@extends('layouts.default') @section('content')
Credit Card Apply Form
@csrf
Personal Details
Name
DOB
Gender
Select an Option
personal_gender=='male' ? 'selected': ''}}>Male
personal_gender=='female' ? 'selected': ''}}>Female
personal_gender=='others' ? 'selected': ''}}>Others
Father Name
Mother Name
Marital Status
Select an Option
marital_status=='married' ? 'selected': ''}}>Married
marital_status=='unmarried' ? 'selected': ''}}>Unmarried
marital_status=='divorced' ? 'selected': ''}}>Divorced
Aadhaar No
Is Pan Card available ?
Select an Option
pancard_available=='Yes' ? 'selected': ''}}>Yes
pancard_available=='No' ? 'selected': ''}}>No
PAN NO
Height
Weight
Education
Email
Mobile No
Alternate Mobile No
Employee Type
Please Select Employee Type
emp_type=='salaried' ? 'selected': ''}}>Salaried
emp_type=='self_employed' ? 'selected': ''}}>Self Employed
emp_type=='self_employed_professional' ? 'selected': ''}}>Self Employed Professional
Yearly Income
Please Select Income
yearly_income=='upto_3' ? 'selected': ''}}>Up to 3 lacs
yearly_income=='3_to_4' ? 'selected': ''}}>3 to 4 lacs
yearly_income=='4_to_5' ? 'selected': ''}}>4 to 5 lacs
yearly_income=='5_to_10' ? 'selected': ''}}>5 to 10 lacs
yearly_income=='10_above' ? 'selected': ''}}>10+ lacs
Salary Received In
Please Select Bank
salary_received_in=='hdfc' ? 'selected': ''}}>HDFC
salary_received_in=='icici' ? 'selected': ''}}>ICICI
salary_received_in=='sbi' ? 'selected': ''}}>SBI
salary_received_in=='axis' ? 'selected': ''}}>AXIS
salary_received_in=='others' ? 'selected': ''}}>Others
Company Name
Permanent Address
Same as Permanent Address
Communication Address
Occupation
Annual Income
Nationality
Please Select Nationality
nationality=='indian' ? 'selected': ''}}>Indian
nationality=='nri' ? 'selected': ''}}>NRI
nationality=='others' ? 'selected': ''}}>Others
Nominee Details
Nominee Name
Nominee DOB
Nominee Relationship
Select an Option
Appointee?
Appointee Name
Appointee DOB
Appointee Relationship
Select an Option
Father Name
Mother Name
Spouse Name
Premium Details
PPT
PT
Frequency
Select an Option
Monthly
Quartely
Half Yearly
Yearly
Credit Card Eligible
Please Select Amount
Up to 3 lacs
3 to 4 lacs
4 to 5 lacs
5 to 10 lacs
10+ lacs
Number Of Due Collected In Months
Select an Option
1 Month
2 Months
3 Months
Total Premium With Tax / Collected premium
GST Percentage
Select an Option
GST AMOUNT
Premium Without Tax
Annualised Net Premium
Total Sum Assured
Team Details
TEAM DETAILS
Employee
Partner
Caller
Select an Option
Team Leader
Assistant Manager
Manager
Center Head
Regional Head / AVP
Zonal Head
Vice President
SM / RM
Select an Option
Branch - Center Location Name
Select an Option
Partner Details
Choose an option
Manager Details
Relationship Manager
Choose an option
Payout Cycle
Location
Discrepancy Team Details
DISCREPANCY TEAM DETAILS
DISCREPANCY TEAM DETAILS
Select Option
YES
NO
Caller
Choose an option
Team Leader
Choose an option
Assistant Manager
Choose an option
Manager
Choose an option
Center Head
Choose an option
Regional Head / AVP
Choose an option
Zonal Head
Choose an option
Vice President
Choose an option
Relationship Manager & Relationship Manager Code
Choose an option
Branch - Center Location Name
Select an Option
Employee List Not Available
Choose an option
New Joinee
Others
Partner Details
Select an Option
Manager Details
Relation Manager
Choose an option
Payout Cycle
Location
Remarks
CBRE
Is Cashback offered ?
Select an Option
Yes
No
CBRE %
Employee who offered CBRE to Client
Select an Option
Remarks
Credit Card Details
Credit Card Referance No
Credit Card No
Quote Id
Ekyc Status
Please Select Amount
kyc_status=='failed'?'selected':''}}>Failed
kyc_status=='pending'?'selected':''}}>Pending
kyc_status=='approved'?'selected':''}}>Approved
Credit Card Type
Please Select Amount
card_type=='new'?'selected':''}}>New
card_type=='renewal'?'selected':''}}>Renewal
Payment Url
Credit Card Limit
Please Select Amount
card_limit=='upto_3' ? 'selected': ''}}>Up to 3 lacs
card_limit=='3_to_4' ? 'selected': ''}}>3 to 4 lacs
card_limit=='4_to_5' ? 'selected': ''}}>4 to 5 lacs
card_limit=='5_to_10' ? 'selected': ''}}>5 to 10 lacs
card_limit=='10_above' ? 'selected': ''}}>10+ lacs
Loan Status
Select an Option
policy_status=='approved'?'selected':''}}>Approved
policy_status=='rejected'?'selected':''}}>Rejected
policy_status=='submitted'?'selected':''}}>Submitted
policy_status=='closed'?'selected':''}}>Closed
Attachments
Add Attchment
@if($checkattachfile == 0 || $checkattachfile == "0")
Document Type
Select an Option
Pan
Aadhaar Front Side
Aadhaar Back Side
Recent Photo
File
Remarks
@endif @foreach($policy_attachmentss as $key => $attchment)
Document Type
Select an Option
Pan
Aadhaar Front Side
Aadhaar Back Side
Recent Photo
File
@if($attchment['file_attach_type'] == "image")
x
@else
x
@endif
Remarks
{{$attchment['attachments_remarks']}}
@endforeach
Remarks
Add Remarks
@if($remarks =='')
Remarks
Remarks Filled by
@endif @foreach($remarks as $remark)
Remarks
{{$remark['pl_remarks']}}
Remarks Filled by
@endforeach
Submit
@stop