File: //www/exchange0old/exchange/cache/%%F8^F8D^F8DA1344%%create_debtor_fields.html.php
<?php /* Smarty version 2.6.19, created on 2024-06-18 12:34:30
compiled from debtors/create_debtor_fields.html */ ?>
<tr>
<td colspan="3">
<?php if (! empty ( $this->_tpl_vars['result'] )): ?>
<div class="success-msgbox">
<?php echo $this->_tpl_vars['result']; ?>
</div>
<?php endif; ?>
<p align="justify" style="background:#F4F4F4;border: 1px solid #000000;color: #1F69BA;font-size: 11px;line-height: 20px;margin: 10px;padding: 5px;"><span style="font-size:11px; height: 60px;width: 90px;float:left;" class="red">IMPORTANT:-</span>Select the currency of the Counterparty before entering any other data. Do not enter details using all capital letters. This will delay your application to have this Counterparty authorised. Enter data by capitalising each word, e.g. do not enter 'COMPANY NAME LIMITED', or 'MAIN STREET'. Enter 'Company Name' and 'Main Street'.</p>
</td>
</tr>
<tr>
<td colspan="3" align="center" width="100%">
<table cellspacing="0" cellpadding="0" border="0" width="100%">
<tr class="row4">
<td align="right" valign="top" style="font-size: 12px; padding: 10px 0 10px 12px;">
<span class="txt_11_red">* </span>
<strong style="font-size:11px;">
Type :
</strong>
</td>
<td align="left" valign="top" style="padding: 5px 0 5px 15px !important;">
<select name="debtor_type" id="debtor_type" class="cmb_bx1" tabindex="1">
<option value="">Please Select</option>
<option value="debtor" <?php if ($this->_tpl_vars['values']['debtor_type'] == 'debtor'): ?> selected="selected" <?php endif; ?>>Debtor</option>
<option value="creditor" <?php if ($this->_tpl_vars['values']['debtor_type'] == 'creditor'): ?> selected="selected" <?php endif; ?>>Creditor</option>
</select>
<a href="javascript:void(0);" title="Type of Counterparty" class="under">(?)</a>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['debtor_type']; ?>
</span>
</td>
<td align="right" valign="top" style="font-size: 12px; padding: 10px 0px 5px 12px; ">
<span class="txt_11_red">* </span>
<strong style="font-size:11px;">
Company Name :
</strong>
</td>
<td align="left" valign="top" style="font-size: 12px; padding: 5px 0 5px 15px !important; ">
<input type="text" class="text_b debxsearch" value="<?php echo $this->_tpl_vars['values']['debtor_name']; ?>
" name="debtor_name" id="debtor_name" onkeyup="searchDebx();" style="width: 180px;" tabindex="6">
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['0']['content']; ?>
" class="under">(?)</a>
<br>
<span style="color:#FF0000;">
<?php echo $this->_tpl_vars['messages']['debtor_name']; ?>
</span>
</td>
</tr>
<tr class="row4">
<td align="right" valign="top" style="font-size: 12px; padding: 10px 0 5px 12px; "><span class="txt_11_red">* </span>Country : </td>
<td align="left" valign="top" style=" padding: 5px 0 5px 15px !important; ">
<?php $this->assign('country_name', 'country'); ?>
<?php $this->assign('tabindex', 2); ?>
<?php $_smarty_tpl_vars = $this->_tpl_vars;
$this->_smarty_include(array('smarty_include_tpl_file' => "../admin/templates/common/countries.html", 'smarty_include_vars' => array()));
$this->_tpl_vars = $_smarty_tpl_vars;
unset($_smarty_tpl_vars);
?>
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['10']['content']; ?>
" class="under">(?)</a> <br/><span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['country']; ?>
</span>
</td>
<td align="right" valign="top" style="font-size: 12px; padding: 5px 0 5px 16px !important;">Trading Name :</td>
<td align="left" valign="top" style="padding: 5px 0 5px 15px !important;">
<input type="text" class="text_b" value="<?php echo $this->_tpl_vars['values']['trade_name']; ?>
" name="trade_name" id="trade_name" style="width: 180px;" tabindex="7">
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['1']['content']; ?>
" class="under">(?)</a>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['trade_name']; ?>
</span>
</td>
</tr>
<tr class="row4">
<td align="right" valign="top" style="font-size: 12px; padding: 10px 0 5px 12px; ">
<span class="txt_11_red">* </span>Currency :
</td>
<td align="left" valign="top" style=" padding: 5px 0 5px 15px !important; ">
<?php $this->assign('last_value', 'notadd'); ?>
<?php $this->assign('tabindex', 3); ?>
<?php $this->assign('custom_help', $this->_tpl_vars['help']['5']['content']); ?>
<?php $_smarty_tpl_vars = $this->_tpl_vars;
$this->_smarty_include(array('smarty_include_tpl_file' => "../admin/templates/common/currencies.html", 'smarty_include_vars' => array()));
$this->_tpl_vars = $_smarty_tpl_vars;
unset($_smarty_tpl_vars);
?>
</td>
<td align="right" valign="top" style="font-size: 12px; padding: 5px 0 5px 16px !important; ">
<strong style="font-size:11px;">
<span class="txt_11_red">* </span> Company Registration Number :
</strong>
</td>
<td align="left" valign="top" style="padding: 5px 0 5px 15px !important;">
<input type="text" size="30" class="text_b" value="<?php echo $this->_tpl_vars['values']['debtor_crn']; ?>
" name="debtor_crn" id="debtor_crn" style="width:180px;" tabindex="8">
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['3']['content']; ?>
" class="under">(?)</a>
<br>
<span style="color:#FF0000;">
<?php echo $this->_tpl_vars['messages']['debtor_crn']; ?>
</span>
</td>
</tr>
<tr>
<td align="right" valign="top" style="font-size: 12px; padding: 10px 0 10px 12px;">
<span class="txt_11_red">* </span>Organisation :
</td>
<td align="left" valign="top" style="padding: 5px 0 5px 15px !important;">
<select name="organisation_id" id="organisation_id" class="cmb_bx1" tabindex="4">
<?php $_from = $this->_tpl_vars['organisation']; if (!is_array($_from) && !is_object($_from)) { settype($_from, 'array'); }if (count($_from)):
foreach ($_from as $this->_tpl_vars['i']):
?>
<option value="<?php echo $this->_tpl_vars['i']['organisation_id']; ?>
" <?php if ($this->_tpl_vars['values']['organisation_id'] == $this->_tpl_vars['i']['organisation_id']): ?> selected="selected" <?php endif; ?> ><?php echo $this->_tpl_vars['i']['organisation_name']; ?>
</option>
<?php endforeach; endif; unset($_from); ?>
</select>
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['2']['content']; ?>
" class="under">(?)</a>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['organisation_id']; ?>
</span>
</td>
<td align="right" valign="top" style="font-size: 12px; padding: 5px 0 5px 12px !important;">
Previous Name :
</td>
<td align="left" valign="top" style="padding: 5px 0 5px 15px !important;">
<input type="text" size="30" class="text_b" value="<?php echo $this->_tpl_vars['values']['previous_name']; ?>
" name="previous_name" id="previous_name" style="width:180px;" tabindex="9">
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['4']['content']; ?>
" class="under">(?)</a>
<span style="color:#FF0000; float:right;">
<?php echo $this->_tpl_vars['messages']['previous_name']; ?>
</span>
</td>
</tr>
<tr>
<td align="left" valign="top" style="font-size: 12px; padding: 5px 0 5px 12px !important; " class="creditor_details" colspan="2">
<span class="txt_11_red">* </span>
Agreed Early Payment Discount :
<input type="text" class="text_b_8" style="width: 45px;" value="0.00" name="payment_discount" id="payment_discount" tabindex="5" readonly="readonly" > %
<a href="javascript:void(0);" title="Enter the Counterparty's Agreed Early Payment Discount" class="under">(?)</a>
<span style="color:#FF0000; float:right;margin-right:55px;">
<?php echo $this->_tpl_vars['messages']['payment_discount']; ?>
</span>
</td>
</tr>
</table></td>
</tr>
<tr class="creditor_details">
<td align="center" valign="top" colspan="3">
<table cellspacing="0" cellpadding="0" border="0" width="100%">
<tbody>
<tr>
<td align="center" valign="top">
<table cellspacing="0" cellpadding="0" border="0" width="100%">
<tbody>
<tr>
<td align="left" valign="top" class="inves_top3" colspan="3">Bank Details</td>
</tr>
<tr>
<td align="left" width="50%" valign="top">
<table cellspacing="0" cellpadding="0" border="0" width="100%">
<tbody>
<tr class="row4">
<td align="right" width="32%" valign="top"><span class="txt_11_red">* </span>Bank Name :</td>
<td align="left" width="65%" valign="top" colspan="2">
<input type="text" size="30" class="text_b clsBlur" value="<?php echo $this->_tpl_vars['values']['bank_name']; ?>
" name="bank_name" id="bank_name">
<a href="javascript:void(0);" title="Bank Name" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['bank_name']; ?>
</span>
</td>
</tr>
<tr class="row4">
<td align="right" width="32%" valign="top"><span class="txt_11_red">* </span>IBAN Number :</td>
<td align="left" width="65%" valign="top" colspan="2"><input type="text" size="30" class="text_b clsBlur" value="<?php echo $this->_tpl_vars['values']['iban_number']; ?>
" name="iban_number" id="iban_number" tabindex="13">
<a href="javascript:void(0);" title="IBAN Number" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['iban_number']; ?>
</span>
</td>
</tr>
<tr class="row4">
<td align="right" width="32%" valign="top"><span class="txt_11_red">* </span>SWIFT Code :</td>
<td align="left" width="65%" valign="top" colspan="2"><input type="text" size="30" class="text_b clsBlur" value="<?php echo $this->_tpl_vars['values']['swift_code']; ?>
" name="swift_code" id="swift_code" tabindex="14">
<a href="javascript:void(0);" title="SWIFT Code" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['swift_code']; ?>
</span>
</td>
</tr>
</tbody>
</table>
</td>
<td align="left" width="50%" valign="top">
<table cellspacing="0" cellpadding="0" border="0" width="100%">
<tbody>
<tr class="row4"></tr>
<tr class="row4">
<td align="right" width="32%" valign="top"><span class="txt_11_red">* </span>Account Number :</td>
<td align="left" width="65%" valign="top" colspan="2"><input type="text" size="30" class="text_b clsBlur" value="<?php echo $this->_tpl_vars['values']['account_number']; ?>
" name="account_number" id="account_number" tabindex="11">
<a href="javascript:void(0);" title="Account Number" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['account_number']; ?>
</span>
</td>
</tr>
<!--<tr class="row4">
<td align="right" width="32%" valign="top"><span class="txt_11_red"></span>Sort Code :</td>
<td align="left" width="65%" valign="top" colspan="2"><input type="text" size="30" class="text_b clsBlur" value="<?php echo $this->_tpl_vars['values']['sort_code']; ?>
" name="sort_code" id="sort_code">
<a href="javascript:void(0);" title="Sort Code" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['sort_code']; ?>
</span>
</td>
</tr>-->
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td align="center" valign="top" colspan="3"><table cellspacing="0" cellpadding="0" border="0" width="100%">
<tbody>
<tr>
<td align="center" valign="top"><table cellspacing="0" cellpadding="0" border="0" width="100%">
<tbody>
<tr>
<td align="left" valign="top" class="inves_top3" colspan="3">Primary Address</td>
</tr>
<tr>
<td align="left" width="50%" valign="top"><table cellspacing="0" cellpadding="0" border="0" width="100%">
<tbody>
<tr class="row4">
<td align="right" width="32%" valign="top"><span class="txt_11_red">* </span>Address Line 1 :</td>
<td align="left" width="65%" valign="top" colspan="2"><input type="text" size="30" class="text_b clsBlur" value="<?php echo $this->_tpl_vars['values']['address1']; ?>
" name="address1" id="address1" tabindex="15">
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['6']['content']; ?>
" class="under">(?)</a> <br/><span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['address1']; ?>
</span></td>
</tr>
<tr class="row4">
<td align="right" width="32%" valign="top">Address Line 2 :</td>
<td align="left" width="65%" valign="top" colspan="2"><input type="text" size="30" class="text_b clsBlur" value="<?php echo $this->_tpl_vars['values']['address2']; ?>
" name="address2" id="address2" tabindex="16">
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['7']['content']; ?>
" class="under">(?)</a> <br/><span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['address2']; ?>
</span></td>
</tr>
<tr class="row4">
<td align="right" width="32%" valign="top">City / Town : </td>
<td align="left" width="65%" valign="top" colspan="2"><input type="text" size="30" class="text_b clsBlur" value="<?php echo $this->_tpl_vars['values']['city']; ?>
" name="city" id="city" tabindex="17">
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['8']['content']; ?>
" class="under">(?)</a> <br/><span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['city']; ?>
</span></td>
</tr>
<tr class="row4">
<td align="right" width="32%" valign="top"><span class="txt_11_red">* </span>Area / State :</span></td>
<td align="left" width="65%" valign="middle"><span style="font-size: 11px; padding-left:0px;" id="dropState">
<input type="text" size="30" class="text_b clsBlur" value="<?php echo $this->_tpl_vars['values']['state']; ?>
" id="state" name="state" tabindex="18">
</span> <a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['9']['content']; ?>
" class="under">(?)</a> <br/> <span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['state']; ?>
</span></td>
</tr>
<tr class="row4">
</tr>
</tbody>
</table></td>
<td align="left" width="50%" valign="top"><table cellspacing="0" cellpadding="0" border="0" width="100%">
<tbody>
<tr class="row4">
<td align="right" width="32%" valign="top"><span class="txt_11_red">* </span>Post Code :</td>
<td align="left" width="65%" valign="top"><input type="text" class="text_ph_code clsBlur" name="postal" id="postal" value="<?php echo $this->_tpl_vars['values']['postal']; ?>
" tabindex="19" >
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['11']['content']; ?>
" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['postal']; ?>
</span></td>
<td align="right" valign="middle"></td>
</tr>
<tr class="row6 clsrm">
<td align="right" width="32%" valign="top"><span style="font-size: 11px; padding-left: 10px;"><span class="txt_11_red">* </span>Phone Number :</span></td>
<td align="left" width="65%" valign="top"><table cellspacing="3" cellpadding="0" border="0" width="100%">
<tbody>
<tr>
<td align="left" width="1%" valign="top"></td>
<td align="left" width="61%" valign="top"><input type="text" class="text_b clsBlur clsphcode" maxlength="32" name="p_ph_code" id="p_ph_code" value="<?php echo $this->_tpl_vars['values']['p_ph_code']; ?>
" tabindex="22" >
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['12']['content']; ?>
" class="under">(?)</a></td>
</tr>
<tr>
<td align="left" valign="top" class="txt_11_cute"> </td>
<td align="left" valign="top" class="txt_11_cute">Phone Number <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['p_ph_code']; ?>
</span></td>
</tr>
</tbody>
</table></td>
<td align="center" valign="top"></td>
</tr>
<tr class="row6 clsrm">
<td align="right" width="32%" valign="top"><span style="font-size: 11px; padding-left: 20px;">Other Number :</span></td>
<td align="left" width="65%" valign="top"><table cellspacing="3" cellpadding="0" border="0" width="100%">
<tbody>
<tr>
<td align="left" width="1%" valign="top"></td>
<td align="left" width="61%" valign="top"><input type="text" class="text_b clsBlur" maxlength="32" name="f_ph_code" id="f_ph_code" value="<?php echo $this->_tpl_vars['values']['f_ph_code']; ?>
" tabindex="25" >
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['13']['content']; ?>
" class="under">(?)</a> </td>
</tr>
<tr>
<td align="left" valign="top" class="txt_11_cute"> </td>
<td align="left" valign="top" class="txt_11_cute">Phone Number<br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['f_ph_code']; ?>
</span></td>
</tr>
</tbody>
</table></td>
<td align="center" valign="top"></td>
</tr>
<tr class="row4">
<td align="right" width="32%" valign="top"><span class="txt_11_red">* </span>Email Address : </td>
<td align="left" width="65%" valign="top" style="padding-right:0px;">
<input type="text" size="30" class="text_b clsBlur clsEm" value="<?php echo $this->_tpl_vars['values']['email']; ?>
" name="email" id="email" tabindex="26" >
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['14']['content']; ?>
" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['email']; ?>
</span></td>
</tr>
</tbody>
</table></td>
</tr>
</tbody>
</table></td>
</tr>
<tr>
<td align="center" valign="top"><table cellspacing="0" cellpadding="0" border="0" width="100%">
<tbody>
<tr>
<td align="left" valign="top" class="inves_top3" colspan="3">Billing Address <a class="txt_12_blue style1">
<input type="checkbox" name="same_billing_address" id="chk" <?php if ($this->_tpl_vars['values']['same_billing_address'] != ''): ?>checked="true"<?php endif; ?> value="1" tabindex="27"> </a><a class="txt_12_blue style1" >same as Primary Address</a></td>
</tr>
<tr id="billing_address_section">
<td align="left" width="50%" valign="top"><table cellspacing="0" cellpadding="0" border="0" width="100%">
<tbody>
<tr class="row4">
<td align="right" width="32%" valign="top"><span class="txt_11_red">* </span>Address Line 1 :</td>
<td align="left" width="65%" valign="top" colspan="2"><input type="text" size="30" class="text_b" value="<?php echo $this->_tpl_vars['values']['b_address1']; ?>
" name="b_address1" id="b_address1" tabindex="28">
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['15']['content']; ?>
" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['b_address1']; ?>
</span></td>
</tr>
<tr class="row4">
<td align="right" width="32%" valign="top" >Address Line 2 :</td>
<td align="left" width="65%" valign="top" colspan="2"><input type="text" size="30" class="text_b" value="<?php echo $this->_tpl_vars['values']['b_address2']; ?>
" name="b_address2" id="b_address2" tabindex="29" >
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['16']['content']; ?>
" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['b_address2']; ?>
</span></td>
</tr>
<tr class="row4">
<td align="right" width="32%" valign="top">City / Town : </td>
<td align="left" width="65%" valign="top" colspan="2"><input type="text" size="30" maxlength="30" class="text_b" value="<?php echo $this->_tpl_vars['values']['b_city']; ?>
" name="b_city" id="b_city" tabindex="30" >
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['17']['content']; ?>
" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['b_city']; ?>
</span></td>
</tr>
<tr class="row4">
<td align="right" width="32%" valign="top"><span class="txt_11_red">* </span>Area / State :</td>
<td align="left" width="65%" valign="middle"><span style="font-size: 11px; padding-left:0px;" id="b_dropState">
<input type="text" size="30" class="text_b" value="<?php echo $this->_tpl_vars['values']['b_state']; ?>
" id="b_state" name="b_state" tabindex="31" >
</span> <a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['18']['content']; ?>
" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['b_state']; ?>
</span></td>
</tr>
<tr class="row4">
<td align="right" width="32%" valign="top"><span class="txt_11_red">* </span>Country : </td>
<td align="left" width="65%" valign="top">
<?php $this->assign('country_name', 'b_country'); ?>
<?php $this->assign('tabindex', 32); ?>
<?php $_smarty_tpl_vars = $this->_tpl_vars;
$this->_smarty_include(array('smarty_include_tpl_file' => "../admin/templates/common/countries.html", 'smarty_include_vars' => array()));
$this->_tpl_vars = $_smarty_tpl_vars;
unset($_smarty_tpl_vars);
?>
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['19']['content']; ?>
" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['b_country']; ?>
</span></td>
</tr>
</tbody>
</table></td>
<td align="left" width="50%" valign="top"><table cellspacing="0" cellpadding="0" border="0" width="100%">
<tbody>
<tr class="row4">
<td align="right" width="32%" valign="top"><span class="txt_11_red">* </span>Post Code :</td>
<td align="left" width="65%" valign="top"><input type="text" class="text_ph_code" size="8" name="b_postal" id="b_postal" value="<?php echo $this->_tpl_vars['values']['b_postal']; ?>
" tabindex="33">
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['20']['content']; ?>
" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['b_postal']; ?>
</span></td>
<td align="right" valign="middle"></td>
</tr>
<tr class="row6 clsrm">
<td align="right" width="32%" valign="top"><span style="font-size: 11px; padding-left: 10px;"><span class="txt_11_red">* </span>Phone Number :</span></td>
<td align="left" width="65%" valign="top"><table cellspacing="3" cellpadding="0" border="0" width="100%">
<tbody>
<tr>
<td align="left" width="1%" valign="top"></td>
<td align="left" width="61%" valign="top"><input type="text" class="text_b" maxlength="32" name="b_p_ph_code" id="b_p_ph_code" value="<?php echo $this->_tpl_vars['values']['b_p_ph_code']; ?>
" tabindex="36" >
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['21']['content']; ?>
" class="under">(?)</a>
</td>
</tr>
<tr>
<td align="left" valign="top" class="txt_11_cute"> </td>
<td align="left" valign="top" class="txt_11_cute">Phone Number<br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['b_p_ph_code']; ?>
</span></td>
</tr>
</tbody>
</table></td>
<td align="center" valign="top"></td>
</tr>
<tr class="row6 clsrm">
<td align="right" width="32%" valign="top"><span style="font-size: 11px; padding-left: 20px;">Other Number :</span></td>
<td align="left" width="65%" valign="top"><table cellspacing="3" cellpadding="0" border="0" width="100%">
<tbody>
<tr>
<td align="left" width="1%" valign="top"></td>
<td align="left" width="61%" valign="top"><input type="text" class="text_b" maxlength="32" name="b_f_ph_code" id="b_f_ph_code" value="<?php echo $this->_tpl_vars['values']['b_f_ph_code']; ?>
" tabindex="39" >
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['22']['content']; ?>
" class="under">(?)</a> </td>
</tr>
<tr>
<td align="left" valign="top" class="txt_11_cute"> </td>
<td align="left" valign="top" class="txt_11_cute">Phone Number<br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['b_f_ph_code']; ?>
</span></td>
</tr>
</tbody>
</table></td>
<td align="center" valign="top"></td>
</tr>
<tr class="row4">
<td align="right" width="32%" valign="top"><span class="txt_11_red">* </span>Email Address :</td>
<td align="left" width="65%" valign="top" style="padding-right:0px;"><input type="text" size="30" class="text_b" value="<?php echo $this->_tpl_vars['values']['b_email']; ?>
" name="b_email" id="b_email" tabindex="40" >
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['23']['content']; ?>
" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['b_email']; ?>
</span></td>
<td align="right" valign="top"></td>
</tr>
</tbody>
</table></td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td align="left" valign="top" class="inves_top3" colspan="3">Account Contact Details</td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table></td>
</tr>
<tr class="row2">
<td align="left" colspan="2" valign="top"><span class="txt_11_red">* </span>Contact First Name :
<input type="text" size="30" class="text_b" value="<?php echo $this->_tpl_vars['values']['d_name']; ?>
" name="d_name" tabindex="41" >
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['24']['content']; ?>
" class="under" style="margin-right: 100px;">(?)</a>
Last Name :
<input type="text" size="30" class="text_b" value="<?php echo $this->_tpl_vars['values']['last_name']; ?>
" name="last_name" tabindex="42" > <a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['25']['content']; ?>
" class="under">(?)</a><br/>
<span style="color:#FF0000; float:left;">
<?php echo $this->_tpl_vars['messages']['d_name']; ?>
</span> <span style="color:#FF0000; float:right;">
<?php echo $this->_tpl_vars['messages']['last_name']; ?>
</span></td>
<td align="left" valign="top"></td>
</tr>
<tr class="row6 clsrm">
<td align="right" width="31%" valign="middle"><span style="font-size: 11px; padding-left: 10px; display: block; margin-bottom: 15px;"><span class="txt_11_red">* </span>Contact Direct Dial Phone :</span></td>
<td align="left" width="66%" valign="top"><table cellspacing="3" cellpadding="0" border="0" width="55%">
<tbody>
<tr>
<td align="left" width="1%" valign="top"></td>
<td align="left" width="61%" valign="top"><input type="text" class="text_b" id="clsphcode1" maxlength="32" name="d_ph_code" value="<?php echo $this->_tpl_vars['values']['d_ph_code']; ?>
" tabindex="45" >
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['26']['content']; ?>
" class="under">(?)</a> </td>
</tr>
<tr>
<td align="left" valign="top" class="txt_11_cute"> </td>
<td align="left" valign="top" class="txt_11_cute">Phone Number<br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['d_ph_code']; ?>
</span></td>
</tr>
</tbody>
</table></td>
<td align="left" valign="top"> </td>
</tr>
<tr class="row2">
<td align="right" width="31%" valign="top"><a name="debtor-email"></a><span class="txt_11_red">* </span>Contact Email :</td>
<td align="left" width="66%" valign="top"><input type="text" size="30" class="text_b" id="clsEm1" value="<?php echo $this->_tpl_vars['values']['d_email']; ?>
" name="d_email" tabindex="47" >
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['27']['content']; ?>
" class="under">(?)</a> <span style="font-weight:bold;color:#FF0000;font-size:9px;padding-left:5px;">ETR Invoices are Emailed to this Email Address</span><br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['d_email']; ?>
</span></td>
<td align="left" valign="top"></td>
</tr>
<tr class="row1">
<td align="right" width="31%" valign="top"><span class="txt_11_red">* </span>Counterparty Since :</td>
<td align="left" width="66%" valign="top"><?php $this->assign('yr', $this->_tpl_vars['values']['d_since']); ?>
<select name="d_since" class="cmb_bx1" id="d_since" tabindex="48" >
<option value="">Select Year</option>
<?php
$year = $this->get_template_vars('yr');
$option ='';
for($i=date('Y');$i>=1950;$i--) {
$option .= '<option value="'.$i.'"';
if($year == $i) $option .='selected="selected"';
$option .='>'.$i.'</option>';
}
echo $option;
?>
</select>
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['28']['content']; ?>
" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['d_since']; ?>
</span></td>
<td align="left" valign="top"></td>
</tr>
<tr class="row2">
<td align="right" width="31%" valign="top"><span class="txt_11_red"> </span>Total Historic Value :</td>
<td align="left" width="66%" valign="top"><input type="text" size="12" maxlength="12" class="text_b_10" value="<?php echo $this->_tpl_vars['values']['d_value']; ?>
" name="d_value" tabindex="49" >
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['29']['content']; ?>
" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['d_value']; ?>
</span></td>
<td align="left" valign="top"></td>
</tr>
<tr class="row1">
<td align="right" width="31%" valign="top"><span class="txt_11_red">* </span>Average Payment Cycle :</td>
<td align="left" width="66%" valign="top"><input type="text" size="3" maxlength="3" class="text_b_3" value="<?php echo $this->_tpl_vars['values']['d_payment']; ?>
" name="d_payment" tabindex="50">
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['30']['content']; ?>
" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['d_payment']; ?>
</span></td>
<td align="left" valign="top"></td>
</tr>
<tr class="row2">
<td align="right" width="31%" valign="top"><span class="txt_11_red"> </span>Credit Notes Issued :</td>
<td align="left" width="66%" valign="top"><input type="text" size="12" maxlength="12" class="text_b_10" value="<?php echo $this->_tpl_vars['values']['d_notes']; ?>
" name="d_notes" tabindex="51" >
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['31']['content']; ?>
" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['d_notes']; ?>
</span></td>
<td align="left" valign="top"></td>
</tr>
<tr class="row1">
<td align="right" width="31%" valign="top"><span class="txt_11_red">* </span>Invoices Predicted Per Annum :</td>
<td align="left" width="66%" valign="top"><input type="text" size="12" maxlength="5" class="text_b_10" value="<?php echo $this->_tpl_vars['values']['d_invoice']; ?>
" name="d_invoice" tabindex="52" >
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['32']['content']; ?>
" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['d_invoice']; ?>
</span></td>
<td align="left" valign="top"></td>
</tr>
<tr class="row2">
<td align="right" width="31%" valign="top"><span class="txt_11_red">* </span>Predicted Annual Revenue :</td>
<td align="left" width="66%" valign="top"><input type="text" size="12" maxlength="12" class="text_b_10" value="<?php echo $this->_tpl_vars['values']['d_revenue']; ?>
" name="d_revenue" tabindex="53" >
<a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['33']['content']; ?>
" class="under">(?)</a> <br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['d_revenue']; ?>
</span></td>
<td align="left" valign="top"></td>
</tr>
<tr class="debtor_details">
<td align="left" valign="top" colspan="3">
<table cellspacing="0" cellpadding="0" border="0" width="100%">
<tbody>
<tr>
<td align="left" valign="top" class="inves_top3" colspan="3">Experience</td>
</tr>
<tr>
<td align="center" width="100%" valign="top" colspan="3"><br />Upload the Experience File (also called statement, or account history) in XLS, XLSX or CSV file format. Download the Experience File XLSX Template using the link provided below. Read the <a href="http://www.credebtexchange.com/blog/tips-help/debtor-experience-upload" style="font-weight:bold;color:#FF0000;" target="_blank">instructions carefully</a> on how to complete this important file otherwise you will not be able to create this account </td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td align="center" valign="middle" colspan="3">
<table cellspacing="3" cellpadding="3" border="0" width="65%">
<tbody>
<tr class="row6">
<?php if (( $this->_tpl_vars['typeMapping'] != '' )): ?>
<?php echo $this->_tpl_vars['typeMapping']; ?>
<?php else: ?>
<td align="right" width="20%" valign="middle"><span class="txt_11_red">* </span>Experience File</td>
<td align="left" width="36%" valign="middle"><input type="file" class="browse" name="filecsv" size="23" ></td>
<?php endif; ?>
<td align="left" width="2%" valign="middle"></td>
</tr>
</tbody>
</table>
<br/>
<span style="color:#FF0000">
<?php echo $this->_tpl_vars['messages']['filecsv']; ?>
</span></td>
</tr>
<tr>
<td align="center" valign="middle" colspan="2"><a href="/documents/Debtor-Experience-Upload.xlsx" target="_blank" class="txt_12_blue style1">Download XLSX Template</a> <a href="javascript:void(0);" title="<?php echo $this->_tpl_vars['help']['34']['content']; ?>
" class="under">(?)</a></td>
</tr>