<form action="" method="post" name="eprooform">
  <br>
  <table class="tableborder" border="0" cellpadding="3" cellspacing="0" width="100%">
    <tbody>
      <tr valign="top" colspan="3">
        <td>
          <br><br>
          <table width="60%" style="background-color: #fff; border: solid 1px #000;" align="center">
            <tr>
              <td align="center">
                <br>
                <b>[NAME]</b>
                <br>[STRASSE]
                <br>[LAND]-[PLZ] [ORT]
                <br>
                <br>
              </td>
            </tr>
          </table>
          <br><br>
<!--	


        <table width="100%">
          <tr><td>Kundennummer:</td><td><input type="text" name="kundeadressid" size="20" value="[KUNDENNUMMER]"></td>
            <td>&nbsp;</td><td>Lieferantenummer:</td><td><input type="text" name="lieferantadressid" size="20" value="[LIEFERANTENNUMMER]">
	    </td></tr>
          <tr><td>Name/Firma:</td><td><input type="text" name="name" size="20" value="[NAME]"></td>
          <td>&nbsp;</td>
            <td>Vorname:</td><td><input type="text" name="vorname" size="20" value="[VORNAME]"></td></tr>
          <tr><td>Abteilung:</td><td><input type="text" name="abteilung" size="20" value="[ABTEILUNG]"></td><td>&nbsp;</td>
            <td>Unterabteilung:</td><td><input type="text" name="unterabteilung" value="[UNTERABTEILUNG]" size="20"></td></tr>
          <tr><td>Strasse:</td><td><input type="text" name="strasse" size="20" value="[STRASSE]"></td>
          <td>&nbsp;</td>
            <td>Adresszusatz:</td><td><input type="text" name="adresszusatz" size="20" value="[ADRESSZUSATZ]"></td></tr>
          <tr><td>PLZ:</td><td><input type="text" name="plz" size="20"></td><td>&nbsp;</td>
            <td>Ort:</td><td><input type="text" name="ort" size="20"></td></tr>
          <tr><td>Land:</td><td colspan="3">[EPROO_SELECT_LAND]<input type="hidden" name="land"></td>
            </tr>
          <tr><td>USt-ID:</td><td><input type="text" name="ustid" size="20" value="[USTID]"></td><td>&nbsp;</td>
            <td>E-Mail:</td><td><input type="text" name="email" size="20" value="[EMAIL]"></td></tr>
          <tr><td>Telefon:</td><td><input type="text" name="telefon" size="20" value="[TELEFON]"></td><td>&nbsp;</td>
            <td>Telefax:</td><td><input type="text" name="telefax" size="20" value="[TELEFAX]"></td></tr>
        </table>
-->
        </td>
      </tr>
      <tr valign="" height="" bgcolor="" align="" bordercolor="" class="klein" classname="klein">
        <td width="" valign="" height="" bgcolor="" align="center" colspan="3" bordercolor="" classname="orange2" class="orange2">
          <input type="submit" name="zurueck"
              value="Nein, doch nicht" />
          <input type="submit" name="submit"
          value="{|Weiter|}" /></td>
      </tr>
    </tbody>
  </table>
</form>