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allo/resources/views/pdf/newBusiness-pdf.blade.php

newBusiness-pdf.blade.php 36KB
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  1. <!DOCTYPE html>

  2. <html>

  3. <head>

  4. 	<style type="text/css">

  5. 		body{

  6. 			font-family: 'Helvetica','sans-serif';

  7. 		}

  8. 		.fontStyle1 {

  9. 			font-size: 8px;

  10. 			line-height: 10px;

  11. 		}

  12. 		.fontStyle1 p{

  13. 			margin-top: 0px;

  14. 			margin-bottom: 0px;

  15. 		}

  16. 		.page-break {

  17. 		    page-break-after: always;

  18. 		}

  19. 	</style>

  20. </head>

  21. <body>

  22. 	<!-- Address -->

  23. 	<table width="100%">

  24. 		<tr>

  25. 			<td align="right" class="fontStyle1">

  26. 				<b>ALLO TECHNOLOGY SDN BHD</b>

  27. 				<p>Cyberview Garden Villas, Persiaran Multimedia, Cyber 7</p>

  28. 				<p>63000 Cyberjaya, Selangor Darul Ehsan</p>

  29. 				<p>Tel: 03-8800 5222 Fax 03-8800 5221</p>

  30. 				<p>E-mail:customerservice@citybroadband.my</p>

  31. 				<p>Website:www.citybroadband.my</p>

  32. 			</td>

  33. 		</tr>

  34. 		<tr>

  35. 			<td height="10"></td>

  36. 		</tr>

  37. 		<!-- Title -->

  38. 		<tr>

  39. 			<td style="border: 1px solid #000">

  40. 				<table width="100%">

  41. 					<tr>

  42. 						<td align="center" style="font-size: 13px;line-height:16px;font-weight:bold">

  43. 							BROADBAND INTERNET ACCESS SERVICE APPLICATION FORM

  44. 						</td>

  45. 					</tr>

  46. 				</table>

  47. 			</td>

  48. 		</tr>

  49. 		<tr>

  50. 			<td height="7"></td>

  51. 		</tr>

  52. 		<tr>

  53. 			<td style="font-size: 10px;font-style: italic;">Please write in CAPITAL LETTERS and tick(/) where required</td>

  54. 		</tr>

  55. 		<tr>

  56. 			<td height="7"></td>

  57. 		</tr>

  58. 		<!-- Application Type-->

  59. 		<tr>

  60. 			<td>

  61. 				<table>

  62. 					<tr>

  63. 						<td style="font-size: 11px;">APPLICATION:</td>

  64. 						<td width="20">&nbsp;</td>

  65. 						<td style="width: 16px;border:1px solid #000">

  66. 							<span>

  67. 								@if($form->Form->type_service == "New")

  68. 								<img src="{{ url('/assets/tick.png') }}" style="width:14px; height:auto">

  69. 								@endif

  70. 							</span>

  71. 						</td>

  72. 						<td style="font-size: 10px;">New</td>

  73. 						<td width="20">&nbsp;</td>

  74. 						<td style="width: 16px;border:1px solid #000">

  75. 							<span>

  76. 								@if($form->Form->type_service == "Upgrade")

  77. 								<img src="{{ url('/assets/tick.png') }}" style="width:14px; height:auto">

  78. 								@endif

  79. 							</span>

  80. 						</td>

  81. 						<td style="font-size: 10px;">Upgrading/Downgrading</td>

  82. 						<td width="20">&nbsp;</td>

  83. 						<td style="width: 16px;border:1px solid #000">

  84. 							<span>

  85. 								@if($form->Form->type_service == "Relocation")

  86. 								<img src="{{ url('/assets/tick.png') }}" style="width:14px; height:auto">

  87. 								@endif

  88. 							</span>

  89. 						</td>

  90. 						<td style="font-size: 10px;">Relocation(RM150)</td>

  91. 						<td width="20">&nbsp;</td>

  92. 						<td style="width: 16px;border:1px solid #000">

  93. 							<span>

  94. 								@if($form->Form->type_service == "Rectification")

  95. 								<img src="{{ url('/assets/tick.png') }}" style="width:14px; height:auto">

  96. 								@endif

  97. 							</span>

  98. 						</td>

  99. 						<td style="font-size: 10px;">Rectification</td>

  100. 					</tr>

  101. 				</table>

  102. 			</td>

  103. 		</tr>

  104. 		<!-- Application Type-->

  105. 		<tr>

  106. 			<td>

  107. 				<table border="0" cellpadding="0" cellspacing="0" width="100%">

  108. 					<tr>

  109. 						<td bgcolor="#b4b4e1" style="font-size: 12px;font-weight: bold; padding: 5px 3px;">

  110. 							<span style="display:inline-block;border-bottom:1px solid black; padding-bottom:0px;margin-bottom: 0px">APPLICATION INFORMATION</span>

  111. 						</td>

  112. 					</tr>

  113. 					<tr><td height="5"></td></tr>

  114. 					<tr>

  115. 						<td>

  116. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  117. 								<tr>

  118. 									<td width="28%" style="font-size: 11px;">Full Name</td>

  119. 									<td width="72%" height="18" style="font-size: 11px;border:1px solid black;padding:0px 3px;word-wrap: break-word;">{{ $form->name }}</td>

  120. 								</tr>

  121. 								<tr><td colspan="2" height="10"></td></tr>

  122. 								<tr>

  123. 									<td width="28%" style="font-size: 11px;">NRIC/Passport No.</td>

  124. 									<td width="72%" height="18" style="font-size: 11px;border:1px solid black;padding:0px 3px;word-wrap: break-word;">{{ $form->ic }}</td>

  125. 								</tr>

  126. 								<tr><td colspan="2" height="10"></td></tr>

  127. 								<tr>

  128. 									<td colspan="2">

  129. 										<table border="0" cellpadding="0" cellspacing="0" width="100%">

  130. 											<tr>

  131. 												<td width="28%" style="font-size: 11px;">Primary Contact No.</td>

  132. 												<td width="24%" height="18" style="font-size: 11px;border:1px solid black;padding:0px 3px;word-wrap: break-word;">{{ $form->phone1 }}</td>

  133. 												<td width="24%" style="font-size: 11px;text-align:right;padding-right: 10px">Secondary Contact No.</td>

  134. 												<td width="24%" height="18" style="font-size: 11px;border:1px solid black;padding:0px 3px;word-wrap: break-word;">{{ $form->phone2 }}</td>

  135. 											</tr>

  136. 										</table>

  137. 									</td>

  138. 								</tr>

  139. 								<tr><td colspan="2" height="10"></td></tr>

  140. 								<tr>

  141. 									<td width="28%" style="font-size: 11px;">Designation</td>

  142. 									<td width="72%" height="18" style="font-size: 11px;border:1px solid black;padding:0px 3px;word-wrap: break-word;">{{ $form->designation }}</td>

  143. 								</tr>

  144. 								<tr><td colspan="2" height="10"></td></tr>

  145. 								<tr>

  146. 									<td colspan="2">

  147. 										<table border="0" cellpadding="0" cellspacing="0" width="100%">

  148. 											<tr>

  149. 												<td width="28%" style="font-size: 11px;">Citizenship</td>

  150. 												<td width="24%" height="18" style="font-size: 11px;border:1px solid black;padding:0px 3px;word-wrap: break-word;">-</td>

  151. 												<td width="10%" style="font-size: 11px;text-align:right;padding-right: 10px"> E-mail</td>

  152. 												<td width="38%" height="18" style="font-size: 11px;border:1px solid black;padding:0px 3px;word-wrap: break-word;">{{ $form->email }}</td>

  153. 											</tr>

  154. 										</table>

  155. 									</td>

  156. 								</tr>

  157. 							</table>

  158. 						</td>

  159. 					</tr>

  160. 					<tr><td height="2"></td></tr>

  161. 				</table>

  162. 			</td>

  163. 		</tr>

  164. 		<!-- Installation Address -->

  165. 		<tr>

  166. 			<td>

  167. 				<table border="0" cellpadding="0" cellspacing="0" width="100%">

  168. 					<tr>

  169. 						<td bgcolor="#b4b4e1" style="font-size: 12px;font-weight: bold; padding: 5px 3px;">

  170. 							<span style="display:inline-block;border-bottom:1px solid black; padding-bottom:0px;margin-bottom: 0px">INSTALLATION ADDRESS</span>

  171. 						</td>

  172. 					</tr>

  173. 					<tr><td height="5"></td></tr>

  174. 					<tr>

  175. 						<td>

  176. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  177. 								<tr>

  178. 									<td width="28%" style="font-size: 11px;">Company Reg.No</td>

  179. 									<td width="72%" height="18" style="font-size: 11px;border:1px solid black;padding:0px 3px;word-wrap: break-word;">{{ $form->company_reg }}</td>

  180. 								</tr>

  181. 								<tr><td colspan="2" height="10"></td></tr>

  182. 								<tr>

  183. 									<td width="28%" style="font-size: 11px;">Company Name</td>

  184. 									<td width="72%" height="18" style="font-size: 11px;border:1px solid black;padding:0px 3px;word-wrap: break-word;">{{ $form->company_name }}</td>

  185. 								</tr>

  186. 								<tr><td colspan="2" height="10"></td></tr>

  187. 								<tr>

  188. 									<td width="28%" style="font-size: 11px;">Unit. No</td>

  189. 									<td width="72%" height="18" style="font-size: 11px;border:1px solid black;padding:0px 3px;word-wrap: break-word;">{{ $form->unit_no }}</td>

  190. 								</tr>

  191. 								<tr><td colspan="2" height="10"></td></tr>

  192. 								<tr>

  193. 									<td width="28%" style="font-size: 11px;">Address</td>

  194. 									<td width="72%" height="18" style="font-size: 11px;border:1px solid black;padding:0px 3px;word-wrap: break-word;">{{ $form->street }}</td>

  195. 								</tr>

  196. 								<tr><td colspan="2" height="10"></td></tr>

  197. 								<tr>

  198. 									<td colspan="2">

  199. 										<table border="0" cellpadding="0" cellspacing="0" width="100%">

  200. 											<tr>

  201. 												<td width="28%" style="font-size: 11px;">City/State</td>

  202. 												<td width="32%" height="18" style="font-size: 11px;border:1px solid black;padding:0px 3px;word-wrap: break-word;">{{ $form->city }} / {{ $form->state }}</td>

  203. 												<td width="15%" style="font-size: 11px;text-align:right;padding-right: 10px"> Postcode</td>

  204. 												<td width="25%" height="18" style="font-size: 11px;border:1px solid black;padding:0px 3px;word-wrap: break-word;">{{ $form->postcode }}</td>

  205. 											</tr>

  206. 										</table>

  207. 									</td>

  208. 								</tr>

  209. 								<tr><td colspan="2" height="10"></td></tr>

  210. 								<tr>

  211. 									<td colspan="2">

  212. 										<table border="0" cellpadding="0" cellspacing="0" width="100%">

  213. 											<tr>

  214. 												<td width="28%" style="font-size: 11px;">Company No.</td>

  215. 												<td width="32%" height="18" style="font-size: 11px;border:1px solid black;padding:0px 3px;word-wrap: break-word;">{{ $form->company_num }}</td>

  216. 												<td width="15%" style="font-size: 11px;text-align:right;padding-right: 10px"> Company Fax No.</td>

  217. 												<td width="25%" height="18" style="font-size: 11px;border:1px solid black;padding:0px 3px;word-wrap: break-word;">{{ $form->company_fax }}</td>

  218. 											</tr>

  219. 										</table>

  220. 									</td>

  221. 								</tr>

  222. 							</table>

  223. 						</td>

  224. 					</tr>

  225. 					<tr><td height="2"></td></tr>

  226. 				</table>

  227. 			</td>

  228. 		</tr>

  229. 		<!-- Service Details -->

  230. 		<tr>

  231. 			<td>

  232. 				<table border="0" cellpadding="0" cellspacing="0" width="100%">

  233. 					<tr>

  234. 						<td bgcolor="#b4b4e1" style="font-size: 12px;font-weight: bold; padding: 5px 3px;">

  235. 							<span style="display:inline-block;border-bottom:1px solid black; padding-bottom:0px;margin-bottom: 0px">SERVICE DETAILS</span>

  236. 						</td>

  237. 					</tr>

  238. 					<tr><td height="3"></td></tr>

  239. 					<tr>

  240. 						<td>

  241. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  242. 								<tr>

  243. 									<td width="35%" style="font-size: 11px;">1. Subscription/Contract Period : </td>

  244. 									<td style="width: 20px;border:1px solid #000"><span>

  245. 										@if( $package->contract == "12")

  246. 										<img src="{{ url('/assets/tick.png') }}" style="width:14px; height:auto">

  247. 										@endif

  248. 									</span></td>

  249. 									<td width="5">&nbsp;</td>

  250. 									<td width="13%" style="font-size: 11px;"> 12 months</td>

  251. 									<td style="width: 20px;border:1px solid #000"><span>

  252. 										@if( $package->contract == "24")

  253. 										<img src="{{ url('/assets/tick.png') }}" style="width:14px; height:auto">

  254. 										@endif

  255. 									</span></td>

  256. 									<td width="5">&nbsp;</td>

  257. 									<td style="font-size: 11px;"> 24 months</td>

  258. 								</tr>

  259. 							</table>

  260. 						</td>

  261. 					</tr>

  262. 					<tr><td height="10"></td></tr>

  263. 					<tr>

  264. 						<td>

  265. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  266. 								<tr>

  267. 									<td width="34%" style="font-size: 11px;">2. Required For Service : </td>

  268. 									<td width="25%" height="16" style="font-size: 11px;border:1px solid #000"><span>{{ $package->rfs }}</span></td>

  269. 									<td width="25%" style="font-size: 11px;text-align: right;padding-right: 5px;">Billing Cycle</td>

  270. 									<td width="3%" style="font-size: 11px;border:1px solid #000"><span><img src="{{ url('/assets/tick.png') }}" style="width:14px; height:auto"></span></td>

  271. 									<td width="25%"></td>

  272. 								</tr>

  273. 							</table>

  274. 						</td>

  275. 					</tr>

  276. 					<tr><td height="10"></td></tr>

  277. 					<tr>

  278. 						<td>

  279. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  280. 								<tr>

  281. 									<td width="34%" style="font-size: 11px;">3. Subscribe for Fixed IP : </td>

  282. 									<td width="50%" height="16" style="font-size: 11px;border:1px solid #000"><span>{{ $package->ip }}</span></td>

  283. 									<td width="3%" style="font-size: 11px;"></td>

  284. 									<td width="25%"></td>

  285. 								</tr>

  286. 							</table>

  287. 						</td>

  288. 					</tr>

  289. 					<tr><td height="8"></td></tr>

  290. 					<tr>

  291. 						<td>

  292. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  293. 								<tr>

  294. 									<td style="font-size: 10px;font-style: italic">1. Standard contract period is 24 months unless otherwise stated</td>

  295. 								</tr>

  296. 								<tr>

  297. 									<td style="font-size: 10px;font-style: italic">2. Required For Service (RFS) is subject to the avaiability of required infrastructure and/or equipment</td>

  298. 								</tr>

  299. 								<tr>

  300. 									<td style="font-size: 10px;font-style: italic">3. Early termination will subject to RM 500 penalty.</td>

  301. 								</tr>

  302. 								<tr>

  303. 									<td style="font-size: 10px;font-style: italic">4. Separete penalty charge for broadband and voice</td>

  304. 								</tr>

  305. 							</table>

  306. 						</td>

  307. 					</tr>

  308. 					<tr><td height="8"></td></tr>

  309. 					<tr>

  310. 						<td>

  311. 							<table border="0" cellpadding="0" cellspacing="0">

  312. 								<tr>

  313. 									<td height="20" width="200" style="font-size: 10px;border:1px solid #000;padding: 5px 3px;font-style: italic">Remarks</td>

  314. 								</tr>

  315. 							</table>

  316. 						</td>

  317. 					</tr>

  318. 					<tr><td height="2"></td></tr>

  319. 				</table>

  320. 			</td>

  321. 		</tr>

  322. 		<!-- Service Details -->

  323. 		<tr>

  324. 			<td>

  325. 				<table border="0" cellpadding="0" cellspacing="0" width="100%">

  326. 					<tr>

  327. 						<td bgcolor="#b4b4e1" style="font-size: 12px;font-weight: bold; padding: 5px 3px;">

  328. 							<span style="display:inline-block;border-bottom:1px solid black; padding-bottom:0px;margin-bottom: 0px">PACKAGE DETAILS</span>

  329. 						</td>

  330. 					</tr>

  331. 					<tr><td height="5"></td></tr>

  332. 					<tr>

  333. 						<td>

  334. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  335. 								<tr>

  336. 									<td style="font-size: 11px;font-weight: bold">1. City Broadband Business (Best Effort Bandwith)</td>

  337. 								</tr>

  338. 							</table>

  339. 						</td>

  340. 					</tr>

  341. 					<tr><td height="5"></td></tr>

  342. 					<tr>

  343. 						<td>

  344. 							<table border="0" cellpadding="0" cellspacing="0">

  345. 								@foreach($product as $p)

  346. 									@if($p->speed != '10' && $p->speed != '30')

  347. 									<tr>

  348. 										<td width="13" height="13" style="border:1px solid black;">

  349. 											<span>

  350. 												@if( $package->name == $p->speed )

  351. 												<img src="{{ url('/assets/tick.png') }}" style="width:14px; height:auto">

  352. 												@endif

  353. 											</span>

  354. 										</td>

  355. 										<td width="5">&nbsp;</td>

  356. 										<td style="font-size: 11px;"><b>{{ $p->package_name }}</b></td>

  357. 										<td width="10">&nbsp;</td>

  358. 										<td style="font-size: 11px;"><b>RM {{ $p->retail_price }}</b> ( RM {{ number_format(floatval(preg_replace("/\,/", "",$p->retail_price)) * 1.06, 2) }} )</td>

  359. 										<td>&nbsp;</td>

  360. 									</tr>

  361. 									@endif

  362. 								@endforeach

  363. 							</table>

  364. 						</td>

  365. 					</tr>

  366. 					<tr><td height="4"></td></tr>

  367. 					<tr>

  368. 						<td style="font-size: 9px;font-style: italic">*All prices shown in the bracket include 6% Goods and Services Tax (SST)</td>

  369. 					</tr>

  370. 					<tr><td height="5"></td></tr>

  371. 					<tr>

  372. 						<td>

  373. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  374. 								<tr>

  375. 									<td style="font-size: 11px;font-weight: bold">2. Voice (Home)</td>

  376. 								</tr>

  377. 							</table>

  378. 						</td>

  379. 					</tr>

  380. 					<tr><td height="5"></td></tr>

  381. 					<tr>

  382. 						<td>

  383. 							<table border="0" cellpadding="0" cellspacing="0">

  384. 								<tr>

  385. 									<td width="13" height="13" style="border:1px solid black;">

  386. 										<span>

  387. 											@if($package->voice_fee == "Yes" || $package->voice_fee == "yes")

  388. 											<img src="{{ url('/assets/tick.png') }}" style="width:14px; height:auto">

  389. 											@else

  390. 											@endif

  391. 										</span>

  392. 									</td>

  393. 									<td width="5">&nbsp;</td>

  394. 									<td style="font-size: 11px;"><b>Yes</b></td>

  395. 									<td width="25">&nbsp;</td>

  396. 									<td width="13" height="13" style="border:1px solid black;">

  397. 										<span>

  398. 											@if($package->voice_fee == "no" || $package->voice_fee == '' || $package->voice_fee == "No")

  399. 											<img src="{{ url('/assets/tick.png') }}" style="width:14px; height:auto">

  400. 											@else

  401. 											@endif

  402. 										</span>

  403. 									</td>

  404. 									<td width="5">&nbsp;</td>

  405. 									<td style="font-size: 11px;"><b>No</b></td>

  406. 								</tr>

  407. 							</table>

  408. 						</td>

  409. 					</tr>

  410. 					<tr><td height="20"></td></tr>

  411. 					<tr>

  412. 						<td>

  413. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  414. 								<tr>

  415. 									<td style="font-size: 11px;font-weight: bold;font-style: italic"><u>Advanced Payment</u></td>

  416. 								</tr>

  417. 								<tr>

  418. 									<td style="font-size: 11px;">1 Month Fee : <b>RM {{ $package->montly_fee }}</b> (including GST)</td>

  419. 								</tr>

  420. 								<tr>

  421. 									<td style="font-size: 11px;">Deposit Fee : <b>RM {{ $package->deposit }}</b></td>

  422. 								</tr>

  423. 								<tr>

  424. 									@if($package->voice_fee == "no" || $package->voice_fee == "No" || $package->voice_fee == "NO")

  425. 									<td style="font-size: 11px;">Voice Fee : <b>RM 0</b></td>

  426. 									@elseif($package->voice_fee == "yes" || $package->voice_fee == "Yes" || $package->voice_fee == "YES")

  427. 									<td style="font-size: 11px;">Voice Fee : <b>RM 20</b></td>

  428. 									@endif

  429. 								</tr>

  430. 								<tr>

  431. 									<td style="font-size: 11px;">OTC Fee : <b>RM {{ $package->upfront_payment }}</b></td>

  432. 								</tr>

  433. 								<tr>

  434. 									<td style="font-size: 11px;">Total : <b>RM {{ number_format(floatval($package->montly_fee) + floatval($package->deposit) + floatval($package->voice_fee) + floatval($package->upfront_payment), 2) }}</b></td>

  435. 								</tr>

  436. 								<tr>

  437. 									<td style="font-size: 9px;">*Installation fee will be woved for permises with available of required infrastructure</td>

  438. 								</tr>

  439. 								<tr>

  440. 									<td style="font-size: 9px;">**Deposit is refundable</td>

  441. 								</tr>

  442. 							</table>

  443. 						</td>

  444. 					</tr>

  445. 					<tr><td height="20"></td></tr>

  446. 				</table>

  447. 			</td>

  448. 		</tr>

  449. 		<!-- Document -->

  450. 		<tr>

  451. 			<td>

  452. 				<table border="0" cellpadding="0" cellspacing="0" width="100%">

  453. 					<tr>

  454. 						<td bgcolor="#b4b4e1" style="font-size: 12px;font-weight: bold; padding: 5px 3px;">

  455. 							<span style="display:inline-block;border-bottom:1px solid black; padding-bottom:0px;margin-bottom: 0px">DOCUMENTS AND DECLARATION</span>

  456. 						</td>

  457. 					</tr>

  458. 					<tr><td height="5"></td></tr>

  459. 					<tr>

  460. 						<td style="font-size: 11px;"><b>Documents Required:</b></td>

  461. 					</tr>

  462. 					<tr><td height="5"></td></tr>				

  463. 					<tr>

  464. 						<td>

  465. 							<table border="0" cellpadding="0" cellspacing="0">

  466. 								<tr>

  467. 									<td width="12" height="12" style="border:1px solid black"><span><img src="{{ url('/assets/tick.png') }}" style="width:14px; height:auto"></span></td>

  468. 									<td width="5">&nbsp;</td>

  469. 									<td style="font-size: 11px;">Photocopy of NRIC (both sides) or passport (Non-Malaysian)</td>

  470. 								</tr>

  471. 							</table>

  472. 						</td>

  473. 					</tr>

  474. 					<tr><td height="5"></td></tr>

  475. 					<tr>

  476. 						<td style="font-size: 11px;"><b>Declarations:</b></td>

  477. 					</tr>

  478. 					<tr><td height="5"></td></tr>	

  479. 					<tr>

  480. 						<td>

  481. 							<table border="0" cellpadding="0" cellspacing="0">

  482. 								<tr>

  483. 									<td style="font-size: 12px;text-align: justify"><div style="width:16px;height:16px;border:1px solid black;float:left;margin-right: 3px;"><img src="{{ url('/assets/tick.png') }}" style="width:14px; height:auto"></div>I hereby consent to the collection, use, disclosure of my personal information in accordance with the PRIVACY POLICY available on www.citybroadband.my</td>

  484. 								</tr>

  485. 								<tr><td height="10"></td></tr>

  486. 								<tr>

  487. 									<td style="font-size: 12px;text-align: justify"><div style="width:16px;height:16px;border:1px solid black;float:left;margin-right: 3px;"><img src="{{ url('/assets/tick.png') }}" style="width:14px; height:auto"></div> I hereby declare that the above information, documents and any appendices attached are true and valid. I have read and undertood the consent of this form and agreed to be bound by TERMS & CONDITIONS as stated on the next page of this form which accompany the subscription of product(s) and/or service(s). Setia Haruman Technology Sdn Bhd reserve the rights to refuse any application at any given time should any of the information is incorrect.</td>

  488. 								</tr>

  489. 								<tr><td height="10"></td></tr>

  490. 								<tr>

  491. 									<td style="font-size: 12px;text-align: justify"><div style="width:16px;height:16px;border:1px solid black;float:left;margin-right: 3px;"><img src="{{ url('/assets/tick.png') }}" style="width:14px; height:auto"></div> By signing this document, I agree and accept TERMS & CONDITIONS stipulated herein. I declare that the information provided by me is true and valid. Setia Haruman Technology Sdn Bhd reserve the rights to refuse my application at any given time without any refund or whatever monies held by Setia Haruman Technology Sdn Bhd should any of the above informationis found to be incorrect. If the service is offered to me, I declare to be bound by the TERMS & CONDITIONS of the service herein</td>

  492. 								</tr>

  493. 							</table>

  494. 						</td>

  495. 					</tr>

  496. 					<tr><td height="5"></td></tr>	

  497. 					<tr>

  498. 						<td style="font-size: 12px;text-align: justify"><b>Submitted Date:</b> {{ $form->created_at }}</td>

  499. 					</tr>

  500. 				</table>

  501. 			</td>

  502. 		</tr>

  503. 	</table>

  504. 	@if($form->back_ic != "" && $form->front_ic != "")

  505. 		@if(($ext1 == "jpeg" && $ext2 == "jpeg") || ($ext1 == "jpg" && $ext2 == "jpg") ||  ($ext1 == "JPG" && $ext2 == "JPG"))

  506. 			@if($ext3 == "pdf" && $ext4 == "pdf")

  507. 				@if(($ext5 == "jpeg" && $ext6 == "jpeg") || ($ext5 == "jpg" && $ext6 == "jpg") || ($ext5 == "JPG" && $ext6 == "JPG"))

  508. 				<table border="0" cellpadding="0" cellspacing="0" width="100%">

  509. 					<tr>

  510. 						<td>

  511. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  512. 								<tr>

  513. 									<td align="center" style="font-size: 16; font-weight: bold;">

  514. 										Attachment

  515. 									</td>

  516. 								</tr>

  517. 								<tr><td height="10"></td></tr>

  518. 								<tr>

  519. 									<td style="font-size: 14; font-weight: bold;">

  520. 										Identity Card (Front)

  521. 									</td>

  522. 								</tr>

  523. 								<tr><td height="5"></td></tr>

  524. 								<tr>

  525. 									<td width="100%">

  526. 										<img style="display:block;max-width:670px;height:auto" src="{{ url($form->front_ic) }}">

  527. 									</td>

  528. 								</tr>

  529. 								<tr><td height="5"></td></tr>

  530. 								<tr>

  531. 									<td style="font-size: 14; font-weight: bold;">

  532. 										Identity Card (Back)

  533. 									</td>

  534. 								</tr>

  535. 								<tr><td height="5"></td></tr>

  536. 								<tr>

  537. 									<td width="100%">

  538. 										<img style="display:block;max-width:670px;height:auto"  src="{{ url($form->back_ic) }}">

  539. 									</td>

  540. 								</tr>

  541. 							</table>

  542. 						</td>

  543. 					</tr>

  544. 					<tr>

  545. 						<td>

  546. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  547. 								<tr>

  548. 									<td style="font-size: 14; font-weight: bold;">

  549. 										Visa (Front)

  550. 									</td>

  551. 								</tr>

  552. 								<tr><td height="5"></td></tr>

  553. 								<tr>

  554. 									<td width="100%">

  555. 										<img style="display:block;max-width:670px;height:auto"  src="{{ url($form->visaF) }}">

  556. 									</td>

  557. 								</tr>

  558. 								<tr><td height="5"></td></tr>

  559. 								<tr>

  560. 									<td style="font-size: 14; font-weight: bold;">

  561. 										Visa (Back)

  562. 									</td>

  563. 								</tr>

  564. 								<tr><td height="5"></td></tr>

  565. 								<tr>

  566. 									<td width="100%">

  567. 										<img style="display:block;max-width:670px;height:auto"  src="{{ url($form->visaB) }}">

  568. 									</td>

  569. 								</tr>

  570. 							</table>

  571. 						</td>

  572. 					</tr>

  573. 				</table>

  574. 				@elseif($ext5 == "pdf" && $ext6 == "pdf")	

  575. 				@else

  576. 				<table border="0" cellpadding="0" cellspacing="0" width="100%">

  577. 					<tr>

  578. 						<td>

  579. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  580. 								<tr>

  581. 									<td align="center" style="font-size: 16; font-weight: bold;">

  582. 										Attachment

  583. 									</td>

  584. 								</tr>

  585. 								<tr><td height="10"></td></tr>

  586. 								<tr>

  587. 									<td style="font-size: 14; font-weight: bold;">

  588. 										Identity Card (Front)

  589. 									</td>

  590. 								</tr>

  591. 								<tr><td height="5"></td></tr>

  592. 								<tr>

  593. 									<td width="100%">

  594. 										<img style="display:block;max-width:670px;height:auto" src="{{ url($form->front_ic) }}">

  595. 									</td>

  596. 								</tr>

  597. 								<tr><td height="5"></td></tr>

  598. 								<tr>

  599. 									<td style="font-size: 14; font-weight: bold;">

  600. 										Identity Card (Back)

  601. 									</td>

  602. 								</tr>

  603. 								<tr><td height="5"></td></tr>

  604. 								<tr>

  605. 									<td width="100%">

  606. 										<img style="display:block;max-width:670px;height:auto"  src="{{ url($form->back_ic) }}">

  607. 									</td>

  608. 								</tr>

  609. 							</table>

  610. 						</td>

  611. 					</tr>

  612. 				</table>

  613. 				@endif

  614. 			@elseif(($ext3 == "jpeg" && $ext4 == "jpeg") || ($ext3 == "jpg" && $ext4 == "jpg") || ($ext3 == "JPG" && $ext4 == "JPG") || ($ext3 == "" && $ext4 == "jpg"))

  615. 				@if(($ext5 == "jpeg" && $ext6 == "jpeg") || ($ext5 == "jpg" && $ext6 == "jpg") || ($ext5 == "JPG" && $ext6 == "JPG"))

  616. 				<table border="0" cellpadding="0" cellspacing="0" width="100%">

  617. 					<tr>

  618. 						<td>

  619. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  620. 								<tr>

  621. 									<td align="center" style="font-size: 16; font-weight: bold;">

  622. 										Attachment

  623. 									</td>

  624. 								</tr>

  625. 								<tr><td height="10"></td></tr>

  626. 								<tr>

  627. 									<td style="font-size: 14; font-weight: bold;">

  628. 										Identity Card (Front)

  629. 									</td>

  630. 								</tr>

  631. 								<tr><td height="5"></td></tr>

  632. 								<tr>

  633. 									<td width="100%">

  634. 										<img style="display:block;max-width:670px;height:auto" src="{{ url($form->front_ic) }}">

  635. 									</td>

  636. 								</tr>

  637. 								<tr><td height="5"></td></tr>

  638. 								<tr>

  639. 									<td style="font-size: 14; font-weight: bold;">

  640. 										Identity Card (Back)

  641. 									</td>

  642. 								</tr>

  643. 								<tr><td height="5"></td></tr>

  644. 								<tr>

  645. 									<td width="100%">

  646. 										<img style="display:block;max-width:670px;height:auto"  src="{{ url($form->back_ic) }}">

  647. 									</td>

  648. 								</tr>

  649. 							</table>

  650. 						</td>

  651. 					</tr>

  652. 					<tr>

  653. 						<td>

  654. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  655. 								<tr>

  656. 									<td style="font-size: 14; font-weight: bold;">

  657. 										Visa (Front)

  658. 									</td>

  659. 								</tr>

  660. 								<tr><td height="5"></td></tr>

  661. 								<tr>

  662. 									<td width="100%">

  663. 										<img style="display:block;max-width:670px;height:auto"  src="{{ url($form->visaF) }}">

  664. 									</td>

  665. 								</tr>

  666. 								<tr><td height="5"></td></tr>

  667. 								<tr>

  668. 									<td style="font-size: 14; font-weight: bold;">

  669. 										Visa (Back)

  670. 									</td>

  671. 								</tr>

  672. 								<tr><td height="5"></td></tr>

  673. 								<tr>

  674. 									<td width="100%">

  675. 										<img style="display:block;max-width:670px;height:auto"  src="{{ url($form->visaB) }}">

  676. 									</td>

  677. 								</tr>

  678. 							</table>

  679. 						</td>

  680. 					</tr>

  681. 					<tr>

  682. 						<td>

  683. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  684. 								@if($form->form24_49 != '')

  685. 								<tr>

  686. 									<td style="font-size: 14; font-weight: bold;">

  687. 										Form 24_49

  688. 									</td>

  689. 								</tr>

  690. 								<tr><td height="5"></td></tr>

  691. 								<tr>

  692. 									<td width="100%">

  693. 										<img style="display:block;max-width:670px;height:auto" src="{{ url($form->form24_49) }}">

  694. 									</td>

  695. 								</tr>

  696. 								<tr><td height="5"></td></tr>

  697. 								@endif

  698. 								<tr>

  699. 									<td style="font-size: 14; font-weight: bold;">

  700. 										Form 9_44

  701. 									</td>

  702. 								</tr>

  703. 								<tr><td height="5"></td></tr>

  704. 								<tr>

  705. 									<td width="100%">

  706. 										<img style="display:block;max-width:670px;height:auto" src="{{ url($form->form9_44) }}">

  707. 									</td>

  708. 								</tr>

  709. 							</table>

  710. 						</td>

  711. 					</tr>

  712. 				</table>

  713. 				@elseif($ext5 == "pdf" && $ext6 == "pdf")

  714. 				<table border="0" cellpadding="0" cellspacing="0" width="100%">

  715. 					<tr>

  716. 						<td>

  717. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  718. 								<tr>

  719. 									<td align="center" style="font-size: 16; font-weight: bold;">

  720. 										Attachment

  721. 									</td>

  722. 								</tr>

  723. 								<tr><td height="10"></td></tr>

  724. 								<tr>

  725. 									<td style="font-size: 14; font-weight: bold;">

  726. 										Identity Card (Front)

  727. 									</td>

  728. 								</tr>

  729. 								<tr><td height="5"></td></tr>

  730. 								<tr>

  731. 									<td width="100%">

  732. 										<img style="display:block;max-width:670px;height:auto" src="{{ url($form->front_ic) }}">

  733. 									</td>

  734. 								</tr>

  735. 								<tr><td height="5"></td></tr>

  736. 								<tr>

  737. 									<td style="font-size: 14; font-weight: bold;">

  738. 										Identity Card (Back)

  739. 									</td>

  740. 								</tr>

  741. 								<tr><td height="5"></td></tr>

  742. 								<tr>

  743. 									<td width="100%">

  744. 										<img style="display:block;max-width:670px;height:auto"  src="{{ url($form->back_ic) }}">

  745. 									</td>

  746. 								</tr>

  747. 							</table>

  748. 						</td>

  749. 					</tr>

  750. 					<tr>

  751. 						<td>

  752. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  753. 								@if($form->form24_49 != '')

  754. 								<tr>

  755. 									<td style="font-size: 14; font-weight: bold;">

  756. 										Form 24_49

  757. 									</td>

  758. 								</tr>

  759. 								<tr><td height="5"></td></tr>

  760. 								<tr>

  761. 									<td width="100%">

  762. 										<img style="display:block;max-width:670px;height:auto" src="{{ url($form->form24_49) }}">

  763. 									</td>

  764. 								</tr>

  765. 								<tr><td height="5"></td></tr>

  766. 								@endif

  767. 								<tr>

  768. 									<td style="font-size: 14; font-weight: bold;">

  769. 										Form 9_44

  770. 									</td>

  771. 								</tr>

  772. 								<tr><td height="5"></td></tr>

  773. 								<tr>

  774. 									<td width="100%">

  775. 										<img style="display:block;max-width:670px;height:auto" src="{{ url($form->form9_44) }}">

  776. 									</td>

  777. 								</tr>

  778. 							</table>

  779. 						</td>

  780. 					</tr>

  781. 				</table>

  782. 				@else

  783. 				<table border="0" cellpadding="0" cellspacing="0" width="100%">

  784. 					<tr>

  785. 						<td>

  786. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  787. 								<tr>

  788. 									<td align="center" style="font-size: 16; font-weight: bold;">

  789. 										Attachment

  790. 									</td>

  791. 								</tr>

  792. 								<tr><td height="10"></td></tr>

  793. 								<tr>

  794. 									<td style="font-size: 14; font-weight: bold;">

  795. 										Identity Card (Front)

  796. 									</td>

  797. 								</tr>

  798. 								<tr><td height="5"></td></tr>

  799. 								<tr>

  800. 									<td width="100%">

  801. 										<img style="display:block;max-width:670px;height:auto" src="{{ url($form->front_ic) }}">

  802. 									</td>

  803. 								</tr>

  804. 								<tr><td height="5"></td></tr>

  805. 								<tr>

  806. 									<td style="font-size: 14; font-weight: bold;">

  807. 										Identity Card (Back)

  808. 									</td>

  809. 								</tr>

  810. 								<tr><td height="5"></td></tr>

  811. 								<tr>

  812. 									<td width="100%">

  813. 										<img style="display:block;max-width:670px;height:auto"  src="{{ url($form->back_ic) }}">

  814. 									</td>

  815. 								</tr>

  816. 							</table>

  817. 						</td>

  818. 					</tr>

  819. 					<tr>

  820. 						<td>

  821. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  822. 								@if($form->form24_49 != '')

  823. 								<tr>

  824. 									<td style="font-size: 14; font-weight: bold;">

  825. 										Form 24_49

  826. 									</td>

  827. 								</tr>

  828. 								<tr><td height="5"></td></tr>

  829. 								<tr>

  830. 									<td width="100%">

  831. 										<img style="display:block;max-width:670px;height:auto" src="{{ url($form->form24_49) }}">

  832. 									</td>

  833. 								</tr>

  834. 								<tr><td height="5"></td></tr>

  835. 								@endif

  836. 								<tr>

  837. 									<td style="font-size: 14; font-weight: bold;">

  838. 										Form 9_44

  839. 									</td>

  840. 								</tr>

  841. 								<tr><td height="5"></td></tr>

  842. 								<tr>

  843. 									<td width="100%">

  844. 										<img style="display:block;max-width:670px;height:auto" src="{{ url($form->form9_44) }}">

  845. 									</td>

  846. 								</tr>

  847. 							</table>

  848. 						</td>

  849. 					</tr>

  850. 				</table>

  851. 				@endif

  852. 			@endif

  853. 		@elseif($ext1 == "pdf" && $ext2 == "pdf")

  854. 			@if($ext3 == "pdf" && $ext4 == "pdf")

  855. 				@if($ext5 == "pdf" && $ext6 == "pdf")

  856. 					

  857. 				@elseif(($ext5 == "jpeg" && $ext6 == "jpeg") || ($ext5 == "jpg" && $ext6 == "jpg") || ($ext5 == "JPG" && $ext6 == "JPG"))

  858. 				<table border="0" cellpadding="0" cellspacing="0" width="100%">

  859. 					<tr>

  860. 						<td>

  861. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  862. 								<tr>

  863. 									<td align="center" style="font-size: 16; font-weight: bold;">

  864. 										Attachment

  865. 									</td>

  866. 								</tr>

  867. 							</table>

  868. 						</td>

  869. 					</tr>

  870. 					<tr>

  871. 						<td>

  872. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  873. 								<tr>

  874. 									<td style="font-size: 14; font-weight: bold;">

  875. 										Visa (Front)

  876. 									</td>

  877. 								</tr>

  878. 								<tr><td height="5"></td></tr>

  879. 								<tr>

  880. 									<td width="100%">

  881. 										<img style="display:block;max-width:670px;height:auto"  src="{{ url($form->visaF) }}">

  882. 									</td>

  883. 								</tr>

  884. 								<tr><td height="5"></td></tr>

  885. 								<tr>

  886. 									<td style="font-size: 14; font-weight: bold;">

  887. 										Visa (Back)

  888. 									</td>

  889. 								</tr>

  890. 								<tr><td height="5"></td></tr>

  891. 								<tr>

  892. 									<td width="100%">

  893. 										<img style="display:block;max-width:670px;height:auto"  src="{{ url($form->visaB) }}">

  894. 									</td>

  895. 								</tr>

  896. 							</table>

  897. 						</td>

  898. 					</tr>

  899. 				</table>

  900. 				@else

  901. 					

  902. 				@endif

  903. 			@elseif(($ext3 == "jpeg" && $ext4 == "jpeg") || ($ext3 == "jpg" && $ext4 == "jpg") || ($ext3 == "JPG" && $ext4 == "JPG"))

  904. 				@if($ext5 == "pdf" && $ext6 == "pdf")

  905. 				<table border="0" cellpadding="0" cellspacing="0" width="100%">

  906. 					<tr>

  907. 						<td>

  908. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  909. 								<tr>

  910. 									<td align="center" style="font-size: 16; font-weight: bold;">

  911. 										Attachment

  912. 									</td>

  913. 								</tr>

  914. 							</table>

  915. 						</td>

  916. 					</tr>

  917. 					<tr>

  918. 						<td>

  919. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  920. 								@if($form->form24_49 != '')

  921. 								<tr>

  922. 									<td style="font-size: 14; font-weight: bold;">

  923. 										Form 24_49

  924. 									</td>

  925. 								</tr>

  926. 								<tr><td height="5"></td></tr>

  927. 								<tr>

  928. 									<td width="100%">

  929. 										<img style="display:block;max-width:670px;height:auto" src="{{ url($form->form24_49) }}">

  930. 									</td>

  931. 								</tr>

  932. 								<tr><td height="5"></td></tr>

  933. 								@endif

  934. 								<tr>

  935. 									<td style="font-size: 14; font-weight: bold;">

  936. 										Form 9_44

  937. 									</td>

  938. 								</tr>

  939. 								<tr><td height="5"></td></tr>

  940. 								<tr>

  941. 									<td width="100%">

  942. 										<img style="display:block;max-width:670px;height:auto" src="{{ url($form->form9_44) }}">

  943. 									</td>

  944. 								</tr>

  945. 							</table>

  946. 						</td>

  947. 					</tr>

  948. 				</table>

  949. 				@elseif(($ext5 == "jpeg" && $ext6 == "jpeg") || ($ext5 == "jpg" && $ext6 == "jpg") || ($ext5 == "JPG" && $ext6 == "JPG"))

  950. 			    <table border="0" cellpadding="0" cellspacing="0" width="100%">

  951. 					<tr>

  952. 						<td>

  953. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  954. 								<tr>

  955. 									<td align="center" style="font-size: 16; font-weight: bold;">

  956. 										Attachment

  957. 									</td>

  958. 								</tr>

  959. 							</table>

  960. 						</td>

  961. 					</tr>

  962. 					<tr>

  963. 						<td>

  964. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  965. 								<tr>

  966. 									<td style="font-size: 14; font-weight: bold;">

  967. 										Visa (Front)

  968. 									</td>

  969. 								</tr>

  970. 								<tr><td height="5"></td></tr>

  971. 								<tr>

  972. 									<td width="100%">

  973. 										<img style="display:block;max-width:670px;height:auto"  src="{{ url($form->visaF) }}">

  974. 									</td>

  975. 								</tr>

  976. 								<tr><td height="5"></td></tr>

  977. 								<tr>

  978. 									<td style="font-size: 14; font-weight: bold;">

  979. 										Visa (Back)

  980. 									</td>

  981. 								</tr>

  982. 								<tr><td height="5"></td></tr>

  983. 								<tr>

  984. 									<td width="100%">

  985. 										<img style="display:block;max-width:670px;height:auto"  src="{{ url($form->visaB) }}">

  986. 									</td>

  987. 								</tr>

  988. 							</table>

  989. 						</td>

  990. 					</tr>

  991. 					<tr>

  992. 						<td>

  993. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  994. 								@if($form->form24_49 != '')

  995. 								<tr>

  996. 									<td style="font-size: 14; font-weight: bold;">

  997. 										Form 24_49

  998. 									</td>

  999. 								</tr>

  1000. 								<tr><td height="5"></td></tr>

  1001. 								<tr>

  1002. 									<td width="100%">

  1003. 										<img style="display:block;max-width:670px;height:auto" src="{{ url($form->form24_49) }}">

  1004. 									</td>

  1005. 								</tr>

  1006. 								<tr><td height="5"></td></tr>

  1007. 								@endif

  1008. 								<tr>

  1009. 									<td style="font-size: 14; font-weight: bold;">

  1010. 										Form 9_44

  1011. 									</td>

  1012. 								</tr>

  1013. 								<tr><td height="5"></td></tr>

  1014. 								<tr>

  1015. 									<td width="100%">

  1016. 										<img style="display:block;max-width:670px;height:auto" src="{{ url($form->form9_44) }}">

  1017. 									</td>

  1018. 								</tr>

  1019. 							</table>

  1020. 						</td>

  1021. 					</tr>

  1022. 				</table>

  1023. 				@else

  1024. 				<table border="0" cellpadding="0" cellspacing="0" width="100%">

  1025. 					<tr>

  1026. 						<td>

  1027. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  1028. 								<tr>

  1029. 									<td align="center" style="font-size: 16; font-weight: bold;">

  1030. 										Attachment

  1031. 									</td>

  1032. 								</tr>

  1033. 							</table>

  1034. 						</td>

  1035. 					</tr>

  1036. 					<tr>

  1037. 						<td>

  1038. 							<table border="0" cellpadding="0" cellspacing="0" width="100%">

  1039. 								<tr>

  1040. 									<td style="font-size: 14; font-weight: bold;">

  1041. 										Form 24_49

  1042. 									</td>

  1043. 								</tr>

  1044. 								<tr><td height="5"></td></tr>

  1045. 								<tr>

  1046. 									<td width="100%">

  1047. 										<img style="display:block;max-width:670px;height:auto" src="{{ url($form->form24_49) }}">

  1048. 									</td>

  1049. 								</tr>

  1050. 								<tr><td height="5"></td></tr>

  1051. 								<tr>

  1052. 									<td style="font-size: 14; font-weight: bold;">

  1053. 										Form 9_44

  1054. 									</td>

  1055. 								</tr>

  1056. 								<tr><td height="5"></td></tr>

  1057. 								<tr>

  1058. 									<td width="100%">

  1059. 										<img style="display:block;max-width:670px;height:auto" src="{{ url($form->form9_44) }}">

  1060. 									</td>

  1061. 								</tr>

  1062. 							</table>

  1063. 						</td>

  1064. 					</tr>

  1065. 				</table>

  1066. 				@endif

  1067. 			@endif

  1068. 		@endif

  1069. 	@endif

  1070. </body>

  1071. </html>