_template"></div>
                    <div data-replace-with-modal-template="advanced_note_to_self_template"></div>

                    <div class="callout account_info" style="display:none;margin-bottom: 0;"></div>
                    <input type="hidden" name="request_type" value="sendMessage" data-default="sendMessage" />
                    <input type="hidden" name="converted_account_id" value="" />
                </form>
            </div>
            <div class="modal-footer" style="margin-top:0;">