mirror of
https://github.com/invoiceninja/invoiceninja.git
synced 2025-07-31 15:42:03 -04:00
67 lines
3.6 KiB
PHP
67 lines
3.6 KiB
PHP
<div class="px-4 py-5 border-b border-gray-200 sm:px-6">
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<h3 class="text-lg font-medium leading-6 text-gray-900">
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{{ ctrans('texts.account_holder_information') }}
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</h3>
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<p class="max-w-2xl mt-1 text-sm leading-5 text-gray-500">
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{{ ctrans('texts.enter_information_for_the_account_holder') }}
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</p>
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</div>
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<div class="px-4 py-2 sm:px-6 lg:grid lg:grid-cols-3 lg:gap-4 lg:flex lg:items-center">
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<dt class="text-sm leading-5 font-medium text-gray-500 mr-4">
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{{ ctrans('texts.account_holder_name') }}
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</dt>
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<dd class="mt-1 text-sm leading-5 text-gray-900 sm:mt-0 sm:col-span-2">
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<input class="input w-full" id="name" name="name" type="text" placeholder="{{ ctrans('texts.name') }}" required value="{{ old('name', $name) }}">
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</dd>
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</div>
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<div class="px-4 py-2 sm:px-6 lg:grid lg:grid-cols-3 lg:gap-4 lg:flex lg:items-center">
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<dt class="text-sm leading-5 font-medium text-gray-500 mr-4">
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{{ ctrans('texts.email_address') }}
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</dt>
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<dd class="mt-1 text-sm leading-5 text-gray-900 sm:mt-0 sm:col-span-2">
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<input class="input w-full" name="email" id="email" type="email" placeholder="{{ ctrans('texts.email_address') }}" required value="{{ old('email', $email) }}">
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</dd>
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</div>
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<div class="px-4 py-2 sm:px-6 lg:grid lg:grid-cols-3 lg:gap-4 lg:flex lg:items-center">
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<dt class="text-sm leading-5 font-medium text-gray-500 mr-4">
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{{ ctrans('texts.contact_phone') }}
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</dt>
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<dd class="mt-1 text-sm leading-5 text-gray-900 sm:mt-0 sm:col-span-2">
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<input class="input w-full" id="home_phone" name="home_phone" type="text" placeholder="{{ ctrans('texts.phone') }}" required value="{{ old('home_phone', $home_phone) }}">
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</dd>
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</div>
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<div class="px-4 py-2 sm:px-6 lg:grid lg:grid-cols-3 lg:gap-4 lg:flex lg:items-center">
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<dt class="text-sm leading-5 font-medium text-gray-500 mr-4">
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{{ ctrans('texts.work_phone') }}
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</dt>
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<dd class="mt-1 text-sm leading-5 text-gray-900 sm:mt-0 sm:col-span-2">
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<input class="input w-full" id="phone" name="phone" type="text" placeholder="{{ ctrans('texts.work_phone') }}" required value="{{ old('phone', $phone) }}">
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</dd>
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</div>
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<div class="px-4 py-2 sm:px-6 lg:grid lg:grid-cols-3 lg:gap-4 lg:flex lg:items-center">
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<dt class="text-sm leading-5 font-medium text-gray-500 mr-4">
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{{ ctrans('texts.customer_type') }}
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</dt>
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<dd class="mt-1 text-sm leading-5 text-gray-900 sm:mt-0 sm:col-span-2">
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<div class="sm:grid-cols-2 sm:flex">
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<div class="flex items-center px-2">
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<input id="customer_type_personal" name="customer_type" value="Personal" required @checked(old('customer_type', $customer_type) == 'Personal') type="radio" class="focus:ring-gray-500 h-4 w-4 border-gray-300 disabled:opacity-75 disabled:cursor-not-allowed">
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<label for="customer_type_personal" class="ml-3 block text-sm font-medium cursor-pointer">{{ ctrans('texts.personal') }}</label>
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</div>
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<div class="flex items-center px-2">
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<input id="customer_type_business" name="customer_type" value="Business" required @checked(old('customer_type', $customer_type) == 'Business') type="radio" class="focus:ring-gray-500 h-4 w-4 border-gray-300 disabled:opacity-75 disabled:cursor-not-allowed">
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<label for="customer_type_business" class="ml-3 block text-sm font-medium cursor-pointer">{{ ctrans('texts.business') }}</label>
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</div>
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</div>
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</dd>
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</div>
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<input name="id" type="hidden" value="{{ old('id', $id) }}">
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<input name="custom_identifier" type="hidden" value="{{ old('custom_identifer', $custom_identifier) }}">
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