DAHLIA Pattern Library

Angular Income Form 

<div class="form-group" ng-class="{ error: (inputInvalid('incomeTotal') || inputInvalid('incomeTimeframe')) }">
    <label class="form-label margin-bottom--half">
    What is your household total pre-tax income?
  </label>
    <div class="form-income">
        <label class="sr-only" for="incomeTotal">Income</label>
        <span class="label-dollar">$</span>
        <input aria-describedby="incomeTotal_error" class="form-income_input" currency-symbol="" id="incomeTotal" name="incomeTotal" ng-change="invalidateIncomeForm()" ng-class="{ error: inputInvalid('incomeTotal') }" ng-currency="" ng-model="applicant.householdIncome.incomeTotal"
            ng-required="true" placeholder="Total all of your income sources" type="text">
        <small class="error" id="incomeTotal_error" ng-show="inputInvalid('incomeTotal')">
      Please enter an income amount
    </small>
    </div>
    <div aria-label="Income" class="radio-group" ng-class="{ error: inputInvalid('incomeTimeframe') }" role="radiogroup">
        <p class="radio-block">
            <input id="per_month" name="incomeTimeframe" ng-model="applicant.householdIncome.incomeTimeframe" ng-required="true" type="radio" value="per_month">
            <label class="radio-block_label" for="per_month">per month</label>
        </p>
        <p class="radio-block">
            <input aria-describedby="per_year_error" id="per_year" name="incomeTimeframe" ng-click="invalidateIncomeForm()" ng-model="applicant.householdIncome.incomeTimeframe" ng-required="true" type="radio" value="per_year">
            <label class="radio-block_label" for="per_year">per year</label>
        </p><small class="error" id="per_year_error" ng-show="inputInvalid('incomeTimeframe')" aria-hidden="true">Please enter an income timeframe</small>
    </div>
</div>
 
<div class="form-group" ng-class="{ error: (inputInvalid('incomeTotal') || inputInvalid('incomeTimeframe')) }">
  <label class="form-label margin-bottom--half">
    What is your household total pre-tax income?
  </label>
  <div class="form-income">
    <label class="sr-only" for="incomeTotal">Income</label>
    <span class="label-dollar">$</span>
    <input aria-describedby="incomeTotal_error" class="form-income_input" currency-symbol="" id="incomeTotal" name="incomeTotal" ng-change="invalidateIncomeForm()" ng-class="{ error: inputInvalid('incomeTotal') }" ng-currency="" ng-model="applicant.householdIncome.incomeTotal" ng-required="true" placeholder="Total all of your income sources" type="text">
    <small class="error" id="incomeTotal_error" ng-show="inputInvalid('incomeTotal')">
      Please enter an income amount
    </small>
  </div>
  <div aria-label="Income" class="radio-group" ng-class="{ error: inputInvalid('incomeTimeframe') }" role="radiogroup">
    <p class="radio-block">
      <input id="per_month" name="incomeTimeframe" ng-model="applicant.householdIncome.incomeTimeframe" ng-required="true" type="radio" value="per_month">
      <label class="radio-block_label" for="per_month">per month</label>
    </p>
    <p class="radio-block">
      <input aria-describedby="per_year_error" id="per_year" name="incomeTimeframe" ng-click="invalidateIncomeForm()" ng-model="applicant.householdIncome.incomeTimeframe" ng-required="true" type="radio" value="per_year">
      <label class="radio-block_label" for="per_year">per year</label>
    </p><small class="error" id="per_year_error" ng-show="inputInvalid('incomeTimeframe')" aria-hidden="true">Please enter an income timeframe</small>
  </div>
</div>
 
{
  "inputs": {
    "states": [
      {
        "name": "Alabama",
        "attr": "AL"
      },
      {
        "name": "Alaska",
        "attr": "AK"
      },
      {
        "name": "Arizona",
        "attr": "AK"
      },
      {
        "name": "Arkansas",
        "attr": "AK"
      },
      {
        "name": "California",
        "attr": "CA"
      },
      {
        "name": "Colorado",
        "attr": "CO"
      },
      {
        "name": "Connecticut",
        "attr": "CT"
      },
      {
        "name": "Delaware",
        "attr": "DE"
      },
      {
        "name": "District Of Columbia",
        "attr": "DC"
      },
      {
        "name": "Florida",
        "attr": "FL"
      },
      {
        "name": "Georgia",
        "attr": "GA"
      },
      {
        "name": "Hawaii",
        "attr": "HI"
      },
      {
        "name": "Idaho",
        "attr": "ID"
      },
      {
        "name": "Illinois",
        "attr": "IL"
      },
      {
        "name": "Indiana",
        "attr": "IN"
      },
      {
        "name": "Iowa",
        "attr": "IA"
      },
      {
        "name": "Kansas",
        "attr": "KS"
      },
      {
        "name": "Kentucky",
        "attr": "KY"
      },
      {
        "name": "Louisiana",
        "attr": "LA"
      },
      {
        "name": "Maine",
        "attr": "ME"
      },
      {
        "name": "Maryland",
        "attr": "MD"
      },
      {
        "name": "Massachusetts",
        "attr": "MA"
      },
      {
        "name": "Michigan",
        "attr": "MI"
      },
      {
        "name": "Minnesota",
        "attr": "MN"
      },
      {
        "name": "Mississippi",
        "attr": "MS"
      },
      {
        "name": "Missouri",
        "attr": "MO"
      },
      {
        "name": "Montana",
        "attr": "MT"
      },
      {
        "name": "Nebraska",
        "attr": "NE"
      },
      {
        "name": "Nevada",
        "attr": "NV"
      },
      {
        "name": "New Hampshire",
        "attr": "NH"
      },
      {
        "name": "New Jersey",
        "attr": "NJ"
      },
      {
        "name": "New Mexico",
        "attr": "NM"
      },
      {
        "name": "New York",
        "attr": "NY"
      },
      {
        "name": "North Carolina",
        "attr": "NC"
      },
      {
        "name": "North Dakota",
        "attr": "ND"
      },
      {
        "name": "Ohio",
        "attr": "OH"
      },
      {
        "name": "Oklahoma",
        "attr": "OK"
      },
      {
        "name": "Oregon",
        "attr": "OR"
      },
      {
        "name": "Pennsylvania",
        "attr": "PA"
      },
      {
        "name": "Rhode Island",
        "attr": "RI"
      },
      {
        "name": "South Carolina",
        "attr": "SC"
      },
      {
        "name": "South Dakota",
        "attr": "SD"
      },
      {
        "name": "Tennessee",
        "attr": "TN"
      },
      {
        "name": "Texas",
        "attr": "TX"
      },
      {
        "name": "Utah",
        "attr": "UT"
      },
      {
        "name": "Vermont",
        "attr": "VT"
      },
      {
        "name": "Virginia",
        "attr": "VA"
      },
      {
        "name": "Washington",
        "attr": "WA"
      },
      {
        "name": "West Virginia",
        "attr": "WV"
      },
      {
        "name": "Wisconsin",
        "attr": "WI"
      },
      {
        "name": "Wyoming",
        "attr": "WY"
      }
    ]
  }
}

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