healthchecks/templates/payments/address.html

{% if a.company %}
    <p>{{ a.company }}</p>
{% else %}
	<p>{{ email }}</p>
{% endif %}

{% if a.extended_address %}
    <p>VAT: {{ a.extended_address }}</p>
{% endif %}

{% if a.street_address %}
    <p>{{ a.street_address }}</p>
{% endif %}

{% if a.locality %}
    <p>{{ a.locality }}</p>
{% endif %}

{% if a.region %}
<p>{{ a.region }}</p>
{% endif %}

{% if a.country_name %}
<p>{{ a.country_name }}</p>
{% endif %}

{% if a.postal_code %}
<p>{{ a.postal_code }}</p>
{% endif %}

<input type="hidden" name="company" value="{{ a.company|default:"" }}">
<input type="hidden" name="street_address" value="{{ a.street_address|default:"" }}">
<input type="hidden" name="extended_address" value="{{ a.extended_address|default:"" }}">
<input type="hidden" name="locality" value="{{ a.locality|default:"" }}">
<input type="hidden" name="region" value="{{ a.region|default:"" }}">
<input type="hidden" name="country_code_alpha2" value="{{ a.country_code_alpha2|default:"US" }}">
<input type="hidden" name="postal_code" value="{{ a.postal_code|default:"" }}">