chromium/components/test/data/autofill/heuristics/input/028_checkout_jr.com.html


<!DOCTYPE html PUBLIC
 "-//W3C//DTD XHTML 1.0 Transitional//EN"
 "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en">
<head>
	<title>
		Secure Checkout at JR.com
	</title>
	<meta http-equiv="content-type" content="iso-8859-1" />
	<meta name="MSSmartTagsPreventParsing" content="TRUE" />
	<meta name="autosize" content="off" />
	<meta http-equiv="imagetoolbar" content="no" />
	<meta name="robots" content="noindex,nofollow" />
	<meta name="description" content="Checkout at J&amp;R Music &amp; Computer World" />
</head>
<body class="yui-skin-clint yui-skin-sam" >



<form method="POST" id="addressForm">


<div class="yui-g">
	<div class="yui-u first">
		<div class="pageHeader">
			Billing and Shipping Addresses		</div>
	</div>
	<div class="yui-u jrui-right">
		<input type="hidden" name="_flowExecutionKey" value="_c1CD2F5A1-28EE-6B0F-71FC-DCDBE4BCCA78_k64250CE6-ADB4-BD9D-FEED-2C51C69CE671" />
		<input type="image" name="_eventId_continue" value="submit" alt="Continue" src="#" />
	</div>
</div>

	
	<div class="yui-g">
		<div class="yui-u first firstCol">
			<div class="subHead">
Billing Address				<span class="subNote">&nbsp;&nbsp;&nbsp; 			<span class='asterisk'>*</span>
required fields</span>
			</div>
<div class="subNote">
	Please enter info as it appears on your credit card statement.</div>

<div class="addressRowGroup">
	<div class="addressCell">
		<div>
	<div class='mark asterisk'> &nbsp; </div>
			<div class="field label">
First Name			</div>
		</div>
		<div>
	<div class='mark asterisk'> * </div>
    <input type="text" id="billingAddress.firstName" name="billingAddress.firstName" value="" style='width: 124px' maxlength='14'    >

		</div>
		<div>	
 </div>
	</div>

	<div class="addressCell">
		<div>
	<div class='mark asterisk'> &nbsp; </div>
			<div class="field label">
Last Name			</div>
		</div>
		<div>
	<div class='mark asterisk'> * </div>
    <input type="text" id="billingAddress.lastName" name="billingAddress.lastName" value="" style='width: 124px' maxlength='15'     >

		</div>
		<div>	
</div>
	</div>
	
	<div style="clear: both;"></div>
</div>

<div class="addressRowGroup">
	<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
		<div class="field label">
Address		</div>
	</div>
	
	<div class="addressRow">
	<div class='mark asterisk'> * </div>
		<div>    <input type="text" id="billingAddress.address1" name="billingAddress.address1" value="" style='width: 275px' maxlength='30' >

</div>
	</div>

	<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
		<div class="field subNote">
Street address or P.O. box		</div>
	</div>

	
	
	<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
		<div class="field">    <input type="text" id="billingAddress.address2" name="billingAddress.address2" value="" style='width: 275px' maxlength='30' >

</div>

	</div>

	<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
		<div class="field subNote">
Apartment, suite, company, care of, etc.		</div>
	</div>
</div>

<div class="addressRowGroup">

	<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
		<div class="field label">City</div>
	</div>

	<div class="addressRow">
	<div class='mark asterisk'> * </div>
		<div class="field">
    <input type="text" id="billingAddress.city" name="billingAddress.city" value="" style='width: 275px' maxlength='20' >

		</div>
	</div>

	<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
		<div class="field subNote">
			Enter APO or FPO in the City field above
		</div>
	</div>
	
	

</div>

<div class="addressRowGroup">

	<div class="addressCell" style="width: 215px;">

	<div class='mark asterisk'> &nbsp; </div>
		<div class="field label">State/Province</div>

	<div class='mark asterisk'> * </div>
		<div class="field">
    <select id="billingAddress.stateCode" name="billingAddress.stateCode" >
        <option value="XX"    
    
>Select a State:</option>
        <option value="AA"    
    
>AA - Armed Forces America</option>
        <option value="AE"    
    
>AE - Armed Forces Europe</option>
        <option value="AK"    
    
>AK - Alaska</option>
        <option value="AL"    
    
>AL - Alabama</option>
        <option value="AP"    
    
>AP - Armed Forces Pacific</option>
        <option value="AR"    
    
>AR - Arkansas</option>
        <option value="AS"    
    
>AS - American Somoa</option>
        <option value="AZ"    
    
>AZ - Arizona</option>
        <option value="CA"    
    
>CA - California</option>
        <option value="CO"    
    
>CO - Colorado</option>
        <option value="CT"    
    
>CT - Connecticut</option>
        <option value="DC"    
    
>DC - District of Columbia</option>
        <option value="DE"    
    
>DE - Delaware</option>
        <option value="FL"    
    
>FL - Florida</option>
        <option value="FM"    
    
>FM - FS of Micronesia</option>
        <option value="GA"    
    
>GA - Georgia</option>
        <option value="GU"    
    
>GU - Guam</option>
        <option value="HI"    
    
>HI - Hawaii</option>
        <option value="IA"    
    
>IA - Iowa</option>
        <option value="ID"    
    
>ID - Idaho</option>
        <option value="IL"    
    
>IL - Illinois</option>
        <option value="IN"    
    
>IN - Indiana</option>
        <option value="KS"    
    
>KS - Kansas</option>
        <option value="KY"    
    
>KY - Kentucky</option>
        <option value="LA"    
    
>LA - Louisiana</option>
        <option value="MA"    
    
>MA - Massachusetts</option>
        <option value="MD"    
    
>MD - Maryland</option>
        <option value="ME"    
    
>ME - Maine</option>
        <option value="MH"    
    
>MH - Marshall Islands</option>
        <option value="MI"    
    
>MI - Michigan</option>
        <option value="MN"    
    
>MN - Minnesota</option>
        <option value="MO"    
    
>MO - Missouri</option>
        <option value="MP"    
    
>MP - Mariana Islands</option>
        <option value="MS"    
    
>MS - Mississippi</option>
        <option value="MT"    
    
>MT - Montana</option>
        <option value="NC"    
    
>NC - North Carolina</option>
        <option value="ND"    
    
>ND - North Dakota</option>
        <option value="NE"    
    
>NE - Nebraska</option>
        <option value="NH"    
    
>NH - New Hampshire</option>
        <option value="NJ"    
    
>NJ - New Jersey</option>
        <option value="NM"    
    
>NM - New Mexico</option>
        <option value="NV"    
    
>NV - Nevada</option>
        <option value="NY"    
    
>NY - New York</option>
        <option value="OH"    
    
>OH - Ohio</option>
        <option value="OK"    
    
>OK - Oklahoma</option>
        <option value="OR"    
    
>OR - Oregon</option>
        <option value="PA"    
    
>PA - Pennsylvania</option>
        <option value="PR"    
    
>PR - Puerto Rico</option>
        <option value="PW"    
    
>PW - Palau</option>
        <option value="RI"    
    
>RI - Rhode Island</option>
        <option value="SC"    
    
>SC - South Carolina</option>
        <option value="SD"    
    
>SD - South Dakota</option>
        <option value="TN"    
    
>TN - Tennessee</option>
        <option value="TX"    
    
>TX - Texas</option>
        <option value="UT"    
    
>UT - Utah</option>
        <option value="VA"    
    
>VA - Virginia</option>
        <option value="VI"    
    
>VI - Virgin Islands</option>
        <option value="VT"    
    
>VT - Vermont</option>
        <option value="WA"    
    
>WA - Washington</option>
        <option value="WI"    
    
>WI - Wisconsin</option>
        <option value="WV"    
    
>WV - West Virginia</option>
        <option value="WY"    
    
>WY - Wyoming</option>
        <option value="XY"    
    
>Select a Province:</option>
        <option value="AB"    
    
>AB - Alberta</option>
        <option value="BC"    
    
>BC - British Columbia</option>
        <option value="MB"    
    
>MB - Manitoba</option>
        <option value="NU"    
    
>NU - Nunavut</option>
        <option value="NB"    
    
>NB - New Brunswick</option>
        <option value="NF"    
    
>NF - Newfoundland</option>
        <option value="NT"    
    
>NT - Northwest Territories</option>
        <option value="NS"    
    
>NS - Nova Scotia</option>
        <option value="ON"    
    
>ON - Ontario</option>
        <option value="PE"    
    
>PE - Prince Edward Island</option>
        <option value="QC"    
    
>QC - Quebec</option>
        <option value="SK"    
    
>SK - Saskatchewan</option>
        <option value="YT"    
    
>YT - Yukon Territory</option>
        <option value="XQ"    
    
>International</option>
    </select>
		</div>

	
	</div>

	<div class="addressCell" style="width: 150px;">
	<div class='mark asterisk'> &nbsp; </div>
		<div class="field label">ZIP/Postal Code</div>
	
	<div class='mark asterisk'> * </div>
		<div class="field">
    <input type="text" id="billingAddress.postalCode" name="billingAddress.postalCode" value="" style='width: 90px' maxlength='10' >

		</div>
	
	
	</div>

	<div style="clear: both;"></div>
</div>


<div class="addressRowGroup">

	<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
		<div class="field label">Country</div>
	</div>

	<div class="addressRow">
	<div class='mark asterisk'> * </div>
		<div class="field">
    <select id="billingAddress.country" name="billingAddress.country" >
        <option value="US"    
    
>United States</option>
        <option value="CA"    
    
>Canada</option>
    </select>
			<span style="margin-left: 10px">
			<a 
				target="nonUSBill"
				href="http://www.jr.com/information/pop_nonUSBilling.jsp">International billing instructions</a>
			</span>
		</div>
	</div>

	

</div>

<div class="addressRowGroup">

	<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
		<div class="field label">Contact Phone Number</div>
	</div>

	<div class="addressRow">
	<div class='mark asterisk'> * </div>
		<div class="field">
    <input type="text" id="billingAddress.phoneNumber" name="billingAddress.phoneNumber" value="" maxlength='18' size='18' style='width: 120px;' >

		</div>
	</div>
	<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
		<div class="field subNote">Used only for billing inquiries</div>
	</div>

	
	
</div>

<div class="addressRowGroup">

	<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
		<div class="field label">Email Address</div>
	</div>

	<div class="addressRow">
	<div class='mark asterisk'> * </div>
		<div class="field">
    <input type="text" id="customer.emailAddress" name="customer.emailAddress" value="" maxlength='50' style='width: 275px'    >

		</div>
	</div>

	
	

</div>

<div class="addressRowGroup">	
	<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
		<span class="field">
    <input type="hidden" name="_customer.optIn" value="false" />
    <input type="checkbox" id="customer.optIn" name="customer.optIn"
        checked="checked"
        
    >
			<label for="customer.optIn">Yes, send me J&amp;R's promotional email newsletter.</label>
		</span>
	</div>
	
</div>

		</div>
		<div class="yui-u">

			<div class="subHead">Shipping Address</div>
				<div style="margin-top: 20px;">
						
						<span>    <input type="hidden" name="_storePickup" value="false" />
    <input type="checkbox" id="storePickup" name="storePickup"
        
        >
</span> 
						<span class="keyOption"><label for="storePickup">Pickup In-Store (Park Row, New York NY)</label></span>
				</div>						
			
			<div id="shipToBillingDiv" style="margin-top: 10px;">
			
				<div>
					<span>    <input type="hidden" name="_shipToBillingAddress" value="false" />
    <input type="checkbox" id="shipToBillingAddress" name="shipToBillingAddress"
        
        
    >
</span>
					<span class="keyOption"><label for="shipToBillingAddress">Ship to my billing address</label></span>
				</div>
				
				<div style="padding-left: 18px; padding-right: 70px;">
	<div class='mark asterisk'> &nbsp; </div>
					<div class="subNote"><font color='#990000' style='font-weight: bold'>SAVE TIME!</font>
		     If your shipping address is the same as your billing address, it will expedite your order.</div>
				</div>

			</div>
			
			<div id="shippingAddressFields">
	
	<div style='margin-bottom: 4px'> </div>
	

	<div class="addressRowGroup">
		<div class="addressCell">
			<div>
	<div class='mark asterisk'> &nbsp; </div>
				<div class="field label">
First Name				</div>
			</div>
			<div>
	<div class='mark asterisk'> * </div>
    <input type="text" id="shippingAddress.firstName" name="shippingAddress.firstName" value="" style='width: 124px' maxlength='14'    >

			</div>
			<div>	
 </div>
		</div>

		<div class="addressCell">
			<div>
	<div class='mark asterisk'> &nbsp; </div>
				<div class="field label">
Last Name				</div>
			</div>
			<div>
	<div class='mark asterisk'> * </div>
    <input type="text" id="shippingAddress.lastName" name="shippingAddress.lastName" value="" style='width: 124px' maxlength='15'     >

			</div>
			<div>	
 </div>
		</div>
		
		<div style="clear: both;"></div>
	</div>

	<div class="addressRowGroup">
		<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
			<div class="field label">
Address			</div>
		</div>

		<div class="addressRow">
	<div class='mark asterisk'> * </div>
			<div>    <input type="text" id="shippingAddress.address1" name="shippingAddress.address1" value="" style='width: 275px' maxlength='30'     >

</div>

		</div>

		<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
			<div class="field subNote">
Street address or P.O. box			</div>
		</div>
	
	
		
		<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
			<div class="field">    <input type="text" id="shippingAddress.address2" name="shippingAddress.address2" value="" style='width: 275px' maxlength='30'     >

</div>

		</div>

		<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
			<div class="field subNote">
Apartment, suite, company, care of, etc.			</div>
		</div>
	</div>

	<div class="addressRowGroup">

		<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
			<div class="field label">City</div>
		</div>

		<div class="addressRow">
	<div class='mark asterisk'> * </div>
			<div class="field">
    <input type="text" id="shippingAddress.city" name="shippingAddress.city" value="" style='width: 275px' maxlength='20'     >

			</div>
		</div>

		<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
			<div class="field subNote">
				Enter APO or FPO in the City field above
			</div>
		</div>

	
	</div>

	<div class="addressRowGroup">
		<div class="addressCell" style="width: 205px;">
			<div>
	<div class='mark asterisk'> &nbsp; </div>
				<div class="field label">State/Province</div>
			</div>

			<div>
	<div class='mark asterisk'> * </div>
				<div class="field">
    <select id="shippingAddress.stateCode" name="shippingAddress.stateCode" >
        <option value="XX"    
    
>Select a State:</option>
        <option value="AA"    
    
>AA - Armed Forces America</option>
        <option value="AE"    
    
>AE - Armed Forces Europe</option>
        <option value="AK"    
    
>AK - Alaska</option>
        <option value="AL"    
    
>AL - Alabama</option>
        <option value="AP"    
    
>AP - Armed Forces Pacific</option>
        <option value="AR"    
    
>AR - Arkansas</option>
        <option value="AS"    
    
>AS - American Somoa</option>
        <option value="AZ"    
    
>AZ - Arizona</option>
        <option value="CA"    
    
>CA - California</option>
        <option value="CO"    
    
>CO - Colorado</option>
        <option value="CT"    
    
>CT - Connecticut</option>
        <option value="DC"    
    
>DC - District of Columbia</option>
        <option value="DE"    
    
>DE - Delaware</option>
        <option value="FL"    
    
>FL - Florida</option>
        <option value="FM"    
    
>FM - FS of Micronesia</option>
        <option value="GA"    
    
>GA - Georgia</option>
        <option value="GU"    
    
>GU - Guam</option>
        <option value="HI"    
    
>HI - Hawaii</option>
        <option value="IA"    
    
>IA - Iowa</option>
        <option value="ID"    
    
>ID - Idaho</option>
        <option value="IL"    
    
>IL - Illinois</option>
        <option value="IN"    
    
>IN - Indiana</option>
        <option value="KS"    
    
>KS - Kansas</option>
        <option value="KY"    
    
>KY - Kentucky</option>
        <option value="LA"    
    
>LA - Louisiana</option>
        <option value="MA"    
    
>MA - Massachusetts</option>
        <option value="MD"    
    
>MD - Maryland</option>
        <option value="ME"    
    
>ME - Maine</option>
        <option value="MH"    
    
>MH - Marshall Islands</option>
        <option value="MI"    
    
>MI - Michigan</option>
        <option value="MN"    
    
>MN - Minnesota</option>
        <option value="MO"    
    
>MO - Missouri</option>
        <option value="MP"    
    
>MP - Mariana Islands</option>
        <option value="MS"    
    
>MS - Mississippi</option>
        <option value="MT"    
    
>MT - Montana</option>
        <option value="NC"    
    
>NC - North Carolina</option>
        <option value="ND"    
    
>ND - North Dakota</option>
        <option value="NE"    
    
>NE - Nebraska</option>
        <option value="NH"    
    
>NH - New Hampshire</option>
        <option value="NJ"    
    
>NJ - New Jersey</option>
        <option value="NM"    
    
>NM - New Mexico</option>
        <option value="NV"    
    
>NV - Nevada</option>
        <option value="NY"    
    
>NY - New York</option>
        <option value="OH"    
    
>OH - Ohio</option>
        <option value="OK"    
    
>OK - Oklahoma</option>
        <option value="OR"    
    
>OR - Oregon</option>
        <option value="PA"    
    
>PA - Pennsylvania</option>
        <option value="PR"    
    
>PR - Puerto Rico</option>
        <option value="PW"    
    
>PW - Palau</option>
        <option value="RI"    
    
>RI - Rhode Island</option>
        <option value="SC"    
    
>SC - South Carolina</option>
        <option value="SD"    
    
>SD - South Dakota</option>
        <option value="TN"    
    
>TN - Tennessee</option>
        <option value="TX"    
    
>TX - Texas</option>
        <option value="UT"    
    
>UT - Utah</option>
        <option value="VA"    
    
>VA - Virginia</option>
        <option value="VI"    
    
>VI - Virgin Islands</option>
        <option value="VT"    
    
>VT - Vermont</option>
        <option value="WA"    
    
>WA - Washington</option>
        <option value="WI"    
    
>WI - Wisconsin</option>
        <option value="WV"    
    
>WV - West Virginia</option>
        <option value="WY"    
    
>WY - Wyoming</option>
        <option value="XY"    
    
>Select a Province:</option>
        <option value="AB"    
    
>AB - Alberta</option>
        <option value="BC"    
    
>BC - British Columbia</option>
        <option value="MB"    
    
>MB - Manitoba</option>
        <option value="NU"    
    
>NU - Nunavut</option>
        <option value="NB"    
    
>NB - New Brunswick</option>
        <option value="NF"    
    
>NF - Newfoundland</option>
        <option value="NT"    
    
>NT - Northwest Territories</option>
        <option value="NS"    
    
>NS - Nova Scotia</option>
        <option value="ON"    
    
>ON - Ontario</option>
        <option value="PE"    
    
>PE - Prince Edward Island</option>
        <option value="QC"    
    
>QC - Quebec</option>
        <option value="SK"    
    
>SK - Saskatchewan</option>
        <option value="YT"    
    
>YT - Yukon Territory</option>
        <option value="XQ"    
    
>International</option>
    </select>
				</div>
			</div>

	

		</div>

		<div class="addressCell" style="width: 170px;">
			<div>
	<div class='mark asterisk'> &nbsp; </div>
				<div class="field label">ZIP/Postal Code</div>
			</div>

			<div>
	<div class='mark asterisk'> * </div>
				<div class="field">
    <input type="text" id="shippingAddress.postalCode" name="shippingAddress.postalCode" value="" style='width: 90px' maxlength='10'     >

				</div>
			</div>

	
		</div>

		<div style="clear: both;"></div>
	</div>

	<div class="addressRowGroup">

		<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
			<div class="field label">Country</div>
		</div>

		<div class="addressRow">
	<div class='mark asterisk'> * </div>
			<div class="field">
    <select id="shippingAddress.country" name="shippingAddress.country" >
        <option value="US"    
    
>United States</option>
        <option value="CA"    
    
>Canada</option>
    </select>
			</div>
		</div>

	
	</div>

	<div class="addressRowGroup">

		<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
			<div class="field label">Contact Phone Number</div>
		</div>

		<div class="addressRow">
	<div class='mark asterisk'> * </div>
			<div class="field">
    <input type="text" id="shippingAddress.phoneNumber" name="shippingAddress.phoneNumber" value="" maxlength='18' size='18' style='width: 120px;'    >

			</div>
		</div>
		<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
			<div class="field subNote">Used only for order inquiries</div>
		</div>

	
	</div>

			</div>
		</div>
	</div>
	

<div id='restOfForm'>

<div class="yui-g">

	<div class="yui-u first firstCol">

          <a name="info"></a>
          <div class="subHead"></span>Other Information</div>
			
			<div class="addressRowGroup">
				<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
					<div class="field label">
International Billing					</div>
				</div>

				<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
					<div class="field">
    <input type="text" id="customOrderHeader.internationalBilling" name="customOrderHeader.internationalBilling" value="" maxlength='50' style='width: 225px;'    >

					</div>
				</div>

				<div class="addressRow" style="width: 300px;">
	<div class='mark asterisk'> &nbsp; </div>
					<div class="field subNote">
Enter your country and phone number, with country code and city code. (max. 50 characters)					</div>
				</div>
			</div>
			
      		<div class="addressRowGroup">
				<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
					<div class="field label">
Salesperson Number					</div>
				</div>

				<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
					<div class="field">
    <input type="text" id="customOrderHeader.salespersonNumber" name="customOrderHeader.salespersonNumber" value="" maxlength='3' style='width: 30px;'     >

					</div>
				</div>

				<div class="addressRow" style="width: 300px;">
	<div class='mark asterisk'> &nbsp; </div>
					<div class="field subNote">
If you received help from a J&amp;R salesperson, please enter their number here.					</div>
				</div>
			</div>
	
	</div> 
	<div class="yui-u">

		<div class="subHead">
Gift Options		</div>
	
		<div class="addressRowGroup">
			<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
				<div class="field label">
Gift From				</div>
			</div>
			
			<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
				<div class="field">
    <input type="text" id="customOrderHeader.giftFromName" name="customOrderHeader.giftFromName" value="" style='width: 225px;' maxlength='30'    >

				</div>
			</div>
		</div>



		<div class="addressRowGroup">
			<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
				<div class="field label">
Gift Message				</div>
			</div>
			
			<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
				<div class="field">
    <input type="text" id="customOrderHeader.giftMessage" name="customOrderHeader.giftMessage" value="" style='width: 225px;' maxlength='60'    >

				</div>
			</div>
			
			<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
				<div class="field subNote">(max. 60 characters)</div>
		</div>


		<div class="addressRowGroup">
			<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
				<div class="field label">
Gift Email				</div>
			</div>
			
			<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
				<div class="field">
    <input type="text" id="customOrderHeader.giftEmailAddress" name="customOrderHeader.giftEmailAddress" value="" style='width: 225px;' maxlength='50'    >

				</div>
			</div>
			
			<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
				<div class="field">
					<a 
						target="giftnote"
						href="http://www.jr.com/information/pop_giftNotification.jsp">
							Learn more</a>
				</div>
			</div>
		</div>			

		<div class="addressRowGroup">
			<div class="addressRow">
	<div class='mark asterisk'> &nbsp; </div>
    <input type="hidden" name="_customOrderHeader.giftHidePrices" value="false" />
    <input type="checkbox" id="customOrderHeader.giftHidePrices" name="customOrderHeader.giftHidePrices"
        
        
    >
				<label for="customOrderHeader.giftHidePrices">Hide prices on the recipient's invoice and products on gift email.</label>
			</div>
		</div>	

	</div>

</div> 
</div>

<style type="text/css">
<!--
		div.orderSummaryRow {
		clear: both;
		margin-bottom: 15px;
		text-align: left;
	}
	div.orderSummaryLeft {
		float: left;
		width: 50px;
		font-weight: bold;
		text-align: left;
	}
	div.orderSummaryRight {
		margin-left: 55px;
		text-align: right;
		font-weight: bold;
	}
-->
</style>


<div class="subHead">In Your Cart</div>

	<div class="yui-ge">
		<div class="yui-u first">
	<div class="cartDetailHeader">
		<table align="center" bgcolor="#ffffff" cellpadding="0" cellspacing="0" width="95%">
			<tr>
				<td align="left">
					<b>Item Description</b>
				</td>
				<td align="right" width="80">
					<b>Price</b>
				</td>
				<td align="center" width="75">
					<b>Quantity</b>
				</td>
				<td align="right" width="90">
					<b>Total</b>
				</td>
			</tr>
		</table>
	</div>

	<table id="cartDetailTab" align="center" bgcolor="#ffffff" cellpadding="0" cellspacing="0" width="95%">
			<tr>
				<td cellpadding="0" cellspacing="0" align="left" valign="top">
				<div style="padding: 0px;">
					Panasonic Lumix DMC-LX5 10.1 Megapixel Digital Camera - Black
				</div>
				<div class="productItemMessage" style="font-style:italic;">
					
				</div>
			</td>
			<td cellspacing="0" cellpadding="0" align="right" valign="top" width="80">
				$499.95
			</td>
			<td cellspacing="0" cellpadding="0" align="center" valign="top" width="75">
				1
			</td>
			<td cellspacing="0" cellpadding="0" align="right" valign="top" width="90">
				<div class="fontItemPrice">
						$499.95
				</div>
				&nbsp;
			</td>
		</tr>

			<tr>
				<td colspan="4" valign="bottom">
					<div class="productItemMessage">Buy this Camera Save $5 off select memory cards. <a href="/promotion/listContent.jsp?promoName=MemCard" ><b> See Details</b></a></div>
				</td>
			</tr>
			
		<tr>
			<td colspan="4" valign="bottom">
				<div style="margin: 0 0 2px 315px; text-align: left;">
						<span class="fontsmall" style="margin-left: 5px;">&nbsp;</span>
				</div>
			</td>
		</tr>
		<tr><td colspan="4" style="padding: 0px 0px 5px;"><div style="background-image: url(/media/images/dotted_horiz_v1_m56577569831605050.gif); height: 1px;"><img src="#" alt="" border="0" height="1" width="212"></div></td></tr>
	</table>
		<div class="stepsWarning">
			(You may go back to the 
			<a href="/checkout.flow?_flowExecutionKey=_c1CD2F5A1-28EE-6B0F-71FC-DCDBE4BCCA78_k64250CE6-ADB4-BD9D-FEED-2C51C69CE671&_eventId=cancelOrder">Shopping Cart</a>
			to change your selections.)
		</div>
	
	</div>

	<div class="yui-u">



	<div class="refinements jrui-center">Order Summary</div>
	
	<div class="orderSummaryBox">
				<div class="orderSummaryRow">
					<div class="orderSummaryLeft largerFont">Subtotal:</div>
					<div class="orderSummaryRight largerFont">$499.95</div>
				</div>
		
				<div class="orderSummaryRow">
Shipping charge and total will be displayed once you select your shipping option later in the process.				</div>
				
			
				<div class="orderSummaryRow">
					<div class="orderSummaryLeft">Tax:</div>
					<div class="orderSummaryRight">
NY Only*					</div>
				</div>
		
				<div class="orderSummaryRow">
*J&amp;R only collects local sales tax on orders shipped to NY State.				</div>
		
				<div class="orderSummaryRow" style="text-align: center;">
					<input type="image" name="_eventId_continue" value="submit" alt="Continue" src="#" />
				</div>
				
	</div>

		</div>
	 
</div> 
</form>




 
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