
<tr>
<td colspan=2>


        <table width="100%" cellspacing="0" cellpadding="2" border="0">
          <tbody><tr>
            <td colspan="6"><h3>Identification</h3></td>
          </tr>
          <tr>
            <td>Manufacturer</td>
            <td><input type="text" name="manufacturer" value="%s" %s size="20" maxlength="64"></td>
            <td>Model Number</td>
            <td><input type="text" name="modelnumber" value="%s" %s size="20" maxlength="64"></td>
            <td>Serial Number</td>
            <td><input type="text" name="serialnumber" value="%s" %s size="20" maxlength="64"></td>
          </tr>
          <tr>
            <td>Asset Number</td>
            <td><input type="text" name="assetnumber" value="%s" %s size="20" maxlength="64"></td>
            <td>Date Installed</td>
            <td><input type="text" name="dateinstalled" value="%s" %s size="20" maxlength="64"></td>
            <td>Operating System</td>

            <td><input type="text" name="os" value="%s" %s size="20" maxlength="64"></td>
          </tr>
          <tr>
            <td colspan="6"><h3>Location</h3></td>
          </tr>
          <tr>
            <td>Region</td>
            <td><input type="text" name="region" value="%s" %s size="20" maxlength="64"></td>
            <td>Division</td>
            <td><input type="text" name="division" value="%s" %s size="20" maxlength="64"></td>
            <td>Department</td>
            <td><input type="text" name="department" value="%s" %s size="20" maxlength="64"></td>
          </tr>
          <tr>
            <td>Address1</td>
            <td colspan="5"><input type="text" value="%s" %s name="address1" size="100" maxlength="255"></td>
          </tr>
          <tr>
            <td>Address2</td>
            <td colspan="5"><input type="text" value="%s" %s name="address2" size="100" maxlength="255"></td>
          </tr>
          <tr>
            <td>City</td>
            <td colspan="5"><input type="text" value="%s" %s name="city" size="100" maxlength="255"></td>
          </tr>
          <tr>
            <td>State</td>
            <td><input type="text" value="%s" %s name="state" size="20" maxlength="64"></td>
            <td>Country</td>
            <td><input type="text" value="%s" %s name="country" size="20" maxlength="64"></td>
            <td>ZIP</td>
            <td><input type="text" value="%s" %s name="zip" size="20" maxlength="64"></td>
          </tr>
          <tr>
            <td>Building</td>
            <td><input type="text" name="building" value="%s" %s size="20" maxlength="64"></td>
            <td>Floor</td>
            <td><input type="text" name="floor" value="%s" %s size="20" maxlength="64"></td>
            <td>Room</td>
            <td><input type="text" name="room" value="%s" %s size="20" maxlength="64"></td>
          </tr>
          <tr>
            <td>Rack</td>
            <td><input type="text" name="rack" value="%s" %s size="20" maxlength="64"></td>
            <td>Slot</td>
            <td><input type="text" name="slot" value="%s" %s size="20" maxlength="64"></td>
            <td>Port</td>
            <td><input type="text" name="port" value="%s" %s size="20" maxlength="64"></td>
          </tr>
          <tr>
            <td>CircuitID</td>
            <td><input type="text" name="circuitid" value="%s" %s size="20" maxlength="64"></td>
            <td></td>
            <td></td>
            <td></td>
            <td></td>
          </tr>
          <tr>
            <td colspan="6"><h3>Vendor</h3></td>
          </tr>
          <tr>
            <td>Name</td>
            <td><input type="text" name="vendor" value="%s" %s size="20" maxlength="64"></td>
            <td>Phone</td>
            <td><input type="text" name="vendorphone" value="%s" %s size="20" maxlength="64"></td>
            <td>Fax</td>
            <td><input type="text" name="vendorfax" value="%s" %s size="20" maxlength="64"></td>
          </tr>
          <tr>
            <td>Email</td>
            <td><input type="text" name="vendoremail" value="%s" %s size="20" maxlength="64"></td>
            <td>Instant Message</td>
            <td><input type="text" name="vendorim" value="%s" %s size="20" maxlength="64"></td>
            <td>Web Site</td>
            <td><input type="text" name="vendorurl" value="%s" %s size="20" maxlength="64"></td>
          </tr>
          <tr>
            <td>Lease</td>
            <td><input type="text" name="lease" value="%s" %s size="20" maxlength="64"></td>
            <td>Lease Expires</td>
            <td><input type="text" name="leaseexpires" value="%s" %s size="20" maxlength="64"></td>
            <td>Vendor Asset</td>
            <td><input type="text" name="vendorassetnumber" value="%s" %s size="20" maxlength="64"></td>
          </tr>
          <tr>
            <td>Maint Contract</td>
            <td><input type="text" name="maintcontract" value="%s" %s size="20" maxlength="64"></td>
            <td>Contract Expires</td>
            <td><input type="text" name="maintcontractexpires" value="%s" %s size="20" maxlength="64"></td>
            <td>Maint Phone</td>
            <td><input type="text" name="supportphone" value="%s" %s size="20" maxlength="64"></td>
          </tr>
          <tr>
            <td colspan="6" align=center><h3>Comments</h3></td>
          </tr>
          <tr>
            <td colspan="6" align=center><textarea name="comment" cols="127" rows="2" %s>%s</textarea></td>
          </tr>
        </tbody></table>

</td>
</tr>
