<!-- Begin Body --> 
<form  role="form" id="releases_to_broker_for_wht_form" class="form-horizontal"  autocomplete="on">
<input type="hidden" id="current_model">
<input type="hidden" id="reservation_fee">

<input type="hidden" id="current_user_type" value="<?=$user_type?>" name="current_user_type">
<div class="container-fluid" style="padding-top:120px; height:550px">
	<div class="row"><br/></div>
	<div class="row">
		<div class="col-lg-4 col-md-4 col-sm-4 col-xs-12">
			<fieldset> 
				<div class="form-group">
					<label class="col-md-5 control-label text-right" for="bpm_buyer"><small>Buyer</small></label>
					<div class="col-md-7">
							<input type="text" id="bpm_buyer" readonly placeholder="Buyer" value="" name="bpm_buyer" class="form-control text-left">
							<input type="hidden" name="reservation_id" id="reservation_id">
					</div>
				</div>
				

				<div class="form-group"> 
					<label class="col-md-5 control-label text-right" for="bpm_reservation"><a href="#" style="cursor:hand; text-decoration:none" class="glyphicon glyphicon-pencil" onclick="updateReservationPrice(<?=$_REQUEST['id']?>)"></a>&nbsp;<small>Reservation</small></label>
					<div class="col-md-7"><input type="text" id="bpm_reservation" name="bpm_reservation" placeholder="0.00" onblur = "javascript:this.value=Comma(this.value); computeBalance();" readonly onkeypress="return isNumberKey(event);" value="" class="form-control text-right"></div>
				</div>

				<div class="form-group"> 
					<label class="col-md-5 control-label text-right" for="bpm_less_ca"><a href="#" style="cursor:hand; text-decoration:none" class="glyphicon glyphicon-pencil" onclick="updateCaPrice(<?=$_REQUEST['id']?>)"></a>&nbsp;<small>Less : CA</small></label>
					<div class="col-md-7"><input type="text" id="bpm_less_ca" name="bpm_less_ca" placeholder="0.00" onblur = "javascript:this.value=Comma(this.value); computeBalance();" readonly onkeypress="return isNumberKey(event);" value="" class="form-control text-right"></div>
				</div>

				<div class="form-group"> 
					<label class="col-md-5 control-label text-right" for="bpm_reservation_less_ca"><small>Balance</small></label>
					<div class="col-md-7"><input type="text" id="bpm_reservation_less_ca" name="bpm_reservation_less_ca" placeholder="0.00" onblur = "javascript:this.value=Comma(this.value);" readonly onkeypress="return isNumberKey(event);" value="" class="form-control text-right"></div>
				</div>

				<div class="form-group"> 
					<label class="col-md-5 control-label text-right" for="bpm_tcp"><small>TCP</small></label>
					<div class="col-md-7"><input type="text" id="bpm_tcp" name="bpm_tcp" placeholder="0.00" onblur = "javascript:this.value=Comma(this.value); computeBasisCommission(); computeCommission(); computeNetSellingPrice();" readonly onkeypress="return isNumberKey(event);" value="" class="form-control text-right"></div>
				</div>

				<div class="form-group">
					<label class="col-md-5 control-label text-right" for="bpm_less_discount"><a href="#" style="cursor:hand; text-decoration:none" class="glyphicon glyphicon-pencil" onclick="updateDiscountPrice(<?=$_REQUEST['id']?>)"></a>&nbsp;<small>Less : Discount</small></label>
					<div class="col-md-7"><input type="text" id="bpm_less_discount" name="bpm_less_discount" placeholder="0.00" onblur = "javascript:this.value=Comma(this.value);" onkeypress="return isNumberKey(event); computeBasisCommission(); computeCommission()" onkeyup="computeBasisCommission(); computeCommission(); computeNetSellingPrice();" readonly value="" class="form-control text-right" style="cursor:pointer"></div>
				</div>

	<?php 
		//(Danville E and Villa Castalia)
		if($_SESSION['danvilles_release_broker_type']=='template1'):  
	?>
				<div class="form-group">
					<label class="col-md-5 control-label text-right" for="bpm_misc_expenses"><small>Less : Misc Expenses</small></label>
					<div class="col-md-7"><input type="text" id="bpm_misc_expenses" name="bpm_misc_expenses" placeholder="0.00" onblur = "javascript:this.value=Comma(this.value);" onkeypress="return isNumberKey(event); computeBasisCommission(); computeCommission()" readonly value="" class="form-control text-right"></div>
				</div>
	<?php endif; ?>			


	<?php 
		//(Danville S)
		if($_SESSION['danvilles_release_broker_type']=='template2'):  
	?>
				<div class="form-group">
					<label class="col-md-5 control-label text-right" for="net_selling_price"><small>Net Selling Price</small></label>
					<div class="col-md-7"><input type="text" id="net_selling_price" name="net_selling_price" placeholder="0.00" onblur = "javascript:this.value=Comma(this.value);" onkeypress="return isNumberKey(event); computeBasisCommission(); computeCommission()" readonly value="" class="form-control text-right"></div>
				</div>


				<div class="form-group"><br/></div>
	<?php endif; ?>		



				<div class="form-group">
					<input type="hidden" id="release_broker_type" value="<?=$_SESSION['danvilles_release_broker_type']?>">

	<?php 
		//(Danville E and Villa Castalia)
		if($_SESSION['danvilles_release_broker_type']=='template1'):  
	?>
					<label class="col-md-5 control-label text-right" for="bpm_basis_commission"><small>Basis of Commission</small></label>
	<?php endif; ?>

	<?php 
		//(Danville S)
		if($_SESSION['danvilles_release_broker_type']=='template2'):  
	?>
					<label class="col-md-5 control-label text-right" for="bpm_basis_commission"><small>Basis of Commission (Loanable Amount)</small></label>
					<input type="hidden" id="loanable_amount" value="">
	<?php endif; ?>

					<div class="col-md-7"><input type="text" id="bpm_basis_commission" name="bpm_basis_commission" placeholder="0.00" onblur = "javascript:this.value=Comma(this.value);" onkeypress="return isNumberKey(event); computeCommission();" readonly value="" class="form-control text-right"></div>
				</div>

				<div class="form-group">
					<label class="col-md-5 control-label text-right" for="bpm_rate"><a href="#" style="cursor:hand; text-decoration:none" class="glyphicon glyphicon-pencil" onclick="updateRatePrice(<?=$_REQUEST['id']?>)"></a>&nbsp;<small>Rate %</small></label>
					<div class="col-md-7"><input type="text" id="bpm_rate" name="bpm_rate" placeholder="%" onblur = "javascript:this.value=Comma(this.value);" onkeypress="return isNumberKey(event); computeBasisCommission(); computeCommission()"   value="" class="form-control text-right" readonly onkeyup="computeBasisCommission(); computeCommission();" style="cursor:pointer"></div> 
				</div>

				<div class="form-group">
					<label class="col-md-5 control-label text-right" for="bpm_commission"><small>Commission</small></label>
					<div class="col-md-7"><input type="text" id="bpm_commission" name="bpm_commission" placeholder="0.00" onblur = "javascript:this.value=Comma(this.value);" onkeypress="return isNumberKey(event);" readonly value="" class="form-control text-right"></div>
				</div> 
			</fieldset>
		</div>
		<div class="col-lg-4 col-md-4 col-sm-4 col-xs-12">
			<fieldset>  
				

				
				<div class="form-group">
					<label class="col-md-5 control-label text-right" for="bpm_realty"><small>Realty</small></label>
					<div class="col-md-7"><input type="text" id="bpm_realty" name="bpm_realty"  readonly placeholder="Realty" value="" class="form-control text-left"></div>
				</div>

				
				<div class="form-group">
					<label class="col-md-5 control-label text-right" for="bpm_broker"><small>Broker</small></label>
					<div class="col-md-7"><input type="text" id="bpm_broker" name="bpm_broker"  readonly placeholder="Broker" value="" class="form-control text-left"></div>
				</div>

				<div class="form-group">
					<label class="col-md-5 control-label text-right" for="bpm_agent"><small>Agent</small></label>
					<div class="col-md-7"><input type="text" id="bpm_agent" readonly placeholder="Agent" value="" class="form-control text-left"></div>
				</div>

				<div class="form-group">
					<label class="col-md-6 control-label text-right">&nbsp;</label>
					<div class="col-md-6">&nbsp;</div>
				</div>

				<div class="form-group">
					<label class="col-md-6 control-label text-right">&nbsp;</label>
					<div class="col-md-6">&nbsp;</div>
				</div>

				<div class="form-group">
					<label class="col-md-6 control-label text-right">&nbsp;</label>
					<div class="col-md-6">&nbsp;</div>
				</div>

				<div class="form-group">
					<label class="col-md-6 control-label text-right">&nbsp;</label>
					<div class="col-md-6">&nbsp;</div>
				</div>
 
 
<?php if($_SESSION['danvilles_release_broker_type']=='template1'): ?>
				<div class="form-group">
					<label class="col-md-6 control-label text-right" for="bpm_misc_expense_rate"><a href="#" style="cursor:hand; text-decoration:none" class="glyphicon glyphicon-pencil" onclick="updateMiscPercentagePrice(<?=$_REQUEST['id']?>)"></a>&nbsp;<small>&nbsp;%</small></label>
					<div class="col-md-6"><input type="text" id="bpm_misc_expense_rate" name="bpm_misc_expense_rate" placeholder="%" value="" class="form-control text-left"  readonly style="cursor:pointer" onkeyup="computeMiscExpense(); computeBasisCommission(); computeCommission();"></div>
				</div>
<?php endif; ?>


			</fieldset>
		</div>
		<div class="col-lg-4 col-md-4 col-sm-4 col-xs-12">
			<fieldset> 

				<div class="form-group">
					<label class="col-md-6 control-label text-right" for="bpm_block"><small>Block</small></label>
					<div class="col-md-6"><input type="text" id="bpm_block" name="bpm_block" placeholder="Block" value="" class="form-control text-left" readonly style="cursor:pointer"></div>
				</div> 


				<div class="form-group">
					<label class="col-md-6 control-label text-right" for="bpm_lot"><small>Lot</small></label>
					<div class="col-md-6"><input type="text" id="bpm_lot" name="bpm_lot" placeholder="Lot" value="" class="form-control text-left" readonly style="cursor:pointer"></div>
				</div>
				
 
				<div class="form-group">
					<label class="col-md-6 control-label text-right">&nbsp;</label>
					<div class="col-md-6">&nbsp;</div>
				</div>

				<div class="form-group">
					<label class="col-md-6 control-label text-right" for="bpm_date_rf_deposited"><small>Date RF Deposited</small></label>
					<div class="col-md-6"><input type="text" id="bpm_date_rf_deposited" name="bpm_date_rf_deposited" placeholder="MM/DD/YYYY" value="" class="form-control text-right " style="cursor:disabled" readonly></div>
				</div>  

				<div class="form-group">
					<label class="col-md-6 control-label text-right" for="bpm_take_out_date"><small>Take-out Date</small></label>
					<div class="col-md-6"><input type="text" id="bpm_take_out_date" name="bpm_take_out_date" placeholder="MM/DD/YYYY" value="" class="form-control text-right" style="cursor:pointer" readonly></div>
				</div>  
				
				<div class="form-group">
					<div class="col-md-6"><br/><br/></div>
				</div>
                

			</fieldset>
		</div>
	</div>
	 
	 
	<!-------------->

 	<div class="row"><div class="col-lg-12 col-md-12 col-sm-12 col-xs-12"><br></div></div>

	<div class="row">
		<div class="col-lg-12 col-md-12 col-sm-12 col-xs-12">
			<fieldset> 
				<div class="table-responsive"> 
				<table cellpadding="0" cellspacing="0" width="100%" class="table table-bordered table-condense table-striped">
					<tr>
						<td class="center text-center">&nbsp;</td>
						<td>&nbsp;</td>
						<td class="center text-center">&nbsp;</td>
						<td class="center text-center">&nbsp;</td>
						<td class="center text-center">&nbsp;</td>
						<td class="center text-center" colspan="2">Account No. / Check No.</td> 
						<td class="center text-center">&nbsp;</td>
					</tr>
					<tr>
						<td>&nbsp;</td>
						<td class="center text-center" width="12%">Releases</td>
						<td class="center text-center" width="12%">Equity Paid</td>
						<td class="center text-center">Broker</td>
						<td class="center text-center">Agent</td>
						<td class="center text-center">Broker</td>
						<td class="center text-center">Agent</td>
						<td class="center text-center">Date Processed</td> 
					</tr>
			

					<tr>
						<td><input type="checkbox" disabled  id="first_release_checkbox" name="first_release_checkbox"></td>
						<td>1st Release</td>
						<td><input type="text" class="form-control text-right right" readonly id="first_release_type" name="first_release_type" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" readonly id="first_release_broker_amount" name="first_release_broker_amount" value="0.00" placeholder="0.00"></td>
						<td><input type="text" class="form-control text-right right" readonly id="first_release_agent_amount" name="first_release_agent_amount" value="0.00" placeholder="0.00"></td>

			 
						<td><input type="text" class="form-control text-right right" id="first_release_broker_check" name="first_release_broker_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" id="first_release_agent_check" name="first_release_agent_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right datepicker whitebg" style="cursor:pointer" readonly id="first_release_date" name="first_release_date" value="" placeholder=""></td>
						
					</tr>

					<tr>
						<td><input type="checkbox" disabled  id="second_release_checkbox" name="second_release_checkbox"></td>
						<td>2nd Release</td>
						<td><input type="text" class="form-control text-right right" readonly id="second_release_type" name="second_release_type" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" readonly id="second_release_broker_amount" name="second_release_broker_amount" value="0.00" placeholder="0.00"></td>
						<td><input type="text" class="form-control text-right right" readonly id="second_release_agent_amount" name="second_release_agent_amount" value="0.00" placeholder="0.00"></td>
 
						<td><input type="text" class="form-control text-right right" id="second_release_broker_check" name="second_release_broker_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" id="second_release_agent_check" name="second_release_agent_check" value="" placeholder=""></td>

						<td><input type="text" class="form-control text-right datepicker whitebg" style="cursor:pointer" readonly id="second_release_date" name="second_release_date" value="" placeholder=""></td>
					</tr>

					<tr>
						<td><input type="checkbox" disabled  id="third_release_checkbox" name="third_release_checkbox"></td>
						<td>3rd Release</td>
						<td><input type="text" class="form-control text-right right" readonly id="third_release_type" name="third_release_type" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" readonly id="third_release_broker_amount" name="third_release_broker_amount" value="0.00" placeholder="0.00"></td>
						<td><input type="text" class="form-control text-right right" readonly id="third_release_agent_amount" name="third_release_agent_amount" value="0.00" placeholder="0.00"></td>
					 
						<td><input type="text" class="form-control text-right right" id="third_release_broker_check" name="third_release_broker_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" id="third_release_agent_check" name="third_release_agent_check" value="" placeholder=""></td>

						<td><input type="text" class="form-control text-right datepicker whitebg" style="cursor:pointer" readonly id="third_release_date" name="third_release_date" value="" placeholder=""></td>
					</tr>


<!---------------------------------------------------------------------->
					<tr>
						<td><input type="checkbox" disabled  id="fourth_release_checkbox" name="fourth_release_checkbox"></td>
						<td>4th Release</td>
						<td><input type="text" class="form-control text-right right" readonly id="fourth_release_type" name="fourth_release_type" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" readonly id="fourth_release_broker_amount" name="fourth_release_broker_amount" value="0.00" placeholder="0.00"></td>
						<td><input type="text" class="form-control text-right right" readonly id="fourth_release_agent_amount" name="fourth_release_agent_amount" value="0.00" placeholder="0.00"></td>
					 

						<td><input type="text" class="form-control text-right right" id="fourth_release_broker_check" name="fourth_release_broker_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" id="fourth_release_agent_check" name="fourth_release_agent_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right datepicker whitebg" style="cursor:pointer" readonly id="fourth_release_date" name="fourth_release_date" value="" placeholder=""></td>
					</tr>

					<tr>
						<td><input type="checkbox" disabled  id="fifth_release_checkbox" name="fifth_release_checkbox"></td>
						<td>5th Release</td>
						<td><input type="text" class="form-control text-right right" readonly id="fifth_release_type" name="fifth_release_type" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" readonly id="fifth_release_broker_amount" name="fifth_release_broker_amount" value="0.00" placeholder="0.00"></td>
						<td><input type="text" class="form-control text-right right" readonly id="fifth_release_agent_amount" name="fifth_release_agent_amount" value="0.00" placeholder="0.00"></td>
 
						<td><input type="text" class="form-control text-right right" id="fifth_release_broker_check" name="fifth_release_broker_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" id="fifth_release_agent_check" name="fifth_release_agent_check" value="" placeholder=""></td>

						<td><input type="text" class="form-control text-right datepicker whitebg" style="cursor:pointer" readonly id="fifth_release_date" name="fifth_release_date" value="" placeholder=""></td>
					</tr>

					<tr>
						<td><input type="checkbox" disabled  id="six_release_checkbox" name="six_release_checkbox"></td>
						<td>6th Release</td>
						<td><input type="text" class="form-control text-right right" readonly id="six_release_type" name="six_release_type" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" readonly id="six_release_broker_amount" name="six_release_broker_amount" value="0.00" placeholder="0.00"></td>
						<td><input type="text" class="form-control text-right right" readonly id="six_release_agent_amount" name="six_release_agent_amount" value="0.00" placeholder="0.00"></td>
 
						
						<td><input type="text" class="form-control text-right right" id="six_release_broker_check" name="six_release_broker_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" id="six_release_agent_check" name="six_release_agent_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right datepicker whitebg" style="cursor:pointer" readonly id="six_release_date" name="six_release_date" value="" placeholder=""></td>
					</tr>


					<tr>
						<td><input type="checkbox" disabled  id="seven_release_checkbox" name="seven_release_checkbox"></td>
						<td>7th Release</td>
						<td><input type="text" class="form-control text-right right" readonly id="seven_release_type" name="seven_release_type" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" readonly id="seven_release_broker_amount" name="seven_release_broker_amount" value="0.00" placeholder="0.00"></td>
						<td><input type="text" class="form-control text-right right" readonly id="seven_release_agent_amount" name="seven_release_agent_amount" value="0.00" placeholder="0.00"></td>
					 
						
						<td><input type="text" class="form-control text-right right" id="seven_release_broker_check" name="seven_release_broker_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" id="seven_release_agent_check" name="seven_release_agent_check" value="" placeholder=""></td>

						<td><input type="text" class="form-control text-right datepicker whitebg" style="cursor:pointer" readonly id="seven_release_date" name="seven_release_date" value="" placeholder=""></td>
					</tr>



					<tr>
						<td><input type="checkbox" disabled  id="eight_release_checkbox" name="eight_release_checkbox"></td>
						<td>8th Release</td>
						<td><input type="text" class="form-control text-right right" readonly id="eight_release_type" name="eight_release_type" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" readonly id="eight_release_broker_amount" name="eight_release_broker_amount" value="0.00" placeholder="0.00"></td>
						<td><input type="text" class="form-control text-right right" readonly id="eight_release_agent_amount" name="eight_release_agent_amount" value="0.00" placeholder="0.00"></td>
			 
						<td><input type="text" class="form-control text-right right" id="eight_release_broker_check" name="eight_release_broker_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" id="eight_release_agent_check" name="eight_release_agent_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right datepicker whitebg" style="cursor:pointer" readonly id="eight_release_date" name="eight_release_date" value="" placeholder=""></td>
					</tr>



					<tr>
						<td><input type="checkbox" disabled  id="nine_release_checkbox" name="nine_release_checkbox"></td>
						<td>9th Release</td>
						<td><input type="text" class="form-control text-right right" readonly id="nine_release_type" name="nine_release_type" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" readonly id="nine_release_broker_amount" name="nine_release_broker_amount" value="0.00" placeholder="0.00"></td>
						<td><input type="text" class="form-control text-right right" readonly id="nine_release_agent_amount" name="nine_release_agent_amount" value="0.00" placeholder="0.00"></td>
					 

						<td><input type="text" class="form-control text-right right" id="nine_release_broker_check" name="nine_release_broker_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" id="nine_release_agent_check" name="nine_release_agent_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right datepicker whitebg" style="cursor:pointer" readonly id="nine_release_date" name="nine_release_date" value="" placeholder=""></td>
					</tr>



					<tr>
						<td><input type="checkbox" disabled id="ten_release_checkbox" name="ten_release_checkbox"></td>
						<td>10th Release</td>
						<td><input type="text" class="form-control text-right right" readonly id="ten_release_type" name="ten_release_type" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" readonly id="ten_release_broker_amount" name="ten_release_broker_amount" value="0.00" placeholder="0.00"></td>
						<td><input type="text" class="form-control text-right right" readonly id="ten_release_agent_amount" name="ten_release_agent_amount" value="0.00" placeholder="0.00"></td>
 
						<td><input type="text" class="form-control text-right right" id="ten_release_broker_check" name="ten_release_broker_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" id="ten_release_agent_check" name="ten_release_agent_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right datepicker whitebg" style="cursor:pointer" readonly id="ten_release_date" name="ten_release_date" value="" placeholder=""></td>
					</tr>


					<tr>
						<td><input type="checkbox" disabled id="eleven_release_checkbox" name="eleven_release_checkbox"></td>
						<td>11th Release</td>
						<td><input type="text" class="form-control text-right right" readonly id="eleven_release_type" name="eleven_release_type" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" readonly id="eleven_release_broker_amount" name="eleven_release_broker_amount" value="0.00" placeholder="0.00"></td>
						<td><input type="text" class="form-control text-right right" readonly id="eleven_release_agent_amount" name="eleven_release_agent_amount" value="0.00" placeholder="0.00"></td>
 
											
						<td><input type="text" class="form-control text-right right" id="eleven_release_broker_check" name="eleven_release_broker_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" id="eleven_release_agent_check" name="eleven_release_agent_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right datepicker whitebg" style="cursor:pointer" readonly id="eleven_release_date" name="eleven_release_date" value="" placeholder=""></td>
					</tr>


					<tr>
						<td><input type="checkbox" disabled id="twelve_release_checkbox" name="twelve_release_checkbox"></td>
						<td>12th Release</td>
						<td><input type="text" class="form-control text-right right" readonly id="twelve_release_type" name="twelve_release_type" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" readonly id="twelve_release_broker_amount" name="twelve_release_broker_amount" value="0.00" placeholder="0.00"></td>
						<td><input type="text" class="form-control text-right right" readonly id="twelve_release_agent_amount" name="twelve_release_agent_amount" value="0.00" placeholder="0.00"></td>
 
											
						<td><input type="text" class="form-control text-right right" id="twelve_release_broker_check" name="twelve_release_broker_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right right" id="twelve_release_agent_check" name="twelve_release_agent_check" value="" placeholder=""></td>
						<td><input type="text" class="form-control text-right datepicker whitebg" style="cursor:pointer" readonly id="twelve_release_date" name="twelve_release_date" value="" placeholder=""></td>
					</tr>
<!---------------------------------------------------------------------->


					<tr>
						<td>&nbsp;</td>
						<td>Sub-total</td>
						<td>&nbsp;</td>
						<td><input readonly type="text" class="form-control text-right right" value="0.00" id="subtotal_release_broker_amount" name="subtotal_release_broker_amount"></td>
						<td><input readonly type="text" class="form-control text-right right" value="0.00" id="subtotal_release_agent_amount" name="subtotal_release_agent_amount"></td>
					 

						<td>&nbsp;</td>
						<td>&nbsp;</td>
						<td>&nbsp;</td>
					</tr>



					<tr>
						<td>&nbsp;</td>
						<td>Total Partial Releases</td>
						<td><input readonly type="text" class="form-control text-right right" id="subtotal_release_amount" name="subtotal_release_amount"></td>
						<td colspan="2"></td> 
						<td>&nbsp;</td> 
						<td>&nbsp;</td>
						<td>&nbsp;</td>
					</tr>


					<tr>
						<td>&nbsp;</td>
						<td>Add: Cash Advance</td>
						<td><input readonly type="text" class="form-control text-right right" id="add_cash_advance" name="add_cash_advance"></td>
						<td colspan="2"></td> 
						<td>&nbsp;</td> 
						<td>&nbsp;</td>
						<td>&nbsp;</td>
					</tr>

					<tr>
						<td>&nbsp;</td>
						<td>Total Releases</td>
						<td><input readonly type="text" class="form-control text-right right" id="total_releases_amount" name="total_releases_amount"></td>
						<td colspan="2"></td> 
						<td>&nbsp;</td> 
						<td>&nbsp;</td>
						<td>&nbsp;</td>
					</tr>

		  


					<tr><td colspan="11"><br/></td></tr>

					<tr> 
						<td class="center text-center"><input type="checkbox" id="full_release_checkbox"  name="full_release_checkbox"><span class="glyphicon glyphicon-exclamation-sign showicon" style="color:#ff0000; font-size:10pt"></span></td>
						<td class="text-right">For Full Commission:</td>
						<td>&nbsp;</td>
						<td align="center">EWT</td>
						<td align="center">Net Amount</td>
					 
						<td colspan="2" align="center">Broker’s Account No. / Check No.</td>
						<td align="center">Date Processed</td>
					</tr>
					<input type="hidden" id="financing" value="">
					<input type="hidden" id="complete_equity" value="">
					<input type="hidden" id="take_out_date" value="">
					<input type="hidden" id="twenty_four_checks" value="">
					<input type="hidden" id="signed_loan_documents" value="">
					<input type="hidden" id="attended_homeowners_orientation_and_signed_deed_of_restriction" value=""> 

					<tr>
						<td>&nbsp;</td>
						<td class="text-right">Balance Payable</td>
						<td><input readonly type="text" class="form-control text-right right" id="full_amount" name="full_amount" value="0.00"></td>
						<td></td>
						<td><input readonly type="text" class="form-control text-right right" id="full_net" name="full_net" value="0.00"></td>

						<td colspan="2"><input type="text" class="form-control text-right right" id="full_check" name="full_check"></td>
						<td><input type="text" class="form-control text-right datepicker whitebg" style="cursor:pointer" readonly id="full_date" name="full_date" value="" placeholder=""></td>
					</tr>


					<tr>
						<td>&nbsp;</td>
						<td class="text-right">Total Commission</td>
						<td><input readonly type="text" class="form-control text-right right" id="total_amount" name="total_amount" value="0.00"></td>
						<td><input readonly type="text" class="form-control text-right right" id="total_wht" name="total_wht" value="0.00"></td>
						<td></td>						
						<td colspan="2">&nbsp;</td>
						<td>&nbsp;</td>
					</tr>





					<tr>
						<td>&nbsp;</td>
						<td>Sales Commission</td>  
						<td><input type="text" id="releases_status" name="releases_status" readonly placeholder="Status" value="" class="form-control text-left"></td> 
						<td></td>
						<td colspan="7"></td>
					</tr>


					<tr>
						<td>&nbsp;</td>
						<td>Remarks</td>
						<td>&nbsp;</td>
						<td colspan="9"><textarea cols="10" row="5" class="form-control" id="releases_remarks" name="releases_remarks"></textarea></td>
					</tr>
				</table>
				</div>
			</fieldset>
		</div>
	</div>
	 


	<!-------------->
	 
	
	
	 


</div>
</form>

