<?php
//bancos brasileiros
$bancos = array(
	array('code' => '001', 'name' => 'Banco do Brasil'),
	array('code' => '003', 'name' => 'Banco da Amazônia'),
	array('code' => '004', 'name' => 'Banco do Nordeste'),
	array('code' => '021', 'name' => 'Banestes'),
	array('code' => '025', 'name' => 'Banco Alfa'),
	array('code' => '027', 'name' => 'Besc'),
	array('code' => '029', 'name' => 'Banerj'),
	array('code' => '031', 'name' => 'Banco Beg'),
	array('code' => '033', 'name' => 'Banco Santander Banespa'),
	array('code' => '036', 'name' => 'Banco Bem'),
	array('code' => '037', 'name' => 'Banpará'),
	array('code' => '038', 'name' => 'Banestado'),
	array('code' => '039', 'name' => 'BEP'),
	array('code' => '040', 'name' => 'Banco Cargill'),
	array('code' => '041', 'name' => 'Banrisul'),
	array('code' => '044', 'name' => 'BVA'),
	array('code' => '045', 'name' => 'Banco Opportunity'),
	array('code' => '047', 'name' => 'Banese'),
	array('code' => '062', 'name' => 'Hipercard'),
	array('code' => '063', 'name' => 'Ibibank'),
	array('code' => '065', 'name' => 'Lemon Bank'),
	array('code' => '066', 'name' => 'Banco Morgan Stanley Dean Witter'),
	array('code' => '069', 'name' => 'BPN Brasil'),
	array('code' => '070', 'name' => 'Banco de Brasília – BRB'),
	array('code' => '072', 'name' => 'Banco Rural'),
	array('code' => '073', 'name' => 'Banco Popular'),
	array('code' => '074', 'name' => 'Banco J. Safra'),
	array('code' => '075', 'name' => 'Banco CR2'),
	array('code' => '076', 'name' => 'Banco KDB'),
	array('code' => '096', 'name' => 'Banco BMF'),
	array('code' => '104', 'name' => 'Caixa Econômica Federal'),
	array('code' => '107', 'name' => 'Banco BBM'),
	array('code' => '116', 'name' => 'Banco Único'),
	array('code' => '151', 'name' => 'Nossa Caixa'),
	array('code' => '175', 'name' => 'Banco Finasa'),
	array('code' => '184', 'name' => 'Banco Itaú BBA'),
	array('code' => '204', 'name' => 'American Express Bank'),
	array('code' => '208', 'name' => 'Banco Pactual'),
	array('code' => '212', 'name' => 'Banco Matone'),
	array('code' => '213', 'name' => 'Banco Arbi'),
	array('code' => '214', 'name' => 'Banco Dibens'),
	array('code' => '217', 'name' => 'Banco Joh Deere'),
	array('code' => '218', 'name' => 'Banco Bonsucesso'),
	array('code' => '222', 'name' => 'Banco Calyon Brasil'),
	array('code' => '224', 'name' => 'Banco Fibra'),
	array('code' => '225', 'name' => 'Banco Brascan'),
	array('code' => '229', 'name' => 'Banco Cruzeiro'),
	array('code' => '230', 'name' => 'Unicard'),
	array('code' => '233', 'name' => 'Banco GE Capital'),
	array('code' => '237', 'name' => 'Bradesco'),
	array('code' => '241', 'name' => 'Banco Clássico'),
	array('code' => '243', 'name' => 'Banco Stock Máxima'),
	array('code' => '246', 'name' => 'Banco ABC Brasil'),
	array('code' => '248', 'name' => 'Banco Boavista Interatlântico'),
	array('code' => '249', 'name' => 'Investcred Unibanco'),
	array('code' => '250', 'name' => 'Banco Schahin'),
	array('code' => '252', 'name' => 'Fininvest'),
	array('code' => '254', 'name' => 'Paraná Banco'),
	array('code' => '263', 'name' => 'Banco Cacique'),
	array('code' => '265', 'name' => 'Banco Fator'),
	array('code' => '266', 'name' => 'Banco Cédula'),
	array('code' => '300', 'name' => 'Banco de la Nación Argentina'),
	array('code' => '318', 'name' => 'Banco BMG'),
	array('code' => '320', 'name' => 'Banco Industrial e Comercial'),
	array('code' => '356', 'name' => 'ABN Amro Real'),
	array('code' => '341', 'name' => 'Itau'),
	array('code' => '347', 'name' => 'Sudameris'),
	array('code' => '351', 'name' => 'Banco Santander'),
	array('code' => '353', 'name' => 'Banco Santander Brasil'),
	array('code' => '366', 'name' => 'Banco Societe Generale Brasil'),
	array('code' => '370', 'name' => 'Banco WestLB'),
	array('code' => '376', 'name' => 'JP Morgan'),
	array('code' => '389', 'name' => 'Banco Mercantil do Brasil'),
	array('code' => '394', 'name' => 'Banco Mercantil de Crédito'),
	array('code' => '399', 'name' => 'HSBC'),
	array('code' => '409', 'name' => 'Unibanco'),
	array('code' => '412', 'name' => 'Banco Capital'),
	array('code' => '422', 'name' => 'Banco Safra'),
	array('code' => '453', 'name' => 'Banco Rural'),
	array('code' => '456', 'name' => 'Banco Tokyo Mitsubishi UFJ'),
	array('code' => '464', 'name' => 'Banco Sumitomo Mitsui Brasileiro'),
	array('code' => '477', 'name' => 'Citibank'),
	array('code' => '479', 'name' => 'Itaubank (antigo Bank Boston)'),
	array('code' => '487', 'name' => 'Deutsche Bank'),
	array('code' => '488', 'name' => 'Banco Morgan Guaranty'),
	array('code' => '492', 'name' => 'Banco NMB Postbank'),
	array('code' => '494', 'name' => 'Banco la República Oriental del Uruguay'),
	array('code' => '495', 'name' => 'Banco La Provincia de Buenos Aires'),
	array('code' => '505', 'name' => 'Banco Credit Suisse'),
	array('code' => '600', 'name' => 'Banco Luso Brasileiro'),
	array('code' => '604', 'name' => 'Banco Industrial'),
	array('code' => '610', 'name' => 'Banco VR'),
	array('code' => '611', 'name' => 'Banco Paulista'),
	array('code' => '612', 'name' => 'Banco Guanabara'),
	array('code' => '613', 'name' => 'Banco Pecunia'),
	array('code' => '623', 'name' => 'Banco Panamericano'),
	array('code' => '626', 'name' => 'Banco Ficsa'),
	array('code' => '630', 'name' => 'Banco Intercap'),
	array('code' => '633', 'name' => 'Banco Rendimento'),
	array('code' => '634', 'name' => 'Banco Triângulo'),
	array('code' => '637', 'name' => 'Banco Sofisa'),
	array('code' => '638', 'name' => 'Banco Prosper'),
	array('code' => '643', 'name' => 'Banco Pine'),
	array('code' => '652', 'name' => 'Itaú Holding Financeira'),
	array('code' => '653', 'name' => 'Banco Indusval'),
	array('code' => '654', 'name' => 'Banco A.J. Renner'),
	array('code' => '655', 'name' => 'Banco Votorantim'),
	array('code' => '707', 'name' => 'Banco Daycoval'),
	array('code' => '719', 'name' => 'Banif'),
	array('code' => '721', 'name' => 'Banco Credibel'),
	array('code' => '734', 'name' => 'Banco Gerdau'),
	array('code' => '735', 'name' => 'Banco Pottencial'),
	array('code' => '738', 'name' => 'Banco Morada'),
	array('code' => '739', 'name' => 'Banco Galvão de Negócios'),
	array('code' => '740', 'name' => 'Banco Barclays'),
	array('code' => '741', 'name' => 'BRP'),
	array('code' => '743', 'name' => 'Banco Semear'),
	array('code' => '745', 'name' => 'Banco Citibank'),
	array('code' => '746', 'name' => 'Banco Modal'),
	array('code' => '747', 'name' => 'Banco Rabobank International'),
	array('code' => '748', 'name' => 'Banco Cooperativo Sicredi'),
	array('code' => '749', 'name' => 'Banco Simples'),
	array('code' => '751', 'name' => 'Dresdner Bank'),
	array('code' => '752', 'name' => 'BNP Paribas'),
	array('code' => '753', 'name' => 'Banco Comercial Uruguai'),
	array('code' => '755', 'name' => 'Banco Merrill Lynch'),
	array('code' => '756', 'name' => 'Banco Cooperativo do Brasil'),
	array('code' => '757', 'name' => 'KEB'),
);

?>

<div class="col-md-6 col-xs-12">
    <div class="form-group">
        <label for="cliente_sobrenome">Banco </label>
        <span class="text-danger">*</span>
        <select class="form-control" name="saque_conta_bancaria_banco">
            <option value="">Selecione</option> 
            <?php foreach($bancos as $banco){ ?>
                <option value="<?php echo $banco["name"]; ?>"><?php echo $banco["name"]; ?></option> 
            <?php } ?>
        </select>
    </div>
</div>
<div class="col-md-6 col-xs-12">
    <div class="form-group">
        <label for="cliente_nome">Tipo</label>
        <span class="text-danger">*</span> 
        <select class="form-control" name="saque_conta_bancaria_tipo" required>
            <option value="1">Poupança</option>
            <option value="2">Conta Corrente</option> 
        </select>
    </div>
</div>
<div class="col-md-4 col-xs-12">
    <div class="form-group">
        <label for="cliente_sobrenome">Agência </label>
        <span class="text-danger">*</span>
        <input type="text" name="saque_conta_bancaria_agencia" id="saque_conta_bancaria_agencia" class="form-control saque_conta_bancaria_agencia" placeholder="informe sua agência"  />
    </div>
</div> 
<div class="col-md-2 col-xs-12">
    <div class="form-group">
        <label for="cliente_sobrenome">Digito Ag. </label> 
        <input type="text" name="saque_conta_bancaria_digito_agencia" id="saque_conta_bancaria_digito_agencia" class="form-control saque_conta_bancaria_digito_agencia" placeholder="informe digito da agência"  />
    </div>
</div> 

<div class="col-md-4 col-xs-12">
    <div class="form-group">
        <label for="cliente_sobrenome">Conta </label>
        <span class="text-danger">*</span>
        <input type="text" name="saque_conta_bancaria_conta" id="saque_conta_bancaria_conta" class="form-control saque_conta_bancaria_conta" placeholder="informe sua conta" />
    </div>
</div> 
<div class="col-md-2 col-xs-12">
    <div class="form-group">
        <label for="cliente_sobrenome">Digito Ag. </label> 
        <input type="text" name="saque_conta_bancaria_digito_conta" id="saque_conta_bancaria_digito_conta" class="form-control saque_conta_bancaria_digito_conta" placeholder="informe digito da conta"  />
    </div>
</div>