<option value="DF">DF</option><option value="ES">ES</option><option value="GO">GO</option> <option value="MA">MA</option><option value="MG">MG</option><option value="MS">MS</option> <option value="MT">MT</option><option value="PA">PA</option><option value="PB">PB</option> <option value="PE">PE</option><option value="PI">PI</option><option value="PR">PR</option> <option value="RJ">RJ</option><option value="RN">RN</option><option value="RO">RO</option> <option value="RR">RR</option><option value="RS">RS</option><option value="SC">SC</option> <option value="SE">SE</option><option value="SP">SP</option><option value="TO">TO</option> </select> </div> </div> <div class="form-group"> <label for="pais" class="col-sm-2 control-label no-padding-right"><strong>País:</strong></label> <div class="col-sm-9"> <input type="text" id="pais" class="col-xs-10 col-sm-5" name="pais" value="<?php echo $conta->getPais(); ?> " /> </div> </div> <div class="form-group"> <label for="pontoReferencia" class="col-sm-2 control-label no-padding-right"><strong>Referência:</strong></label> <div class="col-sm-9"> <input type="text" id="pontoReferencia" class="col-xs-10 col-sm-5" name="pontoReferencia" value="<?php echo $conta->getPontoReferencia(); ?> " maxlength="100" /> </div> </div> </fieldset>