<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>
        <input name="ssl_country" id="ssl_country" value="{tmpl_var name='ssl_country'}" size="2" maxlength="2" type="text" class="textInput" />
			</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_domain_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_domain_list.php');"><span>{tmpl_var name='btn_cancel_txt'}</span></button>
    </div>
  </div>
  
</div>
