<h2><tmpl_var name="list_head_txt"></h2>
<p><tmpl_var name="list_desc_txt"></p>

<div class="panel panel_web_domain">

    <div class="pnl_formsarea">
        <fieldset class="inlineLabels">
            <div class="ctrlHolder">
                <label for="ssl_state">{tmpl_var name='ssl_state_txt'}</label>
                <input name="ssl_state" id="ssl_state" value="{tmpl_var name='ssl_state'}" size="30" maxlength="255" type="text" class="textInput" />
            </div>
            <div class="ctrlHolder">
                <label for="ssl_locality">{tmpl_var name='ssl_locality_txt'}</label>
                <input name="ssl_locality" id="ssl_locality" value="{tmpl_var name='ssl_locality'}" size="30" maxlength="255" type="text" class="textInput" />
            </div>
            <div class="ctrlHolder">
                <label for="ssl_organisation">{tmpl_var name='ssl_organisation_txt'}</label>
                <input name="ssl_organisation" id="ssl_organisation" value="{tmpl_var name='ssl_organisation'}" size="30" maxlength="255" type="text" class="textInput" />
            </div>
            <div class="ctrlHolder">
                <label for="ssl_organisation_unit">{tmpl_var name='ssl_organisation_unit_txt'}</label>
                <input name="ssl_organisation_unit" id="ssl_organisation_unit" value="{tmpl_var name='ssl_organisation_unit'}" size="30" maxlength="255" type="text" class="textInput" />
            </div>
            <div class="ctrlHolder">
                <label for="ssl_country">{tmpl_var name='ssl_country_txt'}</label>
                <select name="ssl_country" id="ssl_country" class="selectInput flags">
                    {tmpl_var name='ssl_country'}
                </select>
            </div>
            <div class="ctrlHolder">
                <label for="client_group_id">{tmpl_var name='ssl_domain_txt'}</label>
                <select name="ssl_domain" id="ssl_domain" class="selectInput">
                    {tmpl_var name='ssl_domain'}
                </select>
            </div>
			<div class="ctrlHolder">
                <label for="ssl_request">{tmpl_var name='ssl_key_txt'}</label>
                <textarea name="ssl_key" id="ssl_key" rows='10' cols='30'>{tmpl_var name='ssl_key'}</textarea>
            </div>
            <div class="ctrlHolder">
                <label for="ssl_request">{tmpl_var name='ssl_request_txt'}</label>
                <textarea name="ssl_request" id="ssl_request" rows='10' cols='30'>{tmpl_var name='ssl_request'}</textarea>
            </div>
            <div class="ctrlHolder">
                <label for="ssl_cert">{tmpl_var name='ssl_cert_txt'}</label>
                <textarea name="ssl_cert" id="ssl_cert" rows='10' cols='30'>{tmpl_var name='ssl_cert'}</textarea>
            </div>
            <div class="ctrlHolder">
                <label for="ssl_bundle">{tmpl_var name='ssl_bundle_txt'}</label>
                <textarea name="ssl_bundle" id="ssl_bundle" rows='10' cols='30'>{tmpl_var name='ssl_bundle'}</textarea>
            </div>
            <div class="ctrlHolder">
                <label for="ssl_action">{tmpl_var name='ssl_action_txt'}</label>
                <select name="ssl_action" id="ssl_action" class="selectInput formLengthHalf">
                    {tmpl_var name='ssl_action'}
                </select>
            </div>
        </fieldset>

        <input type="hidden" name="id" value="{tmpl_var name='id'}">

        <div class="buttonHolder buttons">
            <button class="positive iconstxt icoPositive" type="button" value="{tmpl_var name='btn_save_txt'}" onClick="submitForm('pageForm','sites/web_vhost_aliasdomain_edit.php');"><span>{tmpl_var name='btn_save_txt'}</span></button>
            <button class="negative iconstxt icoNegative" type="button" value="{tmpl_var name='btn_cancel_txt'}" onClick="loadContent('sites/web_vhost_aliasdomain_list.php');"><span>{tmpl_var name='btn_cancel_txt'}</span></button>
        </div>
    </div>

</div>