HTML Code:
function ShipToBillPerson(form) {
if (form.copy.checked) {
InitSaveVariables(form);
tweede.street2.value = components[1].long_name;
tweede.nr2.value = components[0].long_name;
tweede.pc2.value = components[7].long_name;
tweede.city2.value = components[4].long_name;
tweede.country2.value = components[6].long_name;
}
else {
tweede.street2.value = street;
tweede.nr2.value = nr;
tweede.pc2.value = pc;
tweede.city2.value = city;
tweede.country2.value = country;
   }
}
//  End -->
</SCRIPT>
<style>
#mapcontainer {
  position: relative;
  width: 640px;
  height: 480px;
  margin: 10px;
  float: left;
}

#map {
  width: 100%;
  height: 100%;
  border: 1px solid black;
  position: absolute;
}

#boundsLegend,#viewportLegend {
  position: absolute;
  background-color: white;
  right: 1px;
  font-family: sans-serif;
  font-size: small;
  padding: 2px;
  color: #222222;
  display: none;
}

#boundsLegend {
  border: 1px solid red;
  bottom: 40px;
}

#viewportLegend {
  border: 1px solid blue;
  bottom: 15px;
}

#responseStatus {
  display: none;
}

#responseCount {
  display: none;
}

#responseInfo {
  margin-top: 10px;
  margin-left: 10px;
  background-color: #eeeeee;
  border: 1px solid #999999;
  padding: 10px;
  width: 620px;
  display: none;
}

.info {
  border-top: 1px solid #666666;
  padding: 4px;
  padding-left: 8px;
  font: 10pt sans-serif;
  margin-left: 4px;
  margin-right: 4px;
  cursor: pointer;
  background-color: white;
}

.infoWindowContent {
  width: 272px;
  height: 120px;
  overflow: auto;
}

.tabContent {
  font: 10pt sans-serif;
  border-collapse: collapse;
  table-layout: auto;
}

#matches {
  margin-top: 10px;
  width: 320px;
  height: 490px;
  float: left;
  border: 1px solid #666666;
  display: none;
  overflow: auto;
}

h1 {
  border-bottom: 1px solid #999999;
  font-family: sans-serif;
  padding-bottom: 12px;
  width: 650px;
  margin-bottom: 0px;
}

#inputForm {
  width: 650px;
  margin: 10px;
}

#footer {
  padding-top: 4px;
  font-family: sans-serif;
  font-size: 8pt;
  clear: both;
  width: 650px;
  border-top: 1px solid #999999;
}

#instructions {
  padding-bottom: 8px;
}

.key {
  text-align: right;
  font-weight: bold;
  vertical-align: top;
  white-space: nowrap
}

.value {
  vertical-align: top;
}

#options {
  margin-top: 5px;
}

#suggestions {
  display: none;
}

span.dym {
  color: red;
}

span.dym,
span.pc_localities {
  font-size: 0.8em;
  font-family: sans-serif;
}

#biasViewport,#country {
  margin-right: 16px;
}

#newFeatures {
  position: absolute;
  top: 1px;
  right: -2px;
  background-color: #ffffd0;
  border: 1px solid black;
  font-family: sans-serif;
  font-size: 8pt;
  padding: 2px;
}
</style>
</head>
<body onload="init()">
</style>
  <div id="Main">
    <div id="wrapper">
      <!--******* Start Header *****-->
         <div id="header">
           <div class="header-Right">
         </div>
         <div id="Container">
            <div class="col-1">
              </div>
            </div>
            <div class="col-2">
               <div class="col-2-cont">
		    <div id="wrap">
        	<div class="cont_details">
				  <div id="suggestions"></div>
				  <div id="options">
					<span style="font-weight: bold">Bias this viewport:</span>
					<input type="checkbox" id="biasViewport"/>
					<span style="font-weight: bold">Country bias:</span>
					<input type="text" size="2" id="country"/>
					<span style="font-weight: bold">Language:</span>
					<input type="text" size="2" id="language"/>
				  </div>
				</div>
				<div id="responseInfo">
				  <div id="responseStatus">
					<div>
					  <span style="font-weight: bold">Geocoder response: </span>
					  <span id="statusValue"></span> (<span id="statusDescription"></span>)
					</div>
				  </div>
				  <div id="responseCount">
					<span style="font-weight: bold;">Matches returned: </span>
					<span id="matchCount"></span>
				  </div>
				</div>
				<div id="mapcontainer">
				  <div id="map"></div>
				  <div id="boundsLegend">Bounds</div>
				  <div id="viewportLegend">Viewport</div>
				</div>
				<div id="matches"></div>  
            <table width="725">
                 <form action="#" id="inputForm" name="eerste" onsubmit="submitQuery(this.street.value + ' ' + this.nr.value + ', ' + this.city.value + ', ' + this.country.value); return false">
               <tr>
                    <td width="180" height="30"><b>Country:</b></td>
                    <td width="230" height="30"><input type="text" size="25" name="country" value="" /></td>
                </tr>
				<tr id="city" style="font:24px bold;">
                    <td width="180" height="30"><b>City:</b></td>
                    <td width="230" height="30"><input type="text" id="query" size="25" name="city" value="Herengracht 110, Amsterdam" /> PC <input type="text" size="10" name="pc" value="" /></td>
                </tr>
			   <tr>
                    <td width="180"><b>Street:</b></td>
                    <td width="230"><input type="text" size="25" name="street" value="" /> nr <input type="text" size="10" name="nr" value="" /></td>
                </tr>
               <tr>
                    <td width="180" height="30">(Copy...): <input type="checkbox" name="copy" OnClick="javascript:ShipToBillPerson(this.form);" value="checkbox"> </td>
                    <td width="230" height="30"><input type="button" value="Search!" onclick="submitQuery()"/></td>
               </tr>   
             
</form></table>

			</div>  
	</div>			   
<hr />
    <div id="wrap">
        	<div class="cont_details">
			   <table width="725">
				<form name="tweede" method="post" action="saverelation.asp">
               <tr>
                    <td width="180" height="30"><b>Country:</b></td>
                    <td width="230" height="30"><input type="text" size="25" name="country" value="" disabled/></td>
                </tr>
                <tr>
                    <td width="180">
                        <b>Street:</b></td>
                    <td width="230">
                        <input type="text" size="34" name="street2" value="" id="street2" disabled /></td>
                </tr>
                <tr>
                    <td width="180">
                        <b>nr:</b></td>
                    <td width="230">
                        <input type="text" size="34" name="nr2" value="" id="nr2" disabled /></td>
                </tr>
                <tr>
                    <td width="180">
                        <b>PC:</b></td>
                    <td width="230">
                        <input type="text" size="34" name="PC" value="" id="PC" disabled /></td>
                </tr>
				<tr>
                    <td width="180">
                        <b>City:</b></td>
                    <td width="230">
                        <input type="text" size="34" name="city2" value="" id="city2" disabled /></td>
                </tr>
                <tr>
                   <td width="180">
                        <b>lat:</b></td>
                    <td width="230"><input type="text" size="34" name="lat" value="" id="lat" /></td>
                   <td width="180">
                        <b>lng:</b></td>
                    <td width="230"><input type="text" size="34" name="lng" value="" id="lng" /></td>
                </tr>
				</form>
            </table>
			</div>  
	</div><!--End of wrap-->
</div> 
</body>

</html>