<?xml version="1.0" encoding="utf-8"?>
<odoo>

    <!-- ============================================================ -->
    <!-- PAYROLL REGISTER REPORT                                       -->
    <!-- ============================================================ -->
    <record id="action_report_payroll_register" model="ir.actions.report">
        <field name="name">Payroll Register</field>
        <field name="model">hr.payslip.run</field>
        <field name="report_type">qweb-pdf</field>
        <field name="report_name">fusion_payroll.report_payroll_register_document</field>
        <field name="report_file">fusion_payroll.report_payroll_register_document</field>
        <field name="binding_model_id" ref="hr_payroll.model_hr_payslip_run"/>
        <field name="binding_type">report</field>
    </record>

    <template id="report_payroll_register_document">
        <t t-call="web.html_container">
            <t t-foreach="docs" t-as="o">
                <t t-call="web.external_layout">
                    <div class="page">
                        <h2 class="text-center">Payroll Register</h2>
                        <h4 class="text-center text-muted"><t t-out="o.name"/></h4>
                        
                        <div class="row mb-4">
                            <div class="col-6">
                                <strong>Company:</strong> <t t-out="o.company_id.name"/>
                            </div>
                            <div class="col-6 text-end">
                                <strong>Period:</strong> <t t-out="o.date_start"/> to <t t-out="o.date_end"/>
                            </div>
                        </div>

                        <table class="table table-sm table-bordered">
                            <thead class="table-dark">
                                <tr>
                                    <th>Employee</th>
                                    <th class="text-end">Gross Pay</th>
                                    <th class="text-end">CPP</th>
                                    <th class="text-end">EI</th>
                                    <th class="text-end">Income Tax</th>
                                    <th class="text-end">Deductions</th>
                                    <th class="text-end">Net Pay</th>
                                </tr>
                            </thead>
                            <tbody>
                                <t t-set="total_gross" t-value="0"/>
                                <t t-set="total_cpp" t-value="0"/>
                                <t t-set="total_ei" t-value="0"/>
                                <t t-set="total_tax" t-value="0"/>
                                <t t-set="total_net" t-value="0"/>
                                <t t-foreach="o.slip_ids" t-as="slip">
                                    <t t-set="total_gross" t-value="total_gross + slip.gross_wage"/>
                                    <t t-set="total_cpp" t-value="total_cpp + slip.employee_cpp"/>
                                    <t t-set="total_ei" t-value="total_ei + slip.employee_ei"/>
                                    <t t-set="total_tax" t-value="total_tax + slip.employee_income_tax"/>
                                    <t t-set="total_net" t-value="total_net + slip.net_wage"/>
                                    <tr>
                                        <td><t t-out="slip.employee_id.name"/></td>
                                        <td class="text-end"><t t-out="slip.gross_wage" t-options="{'widget': 'monetary', 'display_currency': slip.currency_id}"/></td>
                                        <td class="text-end"><t t-out="slip.employee_cpp" t-options="{'widget': 'monetary', 'display_currency': slip.currency_id}"/></td>
                                        <td class="text-end"><t t-out="slip.employee_ei" t-options="{'widget': 'monetary', 'display_currency': slip.currency_id}"/></td>
                                        <td class="text-end"><t t-out="slip.employee_income_tax" t-options="{'widget': 'monetary', 'display_currency': slip.currency_id}"/></td>
                                        <td class="text-end"><t t-out="slip.total_employee_deductions" t-options="{'widget': 'monetary', 'display_currency': slip.currency_id}"/></td>
                                        <td class="text-end"><t t-out="slip.net_wage" t-options="{'widget': 'monetary', 'display_currency': slip.currency_id}"/></td>
                                    </tr>
                                </t>
                            </tbody>
                            <tfoot class="table-secondary fw-bold">
                                <tr>
                                    <td>TOTALS (<t t-out="len(o.slip_ids)"/> employees)</td>
                                    <td class="text-end"><t t-out="total_gross" t-options="{'widget': 'monetary', 'display_currency': o.slip_ids[:1].currency_id}"/></td>
                                    <td class="text-end"><t t-out="total_cpp" t-options="{'widget': 'monetary', 'display_currency': o.slip_ids[:1].currency_id}"/></td>
                                    <td class="text-end"><t t-out="total_ei" t-options="{'widget': 'monetary', 'display_currency': o.slip_ids[:1].currency_id}"/></td>
                                    <td class="text-end"><t t-out="total_tax" t-options="{'widget': 'monetary', 'display_currency': o.slip_ids[:1].currency_id}"/></td>
                                    <td class="text-end">-</td>
                                    <td class="text-end"><t t-out="total_net" t-options="{'widget': 'monetary', 'display_currency': o.slip_ids[:1].currency_id}"/></td>
                                </tr>
                            </tfoot>
                        </table>

                        <!-- Employer Contributions Summary -->
                        <h5 class="mt-4">Employer Contributions</h5>
                        <table class="table table-sm" style="width: 50%;">
                            <t t-set="total_er_cpp" t-value="sum(o.slip_ids.mapped('employer_cpp'))"/>
                            <t t-set="total_er_ei" t-value="sum(o.slip_ids.mapped('employer_ei'))"/>
                            <tr>
                                <td>Employer CPP</td>
                                <td class="text-end"><t t-out="total_er_cpp" t-options="{'widget': 'monetary', 'display_currency': o.slip_ids[:1].currency_id}"/></td>
                            </tr>
                            <tr>
                                <td>Employer EI (1.4x)</td>
                                <td class="text-end"><t t-out="total_er_ei" t-options="{'widget': 'monetary', 'display_currency': o.slip_ids[:1].currency_id}"/></td>
                            </tr>
                            <tr class="fw-bold">
                                <td>Total Employer Cost</td>
                                <td class="text-end"><t t-out="total_er_cpp + total_er_ei" t-options="{'widget': 'monetary', 'display_currency': o.slip_ids[:1].currency_id}"/></td>
                            </tr>
                        </table>

                        <!-- Remittance Summary -->
                        <h5 class="mt-4">CRA Remittance Summary</h5>
                        <table class="table table-sm table-bordered" style="width: 50%;">
                            <tr>
                                <td>Employee CPP</td>
                                <td class="text-end"><t t-out="total_cpp" t-options="{'widget': 'monetary', 'display_currency': o.slip_ids[:1].currency_id}"/></td>
                            </tr>
                            <tr>
                                <td>Employer CPP</td>
                                <td class="text-end"><t t-out="total_er_cpp" t-options="{'widget': 'monetary', 'display_currency': o.slip_ids[:1].currency_id}"/></td>
                            </tr>
                            <tr>
                                <td>Employee EI</td>
                                <td class="text-end"><t t-out="total_ei" t-options="{'widget': 'monetary', 'display_currency': o.slip_ids[:1].currency_id}"/></td>
                            </tr>
                            <tr>
                                <td>Employer EI</td>
                                <td class="text-end"><t t-out="total_er_ei" t-options="{'widget': 'monetary', 'display_currency': o.slip_ids[:1].currency_id}"/></td>
                            </tr>
                            <tr>
                                <td>Income Tax Withheld</td>
                                <td class="text-end"><t t-out="total_tax" t-options="{'widget': 'monetary', 'display_currency': o.slip_ids[:1].currency_id}"/></td>
                            </tr>
                            <tr class="fw-bold table-warning">
                                <td>TOTAL TO REMIT</td>
                                <td class="text-end"><t t-out="total_cpp + total_er_cpp + total_ei + total_er_ei + total_tax" t-options="{'widget': 'monetary', 'display_currency': o.slip_ids[:1].currency_id}"/></td>
                            </tr>
                        </table>

                        <div class="text-muted small mt-4">
                            <p>Generated on <t t-out="datetime.datetime.now().strftime('%Y-%m-%d %H:%M')"/></p>
                        </div>
                    </div>
                </t>
            </t>
        </t>
    </template>

    <!-- ============================================================ -->
    <!-- REMITTANCE SUMMARY REPORT                                     -->
    <!-- ============================================================ -->
    <record id="action_report_remittance_summary" model="ir.actions.report">
        <field name="name">Remittance Summary</field>
        <field name="model">hr.tax.remittance</field>
        <field name="report_type">qweb-pdf</field>
        <field name="report_name">fusion_payroll.report_remittance_summary_document</field>
        <field name="report_file">fusion_payroll.report_remittance_summary_document</field>
        <field name="binding_model_id" ref="fusion_payroll.model_hr_tax_remittance"/>
        <field name="binding_type">report</field>
    </record>

    <template id="report_remittance_summary_document">
        <t t-call="web.html_container">
            <t t-foreach="docs" t-as="o">
                <t t-call="web.external_layout">
                    <div class="page">
                        <h2 class="text-center">CRA Remittance Summary</h2>
                        <h4 class="text-center text-muted"><t t-out="o.name"/></h4>

                        <div class="row mb-4">
                            <div class="col-6">
                                <strong>Company:</strong> <t t-out="o.company_id.name"/><br/>
                                <strong>Period:</strong> <t t-out="o.period_start"/> to <t t-out="o.period_end"/>
                            </div>
                            <div class="col-6 text-end">
                                <strong>Due Date:</strong> <t t-out="o.due_date"/><br/>
                                <strong>Status:</strong> <t t-out="o.state"/>
                            </div>
                        </div>

                        <table class="table table-bordered">
                            <thead class="table-dark">
                                <tr>
                                    <th>Description</th>
                                    <th class="text-end">Amount</th>
                                </tr>
                            </thead>
                            <tbody>
                                <tr>
                                    <td>Canada Pension Plan - Employee</td>
                                    <td class="text-end"><t t-out="o.cpp_employee" t-options="{'widget': 'monetary', 'display_currency': o.currency_id}"/></td>
                                </tr>
                                <tr>
                                    <td>Canada Pension Plan - Employer</td>
                                    <td class="text-end"><t t-out="o.cpp_employer" t-options="{'widget': 'monetary', 'display_currency': o.currency_id}"/></td>
                                </tr>
                                <tr t-if="o.cpp2_employee">
                                    <td>CPP2 - Employee</td>
                                    <td class="text-end"><t t-out="o.cpp2_employee" t-options="{'widget': 'monetary', 'display_currency': o.currency_id}"/></td>
                                </tr>
                                <tr t-if="o.cpp2_employer">
                                    <td>CPP2 - Employer</td>
                                    <td class="text-end"><t t-out="o.cpp2_employer" t-options="{'widget': 'monetary', 'display_currency': o.currency_id}"/></td>
                                </tr>
                                <tr>
                                    <td>Employment Insurance - Employee</td>
                                    <td class="text-end"><t t-out="o.ei_employee" t-options="{'widget': 'monetary', 'display_currency': o.currency_id}"/></td>
                                </tr>
                                <tr>
                                    <td>Employment Insurance - Employer (1.4x)</td>
                                    <td class="text-end"><t t-out="o.ei_employer" t-options="{'widget': 'monetary', 'display_currency': o.currency_id}"/></td>
                                </tr>
                                <tr>
                                    <td>Income Tax Withheld</td>
                                    <td class="text-end"><t t-out="o.income_tax" t-options="{'widget': 'monetary', 'display_currency': o.currency_id}"/></td>
                                </tr>
                            </tbody>
                            <tfoot class="table-warning fw-bold fs-5">
                                <tr>
                                    <td>TOTAL REMITTANCE</td>
                                    <td class="text-end"><t t-out="o.total" t-options="{'widget': 'monetary', 'display_currency': o.currency_id}"/></td>
                                </tr>
                            </tfoot>
                        </table>

                        <div class="mt-4" t-if="o.payment_date">
                            <h5>Payment Information</h5>
                            <table class="table table-sm" style="width: 50%;">
                                <tr><td>Payment Date:</td><td><t t-out="o.payment_date"/></td></tr>
                                <tr><td>Payment Method:</td><td><t t-out="o.payment_method or '-'"/></td></tr>
                                <tr><td>Reference:</td><td><t t-out="o.payment_reference or '-'"/></td></tr>
                            </table>
                        </div>

                        <div class="text-muted small mt-4">
                            <p>Generated on <t t-out="datetime.datetime.now().strftime('%Y-%m-%d %H:%M')"/></p>
                        </div>
                    </div>
                </t>
            </t>
        </t>
    </template>

    <!-- ============================================================ -->
    <!-- EMPLOYEE DIRECTORY REPORT                                     -->
    <!-- ============================================================ -->
    <record id="action_report_employee_directory_pdf" model="ir.actions.report">
        <field name="name">Employee Directory (Canada)</field>
        <field name="model">hr.employee</field>
        <field name="report_type">qweb-pdf</field>
        <field name="report_name">fusion_payroll.report_employee_directory_document</field>
        <field name="report_file">fusion_payroll.report_employee_directory_document</field>
        <field name="binding_model_id" ref="hr.model_hr_employee"/>
        <field name="binding_type">report</field>
    </record>

    <template id="report_employee_directory_document">
        <t t-call="web.html_container">
            <t t-call="web.external_layout">
                <div class="page">
                    <h2 class="text-center">Employee Directory</h2>
                    <h4 class="text-center text-muted"><t t-out="docs[0].company_id.name if docs else ''"/></h4>

                    <table class="table table-sm table-striped">
                        <thead class="table-dark">
                            <tr>
                                <th>Employee ID</th>
                                <th>Name</th>
                                <th>Department</th>
                                <th>Status</th>
                                <th>Hire Date</th>
                                <th>Pay Schedule</th>
                            </tr>
                        </thead>
                        <tbody>
                            <t t-foreach="docs" t-as="emp">
                                <tr>
                                    <td><t t-out="emp.employee_number or '-'"/></td>
                                    <td><t t-out="emp.name"/></td>
                                    <td><t t-out="emp.department_id.name or '-'"/></td>
                                    <td>
                                        <span t-if="emp.employment_status == 'active'" class="badge bg-success">Active</span>
                                        <span t-if="emp.employment_status == 'on_leave'" class="badge bg-warning">On Leave</span>
                                        <span t-if="emp.employment_status == 'terminated'" class="badge bg-danger">Terminated</span>
                                    </td>
                                    <td><t t-out="emp.hire_date"/></td>
                                    <td><t t-out="emp.pay_schedule or '-'"/></td>
                                </tr>
                            </t>
                        </tbody>
                    </table>

                    <div class="text-muted small mt-4">
                        <p>Total Employees: <t t-out="len(docs)"/></p>
                        <p>Generated on <t t-out="datetime.datetime.now().strftime('%Y-%m-%d %H:%M')"/></p>
                    </div>
                </div>
            </t>
        </t>
    </template>

    <!-- ============================================================ -->
    <!-- RECORD OF EMPLOYMENT (ROE) REPORT                            -->
    <!-- ============================================================ -->
    
    <!-- Custom paperformat for ROE with no header/footer margins -->
    <record id="paperformat_roe" model="report.paperformat">
        <field name="name">ROE Letter Format</field>
        <field name="default" eval="False"/>
        <field name="format">Letter</field>
        <field name="page_height">0</field>
        <field name="page_width">0</field>
        <field name="orientation">Portrait</field>
        <field name="margin_top">11</field>
        <field name="margin_bottom">11</field>
        <field name="margin_left">9</field>
        <field name="margin_right">9</field>
        <field name="header_line" eval="False"/>
        <field name="header_spacing">0</field>
        <field name="dpi">90</field>
    </record>
    
    <record id="action_report_roe" model="ir.actions.report">
        <field name="name">Record of Employment (ROE)</field>
        <field name="model">hr.roe</field>
        <field name="report_type">qweb-pdf</field>
        <field name="report_name">fusion_payroll.report_roe_document</field>
        <field name="report_file">fusion_payroll.report_roe_document</field>
        <field name="binding_model_id" ref="fusion_payroll.model_hr_roe"/>
        <field name="binding_type">report</field>
        <field name="paperformat_id" ref="paperformat_roe"/>
    </record>

    <!-- ROE Report Template - Matches provided HTML exactly -->
    <template id="report_roe_document">
        <t t-call="web.html_container">
            <style>
                @page {
                    size: letter;
                    margin: 0.45in 0.35in;
                }
                * {
                    box-sizing: border-box !important;
                    page-break-inside: avoid !important;
                }
                body, html, .o_body_html, #wrapwrap, main, .page, .article {
                    font-family: Arial, sans-serif !important;
                    margin: 0 !important;
                    padding: 0 !important;
                    position: relative !important;
                }
                .roe-wrapper {
                    position: relative !important;
                    width: 100% !important;
                }
                .roe-form {
                    border: 2px solid black !important;
                    position: relative !important;
                    width: 100% !important;
                    page-break-inside: avoid !important;
                    page-break-after: avoid !important;
                    page-break-before: avoid !important;
                }
                .header {
                    background-color: #000 !important;
                    color: #fff !important;
                    padding: 4px 8px !important;
                    font-weight: bold !important;
                    font-size: 12px !important;
                    position: relative !important;
                    z-index: 1 !important;
                    opacity: 1 !important;
                }
                .roe-form table {
                    width: 100% !important;
                    border-collapse: collapse !important;
                    page-break-inside: avoid !important;
                }
                .roe-form table td {
                    border: 1px solid black !important;
                    padding: 1px !important;
                    vertical-align: top !important;
                }
                .field-label, div.field-label, .roe-wrapper .field-label, .roe-form .field-label {
                    background-color: #666 !important;
                    color: #fff !important;
                    font-size: 8px !important;
                    font-weight: bold !important;
                    padding: 3px 3px !important;
                    line-height: 1.2 !important;
                    display: block !important;
                    vertical-align: top !important;
                    width: 100% !important;
                    margin: 0 !important;
                }
                .field-number, div.field-number, .roe-wrapper .field-number, .roe-form .field-number {
                    background-color: #000 !important;
                    color: #fff !important;
                    font-weight: bold !important;
                    padding: 3px 3px !important;
                    font-size: 8px !important;
                    display: inline-block !important;
                    vertical-align: top !important;
                    line-height: 1.2 !important;
                    margin: 0 !important;
                    margin-right: 0 !important;
                }
                .small-text {
                    font-size: 7px !important;
                    line-height: 1.1 !important;
                }
                .date-boxes {
                    display: inline-flex !important;
                    gap: 1px !important;
                    align-items: center !important;
                    margin-top: 0px !important;
                    margin-bottom: 0px !important;
                }
                .date-box, div.date-box, .roe-wrapper .date-box, .roe-form .date-box {
                    border: 1px solid black !important;
                    width: 16px !important;
                    height: 16px !important;
                    text-align: center !important;
                    font-size: 11.5px !important;
                    line-height: 16px !important;
                    display: inline-block !important;
                }
                .earnings-table {
                    width: 100% !important;
                    font-size: 12px !important;
                    border-collapse: separate !important;
                    border-spacing: 0 !important;
                }
                .earnings-table td {
                    text-align: center !important;
                    padding: 2px !important;
                    border: 1px solid black !important;
                }
                .pp-col {
                    width: 24px !important;
                }
                .footer-note {
                    font-size: 10.5px !important;
                    padding: 3px !important;
                }
                .checkbox {
                    display: inline-block !important;
                    width: 11px !important;
                    height: 11px !important;
                    border: 1px solid black !important;
                    margin-right: 3px !important;
                    text-align: center !important;
                    vertical-align: middle !important;
                    line-height: 11px !important;
                    font-size: 9px !important;
                    padding: 0 !important;
                }
                body, html, .o_body_html, #wrapwrap, main, .page, .article {
                    position: relative !important;
                    z-index: 1 !important;
                }
                .roe-wrapper, .roe-form, .roe-form * {
                    position: relative !important;
                    z-index: 1 !important;
                }
                /* Ensure title styling */
                .header, div[style*="RECORD OF EMPLOYMENT"], div[style*="background-color: #000"][style*="RECORD"] {
                    position: relative !important;
                    z-index: 1 !important;
                    opacity: 1 !important;
                    background-color: #000 !important;
                    color: #fff !important;
                    mix-blend-mode: normal !important;
                }
                @media print {
                    body, html {
                        margin: 0 !important;
                    }
                    * {
                        page-break-inside: avoid !important;
                    }
                    .roe-form {
                        page-break-inside: avoid !important;
                        page-break-after: avoid !important;
                        page-break-before: avoid !important;
                    }
                    body, html, .o_body_html, #wrapwrap, main, .page, .article {
                        z-index: 1 !important;
                    }
                    .roe-wrapper, .roe-form, .roe-form * {
                        z-index: 1 !important;
                    }
                /* Ensure title styling */
                .header, div[style*="RECORD OF EMPLOYMENT"], div[style*="background-color: #000"][style*="RECORD"] {
                    position: relative !important;
                    z-index: 1 !important;
                    opacity: 1 !important;
                    background-color: #000 !important;
                    color: #fff !important;
                }
                }
            </style>
            <t t-foreach="docs" t-as="o">
                <t t-set="ppt" t-value="{'W':'Weekly','B':'Bi-weekly','S':'Semi-monthly','M':'Monthly','T':'13 Pay Periods'}"/>
                <t t-set="rc" t-value="{'A':'A - Shortage of Work','B':'B - Strike or Lockout','C':'C - Return to School','D':'D - Illness or Injury','E':'E - Quit','F':'F - Maternity','G':'G - Retirement','H':'H - Work Sharing','J':'J - Apprentice Training','K':'K - Other','M':'M - Dismissal','N':'N - Leave of Absence','P':'P - Parental','Z':'Z - Compassionate Care'}"/>
                <t t-set="ed" t-value="{pp.sequence: pp.amount for pp in o.pay_period_earnings_ids}"/>
                <t t-set="td" t-value="datetime.datetime.now()"/>
                <div style="position: relative; width: 100%;">
                    <div style="border: 2px solid black; position: relative; width: 100%;">
                        <div style="background-color: #000 !important; color: #fff !important; padding: 4px 8px; font-weight: bold; font-size: 12px; position: relative !important; z-index: 1 !important; opacity: 1 !important; mix-blend-mode: normal !important;">RECORD OF EMPLOYMENT (ROE)</div>
                        <table style="border-collapse: collapse; width: 100%;">
                            <tr>
                                <td style="width: 33%; border: 1px solid black; padding: 1px; vertical-align: top;">
                                    <div style="display: table; width: 100%; border-collapse: collapse;">
                                        <div style="display: table-row;">
                                            <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">1</div>
                                            <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">SERIAL NO.</div>
                                        </div>
                                    </div>
                                    <div style="padding: 2px 8px; font-size: 12px;">N/A*</div>
                                </td>
                                <td style="width: 33%; border: 1px solid black; padding: 1px; vertical-align: top;">
                                    <div style="display: table; width: 100%; border-collapse: collapse;">
                                        <div style="display: table-row;">
                                            <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">2</div>
                                            <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">SERIAL NO. OF ROE AMENDED OR REPLACED</div>
                                        </div>
                                    </div>
                                    <div style="padding: 2px 8px; font-size: 12px;">N/A*</div>
                                </td>
                                <td style="width: 34%; border: 1px solid black; padding: 1px; vertical-align: top;">
                                    <div style="display: table; width: 100%; border-collapse: collapse;">
                                        <div style="display: table-row;">
                                            <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">3</div>
                                            <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">EMPLOYER'S PAYROLL REFERENCE NO.</div>
                                        </div>
                                    </div>
                                    <div style="padding: 2px 8px; font-size: 12px;"><t t-out="o.employee_id.employee_number or ''"/></div>
                                </td>
                            </tr>
                        </table>

                        <table style="border-collapse: collapse; width: 100%;">
                            <tr>
                                <td style="width: 66%; border: 1px solid black; padding: 1px; vertical-align: top;">
                                    <div style="display: table; width: 100%; border-collapse: collapse;">
                                        <div style="display: table-row;">
                                            <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">4</div>
                                            <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">EMPLOYER'S NAME AND ADDRESS</div>
                                        </div>
                                    </div>
                                    <div style="padding: 4px 8px; font-size: 12px;">
                                        <t t-out="o.company_id.name or ''"/><br/>
                                        <t t-out="o.company_id.street or ''"/><br/>
                                        <t t-out="o.company_id.city or ''"/>, <t t-out="o.company_id.state_id.code or ''"/> <t t-out="o.company_id.zip or ''"/>
                                    </div>
                                </td>
                                <td style="width: 34%; border: 1px solid black; padding: 1px; vertical-align: top;">
                                    <div style="display: table; width: 100%; border-collapse: collapse;">
                                        <div style="display: table-row;">
                                            <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">5</div>
                                            <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">CRA BUSINESS NUMBER (BN)</div>
                                        </div>
                                    </div>
                                    <div style="padding: 2px 8px; font-size: 12px;"><t t-out="o.cra_business_number or ''"/></div>
                                </td>
                            </tr>
                            <tr>
                                <td style="width: 66%; border: 1px solid black; padding: 1px; vertical-align: top;">
                                    <div style="display: table; width: 100%; border-collapse: collapse;">
                                        <div style="display: table-row;">
                                            <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">7</div>
                                            <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">POSTAL CODE</div>
                                        </div>
                                    </div>
                                    <div style="padding: 2px 8px; font-size: 12px;"><t t-out="o.company_id.zip or ''"/></div>
                                </td>
                                <td style="width: 34%; border: 1px solid black; padding: 1px; vertical-align: top;">
                                    <div style="display: table; width: 100%; border-collapse: collapse;">
                                        <div style="display: table-row;">
                                            <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">6</div>
                                            <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">PAY PERIOD TYPE</div>
                                        </div>
                                    </div>
                                    <div style="padding: 2px 8px; font-size: 12px;"><t t-out="o.pay_period_type or ''"/> - <t t-out="ppt.get(o.pay_period_type,'')"/></div>
                                </td>
                            </tr>
                            <tr>
                                <td style="width: 66%; border: 1px solid black; padding: 0; vertical-align: top;">
                                    <div style="display: table; width: 100%; border-collapse: collapse;">
                                        <div style="display: table-row;">
                                            <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">9</div>
                                            <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">EMPLOYEE'S NAME AND ADDRESS</div>
                                        </div>
                                    </div>
                                    <div style="padding: 8px; font-size: 12px; border-top: 1px solid black; min-height: 80px;">
                                        <t t-out="o.employee_id.name or ''"/><br/>
                                        <t t-out="o.employee_id.home_street or ''"/><br/>
                                        <t t-out="o.employee_id.home_city or ''"/>, <t t-out="o.employee_id.home_province or ''"/> <t t-out="o.employee_id.home_postal_code or ''"/>
                                    </div>
                                </td>
                                <td style="width: 34%; border: 1px solid black; padding: 1px; vertical-align: top;">
                                    <div style="display: table; width: 100%; border-collapse: collapse;">
                                        <div style="display: table-row;">
                                            <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">8</div>
                                            <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">SOCIAL INSURANCE NO.</div>
                                        </div>
                                    </div>
                                    <div style="padding: 2px 8px; font-size: 12px;"><t t-out="o.sin_number or ''"/></div>
                                </td>
                            </tr>
                            <tr>
                                <td style="width: 66%; border: 1px solid black; padding: 1px; vertical-align: top;"></td>
                                <td style="width: 34%; border: 1px solid black; padding: 1px; vertical-align: top;">
                                    <div style="display: table; width: 100%; border-collapse: collapse;">
                                        <div style="display: table-row;">
                                            <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">10</div>
                                            <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">FIRST DAY WORKED</div>
                                        </div>
                                    </div>
                                    <div class="date-boxes">
                                        <span style="font-size:8px; display: inline-block; vertical-align: middle; line-height: 16px; height: 16px;">D</span><div class="date-box"><t t-if="o.first_day_worked" t-out="o.first_day_worked.strftime('%d')[0]"/></div><div class="date-box"><t t-if="o.first_day_worked" t-out="o.first_day_worked.strftime('%d')[1]"/></div>
                                        <span style="font-size:8px; margin-left:2px; display: inline-block; vertical-align: middle; line-height: 16px; height: 16px;">M</span><div class="date-box"><t t-if="o.first_day_worked" t-out="o.first_day_worked.strftime('%m')[0]"/></div><div class="date-box"><t t-if="o.first_day_worked" t-out="o.first_day_worked.strftime('%m')[1]"/></div>
                                        <span style="font-size:8px; margin-left:2px; display: inline-block; vertical-align: middle; line-height: 16px; height: 16px;">Y</span><div class="date-box"><t t-if="o.first_day_worked" t-out="o.first_day_worked.strftime('%Y')[0]"/></div><div class="date-box"><t t-if="o.first_day_worked" t-out="o.first_day_worked.strftime('%Y')[1]"/></div><div class="date-box"><t t-if="o.first_day_worked" t-out="o.first_day_worked.strftime('%Y')[2]"/></div><div class="date-box"><t t-if="o.first_day_worked" t-out="o.first_day_worked.strftime('%Y')[3]"/></div>
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td style="width: 66%; border: 1px solid black; padding: 1px; vertical-align: top;"></td>
                                <td style="width: 34%; border: 1px solid black; padding: 1px; vertical-align: top;">
                                    <div style="display: table; width: 100%; border-collapse: collapse;">
                                        <div style="display: table-row;">
                                            <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">11</div>
                                            <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">LAST DAY FOR WHICH PAID</div>
                                        </div>
                                    </div>
                                    <div class="date-boxes">
                                        <span style="font-size:8px; display: inline-block; vertical-align: middle; line-height: 16px; height: 16px;">D</span><div class="date-box"><t t-if="o.last_day_paid" t-out="o.last_day_paid.strftime('%d')[0]"/></div><div class="date-box"><t t-if="o.last_day_paid" t-out="o.last_day_paid.strftime('%d')[1]"/></div>
                                        <span style="font-size:8px; margin-left:2px; display: inline-block; vertical-align: middle; line-height: 16px; height: 16px;">M</span><div class="date-box"><t t-if="o.last_day_paid" t-out="o.last_day_paid.strftime('%m')[0]"/></div><div class="date-box"><t t-if="o.last_day_paid" t-out="o.last_day_paid.strftime('%m')[1]"/></div>
                                        <span style="font-size:8px; margin-left:2px; display: inline-block; vertical-align: middle; line-height: 16px; height: 16px;">Y</span><div class="date-box"><t t-if="o.last_day_paid" t-out="o.last_day_paid.strftime('%Y')[0]"/></div><div class="date-box"><t t-if="o.last_day_paid" t-out="o.last_day_paid.strftime('%Y')[1]"/></div><div class="date-box"><t t-if="o.last_day_paid" t-out="o.last_day_paid.strftime('%Y')[2]"/></div><div class="date-box"><t t-if="o.last_day_paid" t-out="o.last_day_paid.strftime('%Y')[3]"/></div>
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td style="width: 66%; border: 1px solid black; padding: 1px; vertical-align: top;"></td>
                                <td style="width: 34%; border: 1px solid black; padding: 1px; vertical-align: top;">
                                    <div style="display: table; width: 100%; border-collapse: collapse;">
                                        <div style="display: table-row;">
                                            <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">12</div>
                                            <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">FINAL PAY PERIOD ENDING DATE</div>
                                        </div>
                                    </div>
                                    <div class="date-boxes">
                                        <span style="font-size:8px; display: inline-block; vertical-align: middle; line-height: 16px; height: 16px;">D</span><div class="date-box"><t t-if="o.final_pay_period_end" t-out="o.final_pay_period_end.strftime('%d')[0]"/></div><div class="date-box"><t t-if="o.final_pay_period_end" t-out="o.final_pay_period_end.strftime('%d')[1]"/></div>
                                        <span style="font-size:8px; margin-left:2px; display: inline-block; vertical-align: middle; line-height: 16px; height: 16px;">M</span><div class="date-box"><t t-if="o.final_pay_period_end" t-out="o.final_pay_period_end.strftime('%m')[0]"/></div><div class="date-box"><t t-if="o.final_pay_period_end" t-out="o.final_pay_period_end.strftime('%m')[1]"/></div>
                                        <span style="font-size:8px; margin-left:2px; display: inline-block; vertical-align: middle; line-height: 16px; height: 16px;">Y</span><div class="date-box"><t t-if="o.final_pay_period_end" t-out="o.final_pay_period_end.strftime('%Y')[0]"/></div><div class="date-box"><t t-if="o.final_pay_period_end" t-out="o.final_pay_period_end.strftime('%Y')[1]"/></div><div class="date-box"><t t-if="o.final_pay_period_end" t-out="o.final_pay_period_end.strftime('%Y')[2]"/></div><div class="date-box"><t t-if="o.final_pay_period_end" t-out="o.final_pay_period_end.strftime('%Y')[3]"/></div>
                                    </div>
                                </td>
                            </tr>
                        </table>

                        <table style="border-collapse: collapse; width: 100%;">
                            <tr>
                                <td style="width: 50%; border: 1px solid black; padding: 0; vertical-align: top;">
                                    <table style="border-collapse: collapse; width: 100%; height: 100%;">
                                        <tr style="height: 33.33%;">
                                            <td style="border: 1px solid black; padding: 0; vertical-align: top;">
                                                <div style="display: table; width: 100%; border-collapse: collapse;">
                                                    <div style="display: table-row;">
                                                        <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">13</div>
                                                        <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">OCCUPATION</div>
                                                    </div>
                                                </div>
                                                <div style="padding: 8px; font-size: 12px; border-top: 1px solid black; height: 100%; box-sizing: border-box;"><t t-out="o.occupation or o.employee_id.job_id.name or ''"/></div>
                                            </td>
                                        </tr>
                                        <tr style="height: 33.33%;">
                                            <td style="border: 1px solid black; border-top: 0; padding: 0; vertical-align: top;">
                                                <div style="display: table; width: 100%; border-collapse: collapse;">
                                                    <div style="display: table-row;">
                                                        <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">15A</div>
                                                        <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">TOTAL INSURABLE HOURS</div>
                                                    </div>
                                                </div>
                                                <div style="padding: 8px; font-size: 12px; border-top: 1px solid black; border: 1px solid black; margin: 4px; height: 100%; box-sizing: border-box;"><t t-out="'{:.0f}'.format(o.total_insurable_hours or 0)"/></div>
                                            </td>
                                        </tr>
                                        <tr style="height: 33.33%;">
                                            <td style="border: 1px solid black; border-top: 0; padding: 0; vertical-align: top;">
                                                <div style="display: table; width: 100%; border-collapse: collapse;">
                                                    <div style="display: table-row;">
                                                        <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">15B</div>
                                                        <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">TOTAL INSURABLE EARNINGS</div>
                                                    </div>
                                                </div>
                                                <div style="padding: 8px; font-size: 12px; border-top: 1px solid black; border: 1px solid black; margin: 4px; height: 100%; box-sizing: border-box;"><t t-out="'{:,.2f}'.format(o.total_insurable_earnings or 0)"/></div>
                                            </td>
                                        </tr>
                                    </table>
                                </td>
                                <td style="width: 50%; border: 1px solid black; padding: 0; vertical-align: top;">
                                    <div style="border: 1px solid black; padding: 1px;">
                                        <div style="display: table; width: 100%; border-collapse: collapse;">
                                            <div style="display: table-row;">
                                                <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">14</div>
                                                <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">EXPECTED DATE OF RECALL</div>
                                            </div>
                                        </div>
                                        <div class="date-boxes" style="border-top: 1px solid black; padding: 2px 8px;">
                                            <span style="font-size:8px; display: inline-block; vertical-align: middle; line-height: 16px; height: 16px;">D</span><div class="date-box"><t t-if="o.expected_recall_date" t-out="o.expected_recall_date.strftime('%d')[0]"/></div><div class="date-box"><t t-if="o.expected_recall_date" t-out="o.expected_recall_date.strftime('%d')[1]"/></div>
                                            <span style="font-size:8px; margin-left:2px; display: inline-block; vertical-align: middle; line-height: 16px; height: 16px;">M</span><div class="date-box"><t t-if="o.expected_recall_date" t-out="o.expected_recall_date.strftime('%m')[0]"/></div><div class="date-box"><t t-if="o.expected_recall_date" t-out="o.expected_recall_date.strftime('%m')[1]"/></div>
                                            <span style="font-size:8px; margin-left:2px; display: inline-block; vertical-align: middle; line-height: 16px; height: 16px;">Y</span><div class="date-box"><t t-if="o.expected_recall_date" t-out="o.expected_recall_date.strftime('%Y')[0]"/></div><div class="date-box"><t t-if="o.expected_recall_date" t-out="o.expected_recall_date.strftime('%Y')[1]"/></div><div class="date-box"><t t-if="o.expected_recall_date" t-out="o.expected_recall_date.strftime('%Y')[2]"/></div><div class="date-box"><t t-if="o.expected_recall_date" t-out="o.expected_recall_date.strftime('%Y')[3]"/></div>
                                        </div>
                                    </div>
                                    
                                    <div style="border: 1px solid black; border-top: 0; padding: 1px;">
                                        <div style="display: table; width: 100%; border-collapse: collapse;">
                                            <div style="display: table-row;">
                                                <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">16</div>
                                                <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">REASON FOR ISSUING THIS ROE</div>
                                            </div>
                                        </div>
                                        <div style="padding: 2px 8px; font-size: 12px; border-top: 1px solid black;"><t t-out="rc.get(o.reason_code, o.reason_code or '')"/></div>
                                    </div>
                                    
                                    <div style="border: 1px solid black; border-top: 0; padding: 1px;">
                                        <div style="display: table; width: 100%; border-collapse: collapse;">
                                            <div style="display: table-row;">
                                                <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">FOR FURTHER INFORMATION, CONTACT</div>
                                            </div>
                                        </div>
                                        <div style="padding: 4px 8px; font-size: 12px; border-top: 1px solid black;"><t t-out="o.contact_name or ''"/><br/><t t-out="o.contact_phone or ''"/></div>
                                    </div>
                                </td>
                            </tr>
                        </table>

                        <table style="border-collapse: collapse; width: 100%;">
                            <tr>
                                <td style="width: 50%; border: 1px solid black; padding: 1px; vertical-align: top;">
                                    <div style="display: table; width: 100%; border-collapse: collapse;">
                                        <div style="display: table-row;">
                                            <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">15C</div>
                                            <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">THE FIRST ENTRY MUST RECORD THE INSURABLE EARNINGS FOR THE FINAL (MOST RECENT) INSURED PAY PERIOD. ENTER DETAILS BY PAY PERIOD</div>
                                        </div>
                                    </div>
                                    <table class="earnings-table">
                                        <tr>
                                            <td class="pp-col"><strong>PP</strong></td>
                                            <td><strong>INSURABLE<br/>EARNINGS</strong></td>
                                            <td class="pp-col"><strong>PP</strong></td>
                                            <td><strong>INSURABLE<br/>EARNINGS</strong></td>
                                            <td class="pp-col"><strong>PP</strong></td>
                                            <td><strong>INSURABLE<br/>EARNINGS</strong></td>
                                        </tr>
                                        <t t-foreach="range(1, 54, 3)" t-as="r">
                                            <tr>
                                                <td><t t-if="r &lt;= 53" t-out="r"/></td>
                                                <td><t t-if="r in ed" t-out="'{:,.2f}'.format(ed[r])"/></td>
                                                <td><t t-if="r+1 &lt;= 53" t-out="r+1"/></td>
                                                <td><t t-if="r+1 in ed" t-out="'{:,.2f}'.format(ed[r+1])"/></td>
                                                <td><t t-if="r+2 &lt;= 53" t-out="r+2"/></td>
                                                <td><t t-if="r+2 in ed" t-out="'{:,.2f}'.format(ed[r+2])"/></td>
                                            </tr>
                                        </t>
                                    </table>
                                </td>
                                <td style="width: 50%; border: 1px solid black; padding: 0; vertical-align: top;">
                                    <table style="border-collapse: collapse; width: 100%; height: 100%;">
                                        <tr style="height: 100%;">
                                            <td style="border: 1px solid black; padding: 1px; vertical-align: top; height: 100%;">
                                                <div style="display: table; width: 100%; border-collapse: collapse;">
                                                    <div style="display: table-row;">
                                                        <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">17</div>
                                                        <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">ONLY COMPLETE IF PAYMENT OR BENEFITS (OTHER THAN REGULAR PAY) PAID DURING OR IN ANTICIPATION OF THE FINAL PAY PERIOD OR PAYABLE AT A LATER DATE</div>
                                                    </div>
                                                </div>
                                                <div style="padding: 4px 8px; font-size: 12px; text-align: center; min-height: 200px; line-height: 200px;"><t t-out="o.other_payments or 'N/A*'"/></div>
                                            </td>
                                        </tr>
                                        <tr>
                                            <td style="border: 1px solid black; padding: 1px; vertical-align: middle; height: 40px;">
                                                <div style="display: table; width: 100%; border-collapse: collapse;">
                                                    <div style="display: table-row;">
                                                        <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">18</div>
                                                        <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">COMMENTS</div>
                                                    </div>
                                                </div>
                                                <div style="padding: 4px 8px; font-size: 12px; text-align: center; line-height: 20px;"><t t-out="o.comments or 'N/A*'"/></div>
                                            </td>
                                        </tr>
                                        <tr>
                                            <td style="border: 1px solid black; padding: 1px; vertical-align: middle; height: 40px;">
                                                <div style="display: table; width: 100%; border-collapse: collapse;">
                                                    <div style="display: table-row;">
                                                        <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">19</div>
                                                        <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">ONLY COMPLETE IF PAID SICK/MATERNITY/PARENTAL LEAVE OR GROUP WAGE LOSS INDEMNITY PAYMENT (AFTER THE LAST DAY WORKED)</div>
                                                    </div>
                                                </div>
                                                <div style="padding: 4px 8px; font-size: 12px; text-align: center; line-height: 20px;">N/A*</div>
                                            </td>
                                        </tr>
                                    </table>
                                </td>
                            </tr>
                        </table>

                        <table style="border-collapse: collapse; width: 100%;">
                            <tr>
                                <td style="width: 30%; border: 1px solid black; padding: 1px; vertical-align: top;">
                                    <div style="display: table; width: 100%; border-collapse: collapse;">
                                        <div style="display: table-row;">
                                            <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">20</div>
                                            <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">COMMUNICATION PREFERRED IN</div>
                                        </div>
                                    </div>
                                    <div style="padding: 2px 8px; font-size: 13.5px;">
                                        <span class="checkbox" style="line-height: 11px; font-size: 9px; padding: 0;"><t t-if="o.communication_language=='E'">X</t></span> ENGLISH
                                        <span style="margin-left: 12px;"><span class="checkbox" style="display: inline-block; width: 11px; height: 11px; border: 1px solid black; margin-right: 3px; text-align: center; vertical-align: middle; line-height: 11px; font-size: 9px; padding: 0;"><t t-if="o.communication_language=='F'">X</t></span> FRENCH</span>
                                    </div>
                                </td>
                                <td style="width: 30%; border: 1px solid black; padding: 1px; vertical-align: top;">
                                    <div style="display: table; width: 100%; border-collapse: collapse;">
                                        <div style="display: table-row;">
                                            <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: table-cell; vertical-align: top; line-height: 1.2; white-space: nowrap;">21</div>
                                            <div style="background-color: #666; color: #fff; font-size: 8px; font-weight: bold; padding: 3px 3px; line-height: 1.2; display: table-cell; vertical-align: top; width: 100%;">TELEPHONE NO.</div>
                                        </div>
                                    </div>
                                    <div style="padding: 2px 8px; font-size: 12px;"><t t-out="o.contact_phone or ''"/></div>
                                </td>
                                <td style="width: 40%; border: 1px solid black; padding: 1px; vertical-align: top;">
                                    <div style="background-color: #000; color: #fff; font-weight: bold; padding: 3px 3px; font-size: 8px; display: inline-block; vertical-align: top; line-height: 1.2;">22</div>
                                    <div style="font-size: 10.5px; line-height: 1.1;">I AM AWARE THAT IT IS AN OFFENSE TO MAKE FALSE ENTRIES AND HEREBY CERTIFY THAT ALL STATEMENTS ON THIS FORM ARE TRUE</div>
                                    <div style="margin-top: 2px; font-size: 12px;">
                                        Name of Issuer <span style="border-bottom:1px solid #000; padding: 0 25px; display: inline-block; min-width: 180px;"></span><br/>
                                        Issuer <span style="border-bottom:1px solid #000; padding: 0 25px; display: inline-block; min-width: 220px;"></span><br/>
                                        Name <span style="border-bottom:1px solid #000; padding: 0 25px; display: inline-block; min-width: 220px;"><t t-out="o.contact_name or ''"/></span>
                                    </div>
                                    <div class="date-boxes" style="margin-top: 2px; float: right;">
                                        <span style="font-size:8px;">D</span><div class="date-box"><t t-out="td.strftime('%d')[0]"/></div><div class="date-box"><t t-out="td.strftime('%d')[1]"/></div>
                                        <span style="font-size:8px; margin-left:2px;">M</span><div class="date-box"><t t-out="td.strftime('%m')[0]"/></div><div class="date-box"><t t-out="td.strftime('%m')[1]"/></div>
                                        <span style="font-size:8px; margin-left:2px;">Y</span><div class="date-box"><t t-out="td.strftime('%Y')[0]"/></div><div class="date-box"><t t-out="td.strftime('%Y')[1]"/></div><div class="date-box"><t t-out="td.strftime('%Y')[2]"/></div><div class="date-box"><t t-out="td.strftime('%Y')[3]"/></div>
                                    </div>
                                </td>
                            </tr>
                        </table>

                        <div class="footer-note">
                            *Not currently supported by Fusion Payroll
                            <span style="float: right;">REV OSP</span>
                        </div>
                    </div>
                </div>
            </t>
        </t>
    </template>

</odoo>
