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User: asjudine (504)
PHP: 5.2.17
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File: /home/asjudine/public_html/mostrar_solicitud3.php
<?php 
require_once("mainfile.php");
include ("config.php");
global $dbi;
$linea = '-';

require_once("Conectarse.php");


if(isset($_POST["enviar"]))
{
	
		$fechan = $mesfn.$linea.$diafn;

	if($codiase=='1')
	{
		
		//$sqlnom6 = "select codigo from vendedores where vendedor = '$vend'";
		//$control6 = mysql_query($sqlnom6, $dbi) or die(mysql_error());	
 			$result = mysql_query('SELECT codigo FROM vendedores WHERE vendedor = "' . $_POST[vend] . '" ');
			if (!$result) {
				die('Invalid query: ' . mysql_error());
			}
 
		list($codigo_asesor) = mysql_fetch_row($result);
		$codiase = $codigo_asesor;
	}
	if($planj=='1')
	{
	   //$sqlnom7 = "select codigo from planes_ventas where plan = '$planc'";
		//$control7 = mysql_query($sqlnom7, $dbi) or die(mysql_error());	
 			$resul = mysql_query('SELECT codigo FROM planes_ventas WHERE plan = "' . $_POST[planc] . '" ');
			if (!$resul) {
				die('Invalid query: ' . mysql_error());
			}
		
		list($cod_plan) = mysql_fetch_row($resul);
		$planj = $cod_plan;
	}

$modificarcod9 = mysql_query("UPDATE  solicitud_credito  set ced_ciudad = '" . $_POST[ciuced] . "', nombre = '" . $_POST[ape] . "', fecha = '" . $_POST[fecsol] . "', direccion = '" . $_POST[dire] . "', ciudad  = '" . $_POST[ciu] . "', telefono = '" . $_POST[tel] . "', celular = '" . $_POST[cel] . "', email = '" . $_POST[email] . "', devengado = '" . $_POST[dev] . "', descuentos = '" . $_POST[desc] . "', neto = '" . $_POST[net] . "', unidad = '" . $_POST[uni] . "', monto_solicitado = '" . $_POST[mon] . "', codigo_plan = '" . $_POST[planj] . "', numero_cuenta  = '" . $_POST[cue] . "', banco = '" . $_POST[ban] . "', codigo_asesor = '" . $_POST[codiase] . "', codigo_militar = '" . $_POST[codigom] . "', grado = '" . $_POST[gra] . "', numero_libranza = '" . $_POST[num_lib] . "', cuotas_credito = '" . $_POST[cuo_cre] . "', con_valor_mensual = '" . $_POST[vmj] . "', con_valor_total = '" . $_POST[vmt] . "', fecha_nac = '" . $_POST[fechan] . "', concepto_rechazo = '" . $_POST[] . "', estado = '0' , numero_contrato = '" . $_POST[numcont] . "'  WHERE cedula = '" . $_POST[ced] . "' ");

	  echo "<script>alert('Se ha modificado correctamente la informacion y se ha enviado a solicitud activa');</script>";
}
	
	//$sqlnom = "select cedula, ced_ciudad, nombre, fecha, direccion, ciudad, telefono, celular, email, devengado, descuentos, neto, unidad, monto_solicitado, codigo_plan, numero_cuenta, banco, codigo_asesor, codigo_militar, grado, codigo_sucursal, numero_libranza, cuotas_credito,con_valor_mensual, con_valor_total, fecha_nac, concepto_rechazo, numero_contrato from solicitud_credito where cedula = '$ced2'";
	
//		$control = mysql_query($sqlnom, $dbi) or die(mysql_error());	

 $result = mysql_query('SELECT cedula, ced_ciudad, nombre, fecha, direccion, ciudad, telefono, celular, email, devengado, descuentos, neto, unidad, monto_solicitado, codigo_plan, numero_cuenta, banco, codigo_asesor, codigo_militar, grado, codigo_sucursal, numero_libranza, cuotas_credito,con_valor_mensual, con_valor_total, fecha_nac, concepto_rechazo, numero_contrato FROM solicitud_credito WHERE cedula =  "' . $HTTP_GET_VARS["ced2"]  . '" ');
			if (!$result) {
				die('Error de consulta: ' . mysql_error());
			}

		list($cedula, $ced_ciudad, $ape2, $fechasol,$direccion, $ciudad, $telefono, $celular, $email, $devengado, $descuentos, $neto, $unidad, $monto_solicitado, $codigo_plan, $numero_cuenta, $banco, $codigo_asesor, $codm, $grad, $codigo_sucursal, $numero_libranza,$cuotas_credito, $val_menj, $val_ment, $fecna, $concept_rec, $numero_contrato) = mysql_fetch_row($result);
	
$resd = mysql_query('SELECT grado FROM solicitud_credito WHERE cedula = "' ."$cedula". '" ');
		if (!$resd) {
				die('Invalid query: ' . mysql_error());
		}	 
		list( $grado) = mysql_fetch_row($resd);
	
	
	//$sqlnom2 = "select nombre, nit, direccion, ciudad, telefono, email, representante, registro_mercantil, ciudad_camara, objeto_social from datos_empresa where cedula = '$ced2'";
		//$control2 = mysql_query($sqlnom2, $dbi) or die(mysql_error());	 
		
		 $resul = mysql_query('SELECT nombre, nit, direccion, ciudad, telefono, email, representante, registro_mercantil, ciudad_camara, objeto_social FROM datos_empresa WHERE cedula =  "' . $HTTP_GET_VARS["ced2"]  . '" ');
			if (!$resul) {
				die('Invalid query: ' . mysql_error());
			}

		list($nombreem, $nitem2, $direccionem, $ciudadem, $telefonoem, $emailem, $representanteem, $registro_mercantilem, $ciudad_camaraem, $objeto_socialem) = mysql_fetch_row($resul);	
		
		
		 $dianaci=substr($fecna, 3, 2);
         $mesnaci=substr($fecna, 0, 2);

	//	$sqlnom3 = "select cedula, nombre, direccion, telefono, celular, email from datos_codeudor where cedula_titular = '$ced2'";
		//$control3 = mysql_query($sqlnom3, $dbi) or die(mysql_error());	
		
		$resu = mysql_query('SELECT cedula, nombre, direccion, telefono, celular, email FROM datos_codeudor WHERE cedula_titular = "' . $HTTP_GET_VARS["ced2"]  . '" ');
			if (!$resu) {
				die('Invalid query: ' . mysql_error());
			}
		list($cedulaco, $apesco, $direccionco, $telefonoco, $celularco, $emailco) = mysql_fetch_row($resu);
		
		//$sqlnom4 = "select plan from planes_ventas where codigo = '$codigo_plan'";
		//$control4 = mysql_query($sqlnom4, $dbi) or die(mysql_error());	
			$res = mysql_query('SELECT plan FROM planes_ventas WHERE codigo = "' ."$codigo_plan". '" ');
			if (!$res) {
				die('Invalid query: ' . mysql_error());
			}
		list($plan) = mysql_fetch_row($res);
		
		//$sqlnom5 = "select vendedor from vendedores where codigo = '$codigo_asesor'";
		//$control5 = mysql_query($sqlnom5, $dbi) or die(mysql_error());	 
		
		$re = mysql_query('SELECT vendedor FROM vendedores WHERE codigo = "' . $_POST[codigo_asesor] . '" ');
			if (!$re) {
				die('Invalid query: ' . mysql_error());
			}
		list($vendedor) = mysql_fetch_row($re);
		
		//$sqlnom8 = "select nombre from sucursal where codigo = '$codigo_sucursal'";
		//$control8 = mysql_query($sqlnom8, $dbi) or die(mysql_error());	
		
		$control8 = mysql_query('SELECT nombre FROM sucursal WHERE codigo = "' ."$codigo_sucursal". '" ');
			if (!$control8) {
				die('Invalid query: ' . mysql_error());
			} 
		list($nombre_sucursal) = mysql_fetch_row($control8);
		
		//$query_sql4 = "SELECT * FROM vendedores order by vendedor";
		//$sql4 = mysql_query($query_sql4, $dbi) or die(mysql_error());
		
		$sql4 = mysql_query('SELECT * FROM vendedores order by vendedor ');
			if (!$sql4) {
				die('Invalid query: ' . mysql_error());
			} 
		
		$row_sql4 = mysql_fetch_assoc($sql4);
		$totalRows_sql4 = mysql_num_rows($sql4); 
		
		//$query_sql7 = "SELECT * FROM planes_ventas where (codigo = '7' || codigo = '8') order by codigo";
		//$sql7 = mysql_query($query_sql7, $dbi) or die(mysql_error());
		
		$sql7 = mysql_query('SELECT * FROM planes_ventas where codigo = "7" or codigo = "8" order by codigo ');
			if (!$sql7) {
				die('Error: ' . mysql_error());
			} 
			
		$row_sql7 = mysql_fetch_assoc($sql7);
		$totalRows_sql7 = mysql_num_rows($sql7); 
?>
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<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Documento sin t&iacute;tulo</title>
<style type="text/css">
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<body>


<form action="" method="post" enctype="multipart/form-data" name="form1" class="color_fondo_sc" id="form1">
  <div align="center">
    <div class="Estilo1">SOLICITUD CREDITO</div>
    <table width="698" border="2" cellpadding="1" cellspacing="1" class="est_cont51">
      <caption>
      <div align="center"><br />
        <span class="Estilo2">DATOS BASICOS - DEUDOR </span><br />
      </div>
      </caption>
      <tr>
        <th colspan="2" scope="col">&nbsp;</th>
        <th width="93" scope="col"><div align="right">
            <div align="right"><strong>Fecha Solicitud :</strong></div>
        </div></th>
        <th scope="col"> <div align="left">
            <input name="fecsol" type="text" class="est_cont2" id="fecsol" value="<?php echo $fechasol ?>" size="10" maxlength="10" readonly="" />
        </div></th>
        <th scope="col"><div align="right"><strong>Sucursal :</strong></div></th>
        <th colspan="2" scope="col"><div align="left">
          <input name="sucu" type="text" class="est_cont2" id="sucu" value="<?php echo $nombre_sucursal ?>" size="35" maxlength="35"  readonly=""/>
        </div></th>
      </tr>
      <tr>
        <td width="70" valign="middle"><div align="center"><strong>Apellidos y Nombres:</strong></div></td>
        <td colspan="3"><div align="left">
          <input name="ape" type="text" class="est_cont2" id="ape" value="<?php echo $ape2 ?>" size="60" maxlength="65" />
        </div></td>
        <td><div align="right"><strong>Cogido Militar :</strong></div></td>
        <td colspan="2"><div align="left">
            <input name="codigom" type="text" class="est_cont2" id="codigom" value="<?php echo $codm ?>" size="20" maxlength="20" />
        </div></td>
      </tr>
      <tr>
        <td height="21"><div align="right"><strong>Cedula No:</strong></div></td>
        <td width="104"><div align="left">
            <input name="ced" type="text" class="est_cont2" id="ced" value="<?php echo $cedula ?>" size="20" maxlength="20" readonly=""/>
        </div></td>
        <td><div align="right"><strong>De:</strong></div></td>
        <td><div align="left">
          <input name="ciuced" type="text" class="est_cont2" id="ciuced" value="<?php echo $ced_ciudad ?>" size="20" maxlength="20" />
        </div></td>
        <td><div align="right"><strong>Unidad :</strong></div></td>
        <td colspan="2"><div align="left">
            <input name="uni" type="text" class="est_cont2" id="uni" value="<?php echo $unidad ?>" size="35" maxlength="35" />
        </div></td>
      </tr>
      <tr>
        <td><div align="right"><strong>Cuidad :</strong></div></td>
        <td><div align="left">
            <input name="ciu" type="text" class="est_cont2" id="ciu" value="<?php echo $ciudad ?>" size="20" maxlength="20" />
        </div></td>
        <td><div align="right"><strong>Direccion :</strong></div></td>
        <td colspan="2"><div align="left">
          <input name="dire" type="text" class="est_cont2" id="dire" value="<?php echo $direccion ?>" size="40" maxlength="45" />
        </div></td>
        <td width="70"><div align="right"><strong>Grado :</strong></div></td>
        <td width="114"><div align="left">
            <input name="gra" type="text" class="est_cont2" id="gra" value="<?php echo $grado ?>" size="12" maxlength="10" />
        </div></td>
      </tr>
      <tr>
        <td><div align="right"><strong>Telefono :</strong></div></td>
        <td><div align="left">
            <input name="tel" type="text" class="est_cont2" id="tel" value="<?php echo $telefono ?>" size="20" maxlength="20" />
        </div></td>
        <td><div align="right"><strong>Celular :</strong></div></td>
        <td><div align="left">
          <input name="cel" type="text" class="est_cont2" id="cel" value="<?php echo $celular ?>" size="20" maxlength="20" />
        </div></td>
        <td><div align="right"><strong>E-mail :</strong></div></td>
        <td colspan="2"><div align="left">
            <input name="email" type="text" class="est_cont2" id="email" value="<?php echo $email ?>" size="35" maxlength="35" />
        </div></td>
      </tr>
      <tr>
        <td><div align="right"><strong>Total Devengado $:</strong></div></td>
        <td><div align="left">
            <input name="dev" type="text" class="est_cont2" id="dev" value="<?php echo $devengado ?>" size="12" maxlength="10" />
        </div></td>
        <td><div align="right"><strong>Descuentos $:</strong></div></td>
        <td width="104"><div align="left">
          <input name="desc" type="text" class="est_cont2" id="desc" value="<?php echo $descuentos ?>" size="12" maxlength="10" />
        </div></td>
        <td width="103"><div align="right"><strong>Neto a Recibir $:</strong></div></td>
        <td colspan="2"><div align="left">
            <input name="net" type="text" class="est_cont2" id="net" value="<?php echo $neto ?>" size="12" maxlength="10" />
        </div></td>
      </tr>
      <tr>
        <td><div align="right"><strong>Monto Solicitado $ :</strong></div></td>
        <td><div align="left">
            <input name="mon" type="text" class="est_cont2" id="mon" value="<?php echo $monto_solicitado ?>" size="12" maxlength="10" />
        </div></td>
        <td><div align="right" class="Estilo65"> Cuotas credito:</div></td>
        <td><div align="left">
            <label></label>
            <input name="cuo_cre" type="text" class="est_cont2" id="cuo_cre" value="<?php echo $cuotas_credito ?>" size="2" maxlength="2" />
        </div></td>
        <td><div align="right" class="Estilo65"> Numero libranza:</div></td>
        <td colspan="2"><div align="left">
            <input name="num_lib" type="text" class="est_cont2" id="num_lib" value="<?php echo $numero_libranza ?>" size="12" maxlength="12" />
          </div>
            <label>
            <div align="left"></div>
          </label></td>
      </tr>
      <tr>
        <td><div align="right"><strong>Nº Contrato:</strong></div></td>
        <td><div align="left">
            <input name="numcont" type="text" class="est_cont2" id="numcont" value="<?php echo $numero_contrato ?>" size="12" maxlength="10" />
        </div></td>
        <td><div align="right"><strong>Banco :</strong></div></td>
        <td><div align="left">
            <input name="ban" type="text" class="est_cont2" id="ban" value="<?php echo $banco ?>" size="20" maxlength="20" />
        </div></td>
        <td><div align="right"><strong>Cuenta No :</strong></div></td>
        <td colspan="2"><div align="left">
            <input name="cue" type="text" class="est_cont2" id="cue" value="<?php echo $numero_cuenta ?>" size="20" maxlength="20" />
        </div></td>
      </tr>
      <tr>
        <td><div align="right"><strong>Plan :</strong></div></td>
        <td><div align="left">
          <input name="planc" type="text" class="est_cont2" id="planc" value="<?php echo $plan ?>" size="12" maxlength="10" readonly=""/>
        </div></td>
        <td><div align="right" class="Estilo54 Estilo65">Valor Mensual :</div></td>
        <td><div align="left">
          <input name="vmj" type="text" class="est_cont2" id="vmj" value="<?php echo $val_menj ?>" size="12" maxlength="10" />
        </div></td>
        <td><div align="right" class="Estilo3">Valor Total :</div></td>
        <td colspan="2"><div align="left">
            <input name="vmt" type="text" class="est_cont2" id="vmt" value="<?php echo $val_ment ?>" size="12" maxlength="10" />
        </div></td>
      </tr>
      <tr>
        <td>&nbsp;</td>
        <td><select name="planj" id="planj">
          <option value="1">-PLAN-</option>
          <?php
     do {  
?>
          <option value="<?php echo $row_sql7['codigo'];?>"><?php echo $row_sql7['plan']?></option>
          <?php
} while ($row_sql7 = mysql_fetch_assoc($sql7));
  $rows7 = mysql_num_rows($sql7);
  if($rows7 > 0) {
      mysql_data_seek($sql7, 0);
       $row_sql7 = mysql_fetch_assoc($sql7);
  }
?>
        </select></td>
        <td><div align="right"><strong>Fecha Nacimiento :</strong></div></td>
        <td><div align="left"> <span class="Estilo64">MES</span>
              <input name="mesfn" type="text" class="est_cont2" id="mesfn" value="<?php echo $mesnaci ?>" size="2" maxlength="2" />
              <span class="Estilo64">-DIA</span>
              <input name="diafn" type="text" class="est_cont2" id="diafn" value="<?php echo $dianaci ?>" size="2" maxlength="2" />
        </div></td>
        <td><div align="right"><strong>Vendedor :</strong></div></td>
        <td colspan="2"><div align="left">
          <input name="vend" type="text" class="est_cont2" id="vend" value="<?php echo $vendedor ?>" size="35" maxlength="50" readonly=""/>
        </div></td>
      </tr>
      <tr>
        <td>&nbsp;</td>
        <td>&nbsp;</td>
        <td>&nbsp;</td>
        <td>&nbsp;</td>
        <td>&nbsp;</td>
        <td colspan="2"><select name="codiase" id="codiase">
          <option value="1">-SELECCIONE VENDEDOR-</option>
          <?php
     do {  
?>
          <option value="<?php echo $row_sql4['codigo'];?>"><?php echo $row_sql4['vendedor']?></option>
          <?php
} while ($row_sql4 = mysql_fetch_assoc($sql4));
  $rows4 = mysql_num_rows($sql4);
  if($rows4 > 0) {
      mysql_data_seek($sql4, 0);
       $row_sql4 = mysql_fetch_assoc($sql4);
  }
?>
        </select></td>
      </tr>
    </table>
    <table width="624" height="62" border="1" class="est_cont51">
      <caption>
      <span class="Estilo66"><br />
        DATOS CODEUDOR </span>
      </caption>
      <tr>
        <th width="107" height="16" scope="col"><div align="right"><strong>Apellidos y Nombres:</strong></div></th>
        <th width="334" scope="col"><div align="left">
            <input name="apeco" type="text" class="est_cont2" id="apeco" value="<?php echo $apesco ?>" size="66" maxlength="65" />
        </div></th>
        <th width="49" scope="col"><div align="right"><strong>Cedula:</strong></div></th>
        <th width="104" scope="col"><div align="left">
            <input name="cedco" type="text" class="est_cont2" id="cedco" value="<?php echo $cedulaco ?>" size="20" maxlength="20" />
        </div></th>
      </tr>
      <tr>
        <td height="16"><div align="right"><strong>Dreccion :</strong></div></td>
        <td><div align="left">
            <input name="dirco" type="text" class="est_cont2" id="dirco" value="<?php echo $direccionco ?>" size="50" maxlength="50" />
        </div></td>
        <td><div align="right"><strong>Telefono:</strong></div></td>
        <td><div align="left">
            <input name="telco" type="text" class="est_cont2" id="telco" value="<?php echo $telefonoco ?>" size="20" maxlength="20" />
        </div></td>
      </tr>
      <tr>
        <td height="18"><div align="right"><strong>Email:</strong></div></td>
        <td><div align="left">
            <input name="emaco" type="text" class="est_cont2" id="emaco" value="<?php echo $emailco ?>" size="35" maxlength="35" />
        </div></td>
        <td><div align="right"><strong>Celular:</strong></div></td>
        <td><div align="left">
            <input name="celco" type="text" class="est_cont2" id="celco" value="<?php echo $celularco ?>" size="20" maxlength="20" />
        </div></td>
      </tr>
    </table>
    <p>&nbsp;</p>
    <p class="Estilo3">DATOS BASICOS - ENTIDAD LABORAL</p>
    <table width="630" height="256" border="2" cellpadding="1" cellspacing="1" class="est_cont6">
      <tr>
        <th width="72" height="25" scope="col"><div align="right"><strong>Nombre :</strong></div></th>
        <th colspan="3" scope="col"><label> </label>
            <div align="left">
              <input name="nomem" type="text" class="sol_cre11" id="nomem" value="<?php echo $nombreem ?>" size="60" maxlength="55" />
          </div></th>
        <th width="89" scope="col"><div align="right"><strong>Nit :</strong></div></th>
        <th width="133" scope="col"> <div align="left">
            <input name="nitem" type="text" class="sol_cre11" id="nitem" value="<?php echo $nitem2 ?>" size="25" maxlength="22" />
        </div></th>
      </tr>
      <tr>
        <td height="28"><div align="right"><strong>Direccion :</strong></div></td>
        <td colspan="3"><div align="left">
            <input name="direm" type="text" class="sol_cre11" id="direm" value="<?php echo $direccionem ?>" size="60" maxlength="55" />
        </div></td>
        <td><div align="right"><strong>Ciudad :</strong></div></td>
        <td><div align="left"><span class="Estilo54">
          <input name="ciuem" type="text" class="sol_cre11" id="ciuem" value="<?php echo $ciudadem ?>" size="25" maxlength="22" />
        </span></div></td>
      </tr>
      <tr>
        <td height="28"><div align="right"><strong>Telefono :</strong></div></td>
        <td width="68"><div align="left">
            <input name="telem" type="text" class="sol_cre11" id="telem" value="<?php echo $telefonoem ?>" size="12" maxlength="12" />
        </div></td>
        <td width="79"><div align="right"><strong>E-mail:</strong></div></td>
        <td width="154"><div align="left">
            <input name="emaem" type="text" class="sol_cre11" id="emaem" value="<?php echo $emailem ?>" size="29" maxlength="29" />
        </div></td>
        <td><div align="right"><strong>Convenio No:</strong></div></td>
        <td><input name="conv" type="text" class="sol_cre1" id="conv" value="<?php echo $convenio ?>" size="25" maxlength="22" /></td>
      </tr>
      <tr>
        <td colspan="6" bgcolor="#DDFFEF"><div align="center"><strong>&nbsp;INFORMACION CAMARA DE COMERCIO</strong></div></td>
      </tr>
      <tr>
        <td height="25" colspan="2" bgcolor="#E2EDD8"><div align="right"><strong>Registro Mercantil No:</strong></div></td>
        <td bgcolor="#E2EDD8"><div align="left">
            <input name="regem" type="text" class="sol_cre11" id="regem" value="<?php echo $registro_mercantilem ?>" size="14" maxlength="14" />
        </div></td>
        <td bgcolor="#E2EDD8"><div align="right"><strong>Camara Comercio de :</strong></div></td>
        <td colspan="2" bgcolor="#E2EDD8"><div align="left">
            <input name="camem" type="text" class="sol_cre11" id="camem" value="<?php echo $ciudad_camaraem ?>" size="25" maxlength="25" />
        </div></td>
      </tr>
      <tr>
        <td height="25" colspan="2" bgcolor="#E2EDD8"><div align="right"><strong>Representante Legal :</strong></div></td>
        <td colspan="2" bgcolor="#E2EDD8"><div align="left">
            <input name="repem" type="text" class="sol_cre11" id="repem" value="<?php echo $representanteem ?>" size="46" maxlength="45" />
        </div></td>
        <td colspan="2" bgcolor="#E2EDD8">&nbsp;</td>
      </tr>
      <tr>
        <td height="55" colspan="2" bgcolor="#E2EDD8"><div align="right"><strong>Objeto Social :</strong></div></td>
        <td colspan="4" bgcolor="#E2EDD8"><label> <span class="Estilo54">
          <textarea name="objem" id="objem" cols="60" rows="3"><?php echo $objeto_socialem ?></textarea>
        </span> </label></td>
      </tr>
      <tr>
        <td height="30" colspan="2" bgcolor="#E2EDD8"><div align="right"><strong>Concepto Rechazo :</strong></div></td>
        <td height="30" colspan="4" bgcolor="#E2EDD8"><div align="left">
          <input name="conrec" type="text" class="sol_cre11" id="conrec" value="<?php echo $concept_rec ?>" size="46" maxlength="45"  readonly=""ç/>
        </div></td>
      </tr>
    </table>
    <p class="Estilo3">
      <input name="enviar" type="submit" class="col_cre2" id="enviar" value="Enviar"  />
    </p>
    <p>&nbsp;</p>
  </div>
</form>
</body>
</html>