/*--- Avanquest WebEasy Custom Script ---*/

<form action="https://www.paypal.com/cgi-bin/webscr" method="post"> 
<input type="hidden" name="cmd" value="_s-xclick"> 
<input type="hidden" name="hosted_button_id" value="9192928"> 
<table> 
<tr><td><input type="hidden" name="on0" value="Case Number">Case Number</td></tr><tr><td><input type="text" name="os0" maxlength="60"></td></tr> 
<tr><td><input type="hidden" name="on1" value="Court (Date, Time &amp; Location)">Court (Date, Time &amp; Location)</td></tr><tr><td><input type="text" name="os1" maxlength="60"></td></tr> 
</table> 
<input type="image" src="https://www.paypal.com/en_US/i/btn/btn_paynowCC_LG.gif" border="0" name="submit" alt="PayPal - The safer, easier way to pay online!"> 
<img alt="" border="0" src="https://www.paypal.com/en_US/i/scr/pixel.gif" width="1" height="1"> 
</form>

/*--- EndOfFile ---*/