blob: fd0cd6d91bc2d144bb3d5bfb171c1055af74c8d9 (
plain)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
|
<? if ($ach_read_only) { $bgShade = 'BGCOLOR="#ffffff"'; } ?>
<TR>
<TD ALIGN="right">Account type</TD>
<TD <? echo $bgShade; ?>>
<? if ($ach_read_only) { echo htmlspecialchars($paytype); ?>
<INPUT TYPE="hidden" NAME="paytype" VALUE="<? echo $paytype; ?>">
<? } else { ?>
<SELECT NAME="paytype">
<? foreach ( $paytypes AS $pt ) { ?>
<OPTION <? if ($pt == $paytype ) { echo 'SELECTED'; } ?> VALUE="<? echo $pt; ?>"><? echo $pt; ?>
<? } ?>
</SELECT>
<? } ?>
</TD>
</TR><TR>
<TD ALIGN="right">Account number</TD>
<TD <? echo $bgShade; ?>>
<? if ($ach_read_only) { echo htmlspecialchars($payinfo1); ?>
<INPUT TYPE="hidden" NAME="payinfo1" VALUE="<? echo $payinfo1; ?>">
<? } else { ?>
<INPUT TYPE="text" NAME="payinfo1" SIZE=10 MAXLENGTH=20 VALUE="<? echo $payinfo1; ?>">
<? } ?>
</TD>
</TR><TR>
<TD ALIGN="right">ABA/Routing number</TD>
<TD <? echo $bgShade; ?>>
<? if ($ach_read_only) { echo htmlspecialchars($payinfo2); ?>
<INPUT TYPE="hidden" NAME="payinfo2" VALUE="<? echo $payinfo2; ?>">
<? } else { ?>
<INPUT TYPE="text" NAME="payinfo2" SIZE=10 MAXLENGTH=9 VALUE="<? echo $payinfo2; ?>"></TD>
<? } ?>
</TR><TR>
<TD ALIGN="right">Bank name</TD>
<TD <? echo $bgShade; ?>>
<? if ($ach_read_only) { echo htmlspecialchars($payname); ?>
<INPUT TYPE="hidden" NAME="payname" VALUE="<? echo $payname; ?>"></TD>
<? } else { ?>
<INPUT TYPE="text" SIZE=32 MAXLENGTH=80 NAME="payname" VALUE="<? echo $payname; ?>"></TD>
<? } ?>
</TR><TR>
<? if ($show_paystate) { ?>
<TR>
<TD ALIGN="right">Bank state</TD>
<TD <? echo $bgShade; ?>>
<? if ($ach_read_only) { echo htmlspecialchars($paystate); ?>
<INPUT TYPE="hidden" NAME="paystate" VALUE="<? echo $paystate; ?>"></TD>
<? } else { ?>
<SELECT NAME="paystate">
<? foreach ( $states AS $s ) { ?>
<OPTION <? if ($s == $paystate ) { echo 'SELECTED'; } ?>><? echo $s; ?>
<? } ?>
</SELECT></TD>
<? } ?>
</TR>
<? } ?>
<? if ($show_ss) { ?>
<TR>
<TD ALIGN="right">Account holder<BR>Social security or tax ID #</TD>
<TD <? echo $bgShade; ?>>
<? if ($ach_read_only) { echo htmlspecialchars($ss); ?>
<INPUT TYPE="hidden" NAME="ss" VALUE="<? echo $ss; ?>"></TD>
<? } else { ?>
<INPUT TYPE="text" SIZE=32 MAXLENGTH=80 NAME="ss" VALUE="<? echo $ss; ?>"></TD>
<? } ?>
</TR>
<? } ?>
<? if ($show_stateid) { ?>
<TR>
<TD ALIGN="right">Account holder<BR><? echo $stateid_label; ?></TD>
<TD <? echo $bgShade; ?>>
<? if ($ach_read_only) { echo htmlspecialchars($stateid); ?>
<INPUT TYPE="hidden" NAME="stateid" VALUE="<? echo $stateid; ?>"></TD>
<TD <? echo $bgShade; ?>> <? echo $stateid_state; ?>
<INPUT TYPE="hidden" NAME="stateid_state" VALUE="<? echo $stateid_state; ?>"></TD>
<? } else { ?>
<INPUT TYPE="text" SIZE=32 MAXLENGTH=80 NAME="stateid" VALUE="<? echo $stateid; ?>"></TD>
<TD ALIGN="right"><? echo $stateid_state_label; ?></TD>
<TD><SELECT NAME="stateid_state">
<? foreach ( $states AS $s ) { ?>
<OPTION <? if ($s == $stateid_state ) { echo 'SELECTED'; } ?>><? echo $s; ?>
<? } ?>
</SELECT></TD>
<? } ?>
</TR>
<? } ?>
|