{layout name="layout2" /}
<style>
    .layui-form-label { width: 85px; }
    .layui-input-block { margin-left: 115px; }
</style>

<div class="layui-card layui-form" style="box-shadow:none;">
    <div class="layui-card-body">
        <div class="layui-form-item">
            <label for="bank_id" class="layui-form-label"><span style="color:red;">*</span>提现账号：</label>
            <div class="layui-input-block">
                <select id="bank_id" name="bank_id" lay-verify="required">
                    <option value=""></option>
                    {volist name="bank" id="vo"}
                        <option value="{$vo.id}">{$vo.name}</option>
                    {/volist}
                </select>
            </div>
        </div>
        <div class="layui-form-item">
            <label for="apply_amount" class="layui-form-label"><span style="color:red;">*</span>提现金额：</label>
            <div class="layui-input-block">
                <input type="number" name="apply_amount" id="apply_amount" lay-verType="tips" lay-verify="required" autocomplete="off" class="layui-input">
                <div class="layui-form-mid layui-word-aux">可提现金额：{$shop.wallet}</div>
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">提现手续费：</label>
            <div class="layui-input-block">
                <div class="layui-form-mid layui-word-aux"> {$withdrawal_service_charge}% (提现金额扣除提现手续费后为实际到账金额)</div>
            </div>
        </div>

        <div class="layui-form-item layui-hide">
            <input type="button" lay-submit lay-filter="addSubmit" id="addSubmit" value="确认">
        </div>
    </div>
</div>