{!! Former::text('address1')
->autocomplete('address-line1')
->placeholder(trans('texts.address1'))
->label('') !!}
{!! Former::text('address2')
->autocomplete('address-line2')
->placeholder(trans('texts.address2'))
->label('') !!}
{!! Former::text('city')
->autocomplete('address-level2')
->placeholder(trans('texts.city'))
->label('') !!}
{!! Former::text('state')
->autocomplete('address-level1')
->placeholder(trans('texts.state'))
->label('') !!}
{!! Former::text('postal_code')
->autocomplete('postal-code')
->placeholder(trans('texts.postal_code'))
->label('') !!}
{!! Former::select('country_id')
->placeholder(trans('texts.country_id'))
->fromQuery($countries, 'name', 'id')
->addGroupClass('country-select')
->label('') !!}
@endif
{{ trans('texts.billing_method') }}
@if($paymentType == PAYMENT_TYPE_STRIPE_ACH)
{{ trans('texts.ach_verification_delay_help') }}
{!! Former::radios('account_holder_type')->radios(array(
trans('texts.individual_account') => array('value' => 'individual'),
trans('texts.company_account') => array('value' => 'company'),
))->inline()->label(''); !!}
{!! Former::text('account_holder_name')
->placeholder(trans('texts.account_holder_name'))
->label('') !!}
{!! Former::select('country')
->placeholder(trans('texts.country_id'))
->fromQuery($countries, 'name', 'iso_3166_2')
->addGroupClass('country-select')
->label('') !!}
{!! Former::select('currency')
->placeholder(trans('texts.currency_id'))
->fromQuery($currencies, 'name', 'code')
->addGroupClass('currency-select')
->label('') !!}
{!! Former::text('')
->id('routing_number')
->placeholder(trans('texts.routing_number'))
->label('') !!}
{!! Former::text('')
->id('account_number')
->placeholder(trans('texts.account_number'))
->label('') !!}
{!! Former::text('')
->id('confirm_account_number')
->placeholder(trans('texts.confirm_account_number'))
->label('') !!}
{!! Button::success(strtoupper(trans('texts.add_account')))
->submit()
->large() !!}
@else
@if (!empty($braintreeClientToken))
@else
{!! Former::text($accountGateway->getPublishableStripeKey() ? '' : 'card_number')
->id('card_number')
->placeholder(trans('texts.card_number'))
->autocomplete('cc-number')
->label('') !!}
@endif
@if (!empty($braintreeClientToken))
@else
{!! Former::text($accountGateway->getPublishableStripeKey() ? '' : 'cvv')
->id('cvv')
->placeholder(trans('texts.cvv'))
->autocomplete('off')
->label('') !!}
@endif
@if (!empty($braintreeClientToken))
@else
{!! Former::select($accountGateway->getPublishableStripeKey() ? '' : 'expiration_month')
->id('expiration_month')
->autocomplete('cc-exp-month')
->placeholder(trans('texts.expiration_month'))
->addOption('01 - January', '1')
->addOption('02 - February', '2')
->addOption('03 - March', '3')
->addOption('04 - April', '4')
->addOption('05 - May', '5')
->addOption('06 - June', '6')
->addOption('07 - July', '7')
->addOption('08 - August', '8')
->addOption('09 - September', '9')
->addOption('10 - October', '10')
->addOption('11 - November', '11')
->addOption('12 - December', '12')->label('')
!!}
@endif
@if (!empty($braintreeClientToken))
@else
{!! Former::select($accountGateway->getPublishableStripeKey() ? '' : 'expiration_year')
->id('expiration_year')
->autocomplete('cc-exp-year')
->placeholder(trans('texts.expiration_year'))
->addOption('2016', '2016')
->addOption('2017', '2017')
->addOption('2018', '2018')
->addOption('2019', '2019')
->addOption('2020', '2020')
->addOption('2021', '2021')
->addOption('2022', '2022')
->addOption('2023', '2023')
->addOption('2024', '2024')
->addOption('2025', '2025')
->addOption('2026', '2026')->label('')
!!}
@endif
@if (isset($amount) && $client && $account->showTokenCheckbox($storageGateway/* will contain gateway id */))
selectTokenCheckbox() ? 'CHECKED' : '' }} value="1" style="margin-left:0px; vertical-align:top">
@if ($storageGateway == GATEWAY_STRIPE)
{!! trans('texts.token_billing_secure', ['link' => link_to('https://stripe.com/', 'Stripe.com', ['target' => '_blank'])]) !!}
@elseif ($storageGateway == GATEWAY_BRAINTREE)
{!! trans('texts.token_billing_secure', ['link' => link_to('https://www.braintreepayments.com/', 'Braintree', ['target' => '_blank'])]) !!}
@endif
@endif
@if (isset($acceptedCreditCardTypes))
@foreach ($acceptedCreditCardTypes as $card)
![{{ $card['alt'] }}]({{ $card['source'] }})
@endforeach
@endif
@if(isset($amount))
{!! Button::success(strtoupper(trans('texts.pay_now') . ' - ' . $account->formatMoney($amount, $client, true) ))
->submit()
->large() !!}
@else
{!! Button::success(strtoupper(trans('texts.add_credit_card') ))
->submit()
->large() !!}
@endif
@endif