_address_details.html

<form action="" method="post" id="ReChargeForm_address">
    <div class="rc_input_container">
        <p class="text-font-14">
            <label for="first_name"> {{ 'First_Name' | t }} </label>
            <input
                class="margin-top-8"
                type="text" name="first_name"
                id="first_name" value=""
                required
            >
        </p>
        <p class="text-font-14">
            <label for="first_name"> {{ 'Last_Name' | t }} </label>
            <input
                class="margin-top-8"
                type="text"
                name="last_name"
                id="last_name"
                value=""
                required
            >
        </p>
    </div>

    <p class="text-font-14">
        <label for="address1"> {{ 'Address' | t }} </label>
        <input
            class="margin-top-8"
            type="text"
            name="address1"
            id="address1"
            value=""
            required
        >
    </p>

    <p class="text-font-14"v>
        <label for="address2"> {{ 'address_line' | t }} </label>
        <input
            class="margin-top-8"
            type="text"
            name="address2"
            id="address2"
            value=""
        >
    </p>

    <p class="text-font-14">
        <label for="company"> {{ 'Company' | t }} </label>
        <input
            class="margin-top-8"
            type="text"
            name="company"
            id="company"
            value=""
        >
    </p>

    <p class="text-font-14">
        <label for="country"> {{ 'Country' | t }} </label>
        <select
            class="margin-top-8"
            name="country"
            id="country"
            data-value=""
            onchange="ReCharge.Forms.updateProvinces(this); ReCharge.Novum.Utils.getZipLabel(this.value)"
            required
        ></select>
    </p>

    <p class="text-font-14">
        <label for="city"> {{ 'City' | t }} </label>
        <input
            class="margin-top-8"
            type="text"
            name="city"
            id="city"
            value=""
            required
        >
    </p>

    <p class="text-font-14">
        <label for="province" class="js-statelabel"> {{ 'Province_State' | t }} </label>
        <input
            class="margin-top-8"
            type="text"
            name="province"
            id="province"
            value=""
        >
        <select
            class="margin-top-8"
            id="province_selector"
            onchange="ReCharge.Forms.updateProvinceInput(this);"
            style="display: none;"
        ></select>
    </p>

    <p class="text-font-14">
        <label for="zip" class="js-zipcode"> {{ 'Postal_Code' | t }} </label>
        <input
            class="margin-top-8"
            type="text"
            name="zip"
            id="zip"
            value=""
            required
        >
    </p>

    <p class="text-font-14">
        <label for="phone"> {{ 'Phone' | t }} </label>
        <input
            class="margin-top-8"
            type="number"
            name="phone"
            id="phone"
            value=""
        >
    </p>

    <button class="rc_btn address-btn text-uppercase title-bold" type="submit">
        {{ 'cp_update_shipping_address' | t }}
    </button>
</form>