<p>Die mit einem Asterisk ("Sternchen") gekennzeichneten Felder sind Pflichtfelder und m&uuml;ssen ausgef&uuml;llt werden.</p>

<form class="cashier" method="post">
	<h2 class="maincontent_headline">Rechnungsanschrift</h2>

	{$ANREDE}*
	<select type="text" name="es_ra_anrede">
		<option value="1" {if $customer_center.es_ra_anrede == 1}selected{/if}>{$HERR}</option>
		<option value="2" {if $customer_center.es_ra_anrede == 2}selected{/if}>{$FRAU}</option>
		<option value="3" {if $customer_center.es_ra_anrede == 3}selected{/if}>{$FIRMA}</option>
	</select>

	{$VORNAME}*
	<input type="text" name="es_ra_vorname" value="{$customer_center.es_ra_vorname}" />

	{$NACHNAME}*
	<input type="text" name="es_ra_nachname" value="{$customer_center.es_ra_nachname}" />

	{$GEBURTSDATUM}*
	<select name="es_ra_gebdd">
	<option value="0">Tag</option>
		{$customer_center.es_ra_gebdd}
	</select>

	<select name="es_ra_gebmm">
		<option value="0">Monat</option>
		{$customer_center.es_ra_gebmm}
	</select>

	<select name="es_ra_gebyy" size="1">
		<option value="0">Jahr</option>
		{$customer_center.es_ra_gebyy}
	</select>

	{$FIRMA}
	<input type="text" name="es_ra_firma" value="{$customer_center.es_ra_firma}" />

	{$STRASSE} und Hausnummer*<br>
	<input type="text" name="es_ra_strasse" value="{$customer_center.es_ra_strasse}" />

	{$PLZ}*
	<input type="text" name="es_ra_plz" value="{$customer_center.es_ra_plz}" />


	{$ORT}*
	<input type="text" name="es_ra_ort" value="{$customer_center.es_ra_ort}" />

	{$LAND}*
	<select name="es_ra_land">
		{$customer_center.laender}
	</select>

	{$TELEFON}*
	<input type="text" name="es_ra_telefon" value="{$customer_center.es_ra_telefon}" />

	Fax
	<input type="text" name="es_ra_fax" style="width:180px;" value="{$customer_center.es_ra_fax}" />

	{$EMAIL}*
	<input type="text" name="es_ra_email" value="{$customer_center.es_ra_email}">

	Homepage
	<input type="text" name="es_ra_homepage" value="{if $customer_center.es_ra_homepage}{$customer_center.es_ra_homepage}{else}keine{/if}" />

	<input type="hidden" name="kundenart" value="{$customer_center.kundenart}" />

	<h2 class="maincontent_headline_text">Lieferanschrift</h2>

	<input type="radio" {if $customer_center.es_lieferanschrift == 1}checked{/if} name="es_lieferanschrift" value="1" />{$GLEICH_WIE_RECHNUNGSANSCHRIFT}
	<input type="radio" {if $customer_center.es_lieferanschrift == 2}checked{/if} name="es_lieferanschrift" value="2" /> {$ABWEICHEND}

	{$ANREDE}*
	<select type="text" name="es_la_anrede" size="1">
		<option value="1" {if $customer_center.es_la_anrede == 1}selected{/if}>{$HERR}</option>
		<option value="2" {if $customer_center.es_la_anrede == 2}selected{/if}>{$FRAU}</option>
		<option value="3" {if $customer_center.es_la_anrede == 3}selected{/if}>{$FIRMA}</option>
	</select>

	{$VORNAME}*
	<input type="text" name="es_la_vorname" value="{$customer_center.es_la_vorname}" />

	{$NACHNAME}*
	<input type="text" name="es_la_nachname" value="{$customer_center.es_la_nachname}" />

	{$FIRMA}
	<input type="text" name="es_la_firma" value="{$customer_center.es_la_firma}" />

	{$STRASSE} und Hausnummer*<br>
	<input type="text" name="es_la_strasse" value="{$customer_center.es_la_strasse}" />

	{$PLZ}*
	<input type="text" name="es_la_plz" value="{$customer_center.es_la_plz}" />

	{$ORT}*
	<input type="text" name="es_la_ort" value="{$customer_center.es_la_ort}" />

	{$LAND}*
	<select name="es_la_land">
		{$customer_center.la_laender}
	</select>

	<h2 class="maincontent_headline">Passwort</h2>

	<p><strong>Achtung:</strong> Passwort nur eingeben, wenn Sie es &auml;ndern wollen, ansonsten Felder leer lassen!</p>
	{$WUNSCH_PASSWD_TEXT}
	<input type="password" name="lo_passwort_1" value="{$customer_center.lo_passwort_1}" />

	{$WUNSCH_PASSWD_TEXT_RE}
	<input type="password" name="lo_passwort_2" value="{$customer_center.lo_passwort_2}" />

	<input class="button_blank" type="submit" name="submit" value="Speichern" />
</form>
