document.writeln('<iframe src=\"about:blank\" name=\"hidform5\" style=\"width:0px;height:0px;display:none\"></iframe>')
document.writeln('<script src=\"/ks_inc/common.js\"></script>')
document.writeln('<script src=\"/ks_inc/form_ck.js\"></script>')
document.writeln('<form name=\"myform5\" action=\"/plus/form/form.asp\" onSubmit=\"return(form_c(5));\"  target=\"hidform5\" method=\"post\"> ')
document.writeln('<table width=\"100%\" border=\"0\" cellspacing=\"2\" cellpadding=\"1\">')
document.writeln('<input type=\"hidden\" value=\"Save\" name=\"action\"/>')
document.writeln('<input type=\"hidden\" value=\"5\" name=\"id\"/>')
document.writeln('<input type=\"hidden\" value=\"0\" name=\"m\"/>')
document.writeln('<input type=\"hidden\" value=\"0\" name=\"d\"/>')
document.writeln('<input type=\"hidden\" value=\"{$ToUserName}\" id=\"tousername\" name=\"tousername\"/>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">电话：</td>')
document.writeln('  <td><input type=\"text\" maxlength=\"255\" class=\"upfile\" style=\"width:500px\" id=\"KS_tel\" name=\"KS_tel\" value=\"\">  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">姓名：</td>')
document.writeln('  <td><input type=\"text\" maxlength=\"255\" class=\"upfile\" style=\"width:500px\" id=\"KS_mail\" name=\"KS_mail\" value=\"\">  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">公证事项：</td>')
document.writeln('  <td><input type=\"text\" maxlength=\"255\" class=\"upfile\" style=\"width:500px\" id=\"KS_xm\" name=\"KS_xm\" value=\"\">  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">详情描述：</td>')
document.writeln('  <td><textarea style=\"width:500px;height:200px\" rows=\"5\" id=\"KS_text\" name=\"KS_text\"></textarea>  </td>')
document.writeln('</tr>')
document.writeln('<tr class=\"tdbg\"><td class=\"lefttdbg\" align=\"right\">验证码：</td><td><input name=\"Verifycode\" id=\"Verifycode\" type=\"text\" name=\"textbox\" size=5><span ')
document.writeln('style=\"color:#999\">请输入右图中的字符</span><IMG style=\"cursor:pointer;display:inline-block;margin-left:10px ;width:60px;height:20px;\" src=\"/plus/verifycode.asp\" ')
document.writeln('onClick=\"this.src=\'/plus/verifycode.asp?n=\'+ Math.random();\" align=\"absmiddle\"></td></tr>')
document.writeln('')
document.writeln('<tr><td colspan=\"2\" class=\"subtdbg\" align=\"center\"><input type=\"submit\" value=\"确认提交\" name=\"submit1\"></td></tr>')
document.writeln('</table>')
document.writeln('</form>')
document.writeln('')