<div class="ilFrame" style="margin-top:5px; width:700px; margin-left:auto; margin-right:auto;"><div class="ilFrameH"><div class="ilFrameTL"><div class="ilFrameTR">
<img src="./templates/default/images/HeaderIcon.png" border="0" style="margin: 20px;"/>
<div class="ilFrameBL"><div class="ilFrameBR" style="min-height: 450px;">
<div style="padding:35px 10px;">

<div class="il_Header"><h1><img border="0" src="{IMG_AUTH}" style="vertical-align:middle" />&nbsp;{TXT_PAGEHEADLINE}</h1></div>
<!-- BEGIN pw_message -->
<div style="text-align:center;">
<p class="warning">&nbsp;{TXT_MESSAGE}&nbsp;</p>
</div>
<!-- END pw_message -->
<p>{TXT_ENTER_USERNAME_AND_EMAIL}</p>
<div align="center" style="padding-top: 25px">
<div align="center">
<form action="{FORMACTION}" {TARGET} method="post" name="Fobject">
<input type="hidden" name="key" value="{KEY}"/>
<table class="std">
  <tr>
	<td class="option" align="right">{TXT_USERNAME}</td>
	<td class="option_value"><input type="text" name="username" value="{USERNAME}"/></td>
  </tr>
  <tr>
	<td class="option" align="right">{TXT_EMAIL}</td>
	<td class="option_value"><input type="text" name="email" value="{EMAIL}"/></td>
  </tr>
  <tr>
	<td class="submit" colspan="2" align="center"><input class="submit" type="submit" name="cmd[submitAssistanceForm]" value="{TXT_SUBMIT}"/></td>
  </tr>
</table>
</form><br />
<a class="il_ContainerItemCommand" href="{LINK_BACK}">{BACK}</a>
</div>

</div>
</div>
</div></div></div></div></div></div>
