
<patTemplate:tmpl name="pageoutput" unusedvars="strip">
	<h2 class="page-header">{PAGETITLE}</h2>
	<form action="{JOMRES_SITEPAGE_URL_ADMIN}" method="post" name="adminForm" class="form-horizontal">
		{JOMRESTOOLBAR}
		<fieldset>
			<div class="control-group">
				<label class="control-label" for="name">{HCODE}</label>
				<div class="controls">
					<input type="text" name="code" value="{CODE}" class="input-large"/>
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="name">{HDESCRIPTION}</label>
				<div class="controls">
					<input type="text" name="description" value="{DESCRIPTION}" class="input-large"/>
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="name">{HRATE}</label>
				<div class="controls">
					<input type="text" name="rate" value="{RATE}" class="input-large"/>
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="name">{_JOMRES_IS_EU_COUNTRY}</label>
				<div class="controls">
					{IS_EU_COUNTRY}
				</div>
			</div>
			<input type="hidden" name="id" value="{ID}"/>
			<input type="hidden" name="option" value="com_jomres"/>
			<input type="hidden" name="task" value="save_taxrate"/>
			{CSRF_TOKEN}
		</fieldset>
	</form>
</patTemplate:tmpl>