<div id="identity-window" class="remodal" data-remodal-id="withdrawal_netteler">
	<div class="modal-head">
		<div class="row">
			<div class="col span_12">
				<h2>Nettelerアカウントへの引き出し</h2>
			</div>
		</div><!-- /.row -->
	</div><!-- /.modal-head -->
	<div class="modal-body">

		<form class="identity_form">

		<div class="row">

			<div class="col span_12">

				<div class="atm_confirm">


					<h6 class="title">Withdraw Amount</h6>


					<div class="form-group">
						<label for="signinInputPassword1">Amount</label>
						<input type="text" name="" id="" class="form-control" maxlength="10" size="10" placeholder="USD">
					</div>


					<div class="form-group">
						<label for="signinInputPassword1">Netteler Email</label>
						<input type="email" name="" id="" class="form-control" maxlength="10" size="10" placeholder="">
					</div>



				</div><!-- /.atm_confirm -->

			</div><!-- /.col.span_12 -->
		</div><!-- /.row -->

		</form>


	</div><!-- /.modal-body -->
	<div class="modal-foot">
		<div class="row">
			<div class="col span_12">
				<a href="#withdrawal_bank_confirm" class="btn confirm">Confirm</a>
				<a href="" class="btn cancel">cancel</a>
			</div>
		</div><!-- /.row -->
	</div><!-- /.modal-foot -->
</div><!-- /#betconfirm-window -->

