+<& /elements/header-popup.html, mt('Void payment') &>
+
+<& /elements/error.html &>
+
+<P ALIGN="center"><B><% mt('Void this payment?') |h %></B>
+
+<FORM action="<% ${p} %>misc/void-cust_pay.cgi">
+<INPUT TYPE="hidden" NAME="paynum" VALUE="<% $paynum %>">
+
+<TABLE BGCOLOR="#cccccc" BORDER="0" CELLSPACING="2" STYLE="margin-left:auto; margin-right:auto">
+<& /elements/tr-select-reason.html,
+ 'field' => 'reasonnum',
+ 'reason_class' => 'X',
+ 'cgi' => $cgi
+&>
+</TABLE>
+
+<BR>
+<P ALIGN="CENTER">
+<INPUT TYPE="submit" NAME="confirm_void_payment" VALUE="<% mt('Void payment') |h %>">
+
+<INPUT TYPE="BUTTON" VALUE="<% mt("Don't void payment") |h %>" onClick="parent.cClick();">
+
+</FORM>
+</BODY>
+</HTML>
+