<?php

/* DorcasTabithaBundle:Print:promissoryformprintable.html.twig */
class __TwigTemplate_b4f78f6ef0938afe33d6742a3cd9dc5d extends Twig_Template
{
    public function __construct(Twig_Environment $env)
    {
        parent::__construct($env);

        $this->parent = false;

        $this->blocks = array(
            'footer' => array($this, 'block_footer'),
        );
    }

    protected function doDisplay(array $context, array $blocks = array())
    {
        // line 1
        echo "<!DOCTYPE html>
<html>
    <head>
        <meta http-equiv=\"Content-Type\" content=\"text/html\"; charset=utf-8\" />
        <link href=\"";
        // line 5
        echo twig_escape_filter($this->env, $this->env->getExtension('assets')->getAssetUrl("bundles/DorcasTabitha/css/printable.css"), "html", null, true);
        echo "\" type=\"text/css\" rel=\"stylesheet\" />
        <script src=\"";
        // line 6
        echo twig_escape_filter($this->env, $this->env->getExtension('assets')->getAssetUrl("bundles/DorcasTabitha/js/js/jquery-1.7.2.min.js"), "html", null, true);
        echo "\" type=\"text/javascript\"></script>
        <script>    
        \$(document).ready(function(){ 
            \$(\"#print_req\").click(function(){ 
                \$(\"#print_req\").css(\"display\",\"none\"); 
                window.print();   
            }); 
        });
        </script>

    </head>
    <body style=\"padding: 0px;\"> 
        <section style=\"font-size:14px;'>

\t\t\t<div style=\"position:absolute; top:10px; left: 10px;\">
\t\t\t\t<input type=\"button\" value=\"Print\" id=\"print_req\" />
\t\t\t</div>
\t\t<div style=\"height: 60px\">
\t\t\t<div style=\"float: left; height: 200px;\">
\t\t\t\t<img src=\"";
        // line 25
        echo twig_escape_filter($this->env, $this->env->getExtension('assets')->getAssetUrl("bundles/dorcastabitha/images/dorcasLogoVertical.png"), "html", null, true);
        echo "\" alt=\"Dorcas\">
\t\t\t\t<h5>
\t\t\t\t\t187 High House Road<br />
\t\t\t\t\tCary, NC 27511<br />
\t\t\t\t</h5>
\t\t\t</div>

\t\t\t<div style=\"border:2px solid red; font-size:12px; float:right; padding:10px;\">
\t\t\t\t<center>Verification of Payment</center><br />
\t\t\t\tDate balance paid:________________ Counselor Initials:______<br /><br />
\t\t\t\tReceipt Number:__________________________________________<br /><br />
\t\t\t\tVendor Contact Name:_____________________________________
\t\t\t\t<br />
\t\t\t</div>
\t\t</div>
\t\t\t<br />&nbsp;<br />
\t\t\t<br />&nbsp;<br />
\t\t\t<br />&nbsp;<br />

\t\t\t<center><h2>Promissory Note</h2></center>
\t\t\t

\t\t\t<br />
\t\t\t<p style=\"line-height:180%; padding-left: 20px;\">
\t\t\t\t<strong>Date:</strong> ";
        // line 49
        echo twig_escape_filter($this->env, twig_date_format_filter($this->env, "now", "m/d/Y"), "html", null, true);
        echo "
\t\t\t\t<span style=\"padding-left:300px;\"><strong>Counselor:</strong> ";
        // line 50
        echo twig_escape_filter($this->env, $this->getAttribute($this->getContext($context, "promissory"), "counselor"), "html", null, true);
        echo "</span>
\t\t\t\t<br />
\t\t\t\t<strong>Client Name:</strong> ";
        // line 52
        echo twig_escape_filter($this->env, $this->getAttribute($this->getContext($context, "promissory"), "clientname"), "html", null, true);
        echo " 
\t\t\t\t<br />
\t\t\t\t<strong>Client Address:</strong> ";
        // line 54
        echo twig_escape_filter($this->env, $this->getAttribute($this->getContext($context, "promissory"), "clientaddress"), "html", null, true);
        echo "
\t\t\t\t<br />
\t\t\t\t
\t\t\t\t
\t\t\t\t<div style=\"border:1px solid;background-color:#cdf1f1; padding:20px; height:100px;\">
\t\t\t\t\t<strong>EXPIRATION DATE OF PROMISSORY NOTE:</strong> ";
        // line 59
        echo twig_escape_filter($this->env, twig_date_format_filter($this->env, $this->getAttribute($this->getContext($context, "promissory"), "expirationdate"), "m/d/Y"), "html", null, true);
        echo "
\t\t\t\t\t<br />
\t\t\t\t\t<div style=\"float: left; line-height: 150%;\">
\t\t\t\t\t\t\t\t
\t\t\t\t\t\t\t\t<span class = \"underline\"><strong>Balance for Client to Pay:</strong></span>
\t\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t\t\t<strong>Assistance Offered by Dorcas: </strong> 
\t\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t\t\t<strong>Amount Offered by Other Agency: </strong>
\t\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t\t\t<strong>Amount Offered by Other Agency: </strong>
\t\t\t\t\t\t\t\t<br />
\t\t\t\t\t</div>
\t\t\t\t\t<div style=\"float: left;line-height: 150%;padding-left: 20px;\">
\t\t\t\t\t\t\t\t
\t\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t\t\t ";
        // line 76
        echo twig_escape_filter($this->env, $this->getAttribute($this->getContext($context, "promissory"), "otherdesc"), "html", null, true);
        echo " 
\t\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t\t\t";
        // line 78
        echo twig_escape_filter($this->env, $this->getAttribute($this->getContext($context, "promissory"), "otherdesc2"), "html", null, true);
        echo " 
\t\t\t\t\t</div>
\t\t\t\t\t<div style=\"float: right; line-height:150%; width:28%;\">
\t\t\t\t\t\t\t\t
\t\t\t\t\t\t\t\t \$ ";
        // line 82
        echo twig_escape_filter($this->env, twig_number_format_filter($this->env, $this->getAttribute($this->getContext($context, "promissory"), "balanceclient"), 2, ".", ","), "html", null, true);
        echo "
\t\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t\t\t \$ ";
        // line 84
        echo twig_escape_filter($this->env, twig_number_format_filter($this->env, $this->getAttribute($this->getContext($context, "promissory"), "pledgedorcas"), 2, ".", ","), "html", null, true);
        echo "
\t\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t\t\t \$ ";
        // line 86
        echo twig_escape_filter($this->env, twig_number_format_filter($this->env, $this->getAttribute($this->getContext($context, "promissory"), "pledgeother"), 2, ".", ","), "html", null, true);
        echo " 
\t\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t\t\t\$ ";
        // line 88
        echo twig_escape_filter($this->env, twig_number_format_filter($this->env, $this->getAttribute($this->getContext($context, "promissory"), "pledgeother2"), 2, ".", ","), "html", null, true);
        echo " 
\t\t\t\t\t</div>
\t\t\t\t\t
\t\t\t\t</div>
\t\t\t\t
\t\t\t\t
\t\t\t\t
\t\t\t\t
\t\t\t\t<div style=\"padding:20px; height: 60px;\">
\t\t\t\t\t<strong>Type of Assistance (Rent, Water, Oasis, etc.):</strong> ";
        // line 97
        echo twig_escape_filter($this->env, $this->getAttribute($this->getContext($context, "promissory"), "checkpurpose"), "html", null, true);
        echo "
\t\t\t\t\t<br />
\t\t\t\t\t<strong>Account Number:</strong> ";
        // line 99
        echo twig_escape_filter($this->env, $this->getAttribute($this->getContext($context, "promissory"), "accountnumber"), "html", null, true);
        echo "
\t\t\t\t\t<br />
\t\t\t\t\t<strong>Vendor Name:</strong> ";
        // line 101
        echo twig_escape_filter($this->env, $this->getAttribute($this->getContext($context, "promissory"), "vendorname"), "html", null, true);
        echo "
\t\t\t\t\t<br />
\t\t\t\t\t<strong>Vendor Address:</strong> ";
        // line 103
        echo twig_escape_filter($this->env, $this->getAttribute($this->getContext($context, "promissory"), "vendoraddress"), "html", null, true);
        echo "
\t\t\t\t\t
\t\t\t\t</div>
\t\t\t\t
\t\t\t\t
\t\t\t</p>    
\t\t\t
\t\t\t
\t\t\t<div style=\"border:1px solid; padding: 14px;  font-size:12px;\">
\t\t\t\t<strong>Attention: This is NOT a pledge.</strong>  The client must pay the remaining balance 
\t\t\t\tby the <em><u>expiration date above</u></em> or this note will expire without further notice.
\t\t\t\t<br /><br />
\t\t\t\t<strong>LANDLORD or BUSINESS</strong> <em><u>must call</u></em> the Crisis Ministry Office by the expiration date to 
\t\t\t\tconfirm that the above balance has been paid.
\t\t\t\t<br /><br />
\t\t\t\t<strong>FOR PROGRESS ENERGY AND OTHER UTILITIES:</strong> The CLIENT <em><u>must call</u></em> Dorcas Ministries with their 
\t\t\t\treceipt number after making a payment.  For Progress Energy, pay: on-line, by phone, or in 
\t\t\t\tperson at an authorized payment center, such as the High House Food Mart (corner of Old Apex/High House Roads).
\t\t\t\t<br />
\t\t\t\t<center>CALL: 919-469-9861, ext 201</center>
\t\t\t\t<br />
\t\t\t\t<strong>NO CHECK WILL BE RELEASED WITHOUT CONFORMATION that the client paid their balance.</strong>
\t\t\t\tDorcas must also have verification that another agency has offered assistance.
\t\t\t\t
\t\t\t</div>

        </section>
\t\t\t<div id=\"footer\">
\t\t\t\t";
        // line 131
        $this->displayBlock('footer', $context, $blocks);
        // line 137
        echo "            </div>
    </body>
</html>



 
";
    }

    // line 131
    public function block_footer($context, array $blocks = array())
    {
        // line 132
        echo "\t\t\t\t&copy; 2012, Copyright JLS Consulting
\t\t\t\t\t\t<br>&nbsp;<br> 
\t\t\t\t\t\t <center><h8>Developed By:</h8></center>
\t\t\t\t\t\t <center><img src=\"";
        // line 135
        echo twig_escape_filter($this->env, $this->env->getExtension('assets')->getAssetUrl("bundles/dorcastabitha/images/jlsLogo_aqua.png"), "html", null, true);
        echo "\" alt=\"JLSConsulting\" /></center>                
\t\t\t\t";
    }

    public function getTemplateName()
    {
        return "DorcasTabithaBundle:Print:promissoryformprintable.html.twig";
    }

    public function isTraitable()
    {
        return false;
    }

    public function getDebugInfo()
    {
        return array (  225 => 135,  220 => 132,  217 => 131,  206 => 137,  204 => 131,  173 => 103,  168 => 101,  163 => 99,  158 => 97,  146 => 88,  141 => 86,  136 => 84,  131 => 82,  124 => 78,  119 => 76,  99 => 59,  91 => 54,  86 => 52,  81 => 50,  77 => 49,  50 => 25,  28 => 6,  24 => 5,  18 => 1,);
    }
}
