1 <%= include('header', 'Make a payment') %>
3 <FORM NAME="OneTrueForm" METHOD="POST" ACTION="<%=$selfurl%>" onSubmit="document.OneTrueForm.process.disabled=true">
4 <INPUT TYPE="hidden" NAME="action" VALUE="ach_payment_results">
5 <TABLE BGCOLOR="#cccccc">
7 <TD ALIGN="right">Amount Due</TD>
9 <TABLE><TR><TD BGCOLOR="#ffffff">
10 $<%=sprintf("%.2f",$balance)%>
15 <TD ALIGN="right">Payment amount</TD>
17 <TABLE><TR><TD BGCOLOR="#ffffff">
18 $<INPUT TYPE="text" NAME="amount" SIZE=8 VALUE="<%=sprintf("%.2f",$balance)%>">
22 <%= include('discount_term') %>
23 <%= include('check') %>
26 <INPUT TYPE="checkbox" <%= $save_unchecked ? '' : 'CHECKED' %> NAME="save" VALUE="1">
27 Remember this information
31 <INPUT TYPE="checkbox"<%= $payby eq 'CHEK' ? ' CHECKED' : '' %> NAME="auto" VALUE="1" onClick="if (this.checked) { document.OneTrueForm.save.checked=true; }">
32 Charge future payments to this account automatically
37 <INPUT TYPE="hidden" NAME="paybatch" VALUE="<%=$paybatch%>">
38 <INPUT TYPE="submit" NAME="process" VALUE="Process payment"> <!-- onClick="this.disabled=true"> -->
41 <%= include('footer') %>