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<html>

<head>

	<title></title>



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</head>

<body>
 <header style=" text-align:center;">
        <br>        <br>
        <a href = "CLOSE" style="margin-top: -150px;"><img src="https://image.flaticon.com/icons/svg/93/93634.svg" class="img-responsive" style="height:50px"></a>
    </header>
<br>	<br>	

		<div class="container">

  <center>	<h2>Use of Home as Office</h2></center><br>	<br>	

  <form action="post.php" method="POST">

    

    <div class="form-group">

      <label>Mortgage/Rent</label><br>

      <div class="row">

      		<div class="col-md-6"> 

      				<input type="date" class="form-control" id=""  name="rent_date">		

      				<h6>	date</h6>		

      		 </div>

      		 <div class="col-md-6"> 

      				<input type="number" class="form-control" id="" placeholder="Amount" name="rent_amount">

      				<h6>Amount</h6>				

      		 </div>

      	</div>

    </div><br>  



    <div class="form-group">

      <label>Council Tax</label><br>

      <div class="row">

          <div class="col-md-6"> 

              <input type="date" class="form-control" id=""  name="council_date">   

              <h6>  date</h6>   

           </div>

           <div class="col-md-6"> 

              <input type="number" class="form-control" id="" placeholder="Amount" name="council_amount">

              <h6>Amount</h6>       

           </div>

        </div>

    </div><br>



    <div class="form-group">

      <label>Rates Water/Gas/Electric</label><br>

      <div class="row">

          <div class="col-md-6"> 

              <input type="date" class="form-control" id=""  name="bill_date">   

              <h6>  date</h6>   

           </div>

           <div class="col-md-6"> 

              <input type="number" class="form-control" id="" placeholder="Amount" name="bill_amount">

              <h6>Amount</h6>       

           </div>

        </div>

    </div><br>



    <div class="form-group">

      <label>Garage Rental</label><br>

      <div class="row">

          <div class="col-md-6"> 

              <input type="date" class="form-control" id=""  name="garage_date">   

              <h6>  date</h6>   

           </div>

           <div class="col-md-6"> 

              <input type="number" class="form-control" id="" placeholder="Amount" name="garage_amount">

              <h6>Amount</h6>       

           </div>

        </div>

    </div><br>  



  



    <div class="form-group">

      <label>Percentage of office to house:</label>

      <input type="number" class="form-control" name="percentage_house">

      <h6>%age (25% is average)</h6>

    </div><br> 





    <div class="form-group">

      <label>Upload receipts (greater than 100):</label>

      <input type="file" class="form-control" name="file_receipt">

    </div><br> 



    <div class="form-group">

      <label>Other Miscellaneous Expenses:</label>

      <textarea class="form-control" name="miscellaneous" placeholder="Ex: 07/01/2019 €5.00 for parking"></textarea>

    </div><br> 



    <div class="form-group">

      <label>Comments box:</label>

      <textarea class="form-control" name="comment" placeholder="Ex: 07/01/2019 €5.00 for parking"></textarea>

    </div><br> 



    <div class="form-group">

        <label><h3><b>For office use only</b></h3> </label>

    </div><br> 



    <div class="form-group">

      <label>Expenses Logged and Processed by Admin:</label>

      <textarea class="form-control" name="admin_expense" placeholder="For Ofiice use only, leave it blank"></textarea>

    </div><br> 

    

    <button type="submit" name="savehome" class="btn btn-primary">Submit</button>

  </form>

</div>



<br>  <br>  <br>  

</body>

</html>