<div class="extra-form">
    <div class="modal-header">
        <button type="button" class="close" data-dismiss="modal">&times;</button>
        <h4 class="modal-title">Extra Charges</h4>
    </div>
    <div class="modal-body">
        <div class="settings">
            <ul>
                <form method="post" id="extrachargeform" >
                    <li>Parking Charge</li>
                    <li><input type="number" required="" name="Parking_Charge" id="Parking_Charge" value="0"></li>
                    <li>Toll Tax</li>
                    <li><input type="number" required="" name="Toll_Taxe" id="Toll_Taxe" value="0"></li>
                    <li>Other Charge</li>
                    <li><input type="number" required="" name="Other_Charge" id="Other_Charge" value="0"></li>
                    <li><strong><input type="submit" value="Save" style="cursor:pointer;" id="extra-charge"></strong></li>
                </form>
            </ul>
        </div>
    </div>
    <div class="modal-footer" style=" padding-top:2px !important;">
        <button type="button" class="btn btn-default" data-dismiss="modal">Close</button>
    </div>
</div>