{template "header.html"}

<form class="form-horizontal" method="post" role="form" id="myform">
    {$form}
    <div class="form-body">

        <div class="form-group">
            <label class="col-xs-3 control-label ajax_name">{dr_lang('付款账号')}</label>
            <div class="col-xs-7">
                <p class="form-control-static"> {Function_list::author($user.username)} </p>
            </div>
        </div>
        <div class="form-group">
            <label class="col-xs-3 control-label ajax_name">{dr_lang('账户余额')}</label>
            <div class="col-xs-7">
                <p class="form-control-static"> {$user.money} </p>
            </div>
        </div>
        <div class="form-group">
            <label class="col-xs-3 control-label ajax_name">{dr_lang('回收金额')}</label>
            <div class="col-xs-7">
                <p class="form-control-static"> {dr_pay_money_html($data.value)} </p>
            </div>
        </div>
        <div class="form-group" id="dr_row_note">
            <label class="col-xs-3 control-label ajax_name">{dr_lang('回收备注')}</label>
            <div class="col-xs-7">
                <textarea class="form-control" id="dr_note" name="data[note]" rows="4"></textarea>
            </div>
        </div>
        <div class="form-group">
            <label class="col-xs-3 control-label ajax_name">{dr_lang('操作说明')}</label>
            <div class="col-xs-7">
                <p class="form-control-static"> {dr_lang('此功能是将本笔资金从付款账号中扣除')} </p>
            </div>
        </div>

    </div>
</form>


{template "footer.html"}