document.write("<title>Electronic Check Payments</title>\n");
document.write("<P align=center><FONT size=5><STRONG>DT Properties</STRONG></FONT></P>\n");
document.write("<P align=center><STRONG>Online Rent Payments</STRONG></P>\n");
document.write("<P align=center>If you would like to pay your rent online by electronic check, please fill out the secure form below and click 'Submit'. Due to the amount of time involved in processing payments, you can only choose \"MONTHLY\" to automatically have the rent payment taken out for you on the 29th of every month. This is the easiest way to always pay on time. This is a free service to our residents. It usually take 1-2 days for the payment to taken from your account. If you do not want auto monthly payments, please mail your paper check to the office.</P>\n");
document.write("<P align=center>\n");
document.write("	<link rel=stylesheet href=\"https://cincilocal.com/cgi-scr"+"ipt/csFormBuilder/forms/calendar/css/xc2_default.css\" type=\"text/css\">\n");
document.write("	<scr"+"ipt language=\"javascr"+"ipt\" src=\"https://cincilocal.com/cgi-scr"+"ipt/csFormBuilder/forms/calendar/config/xc2_default.js\"></scr"+"ipt>\n");
document.write("	<scr"+"ipt language=\"javascr"+"ipt\" src=\"https://cincilocal.com/cgi-scr"+"ipt/csFormBuilder/forms/calendar/scr"+"ipt/xc2_inpage.js\"></scr"+"ipt>\n");
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document.write("<form  method=POST action=\"https://cincilocal.com/cgi-bin/csFormbuilder/csFormbuilder.cgi\" name=\"form_205\"  >\n");
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document.write("<input type=hidden name=command value=\"mailform\">\n");
document.write("<link rel=\"stylesheet\" type=\"text/css\" href=\"https://cincilocal.com/cgi-scr"+"ipt/csFormBuilder/forms/DT_EC_Form.css\">\n");
document.write("<table border=\"0\" cellspacing=\"0\" cellpadding=\"3\">\n");
document.write("<tr><td nowrap class=\"textLabel\" align=\"left\" ></td><td align=left valign=top nowrap class=\"textLabel\"><table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">*Tenant Name</td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"Tenant_Name\"  size=\"25\"  ></td>\n");
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document.write("</table>   <table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">*Tenant Address</td>\n");
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document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"Tenant_Address\"  size=\"25\"  ></td>\n");
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document.write("</table>  <table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">*Apt #</td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"Unit\"  size=\"6\"   maxlength=\"10\" ></td>\n");
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document.write("</table>  <table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">*Rent Amount</td>\n");
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document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"Rent\"  size=\"15\"  ></td>\n");
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document.write("</table>  <table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"right\">*Payments <a href=\"javascr"+"ipt:void(0);\" tabindex=999><img src=\"https://cincilocal.com/cgi-scr"+"ipt/csFormBuilder/images/desc.gif\" width=16 height=16 alt=\"Automatic Monthly Payments- Payments will be automatically taken on the 1st of the month until you move or notify us to stop.\" border=0 align=top></a></td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><select name=\"Number_Payments\"  size=\"1\"   onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\">\n");
document.write("<option value=\"Monthly\">Automatic Monthly</option>\n");
document.write("</select>&nbsp;</td>\n");
document.write("</tr>\n");
document.write("</table><!-- tr ph 4--></td></tr>\n");
document.write("<tr><td nowrap class=\"textLabel\" align=\"left\" ></td><td align=left valign=top nowrap class=\"textLabel\"><table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">*Bank Name</td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"Bank_Name\"  size=\"20\"  ></td>\n");
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document.write("</table>   <table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">*Account Type </td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><select name=\"Account_Type\"  size=\"1\"   onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\">\n");
document.write("<option value=\"\">-= Select =-</option>\n");
document.write("<option>Checking</option>\n");
document.write("<option>Savings</option>\n");
document.write("</select>&nbsp;</td>\n");
document.write("</tr>\n");
document.write("</table>  <table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">Routing #</td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"Routing_Number\"  size=\"20\"  ><a href=\"javascr"+"ipt:void(0);\" tabindex=999><img src=\"https://cincilocal.com/cgi-scr"+"ipt/csFormBuilder/images/desc.gif\" width=16 height=16 alt=\"The first set of digits from the left are the routing number.\n");
document.write("The second set of digits from the left are the account number.\" border=0></a></td>\n");
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document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">*Account #</td>\n");
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document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"Account_Number\"  size=\"20\"  ></td>\n");
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document.write("</table>  <table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">*Email Address</td>\n");
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document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"Email\"  size=\"30\"  ></td>\n");
document.write("</tr>\n");
document.write("</table><!-- tr ph 9--></td></tr>\n");
document.write("<tr><td nowrap class=\"textLabel\" align=\"left\" ></td><td align=left valign=top nowrap class=\"textLabel\"><table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">Additional Information</td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><textarea  onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" name=\"Add_Info\"  rows=\"5\" cols=\"75\"  ></textarea></td>\n");
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document.write("</table> <!-- tr ph 10--></td></tr>\n");
document.write("<tr><td class=\"textLabel\" colspan=2><hr width=\"100%\" size=\"1\" color=\"black\" align=\"left\"></td></tr><tr><td class=\"textLabel\" colspan=2>I authorize payment for rent to be automatically charged every month to the bank account entered above. I understand any applicable late fees or balances owed will be applied at the time of processing. You must accept these terms to proceed with processing. You will be sent a receipt by email after your payment has been processed. Unless otherwise noted, the payment will be processed immediately.\n");
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document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">*Terms: </td>\n");
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document.write("<tr>\n");
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document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">*Date:</td>\n");
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document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"Date\"  size=\"10\"  > <a href=\"javascr"+"ipt:showCalendar('',document.forms[0].Date,null,'','',0,0,1)\"><img src=\"https://cincilocal.com/cgi-scr"+"ipt/csFormBuilder/images/calendar.gif\" border=0></a></td>\n");
document.write("</tr>\n");
document.write("</table><!-- tr ph 12--></td></tr>\n");
document.write("<tr><td nowrap class=\"textLabel\" align=\"right\" ></td><td align=left valign=top nowrap class=\"textLabel\"><table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\">Verify Authentication Code:</td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><img id=\"Verification_img\" align=absmiddle border=0 width=59 height=15 src=\"\"><input type=hidden id=\"Verification_sid\" name=\"Verification_sid\" value=\"\"> <scr"+"ipt language=javascr"+"ipt src=\"https://cincilocal.com/cgi-bin/csFormbuilder/vimage.cgi?command=g&f=Verification\"></scr"+"ipt>&nbsp;<input  onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"Verification\"  size=\"5\"   maxlength=\"5\" ></td>\n");
document.write("</tr>\n");
document.write("</table> <!-- tr ph 13--></td></tr>\n");
document.write("<tr><td colspan=2 align=\"center\"><input onmouseover=\"className='buttonfieldFocus'\" onmouseout=\"className='buttonfield'\" class=\"buttonfield\" type=submit value=\"Submit\"></td></tr>\n");
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document.write("</form></P>\n");