<?php include("../../include/dbconnect.php");?>
<style>
tr.border_bottom td {
  border-bottom:1pt solid black;
}
</style>
<head>
<meta http-equiv=Content-Type content="text/html; charset=windows-1252">
<title>GST Invoice</title></head>
<body bgcolor="#FFFFFF" class="Normall" lang=EN-US>
<?
$aresult = mysqli_query($conn,"select distinct account_year,cenvat_regno,service_tax_no from branches") or die(mysqli_error());
$arow = mysqli_fetch_row($aresult);
$account_year = $arow[0];
$cenvat = $arow[1];
$servicetax = $arow[2];



head($inv_no,$compcode);

$sl = 1;

	
	$x=1;
	
	$valuetot =0;
	$vattot =0;
	$grosstot = 0;
	$distot = 0;
	$qtytot = 0;
$myresult = mysqli_query($conn,"select  prodcode,quantity,rate,value,discount,discount_amt ,vat_percent,vat_amount,specification,vatcess_amt from salesreg8b where account_year='$account_year' and inv_no = '$inv_no'  and quantity > 0  and compcode = '$compcode' ") or die(mysqli_error());
while($myrow = mysqli_fetch_row($myresult))
{
	$prodcode = $myrow[0];
	$qty = $myrow[1];
	$rate = $myrow[2];
	$value = $myrow[3];
	$discount = $myrow[4];
	//$discount_amount = $myrow[5];
	$vat_percent = $myrow[6];
	$vatamt = $myrow[7];
	$specification = $myrow[8];
	$vatcess_amt = $myrow[9];
	$amount = round($value - $discount_amount + $vatamt,2);
	//$distot = $distot + $discount_amount;

	$presult = mysqli_query($conn,"select prodname,schedule,packing from product where prodcode = '$prodcode' ") or die(mysqli_error());
	$prow = mysqli_fetch_row($presult);
	$product= $prow[0];
	$pn = $prow[0];
	if($specification != '')
	{
		$product = $product.'('.$specification.')';
	}
	$schedule = $prow[1];
	$unit  = $prow[2];
	$vattot = $vattot + $vatamt;
	$cesstotal = $cesstotal+$vatcess_amt;
	$valuetot = $valuetot + ($value - $discount_amount);
	$grosstot = $grosstot + $amount;
	
	if($discount >0)
	{
		$di = round($discount,0).'%';
	}
	else
	{
		$di = '   ';
	}

	if($pn == 'FREIGHT')
	{
		$qty='';
		//$rate =0;
		$unit='';
	}
	$qtytot =$qtytot+$qty;
		?>
	   <tr height="30"> 
      <td width=42 valign=top class="Normall" align="center"><font  face="Arial, Helvetica, sans-serif"><? echo($sl);?>  </font></td>
	        <td width=84 valign=top class="Normall" align="center"><font  face="Arial, Helvetica, sans-serif" ><? echo($schedule);?>   </font></td>
      <td width=314 valign=top class="Normall"><font  face="Arial, Helvetica, sans-serif"><? echo($product);?>   </font></td>


      <td width=56 valign=top align="right" class="Normall"><font  face="Arial, Helvetica, sans-serif"><? echo(number_format($rate,2));?>  </font></td>
	  
      <td width=56 valign=top align="right" class="Normall"><font  face="Arial, Helvetica, sans-serif"><? echo($qty);?>  </font></td>
      <td width=49 valign=top align="right" class="Normall"><div align="center"><font  face="Arial, Helvetica, sans-serif"><? echo($unit);?>  </font></div></td>	  
      <td width=63 valign=top align="right" class="Normall"><font  face="Arial, Helvetica, sans-serif"><? echo(number_format($value,2,'.',''));?>  </font></td>
      <td width=47 valign=top align="right" class="Normall"><font  face="Arial, Helvetica, sans-serif"><? echo($vat_percent);?>  </font></td>	  
	        <td width=57 valign=top align="right" class="Normall"><font  face="Arial, Helvetica, sans-serif"><? echo($vatamt);?>  </font></td>
      <td width=63 valign=top align="right" class="Normall"><font  face="Arial, Helvetica, sans-serif"><? echo(number_format($amount,2));?>  </font></td>	  				  	  
      </tr>
  	  <?
	  $x++;
	  $sl++;
	  if($x>20)
	  {
		  footer($name);
		  head($inv_no,$compcode);
		  $x=1;
	  }
		  
	}
	while($sl < 15)
	{
	?>
	   <tr> 
      <td width=42 valign=top class="Normall" align="center"><font  face="Arial, Helvetica, sans-serif">&nbsp; </font></td>
      <td width=84 valign=top class="Normall"><font  face="Arial, Helvetica, sans-serif">&nbsp;  </font></td>
      <td width=314 valign=top class="Normall" align="center"><font  face="Arial, Helvetica, sans-serif" >&nbsp;  </font></td>

      <td width=41 valign=top align="right" class="Normall"><font  face="Arial, Helvetica, sans-serif">&nbsp;  </font></td>
      <td width=56 valign=top align="right" class="Normall"><font  face="Arial, Helvetica, sans-serif">&nbsp;  </font></td>
      <td width=49 valign=top class="Normall"><div align="center"><font  face="Arial, Helvetica, sans-serif">  </font></div></td>
      <td width=63 valign=top class="Normall" align="center"><font  face="Arial, Helvetica, sans-serif" >&nbsp;  </font></td>

      <td width=47 valign=top align="right" class="Normall"><font  face="Arial, Helvetica, sans-serif">&nbsp; </font></td>
      <td width=57 valign=top align="right" class="Normall"><font  face="Arial, Helvetica, sans-serif">&nbsp;  </font></td>
      <td width=63 valign=top align="right" class="Normall"><font  face="Arial, Helvetica, sans-serif">&nbsp;  </font></td>	  
      </tr>	
	<?
	$sl++;
	}
	
	$myresult = mysqli_query($conn,"select packing,form20 ,pur_no,pur_date,desp_no ,vehicle_no  from salesreg8b where account_year='$account_year' and inv_no = '$inv_no'  and prodcode = 'TOTAL' and compcode = '$compcode' ") or die(mysqli_error());
	$myrow = mysqli_fetch_row($myresult);
	$packing = $myrow[0];
	$form20 = $myrow[1];
	$pur_no = $myrow[2];
	$pur_date = $myrow[3];
	$desp_no = $myrow[4];
	$vehicle_no = $myrow[5];
	$total = $myrow[0] +$grosstot;
	

$nt = round($total,0);
$diff = $nt - $total;




	


	?>
	
	
	<tr class="border_bottom" >
	<td>&nbsp;</td>
	<td>&nbsp;</td>
	<td>&nbsp;</td>
	<td>&nbsp;</td>
	<td>&nbsp;</td>
	<td>&nbsp;</td>
	<td>&nbsp;</td>
	<td>&nbsp;</td>
		<td>&nbsp;</td>
	<td>&nbsp;</td>

	</tr>
	
	   <tr> 
      <td valign=top class="Normall" align="center" colspan="4"><font  face="Arial, Helvetica, sans-serif"> Total</font></td>
      <td width=63 valign=top align="right" class="Normall"><font  face="Arial, Helvetica, sans-serif"><? echo(number_format($qtytot,2));?>  </font></td>
	  
       <td width=63 valign=top align="right" class="Normall"><font  face="Arial, Helvetica, sans-serif">&nbsp;  </font></td>
      <td width=63 valign=top align="right" class="Normall"><font  face="Arial, Helvetica, sans-serif"><? echo(number_format($valuetot,2));?>  </font></td>
      <td width=47 valign=top align="right" class="Normall"><font  face="Arial, Helvetica, sans-serif">  </font></td>	  
	        <td width=57 valign=top align="right" class="Normall"><font  face="Arial, Helvetica, sans-serif"><? echo(number_format($vattot,2));?>  </font></td>
      <td width=63 valign=top align="right" class="Normall"><font  face="Arial, Helvetica, sans-serif"><? echo(number_format($grosstot,2));?>  </font></td>	  				  	  
      </tr>
	

	</table>
	
	
	<table width="896"  border=1 cellpadding=0 cellspacing=0  rules = "all" class="MsoTableGrid">
	<?

	$taxresult = mysqli_query($conn,"select vat_percent,round(sum(vat_amount),2),bcode,cess_percent,sum(vatcess_amt) from salesreg8b where account_year='$account_year' and inv_no = '$inv_no'  and prodcode != 'TOTAL' and compcode = '$compcode' group by taxtype ") or die(mysqli_error());
	while($trow = mysqli_fetch_row($taxresult))
	{
		
		$tax_rate = $trow[0];
		$taxamt=round($trow[1],2);
		$bcode = $trow[2];
		$cess_percent = $trow[3];
		$cess_amt = $trow[4];
				
		$bresult = mysqli_query($conn,"select taxtype from buy where bcode = '$bcode' ") or die(mysqli_error());
		$brow = mysqli_fetch_row($bresult);
		$buyertype =  $brow[0];

	
		if($buyertype == 'STATE')
		{
			$cess_amt = round($cess_amt,2);
			$sgst_amt = round($taxamt/2,2);
			$cgst_amt = $sgst_amt;
			$igst_amt =0;
			$tax_rate = $tax_rate/2;
		}
		if($buyertype == 'INTERSTATE')
		{
			$igst_amt = round($taxamt,2);
			$sgst_amt=0;
			$cgst_amt=0;
			$cess_amt=0;
		}

	if($sgst_amt>0)
	{
	?>
	<tr class="border_bottom">

	<td valign=top  class="Normall"  align="left" colspan="2"><font  face="Arial, Helvetica, sans-serif"> SGST &nbsp;@&nbsp;<?=$tax_rate?>&nbsp;% &nbsp;&nbsp;=><? echo($sgst_amt);?></font></div></td>


	<td valign=top  class="Normall"  align="left" colspan="2"><font  face="Arial, Helvetica, sans-serif"> CGST &nbsp;@&nbsp;<?=$tax_rate?>&nbsp;%&nbsp;=><? echo($cgst_amt);?></font></div></td>
	</tr>
    <?	
		}

	if($cess_amt>0)
	{
	?>
	<tr class="border_bottom">
<td>&nbsp;</td><td>&nbsp;</td>
	<td valign=top  class="Normall"  align="right"><font  face="Arial, Helvetica, sans-serif"> KFC &nbsp;@&nbsp;<?=$cess_percent?>&nbsp;%</font></td>
	<td width="248"  align="right"><div align="right"><font  face="Arial, Helvetica, sans-serif"><? echo($cess_amt);?></font></div></td>
	</tr>
    <?	
		}			
		
	if($igst_amt>0)
	{
	?>
	<tr class="border_bottom">
<td>&nbsp;</td>
	<td valign=top  class="Normall"  align="right"><font  face="Arial, Helvetica, sans-serif"> IGST &nbsp;@&nbsp;<?=$tax_rate?>&nbsp;%</font></td>
	<td width="248"  align="right"><div align="right"><font  face="Arial, Helvetica, sans-serif"><? echo($igst_amt);?></font></div></td>
	</tr>
    <?	
		}		
			
	}// end of while loop		

	if($packing > 0)
	{
	?>
	<tr class="border_bottom">

	<td valign=top  class="Normall" colspan="3" align="right"><font  face="Arial, Helvetica, sans-serif"> Packing and Forwarding Charges</font></td>
	<td width="248"  align="right"><div align="right"><font  face="Arial, Helvetica, sans-serif"><? echo($packing);?></font></div></td>
	</tr>
	<?
	}
	$bamt =  $total +$cesstotal;
	$billamt = round($bamt);
	$diff = $billamt- $bamt;	
?>
	
	<tr>

	<td valign=top  class="Normall" colspan="3" align="right"><font  face="Arial, Helvetica, sans-serif"> Round off</font></td>
	<td width="248"  align="right"><div align="right"><font  face="Arial, Helvetica, sans-serif"><? echo(round($diff,2));?></font></div></td>
	</tr>

	
	
	<tr>
	<td valign=top  class="Normall" colspan="2"><font  face="Arial, Helvetica, sans-serif">E&amp;OE</font></td>
	  

	<td width=290 valign=top  class="Normall"><div align="right"><font  face="Arial, Helvetica, sans-serif"><b>Grand Total</b>Rs.</font></div></td>
	<td width="248"  align="right"><div align="right"><font  face="Arial, Helvetica, sans-serif"><b><? echo(number_format($billamt,2,'.',''));?></b></font></div></td>
	</tr>
	<?
	if($distot >0)
	{
	?>
		<tr>

	<td valign=top  class="Normall" colspan="3" align="right"><font  face="Arial, Helvetica, sans-serif"> Total Discount </font></td>
	<td width="248"  align="right"><div align="right"><font  face="Arial, Helvetica, sans-serif"><? echo(round($distot,2));?></font></div></td>
	</tr>
	<?
	}
	?>	

	<tr>
	<td valign=top  class="Normall" align="left" colspan="100%"><font  face="Arial, Helvetica, sans-serif"><b>&nbsp;&nbsp;Rupees &nbsp;<? echo(connum($billamt));?>&nbsp;only.</b></font></td>
	</tr>
	<tr>
	<td valign=top  class="Normall" align="left" colspan="100%"><font  face="Arial, Helvetica, sans-serif">Bank Account Details: Name:TEACHERS CENTRE,CC A/c No:42894648519, Bank:STATE BANK OF INDIA, Branch:ADB Branch,IFSC:SBIN0001660</font></td>
	</tr>    
	
	<tr>
	<td valign=top  class="Normall" colspan="2" align="left"><font  face="Arial, Helvetica, sans-serif">Order Ref No:<?=$pur_no?></font></td>
	  

	<td width=290 valign=top  class="Normall" align="left"><font  face="Arial, Helvetica, sans-serif">Documents through :<?=$form20?></font></td>
	<td width="248"  align="left"><font  face="Arial, Helvetica, sans-serif">Mode of Transport:<?=$vehicle_no?></font></td>
	</tr>    
       </table>
<?
footer();
?>

</td></tr></table>

</body>
</html>

<?
function head($inv_no,$compcode)
{
global $conn;	
$aresult = mysqli_query($conn,"select distinct account_year,cenvat_regno,service_tax_no from branches") or die(mysqli_error());
$arow = mysqli_fetch_row($aresult);
$account_year = $arow[0];
$cenvat = $arow[1];
$servicetax = $arow[2];


	
	$result = mysqli_query($conn,"select distinct inv_date, form20 ,pur_no,pur_date,desp_no ,vehicle_no,schedule,value,vat_percent,vat_amount,taxtype,vatcess_amt,packing,total ,payterms,bcode from salesreg8b where compcode ='$compcode' and inv_no ='$inv_no' and prodcode ='Total'  and account_year ='$account_year' ") or die(mysqli_error());
	$row = mysqli_fetch_row($result);
	$form20=$row[1];
	$date = substr($row[0],8,2).'-'.substr($row[0],5,2).'-'.substr($row[0],0,4);
	$pur_no=$row[2];
	$pur_date= substr($row[3],8,2).'-'.substr($row[3],5,2).'-'.substr($row[3],0,4);
	$desp_no=$row[4];
	$vehicle_no=$row[5];
	$schedule = $row[6];
	$netvalue = $row[7];
	$tax_rate = $row[8];
	$taxamt =$row[9];
	$cess = $row[10];
	$cess_amt= $row[11];
	$packing =$row[12];
	$total = $row[13];
	$addon_term = $row[14];

	
	$result = mysqli_query($conn,"select  name,address1,address2,city,state,pin,cst,gstin,telno,email from company where compcode ='$compcode' ") or die(mysqli_error());
	$row=mysqli_fetch_row($result);
	$name=$row[0];
	$address = $row[1].',&nbsp;'.$row[2].',&nbsp;'.$row[3].'-&nbsp;'.$row[5].',&nbsp;'.$row[4];
		$ad = $row[1].','.$row[2].','.$row[3].',-'.$row[5].'. Tel No: '.$row[8];	
	$tin=$row[7];
	$cst=$row[6];
	$city=$row[3];	
    $tel_no = $row[8];
	$email=$row[9];
	
	$result = mysqli_query($conn,"select  distinct bcode  from salesreg8b where inv_no='$inv_no' and compcode ='$compcode'  and account_year ='$account_year' ") or die(mysqli_error());
	$row=mysqli_fetch_row($result);
	$bcode =$row[0];
	if($bcode != '0')
	{
		$result = mysqli_query($conn,"select  name,address1,address2,city,state,pin,cst,gstin,std,telno,mobile,state_code from buy where bcode ='$bcode' ") or die(mysqli_error());
		$row=mysqli_fetch_row($result);
		$bname=$row[0];
			$bcity=$row[3];
		$baddress = $row[1].',&nbsp;'.$row[2];
		$baddress1 = $row[3].',&nbsp;'.$row[4].',&nbsp;'.$row[5];
		$btin='GSTIN:&nbsp;'.$row[7].'&nbsp;&nbsp;STATE CODE:&nbsp;'.$row[11];
		$btel_no = $row[8].'&nbsp;-&nbsp;'.$row[9].'Mobile:'.$row[10];
		if($row[6] != '')
			$bpan = 'PAN&nbsp;'.$row[6];
	}
	else
	{
		$result = mysqli_query($conn,"select  name,address1,address2,city,state,pin,phone from bill_patient where inv_no='$inv_no'   and account_year ='$account_year' ") or die(mysqli_error());
		$row=mysqli_fetch_row($result);
		$bname=$row[0];
			$bcity=$row[3];
		if($row[1] != '')
		{
			$baddress = $row[1];
		}
		if($row[2] != '')
		{
			$baddress = $baddress.',&nbsp;'.$row[2];
		}

		if($row[3] != '')
		{
			$baddress1 = $baddress1.',&nbsp;'.$row[3];
		}
		
		if($row[4] != '')
		{
			$baddress1 = $baddress1.',&nbsp;'.$row[4];
		}
		if($row[5] != '')
		{
			$baddress1 = $baddress1.',&nbsp;'.$row[5];
		}
		$btel_no = $row[6];

	}	
	

	
		

?>
<table border="0" bordercolordark="#030000">

<tr><td width="893">


  <br>

   <table width="894" border=0 cellpadding=0 cellspacing=0 class=MsoTableGrid>
  <tr><td width="9"></td><td width="850" align="center"><font size="+3" face="Arial, Helvetica, sans-serif"><? echo($name);?></font></td></tr>

	    <tr><td width="9" height="21"></td><td width="850" align="center"><font  face="Arial, Helvetica, sans-serif" size="-1"><? echo($address);?></font></td></tr>
		    <tr><td width="9" height="21"></td><td width="850" align="center"><font  face="Arial, Helvetica, sans-serif" size="-1">Phone : &nbsp;<? echo($tel_no);?>&nbsp;&nbsp;Mail:&nbsp;<?=$email?>,&nbsp;&nbsp;Web:www.classicbelts.com</font></td></tr>
  
    <tr>
    <td width="246" height="21" align="center" colspan="100%"><font  face="Arial, Helvetica, sans-serif" size="-1"><b>GSTIN:&nbsp;<? echo($tin);?>&nbsp;&nbsp;STATE CODE:&nbsp;32</b></font></td></tr>

    <tr>
    <td width="246" height="21" align="center" colspan="100%"><font  face="Arial, Helvetica, sans-serif" size="-1"><b>PAN:&nbsp;<? echo(substr($tin,2,10));?></b></font></td></tr>
	   
	   
</table>
   <table width="896" border=1 cellpadding=0 cellspacing=0 class=MsoTableGrid rules="cols">

 <tr><td colspan="100%"> <p align=center style='text-align:center'><b><font  face="Arial, Helvetica, sans-serif">Tax Invoice-Cash/Credit</font></b></p></td></tr>
</table>

<table width="896" border="1" rules="cols">

    <tr>       <td  valign=top class="Normall" ><font  face="Arial, Helvetica, sans-serif">
	  Name &amp; Address of Dealer / Buyer&nbsp;<br/><b>M/s.&nbsp; <? echo($bname);?></b></font></td>
      <td width="419"   align="left" valign=center class="Normall"><div align="right"><font  face="Arial, Helvetica, sans-serif"> <b>Invoice
        No. &nbsp; <? echo($inv_no);?></b></font></div></td></tr>
		  <tr>
		        <td width="461"  valign=center class="Normall" ><font  face="Arial, Helvetica, sans-serif"><? echo($baddress);?></br>
	            <?=$baddress1?></font></td>
      <td width=419  align="right" class="Normall"><div align="right"><font  face="Arial, Helvetica, sans-serif"> <b> Date : &nbsp;<? echo($date);?></b></font></div></td>
    </tr>
	     <tr> 
      <td width=461 valign=top class="Normall"><font  face="Arial, Helvetica, sans-serif">Phone &nbsp; <? echo($btel_no);?></font></td>
      <td align="right"><font  face="Arial, Helvetica, sans-serif">Reverse Charge: Nil</font></td></tr>
	  <tr><td width=461 valign=top class="Normall"><font  face="Arial, Helvetica, sans-serif"><? echo($btin.'<br>'.$bpan);?></font></td>
	  </tr>
	</table>
  <table width="866" border=0 cellpadding=0 cellspacing=0 class=MsoTableGrid>
    <tr> 
</tr>
      <tr> 
</tr>

	  </table>
  <table width="896" border=1 cellpadding=0 cellspacing=0  rules = "cols" class=MsoTableGrid>
    <tr> 
      <td width=42 valign=top class="Normall" align="center"><font  face="Arial, Helvetica, sans-serif" > <span class=SpellE>Sl.No.</font></td>
      <td width=84 valign=top class="Normall" align="center"><font  face="Arial, Helvetica, sans-serif">HSN/SAC</font></td>	  
      <td width=314 valign=top class="Normall" align="center"><font  face="Arial, Helvetica, sans-serif"> Description of Goods</font></td>

      <td width=56 valign=top class="Normall"  align="center"><div align="center"><font  face="Arial, Helvetica, sans-serif"> Rate </font></div></td>


      <td width=56 valign=top class="Normall"  align="center"><div align="right"><font  face="Arial, Helvetica, sans-serif"> Quantity</font></div></td>
          <td width=49 valign=top class="Normall"  align="center"><div align="center"><font  face="Arial, Helvetica, sans-serif">Unit</font></div></td>
      <td width=63 valign=top class="Normall"  align="center"><div align="right"><font  face="Arial, Helvetica, sans-serif"> Value</font></div></td>			
      <td width=47 valign=top class="Normall"  align="center"><div align="right"><font  face="Arial, Helvetica, sans-serif"> GST % </font></div></td>
          <td width=57 valign=top class="Normall"  align="center"><div align="right"><font  face="Arial, Helvetica, sans-serif"> Tax Amount </font></div></td>
      <td width=63 valign=top class="Normall" align="center"><div align="right"><font  face="Arial, Helvetica, sans-serif"> Gross Value</font></div></td>
    </tr>

	<tr class="border_bottom" >
	<td>&nbsp;</td>
	<td>&nbsp;</td>
	<td>&nbsp;</td>
	<td>&nbsp;</td>
	<td>&nbsp;</td>
	<td>&nbsp;</td>
	<td>&nbsp;</td>
	<td>&nbsp;</td>
		<td>&nbsp;</td>
	<td>&nbsp;</td>

	</tr> 
<?
return;
}

function footer()
{
global $conn;	
$cresult = mysqli_query($conn,"select name,city from company ") or die(mysqli_error());
$crow =mysqli_fetch_row($cresult);
$name = $crow[0];
$city = $crow[1];
	?>
		<table width="896"  border=1 cellpadding=0 cellspacing=0  rules = "all" class="MsoTableGrid"> 
	<tr><td width="507" align="justify"><font  face="Arial, Helvetica, sans-serif" size="-1">
	DECLARATION: Certified that all the particulars shown in the above Tax Invoice are true and correct in all respect. 
	</font></td>
	
	
	<td  align="center" colspan="3"><p><font  face="Arial, Helvetica, sans-serif">for 
	  <?=$name?></font>
	</p>
	  <p>&nbsp;</p>
	  <p><strong><font  face="Arial, Helvetica, sans-serif">Authorised Signatory</font> </strong></p></td>
	</tr>
	</table>
		<table width="896"  border=1 cellpadding=0 cellspacing=0  rules = "all" class="MsoTableGrid"> 
	<tr><td width="100" ><img  src="" width="100" height="100" align="left"></td>

	  <td  colspan="100%" align="justify" ><font face="Arial, Helvetica, sans-serif" size="-1"><p>1.Products are despatched after our usual careful checking of the consignment in respect of contents and packing. Our responsibility ceases once the goods leave our Factory premises.
	    <br/>2.Goods once sold will not be taken back
	    <br/>3. Interest @24% per annum will be charged if not paid by due date from date of this bill.
	    <br/>4.All disputes are subjected to &nbsp;
	      <?=$city?>&nbsp;
Jurisdiction only
	    <br/>5. No acknowledgement of payments is valid unless granded on the companies official receipt form</p></font></td>
	</tr>
	 
	</table>
<DIV style="page-break-before:always"></DIV>

<?
return;
}
?>
