<table cellpadding="0" cellspacing="0" id="lz_form_<!--name-->" class="lz_input">
	<tr>
		<td id="lz_form_caption_<!--name-->" class="lz_form_field"><!--caption--></td>
		<td>&nbsp;&nbsp;&nbsp;</td>
		<td>
			<table cellpadding="0" cellspacing="0">
				<tr>
					<td><input name="form_<!--name-->" class="lz_form_box" value="<!--login_value_<!--name-->-->" maxlength="254"></td>
					<td width="15" align="right"><span class="lz_index_red" id="lz_form_mandatory_<!--name-->" style="display:none;">*</span></td>
				</tr>
			</table>
		</td>
	</tr>
</table>