<table cellspacing=0 cellpadding=0 width="100%">
  <tr>
	<td>
	  <table border=0 cellspacing=0 cellpadding=0 width="100%">
		<tr class=contentbar2>
		  <td colspan=4 class=contentbar2>
		  	<b>&nbsp;[L]Billing Address[/L]</b> - <i>[L]If different than above[/L]</i>
		  </td>
		</tr>
		<tr>
		  <td align=right class=contentbar1>
			<b>[L]First Name[/L]</b>
		  </td>
		  <td align=left class=contentbar1>
			<INPUT TYPE=text NAME=b_fname VALUE="[value b_fname]" size="20" maxlength="20">
		  </td>
		  <td align=right class=contentbar1><b>[L]Last Name[/L]</b> </td>
		  <td align=left class=contentbar1>
			<INPUT TYPE=text NAME=b_lname VALUE="[value b_lname]" size="20">
		  </td>
		</tr>
		<tr>
		  <td align=right class=contentbar1>
			<b>[L]Company[/L]</b>
		  </td>
		  <td align=left class=contentbar1 colspan=3>
			<INPUT TYPE=text NAME=b_company VALUE="[value b_company]" size="20" maxlength="44">
		  </td>
		</tr>
		<tr>
		  <td align=right class=contentbar1>
			<b>[L]Address[/L]</b>
		  </td>
		  <td align=left colspan=3 class=contentbar1>
			<INPUT TYPE=text NAME=b_address1 VALUE="[value b_address1]" size=40 maxlength="64">
		  </td>
		</tr>
		<tr>
		  <td class=contentbar1>&nbsp;</td>
		  <td align=left colspan=3 class=contentbar1>
			<INPUT TYPE=text NAME=b_address2 VALUE="[value b_address2]" size=40 maxlength="64">
		  </td>
		</tr>
		<tr>
		  <td align=right class=contentbar1>
			<b>[L]City[/L]</b>
		  </td>
		  <td class=contentbar1>
			<INPUT TYPE=text NAME=b_city VALUE="[value b_city]" size="20">
		  </td>
		  <td align=right class=contentbar1><b>[L]State/Province[/L]</b></td>
		  <td class=contentbar1>
			<INPUT TYPE=text NAME=b_state VALUE="[value b_state]" size="5" maxlength="5">
		  </td>
		</tr>
		<tr>
		  <td align=right class=contentbar1>
			<b>[L]Zip/Postal Code[/L]</b>
		  </td>
		  <td class=contentbar1 colspan=3>
			<INPUT TYPE=text NAME=b_zip VALUE="[value b_zip]" size="10" maxlength="10">
		  </td>
		</tr>
		<tr>
		  <td align=right class=contentbar1>
			<b>[L]Country[/L]</b>
		  </td>
		  <td class=contentbar1 colspan=3>
			<INPUT TYPE=text NAME=b_country VALUE="[value b_country]" size="10" maxlength="10">
		  </td>
		</tr>
		<tr>
		  <td class=contentbar1 colspan=4>&nbsp;</td>
		</tr>
	  </table>
	</td>
  </tr>
</table>                                          
