{% load staticfiles %} Payment for {{ document.kind }} {{ document.series }}-{{ document.number }} {% block extrahead %} {% endblock %}
{% block payment_processor %} {% endblock %} {% block document %}
Issuer: {{ provider.billing_name }}

{{ provider.address_1 }}
{% if provider.address_2 %} {{ provider.address_2 }}
{% endif %} {{ provider.city }}
{% if provider.state %} {{ provider.state }}
{% endif %} {% if provider.zip_code %} {{ provider.zip_code }}
{% endif %} {% if provider.email %} Email: {{ provider.email }}
{% endif %} {% if provider.extra %} {{ provider.extra|linebreaksbr }} {% endif %}

Customer: {{ customer.billing_name }}

{% if customer.sales_tax_number %} {{ customer.sales_tax_number }}
{% endif %} {{ customer.address_1 }}
{% if customer.address_2 %} {{ customer.address_2 }}
{% endif %} {{ customer.city }}
{% if customer.state %} {{ customer.state }}
{% endif %} {% if customer.zip_code %} {{ customer.zip_code }}
{% endif %} {% if customer.email %} {{ customer.email }}
{% endif %} {% if customer.company %} {{ customer.company }}
{% endif %} {% if customer.extra %} {{ customer.extra|linebreaksbr }}
{% endif %}

{% if transaction.state == transaction.States.Initial %} {% block form %}
{{ transaction.amount }} {{ transaction.currency }} {{ form }}
{% endblock %} {% else %} {% block transaction %} The payment is {{ transaction.state }}. {% endblock %} {% endif %}
{% block document_details %} {% for entry in entries %} {% endfor %}
# Service Unit Qty. Unit Price Total Amount
{{ forloop.counter }} {{ entry.description }} {{ entry.unit }} {{ entry.quantity|floatformat:-2 }} {{ entry.unit_price|floatformat:2 }} {{ document.currency }} {{ entry.total|floatformat:2 }} {{ document.currency }}
Amount paid
* this may not represent document's total amount
{{ transaction.amount }} {{ transaction.currency }}

Total amount

{{ document.total|floatformat:2 }} {{ document.currency }}

{% endblock %} {% endblock %}