<div class="palm-group">  
		<div class="palm-group-title" x-mojo-loc="">
			Страна плательщика
		</div>
		<div class="palm-list">
			<div class="palm-row single">
				<div class="palm-row-wrapper" x-mojo-focus-highlight="true">
					<div id="billCountryListSelector" x-mojo-element="ListSelector"></div>   
				</div>
			</div>
		</div>
		
	</div>
    <div class="palm-group">  
		<div class="palm-group-title" x-mojo-loc="">
			Метод Оплаты
		</div>
		<div id="cardTypeList" class="palm-list" x-mojo-element="List"></div>
	</div>
	
	<div class="palm-group">  
		<div class="palm-group-title" x-mojo-loc="">
			Информация о карте
		</div>
		<div class="palm-list">
			<div class="palm-row first">
				<div class="palm-row-wrapper textfield-group" x-mojo-focus-highlight="true">
					<div class="title">
						<div id="creditCardField" x-mojo-element="TextField"></div>
					</div>
				</div>
			</div>
			<div class="palm-row">
				<div class="palm-row-wrapper textfield-group" x-mojo-focus-highlight="true">
					<div class="title">
            <div class="icon right security-code"></div>
						<div id="secretNumField" x-mojo-element="PasswordField"></div>
					</div>
				</div>
			</div>
			<div class="palm-row last">
				<div class="palm-row-wrapper" x-mojo-focus-highlight="true">
					<div class="title datepicker">
						<div x-mojo-element="DatePicker" id="cardExpDate" class="datepickerClass" name="datepickerName"></div>
					</div>
				</div>
			</div>
		</div>
	</div>
	<div class="palm-group">  
		<div class="palm-group-title" x-mojo-loc="">
			Адрес плательщика
		</div>
		<div class="palm-list">
			<div class="palm-row">
				<div class="palm-row-wrapper textfield-group" x-mojo-focus-highlight="true">
					<div class="title">
						<div id="nameField" x-mojo-element="TextField"></div>
					</div>
				</div>
			</div>
			<div id="address1Container">
			</div>
			<div class="palm-row">
				<div class="palm-row-wrapper textfield-group" x-mojo-focus-highlight="true">
					<div class="title">
						<div id="address2Field" x-mojo-element="TextField"></div>
					</div>
				</div>
			</div>
			<div id="address3Container">
			</div>
			<div id="cityContainer">
			</div>
			<div id="stateContainer">
			</div>
			<div id="zipContainer">
			</div>
			<div class="palm-row last">
				<div class="palm-row-wrapper textfield-group" x-mojo-focus-highlight="true">
					<div class="title">
						<div id="phoneNumField" x-mojo-element="TextField"></div>
					</div>
				</div>
			</div>
		</div>
	</div>
	
	<div class="palm-body-text" x-mojo-loc="">
		Информация о карте сберегается на безопасном сервере, а не на вашем телефоне.
	</div>

	<div x-mojo-element="Button" id="removeButton"></div>
	<div x-mojo-element="Button" id="saveButton" tabindex="1"></div>	
	<div x-mojo-element="Button" id="cancelButton"></div>