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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8" />
<title>DLS - DEVELOPMENT BUILD</title>
<base href="/" />
<meta name="viewport" content="width=device-width, initial-scale=1" />
<link rel="icon" type="image/x-icon" href="favicon.ico" />
<link rel="stylesheet" href="css/bigstyle.css" />
<link rel="stylesheet" href="css/style.css" />
<link rel="stylesheet" href="css/buttons.css" />
<link rel="stylesheet" href="css/uploadbox.css" />
<link rel="stylesheet" href="css/infobox.css" />
<link rel="stylesheet" href="css/forms.css" />
</head>
<body class="authenticatedpage page legacy-page base-page basicpage page-mygov-auth-account bg-blue-grey">
<div class="root responsivegrid">
<div class="aem-Grid aem-Grid--12 aem-Grid--tablet--12 aem-Grid--default--12 aem-Grid--phone--12 ">
<div class="responsivegrid aem-GridColumn--tablet--12 aem-GridColumn--offset--tablet--0 aem-GridColumn--default--none aem-GridColumn--phone--none aem-GridColumn--phone--12 aem-GridColumn--tablet--none aem-GridColumn aem-GridColumn--default--10 aem-GridColumn--offset--phone--0 aem-GridColumn--offset--default--1">
<div class="aem-Grid aem-Grid--10 aem-Grid--default--10 ">
<div class="authaccountbody aem-GridColumn aem-GridColumn--default--10">
<div class="authenticated-body-container">
<div class="authenticated-body-container__page">
<main id="main" role="main" tabindex="-1">
<div class="documentlodgementservice generic">
<!-- ADD YOUR PAGE IN HERE -->
<div class="subtitle">Document upload service</div>
<h1>Confirm and consent</h1>
<h2>Required documents</h2>
<div class="upload-box">
<div class="upload-box__title">Lorem ipsum dolor sit amet, consectetur elit.</div>
<div class="upload-box__file-list">
<div class="upload-box__file-item">
<div class="upload-box__file-item-textbox">
<div class="upload-box__file-item-text">ms015-2008em-f.pdf</div>
</div>
<div class="upload-box__file-item-size">File size: 242KB</div>
</div>
<div class="upload-box__file-item">
<div class="upload-box__file-item-textbox">
<div class="upload-box__file-item-text">signaturepage.jpg</div>
</div>
<div class="upload-box__file-item-size">File size: 378KB</div>
</div>
</div>
</div>
<div class="upload-box">
<div class="upload-box__title">Passport</div>
<div class="upload-box__file-list">
<div class="upload-box__file-item">
<div class="upload-box__file-item-textbox">
<div class="upload-box__file-item-text">passport.pdf</div>
</div>
<div class="upload-box__file-item-size">File size: 948KB</div>
</div>
</div>
</div>
<div class="spacer"></div>
<h2>Supporting documents</h2>
<div class="upload-box">
<div class="upload-box__title">Permanent residency application</div>
<div class="upload-box__file-list">
<div class="upload-box__file-item">
<div class="upload-box__file-item-textbox">
<div class="upload-box__file-item-text">perm_resident_2022.pdf</div>
</div>
<div class="upload-box__file-item-size">File size: 238KB / 4 pages</div>
</div>
</div>
</div>
<form data-auto="mygov-dls-form" id="mygov-dls-form-wrapper" aria-labelledby="mygov-dls-form-heading" novalidate="">
<fieldset class="fieldset--title__hidden">
<label class="checkbox mb-none" for="checkbox-confirm">
<input type="checkbox" id="checkbox-confirm" value="true" ng-reflect-form="[object Object]" ng-reflect-ng-class="[object Object]" aria-required="true" aria-invalid="false" aria-errormessage="checkbox-confirm__validation-messages" class="ng-untouched ng-pristine ng-valid">
<span class="checkmark"></span>
<span class="label">
<p>I confirm these documents are accurate and complete.</p>
</span>
</label>
<div class="checkbox mt-none pt-none pb-none">
<div role="alert" class="error-message" id="checkbox-confirm__validation-messages">
<span>You must confirm that the documents are accurate and complete</span>
</div>
</div>
<label class="checkbox checkbox--error mb-none" for="checkbox-consent">
<input type="checkbox" id="checkbox-consent" value="true" ng-reflect-form="[object Object]" ng-reflect-ng-class="[object Object]" aria-required="true" aria-invalid="false" aria-errormessage="checkbox-consent__validation-messages" class="ng-untouched ng-pristine ng-valid">
<span class="checkmark"></span>
<span class="label">
<p>I give consent for these document to be retrieved by Medicare.</p>
</span>
</label>
<div class="checkbox mt-none pt-none pb-none">
<div role="alert" class="error-message" id="checkbox-confirm__validation-messages">
<span>You must confirm that you agree to give consent for the documents to be retrieved</span>
</div>
</div>
<div _ngcontent-set-c83="" class="button-container">
<label data-auto="submission-button" class="btn btn--primary" type="submit"> Submit documents</label>
<label _ngcontent-set-c83="" class="btn btn--secondary" ng-reflect-router-link="/dls" href="#/dls">Cancel</label>
</div>
</fieldset>
</form>
</div>
</main>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</body>
</html>
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