<div class="ecp-component ecp_EditShippingAddress--checkout">
  <h2 aria-describedby="ecpi_co__esa_info">{message:EditShippingAddress/Title}</h2>
  <div data-ecp-handle="progress_bar">
    <!-- | Checkout__ProgressBar template | -->
  </div>
  <p id="ecpi_co__esa_info" class="ecp-summary">{message:EditShippingAddress/Summary}</p>
  <form class="ecp-form">
    <input type="hidden" name="address_id" value="{message:address_id}">
    <div class="ecp-form-fieldset-scrunched">
      <input type="text" name="first_name" placeholder="{message:EditShippingAddress/FirstNameInput}" aria-label="{message:EditShippingAddress/FirstNameInputLabel}" autocomplete="shipping given-name" required>
      <input type="text" name="last_name" placeholder="{message:EditShippingAddress/LastNameInput}" aria-label="{message:EditShippingAddress/LastNameInputLabel}" autocomplete="shipping family-name" required>
      <input type="text" name="company_name" placeholder="{message:EditShippingAddress/CompanyNameInput}" aria-label="{message:EditShippingAddress/CompanyNameInputLabel}" autocomplete="shipping organization">
      <input type="text" name="address_line_1" placeholder="{message:EditShippingAddress/AddressLine1Input}" aria-label="{message:EditShippingAddress/AddressLine1InputLabel}" autocomplete="shipping address-line1" required>
      <input type="text" name="address_line_2" placeholder="{message:EditShippingAddress/AddressLine2Input}" aria-label="{message:EditShippingAddress/AddressLine2InputLabel}" autocomplete="shipping address-line2">
      <input type="text" name="city" placeholder="{message:EditShippingAddress/CityInput}" aria-label="{message:EditShippingAddress/CityInputLabel}" autocomplete="shipping address-level2" required>
      <select name="state_code" aria-label="{message:EditShippingAddress/StateCodeLabel}" autocomplete="shipping address-level1" required>
        <!-- | Address__StateOption template | -->
      </select>
      <input type="text" name="region" placeholder="{message:EditShippingAddress/RegionInput}" aria-label="{message:EditShippingAddress/RegionInputLabel}" autocomplete="shipping address-level1">
      <input type="text" name="postal_code" placeholder="{message:EditShippingAddress/PostalCodeInput}" aria-label="{message:EditShippingAddress/PostalCodeInputLabel}" autocomplete="shipping postal-code" required>
      <input type="text" name="zip_extension" placeholder="{message:EditShippingAddress/ZipExtensionInput}" maxlength="4" aria-label="{message:EditShippingAddress/ZipExtensionInputLabel}" autocomplete="xyzpdq">
      <select name="country_code" data-ecp-action="change-country"
        <!-- | Address__CountryOption template | -->
      </select>
    </div>
    <p class="ecp-summary">{message:EditShippingAddress/PhoneAndBirthDateInfo}</p>
    <div class="ecp-form-fieldset-scrunched">
      <input type="text" name="birth_date" placeholder="{message:EditShippingAddress/BirthDateInput}" aria-label="{message:EditShippingAddress/BirthDateInputLabel}" autocomplete="bday" required>
      <input type="text" name="phone" placeholder="{message:EditShippingAddress/PhoneInput}" aria-label="{message:EditShippingAddress/PhoneInputLabel}" autocomplete="mobile tel" required>
    </div>
    <div data-ecp-handle="make_default_section">
      <p id="ecpi_co__esa_options" class="ecp-summary">{message:EditShippingAddress/MakeDefaultInfo}</p>
      <ul class="ecp-form-checkboxes" role="listbox" tabindex="0" aria-labelledby="ecpi_co__esa_options">
        <li><input type="checkbox" id="ecpi_co__esa_option_1" name="make_default" role="option"><label for="ecpi_co__esa_option_1">{message:EditShippingAddress/MakeDefaultYesNo}</label></li>
      </ul>
    </div>
    <div class="ecp-grid">
      <div class="ecp-grid-row ecp-clearfix">
        <span class="ecp-grid-col-6">
          <button class="ecp-secondary" data-ecp-action="cancel">{message:EditShippingAddress/CancelButton}</button>
        </span>
        <span class="ecp-grid-col-6">
          <button data-ecp-action="save">{message:EditShippingAddress/SaveButton}</button>
        </span>
      </div>
    </div>
  </form>
</div>