</tr>
<tr>
<td><?=_Location?></td>
- <td><input type="text" name="location"></td>
+ <td><input type="text" name="location" value="<?=$location?>"></td>
</tr>
<tr>
<td><?=_Date?></td>
- <td><input type="text" name="date"><br/><?=_The date when the assurance took place. Please adjust the date if you assured the person on a different day (YYYY-MM-DD).?></td>
+ <td><input type="text" name="date" value="<?=$date?>"><br/><?=_The date when the assurance took place. Please adjust the date if you assured the person on a different day (YYYY-MM-DD).?></td>
</tr>
<tr>
<td><input type="checkbox" name="assertion" value="1"></td>