numerus/web/template/tax-details.html

{{ define "content" }}
			<section class="dialog-content">
				<h2>{{(pgettext "Tax Details" "title")}}</h2>
				<form method="POST">
						<div class="input">
							<input type="text" name="business_name" id="business_name" required="required" value="{{ .BusinessName }}" placeholder="{{( pgettext "Business name" "input" )}}">
							<label for="business_name">{{( pgettext "Business name" "input" )}}</label>
						</div>
						<div class="input">
							<input type="text" name="vatin" id="vatin" required="required" value="{{ .VATIN }}" placeholder="{{( pgettext "VAT number" "input" )}}">
							<label for="vatin">{{( pgettext "VAT number" "input" )}}</label>
						</div>
						<div class="input">
							<input type="text" name="trade_name" id="trade_name" value="{{ .TradeName }}" placeholder="{{( pgettext "Trade name" "input" )}}">
							<label for="trade_name">{{( pgettext "Trade name" "input" )}}</label>
						</div>
						<div class="input">
							<input type="tel" name="phone" id="phone" required="required" value="{{ .Phone }}" placeholder="{{( pgettext "Phone" "input" )}}">
							<label for="phone">{{( pgettext "Phone" "input" )}}</label>
						</div>
						<div class="input">
							<input type="email" name="email" id="email" required="required" value="{{ .Email }}" placeholder="{{( pgettext "Email" "input" )}}">
							<label for="email">{{( pgettext "Email" "input" )}}</label>
						</div>
						<div class="input">
							<input type="url" name="web" id="web" value="{{ .Web }}" placeholder="{{( pgettext "Web" "input" )}}">
							<label for="web">{{( pgettext "Web" "input" )}}</label>
						</div>
						<div class="input">
							<input type="text" name="address" id="address" class="width-2x" required="required" value="{{ .Address }}" placeholder="{{( pgettext "Address" "input" )}}">
							<label for="address">{{( pgettext "Address" "input" )}}</label>
						</div>
						<div class="input">
							<input type="text" name="city" id="city" required="required" value="{{ .City }}" placeholder="{{( pgettext "City" "input" )}}">
							<label for="city">{{( pgettext "City" "input" )}}</label>
						</div>
						<div class="input">
							<input type="text" name="province" id="province" required="required" value="{{ .City }}" placeholder="{{( pgettext "Province" "input" )}}">
							<label for="province">{{( pgettext "Province" "input" )}}</label>
						</div>
						<div class="input">
							<input type="text" name="postal_code" id="postal_code" required="required" value="{{ .PostalCode }}" placeholder="{{( pgettext "Postal code" "input" )}}">
							<label for="postal_code">{{( pgettext "Postal code" "input" )}}</label>
						</div>

						<div class="input">
							<select id="country" name="country" class="width-fixed">
								{{- range $country := .Countries }}
								<option value="{{ .Code }}" {{ if eq .Code $.CountryCode }}selected="selected"{{ end }}>{{ .Name }}</option>
								{{- end }}
							</select>
							<label for="country">{{( pgettext "Country" "input" )}}<label>
						</div>

						<button type="submit">{{( pgettext "Save changes" "action" )}}</button>
				</form>
			</section>
{{- end }}