<h1>Automatic Payment Setup</h1>
<hr />
<form method="post" action="{SELF}">
{MESSAGE}
Automatic payments provide an extra level of convenience by allowing you to schedule a series of monthly payments. 
<br /><br />
To schedule an automatic payment, select the payment method and payment options below. Automatic payments will start on your next scheduled payment date. 
<br /><br />
<table class="bTable">
<tr>
  <td style="width:200px;">Automatic Payments:</td>
  <td><input type="checkbox" name="data[autopay]" value="1" {AUTOPAY}> Enabled</td>
</tr>
<tr>
  <td>Payment Method:</td>
  <td><select name="data[autopay_method]">{AUTOPAY_METHOD}</select></td>
</tr>
<tr>
  <td>Days Before Due Date:</td>
  <td><select name="data[autopay_days]">{AUTOPAY_DAYS}</select></td>
</tr>
<tr>
  <td>Payment Amount:</td>
  <td><input type="radio" name="data[autopay_amount]" value="0" {IT}> Invoice Total<br /><input type="radio" name="data[autopay_amount]" value="1" {IU}> Invoice Amount Up To $<input type="text" name="data[autopay_max]" value="{AUTOPAY_MAX}" size="5"></td>
</tr>
<tr>
  <td></td>
  <td><input type="submit" name="data[uap]" value="Update"></td>
</tr>
</table>
</form>