<div class="checkout-payment-form">
	<?php if(count($activatedTypes) == 1): ?>
	<input type="hidden" name="safeinv_type" value="<?= $paymentTypeCodeMapping[$activatedTypes[0]] ?>" id="p1_safeinv_type">
	<?php endif ?>
	<table class="payone_safeinv_data" data-gambio-widget="payone_checkout" data-payone_checkout-module="safeinv">
		<?php if(count($activatedTypes) > 1): ?>
		<tr class="datarow">
			<td class="p1-label">
				##safeinv_type
			</td>
			<td class="p1-data">
				<select name="safeinv_type" id="p1_safeinv_type">
					<?php if($this->pg_config['types']['billsafe']['active'] == 'true'): ?>
					<option value="BSV" <?= $safeInfTypeSelected === 'BSV' ? 'selected' : '' ?>>
					<?php echo $this->pg_config['types']['billsafe']['name'] ?>
					</option>
					<?php endif ?>
					<?php if($this->pg_config['types']['payolutioninvoicing']['active'] == 'true'): ?>
					<option value="PYV" <?= $safeInfTypeSelected === 'PYV' ? 'selected' : '' ?>>
					<?php echo $this->pg_config['types']['payolutioninvoicing']['name'] ?>
					</option>
					<?php endif ?>
				</select>
			</td>
		</tr>
		<?php endif ?>
		<tr class="datarow">
			<td class="p1-label">
				##your_date_of_birth
			</td>
			<td class="p1-data">
				<select name="p1-safeinv-doby" class="p1-dob">
					<?php for($year = date('Y'); $year >= 1900; $year--): ?>
					<option value="<?= $year ?>" <?= $customerDateOfBirth->format('Y') == $year ? 'selected' : '' ?>><?= $year ?></option>
					<?php endfor ?>
				</select>

				<select name="p1-safeinv-dobm" class="p1-dob">
					<?php for($month = 1; $month <= 12; $month++): ?>
					<option value="<?= $month ?>" <?= $customerDateOfBirth->format('m') == $month ? 'selected' : '' ?>><?= $month ?></option>
					<?php endfor ?>
				</select>

				<select name="p1-safeinv-dobd" class="p1-dob">
					<?php for($day = 1; $day <= 31; $day++): ?>
					<option value="<?= $day ?>" <?= $customerDateOfBirth->format('d') == $day ? 'selected' : '' ?>><?= $day ?></option>
					<?php endfor ?>
				</select>
			</td>
		</tr>
		<tr class="datarow p1-safeinv-agreement p1-show-for-PYV">
			<td colspan="2">
				<div class="p1-invnote">
					<input type="checkbox" name="safeinv_agreement" value="1">
					<?= $invoiceNote ?>
				</div>
			</td>
		</tr>
	</table>
</div>