[% USE HTML %][% USE L %][% USE LxERP %]

 <form method="post" action="[% HTML.escape(script) %]">

  <table>
   <tr class="listheading">
    <th colspan="2" width="50%">[% LxERP.t8('Billing Address') %]</th>
    <th width="50%">[% LxERP.t8('Shipping Address') %]</th>
   </tr>
   <tr height="5"></tr>
   <tr>
    <th align="right" nowrap>[%- IF vc == "customer" %][%- LxERP.t8('Customer Number') %][%- ELSE %][%- LxERP.t8('Vendor Number') %][%- END %]</th>
    <td>[%- IF vc == "customer" %][%- HTML.escape(customernumber) %][%- ELSE %][%- HTML.escape(vendornumber) %][%- END %]</td>
   </tr>
   <tr>
    <th align="right" nowrap>[% LxERP.t8('Company Name') %]</th>
    <td>[% HTML.escape(name) %]</td>
    <td>[% L.input_tag("shiptoname", shiptoname, "size", "35") %]</td>
   </tr>
   <tr>
    <th align="right" nowrap>[% LxERP.t8('Department') %]</th>
    <td>[% HTML.escape(department_1) %]</td>
    <td>[% L.input_tag("shiptodepartment_1", shiptodepartment_1, "size", "35") %]</td>
   </tr>
   <tr>
    <th align="right" nowrap>&nbsp;</th>
    <td>[% HTML.escape(department_2) %]</td>
    <td>[% L.input_tag("shiptodepartment_2", shiptodepartment_2, "size", "35") %]</td>
   </tr>
   <tr>
    <th align="right" nowrap>[% LxERP.t8('Street') %]</th>
    <td>[% HTML.escape(street) %]</td>
    <td>[% L.input_tag("shiptostreet", shiptostreet, "size", "35") %]</td>
   </tr>
   <tr>
    <th align="right" nowrap>[% LxERP.t8('Zipcode') %]</th>
    <td>[% HTML.escape(zipcode) %]</td>
    <td>[% L.input_tag("shiptozipcode", shiptozipcode, "size", "35") %]</td>
   </tr>
   <tr>
    <th align="right" nowrap>[% LxERP.t8('City') %]</th>
    <td>[% HTML.escape(city) %]</td>
    <td>[% L.input_tag("shiptocity", shiptocity, "size", "35") %]</td>
   </tr>
   <tr>
    <th align="right" nowrap>[% LxERP.t8('Country') %]</th>
    <td>[% HTML.escape(country) %]</td>
    <td>[% L.input_tag("shiptocountry", shiptocountry, "size", "35") %]</td>
   </tr>
   <tr>
    <th align="right" nowrap>[% LxERP.t8('Contact') %]</th>
    <td>[% HTML.escape(contact) %]</td>
    <td>[% L.input_tag("shiptocontact", shiptocontact, "size", "35") %]</td>
   </tr>
   <tr>
    <th align="right" nowrap>[% LxERP.t8('Gender') %]</th>
    <td></td>
    <td>
     [% L.select_tag('shiptocp_gender', [ [ 'm', LxERP.t8('male') ], [ 'f', LxERP.t8('female') ] ], 'default' = shiptocp_gender) %]
    </td>
   </tr>
   <tr>
    <th align="right" nowrap>[% LxERP.t8('Phone') %]</th>
    <td>[% HTML.escape(phone) %]</td>
    <td>[% L.input_tag("shiptophone", shiptophone, "size", "35") %]</td>
   </tr>
   <tr>
    <th align="right" nowrap>[% LxERP.t8('Fax') %]</th>
    <td>[% HTML.escape(fax) %]</td>
    <td>[% L.input_tag("shiptofax", shiptofax, "size", "35") %]</td>
   </tr>
   <tr>
    <th align="right" nowrap>[% LxERP.t8('E-mail') %]</th>
    <td>[% HTML.escape(email) %]</td>
    <td>[% L.input_tag("shiptoemail", shiptoemail, "size", "35") %]</td>
   </tr>
  </table>

  <hr size="3" noshade>

  [% L.hidden_tag("action", "ship_to_entered") %]
  [% L.hidden_tag("nextsub", nextsub) %]
  [% L.hidden_tag("previousform", previousform) %]

  [% L.submit_tag("__dummy", LxERP.t8("Continue")) %]
 </form>