<div class="checkout-payment-form">
	<script src="https://secure.pay1.de/client-api/js/ajax.js"></script>
	<script src="<?php echo GM_HTTP_SERVER.DIR_WS_CATALOG ?>/ext/payone/js/client_api.js"></script>

	<table class="payone_paydata payone_elv_data" data-gambio-widget="payone_checkout" data-payone_checkout-module="elv">
		<tr class="datarow">
			<td class="p1-label">
				<label for="p1_elv_country">##elv_country</label>
			</td>
			<td>
				<select id="p1_elv_country" name="p1_elv_country">
					<?php foreach($sepa_countries as $sc): ?>
					<option value="<?php echo $sc['countries_iso_code_2'] ?>" <?php echo $sepa_countries_selected[$sc['countries_iso_code_2']] ?>>
					<?php echo $sc['countries_name'] ?>
					</option>
					<?php endforeach ?>
				</select>
			</td>
		</tr>

		<tr class="datarow sepadata">
			<td class="p1-label">
				<label for="p1_elv_iban">##elv_iban</label>
			</td>
			<td>
				<input type="text" id="p1_elv_iban" name="p1_elv_iban">
			</td>
		</tr>
		<tr class="datarow sepadata">
			<td class="p1-label">
				<label for="p1_elv_bic">##elv_bic</label>
			</td>
			<td>
				<input type="text" id="p1_elv_bic" name="p1_elv_bic">
			</td>
		</tr>

		<?php if($this->pg_config['genre_specific']['sepa_display_ktoblz'] === 'true'): ?>
		<tr class="only_de note_de">
			<td colspan="2" class="note_german_account">##note_german_account</td>
		</tr>

		<tr class="datarow only_de">
			<td class="p1-label">
				<label for="p1_elv_accountnumber">##elv_account_number</label>
			</td>
			<td>
				<input type="text" id="p1_elv_accountnumber" name="p1_elv_accountnumber">
			</td>
		</tr>
		<tr class="datarow only_de">
			<td class="p1-label">
				<label for="p1_elv_bankcode">##elv_bankcode</label>
			</td>
			<td>
				<input type="text" id="p1_elv_bankcode" name="p1_elv_bankcode">
			</td>
		</tr>
		<?php endif; ?>

		<tr class="datarow">
			<td colspan="2">
				<p class="p1_error"></p>
			</td>
		</tr>
	</table>

	<div class="p1_finaldata_elv">
		<table>
			<tr><td>##elv_country</td><td class="final_elv_country"></td></tr>
			<tr><td>##elv_account_number</td><td class="final_elv_accountnumber"></td></tr>
			<tr><td>##elv_bankcode</td><td class="final_elv_bankcode"></td></tr>
			<tr><td>##elv_iban</td><td class="final_elv_iban"></td></tr>
			<tr><td>##elv_bic</td><td class="final_elv_bic"></td></tr>
		</table>
	</div>
</div>