<template>
    <lightning-card>
        <div class="container">

            <div class="csr">
                <header>
                    <!-- header Start -->
                    <div class="slds-grid slds-wrap">
                        <div class="slds-col slds-size_2-of-12 slds-small-size_2-of-12 slds-medium-size_2-of-12 slds-large-size_2-of-12">
                            <span><img src={utahlogo} alt="utahlogo" /> </span>

                        </div>
                        <div class="slds-col slds-size_8-of-12 slds-small-size_8-of-12 slds-medium-size_8-of-12 slds-large-size_8-of-12 slds-border_right slds-border_left">
                            <span style="margin-left: 180px;">
                                Before the Utah State Tax Commission
                                <h1 style="margin-left: 100px;"><strong>Request for Redetermination of County Decision </strong></h1>
                            </span>
                        </div>

                        <div class="slds-col slds-size_2-of-12 slds-small-size_2-of-12 slds-medium-size_2-of-12 slds-large-size_2-of-12">
                            <span style="margin-left: 20px;">
                                <strong>TC-194</strong><br />
                                &nbsp; &nbsp; Rev. 9/20
                            </span>
                        </div>
                    </div>
                </header>
                <!-- header end -->

                <main>
                    <section>
                        <!-- section 1 Start -->
                        <div class="slds-grid slds-wrap">
                            <div class="slds-col slds-medium-size_5-of-12 slds-large-size_5-of-12 red">
                                <span> &nbsp;&nbsp; <strong> Owner/Taxpayer Information</strong></span>
                                <lightning-layout multiple-rows>
                                    <lightning-layout-item size="12" padding="around-small">
                                        <lightning-input type="text" label="Owner/Taxpayer "></lightning-input>
                                    </lightning-layout-item>
                                    <lightning-layout-item size="12" padding="around-small">
                                        <lightning-input-address
                                            address-label=" Mailing Address"
                                            street-label="Street"
                                            city-label="City"
                                            country-label="Country"
                                            province-label="Province"
                                            postal-code-label="PostalCode"
                                            street=""
                                            city=""
                                            country=""
                                            province=""
                                            postal-code=""
                                            required
                                            field-level-help="Help Text for inputAddress field"
                                        ></lightning-input-address>
                                    </lightning-layout-item>

                                    <lightning-layout-item size="12" padding="around-small">
                                        <lightning-input type="Phone Number" name="Input8" label="DayTime Phone Number"></lightning-input>
                                    </lightning-layout-item>
                                    <lightning-layout-item size="12" padding="around-small">
                                        <lightning-input type="Phone Number" name="Input9" label="Fax  Number"></lightning-input>
                                    </lightning-layout-item>
                                    <lightning-layout-item size="12" padding="around-small">
                                        <lightning-input type="Email" name="Input10" label="Email Address"></lightning-input>
                                    </lightning-layout-item>
                                    <lightning-layout-item size="6" padding="around-small"></lightning-layout-item>
                                    <lightning-input
                                        type="checkbox"
                                        label="If applicable, I authorize the person at right as my representative to discuss and share information concerning this appeal with the Utah State Tax Commission"
                                        name="input1"
                                    ></lightning-input>
                                </lightning-layout>
                            </div>

                            <div class="slds-col slds-medium-size_1-of-12 slds-large-size_1-of-12 green">
                                <span><div class="verticalOne"></div></span>
                            </div>

                            <div class="slds-col slds-medium-size_5-of-12 slds-large-size_5-of-12 blue">
                                <span><strong>&nbsp; Representative Information*</strong></span>
                                <lightning-layout multiple-rows>
                                    <lightning-layout-item size="12" padding="around-small">
                                       <lightning-input type="text" label="Representative Name "></lightning-input>
                                    </lightning-layout-item>   
                                    <lightning-layout-item size="12" padding="around-small">
                                        <lightning-input-address
                                            address-label="Mailing Address"
                                            street-label="Street"
                                            city-label="City"
                                            country-label="Country"
                                            province-label="Province"
                                            postal-code-label="PostalCode"
                                            street=""
                                            city=""
                                            country=""
                                            province=""
                                            postal-code=""
                                            required
                                            field-level-help="Help Text for inputAddress field"
                                        ></lightning-input-address>
                                    </lightning-layout-item>

                                    <lightning-layout-item size="12" padding="around-small">
                                        <lightning-input type="Phone Number" name="Input8" label="DayTime Phone Number"></lightning-input>
                                    </lightning-layout-item>
                                    <lightning-layout-item size="12" padding="around-small">
                                        <lightning-input type="Phone Number" name="Input9" label="Fax  Number"></lightning-input>
                                    </lightning-layout-item>
                                    <lightning-layout-item size="12" padding="around-small">
                                        <lightning-input type="Email" name="Input10" label="Email Address"></lightning-input>
                                    </lightning-layout-item>
                                </lightning-layout>
                            </div>
                        </div>
                    </section>
                    <!-- section 1 End -->

                    <section>
                        <!-- section 2 Start -->
                        <div style="margin-left: 180px;">
                            <strong>If you need help with this form, contact the Tax Commission, Appeals Unit at 801-297-3900</strong>
                        </div>
                    </section>
                    <!-- section 2 End -->

                    <section>
                        <!-- section 3 Start -->
                        <span><strong>&nbsp;&nbsp; Property Information</strong></span><br />
                        &nbsp;&nbsp; NOTE: You may use a single form for multiple parcels only if they share the same ownership and are related parcels. If more than one parcel, you must list all parcel numbers on this form

                        <lightning-layout multiple-rows>
                            <lightning-layout-item size="4" padding="around-small">
                                <p>
                                    Was this property was modified in any way during the calendar year prior to the tax year being appealed?
                                    <lightning-checkbox-group name="" label="" options={optionsYES} value={value} onchange={handleChange}></lightning-checkbox-group>
                                </p>
                            </lightning-layout-item>
                            <lightning-layout-item size="4" padding="around-small">
                                <lightning-input type="Text" name="Input1" label="If yes, describe the modification(s) (attach additional pages if necessary): "></lightning-input>
                            </lightning-layout-item>
                            <lightning-layout-item size="4" padding="around-small">
                                <lightning-input type="Number" name="Input1" label="Parcel Number"></lightning-input>
                            </lightning-layout-item>
                        </lightning-layout>

                        <lightning-layout multiple-rows>
                            <lightning-layout-item size="4" padding="around-small">
                                <lightning-input type="Date" name="Input1" label="Tax assessment year"></lightning-input>
                            </lightning-layout-item>
                            <lightning-layout-item size="4" padding="around-small">
                                <lightning-input type="Text" name="Input1" label="Country"></lightning-input>
                            </lightning-layout-item>
                            <lightning-layout-item size="4" padding="around-small">
                                <lightning-input type="Text" name="Input1" label="Location or address of property:"></lightning-input>
                            </lightning-layout-item>
                            <lightning-layout-item size="6" padding="around-small">
                                <lightning-checkbox-group name="Property Types:" label="Property Types" options={options} value={value} onchange={handleChange}></lightning-checkbox-group>
                            </lightning-layout-item>
                            <lightning-layout-item size="6" padding="around-small">
                                <lightning-checkbox-group name="Primary Reason For Appeal:" label="Primary Reason For Appeal:" options={optionsPrimary} value={value} onchange={handleChange}></lightning-checkbox-group>
                            </lightning-layout-item>
                        </lightning-layout>

                        &nbsp;&nbsp; NOTE: If contesting the county’s determination of fair market value, you must provide information to establish the fair market value of your property on January 1 of the year you are appealing.
                    </section>
                    <!-- section 3 End -->

                    <section class="horizontal">
                        <!-- section 4 Start -->
                        <strong>Burden of Proof</strong>
                        <span>
                            If the property is not a qualified real property, the burden of proof lies with the taxpayer, unless the county assessor or county Board of Equalization (BOE ) asserts a greater fair market value than the value
                            given to the property by the county BOE. In that instance, the county assessor or county BOE carries the burden of proof. If both parties argue against the value given to the property by the county BOE, both
                            parties carry the burden of proof. If the property is a qualified real property, the burden of proof lies with the county assessor or county BOE if they assert a fair market value equal to or greater than the
                            inflation adjusted value, which is presumed to equal fair market value. If the taxpayer asserts a lower fair market value than the inflation adjusted value, the burden of proof lies with the taxpayer. If both
                            parties argue against the inflation adjusted value, both parties carry the burden of proof.
                            <h1><strong> Requirements & Signature - </strong> Check all boxes and sign</h1>
                            <lightning-layout multiple-rows>
                                <lightning-layout-item size="4" padding="around-small">
                                    <lightning-input type="checkbox" label="I understand I must complete this form and file it with the County Auditor within 30 days after the date of the county decision" name="input1"></lightning-input>
                                </lightning-layout-item>
                                <lightning-layout-item size="4" padding="around-small">
                                    <lightning-input
                                        type="checkbox"
                                        label="I understand my appeal may be set for mediation and I will have the option to participate in mediation or proceed to a hearing. 
    Check here if you may want to participate in those proceedings by telephone."
                                        name="input2"
                                    ></lightning-input>
                                </lightning-layout-item>
                                <lightning-layout-item size="4" padding="around-small">
                                    <lightning-input
                                        type="checkbox"
                                        label="I understand if I proceed to a hearing I must provide information supporting my position to the county and to the Utah State Tax 
    Commission Appeals Unit 10 business days before the scheduled hearing and that notice of the scheduled hearing date with 
    addresses for the county and the Appeals Unit will be mailed to me. I further understand if my information is not provided as 
    directed, my information might not be accepted at the hearing."
                                        name="input3"
                                    ></lightning-input>
                                </lightning-layout-item>
                                <lightning-layout-item size="4" padding="around-small">
                                    <lightning-input type="Text" name="Input1" label="Owner/Taxpayer name (print)"></lightning-input>
                                </lightning-layout-item>
                                <lightning-layout-item size="4" padding="around-small">
                                    <lightning-input type="Text" name="Input1" label="Signature"></lightning-input>
                                </lightning-layout-item>
                                <lightning-layout-item size="4" padding="around-small">
                                    <lightning-input type="Date" name="Input1" label="Date"></lightning-input>
                                </lightning-layout-item>
                            </lightning-layout>
                        </span>
                    </section>
                    <!-- section 4 End -->
                </main>

                <footer class="csr-footer">
                    <lightning-button class="btnpad" label="Submit" title="Submit"></lightning-button>
                </footer>
            </div>
        </div>
    </lightning-card>
</template> 

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