1 <? if ($ach_read_only) { $bgShade = 'BGCOLOR="#ffffff"'; } ?>
3 <TD ALIGN="right">Account type</TD>
4 <TD <? echo $bgShade; ?>>
5 <? if ($ach_read_only) { echo htmlspecialchars($paytype); ?>
6 <INPUT TYPE="hidden" NAME="paytype" VALUE="<? echo $paytype; ?>">
8 <SELECT NAME="paytype">
9 <? foreach ( $paytypes AS $pt ) { ?>
10 <OPTION <? if ($pt == $paytype ) { echo 'SELECTED'; } ?> VALUE="<? echo $pt; ?>"><? echo $pt; ?>
16 <TD ALIGN="right">Account number</TD>
17 <TD <? echo $bgShade; ?>>
18 <? if ($ach_read_only) { echo htmlspecialchars($payinfo1); ?>
19 <INPUT TYPE="hidden" NAME="payinfo1" VALUE="<? echo $payinfo1; ?>">
21 <INPUT TYPE="text" NAME="payinfo1" SIZE=10 MAXLENGTH=20 VALUE="<? echo $payinfo1; ?>">
25 <TD ALIGN="right">ABA/Routing number</TD>
26 <TD <? echo $bgShade; ?>>
27 <? if ($ach_read_only) { echo htmlspecialchars($payinfo2); ?>
28 <INPUT TYPE="hidden" NAME="payinfo2" VALUE="<? echo $payinfo2; ?>">
30 <INPUT TYPE="text" NAME="payinfo2" SIZE=10 MAXLENGTH=9 VALUE="<? echo $payinfo2; ?>"></TD>
33 <TD ALIGN="right">Bank name</TD>
34 <TD <? echo $bgShade; ?>>
35 <? if ($ach_read_only) { echo htmlspecialchars($payname); ?>
36 <INPUT TYPE="hidden" NAME="payname" VALUE="<? echo $payname; ?>"></TD>
38 <INPUT TYPE="text" SIZE=32 MAXLENGTH=80 NAME="payname" VALUE="<? echo $payname; ?>"></TD>
42 <? if ($show_paystate) { ?>
44 <TD ALIGN="right">Bank state</TD>
45 <TD <? echo $bgShade; ?>>
46 <? if ($ach_read_only) { echo htmlspecialchars($paystate); ?>
47 <INPUT TYPE="hidden" NAME="paystate" VALUE="<? echo $paystate; ?>"></TD>
49 <SELECT NAME="paystate">
50 <? foreach ( $states AS $s ) { ?>
51 <OPTION <? if ($s == $paystate ) { echo 'SELECTED'; } ?>><? echo $s; ?>
60 <TD ALIGN="right">Account holder<BR>Social security or tax ID #</TD>
61 <TD <? echo $bgShade; ?>>
62 <? if ($ach_read_only) { echo htmlspecialchars($ss); ?>
63 <INPUT TYPE="hidden" NAME="ss" VALUE="<? echo $ss; ?>"></TD>
65 <INPUT TYPE="text" SIZE=32 MAXLENGTH=80 NAME="ss" VALUE="<? echo $ss; ?>"></TD>
70 <? if ($show_stateid) { ?>
72 <TD ALIGN="right">Account holder<BR><? echo $stateid_label; ?></TD>
73 <TD <? echo $bgShade; ?>>
74 <? if ($ach_read_only) { echo htmlspecialchars($stateid); ?>
75 <INPUT TYPE="hidden" NAME="stateid" VALUE="<? echo $stateid; ?>"></TD>
76 <TD <? echo $bgShade; ?>> <? echo $stateid_state; ?>
77 <INPUT TYPE="hidden" NAME="stateid_state" VALUE="<? echo $stateid_state; ?>"></TD>
79 <INPUT TYPE="text" SIZE=32 MAXLENGTH=80 NAME="stateid" VALUE="<? echo $stateid; ?>"></TD>
80 <TD ALIGN="right"><? echo $stateid_state_label; ?></TD>
81 <TD><SELECT NAME="stateid_state">
82 <? foreach ( $states AS $s ) { ?>
83 <OPTION <? if ($s == $stateid_state ) { echo 'SELECTED'; } ?>><? echo $s; ?>