<?xml version="1.0" encoding="utf-8"?>
<form>
  <fieldset>
    <field name="id" type="text" readonly="true" class="readonly" default="0" description="JGLOBAL_FIELD_ID_DESC"/>
    <field name="ordering"/>
    <field name="state" default="1" type="list" label="JSTATUS" description="JFIELD_PUBLISHED_DESC" class="inputbox" size="1">
      <option value="1">JPUBLISHED</option>
      <option value="0">JUNPUBLISHED</option>
      <option value="2">JARCHIVED</option>
      <option value="-2">JTRASHED</option>
    </field>
    <field name="checked_out" type="hidden" filter="unset"/>
    <field name="checked_out_time" default="0000-00-00 00:00:00" type="hidden" filter="unset"/>
    <field name="userid" filter="safehtml" type="text" readonly="true" label="COM_WITHDRAW_FORM_LBL_RECORD_USERID" description="COM_WITHDRAW_FORM_DESC_RECORD_USERID" hint="COM_WITHDRAW_FORM_LBL_RECORD_USERID"/>
    <field name="date" class="inputbox" timeformat="12" filter="server_utc" translateformat="false" showtime="false" singleheader="false" todaybutton="false" weeknumbers="false" filltable="false" type="calendar" label="COM_WITHDRAW_FORM_LBL_RECORD_DATE" description="COM_WITHDRAW_FORM_DESC_RECORD_DATE" hint="COM_WITHDRAW_FORM_LBL_RECORD_DATE"/>
    <field name="withdrawlimit" filter="safehtml" type="hidden" label="COM_WITHDRAW_FORM_LBL_RECORD_WITHDRAWLIMIT" description="COM_WITHDRAW_FORM_DESC_RECORD_WITHDRAWLIMIT" hint="COM_WITHDRAW_FORM_LBL_RECORD_WITHDRAWLIMIT"/>
    <field name="withdrawamount" filter="safehtml" type="text" required="true" label="COM_WITHDRAW_FORM_LBL_RECORD_WITHDRAWAMOUNT" description="COM_WITHDRAW_FORM_DESC_RECORD_WITHDRAWAMOUNT" hint="COM_WITHDRAW_FORM_LBL_RECORD_WITHDRAWAMOUNT"/>
    <field name="administrationpercentage" filter="safehtml" type="text" label="COM_WITHDRAW_FORM_LBL_RECORD_ADMINISTRATIONPERCENTAGE" description="COM_WITHDRAW_FORM_DESC_RECORD_ADMINISTRATIONPERCENTAGE" hint="COM_WITHDRAW_FORM_LBL_RECORD_ADMINISTRATIONPERCENTAGE"/>
    <field name="servicecharge" filter="safehtml" type="text" label="COM_WITHDRAW_FORM_LBL_RECORD_SERVICECHARGE" description="COM_WITHDRAW_FORM_DESC_RECORD_SERVICECHARGE" hint="COM_WITHDRAW_FORM_LBL_RECORD_SERVICECHARGE"/>
    <field name="bankcharge" filter="safehtml" type="text" label="COM_WITHDRAW_FORM_LBL_RECORD_BANKCHARGE" description="COM_WITHDRAW_FORM_DESC_RECORD_BANKCHARGE" hint="COM_WITHDRAW_FORM_LBL_RECORD_BANKCHARGE"/>
    <field name="actualamount" filter="safehtml" type="text" readonly="true" label="COM_WITHDRAW_FORM_LBL_RECORD_ACTUALAMOUNT" description="COM_WITHDRAW_FORM_DESC_RECORD_ACTUALAMOUNT" hint="COM_WITHDRAW_FORM_LBL_RECORD_ACTUALAMOUNT"/>
    <field name="bank" filter="safehtml" type="text" required="true" label="COM_WITHDRAW_FORM_LBL_RECORD_BANK" description="COM_WITHDRAW_FORM_DESC_RECORD_BANK" hint="COM_WITHDRAW_FORM_LBL_RECORD_BANK"/>
    <field name="accountname" filter="safehtml" type="text" required="true" label="COM_WITHDRAW_FORM_LBL_RECORD_ACCOUNTNAME" description="COM_WITHDRAW_FORM_DESC_RECORD_ACCOUNTNAME" hint="COM_WITHDRAW_FORM_LBL_RECORD_ACCOUNTNAME"/>
    <field name="accountno" filter="safehtml" type="text" required="true" label="COM_WITHDRAW_FORM_LBL_RECORD_ACCOUNTNO" description="COM_WITHDRAW_FORM_DESC_RECORD_ACCOUNTNO" hint="COM_WITHDRAW_FORM_LBL_RECORD_ACCOUNTNO"/>
    <field name="shiftcode" filter="safehtml" type="text" label="COM_WITHDRAW_FORM_LBL_RECORD_SHIFTCODE" description="COM_WITHDRAW_FORM_DESC_RECORD_SHIFTCODE" hint="COM_WITHDRAW_FORM_LBL_RECORD_SHIFTCODE"/>
    <field name="version_note" type="text" label="JGLOBAL_FIELD_VERSION_NOTE_LABEL" description="JGLOBAL_FIELD_VERSION_NOTE_DESC" class="inputbox" size="45" labelclass="control-label"/>
  </fieldset>
</form>
