foundry/Data/systems/pf2e/templates/actors/remove-coins.hbs

<form autocomplete="off" onsubmit="event.preventDefault();">
    <div class="form-group">
        <label>{{localize "PF2E.CurrencyPP"}}:</label>
        <input type="number" name="pp" value="0" data-dtype="Number"/>
    </div>
    <div class="form-group">
        <label>{{localize "PF2E.CurrencyGP"}}:</label>
        <input type="number" name="gp" value="0" data-dtype="Number"/>
    </div>
    <div class="form-group">
        <label>{{localize "PF2E.CurrencySP"}}:</label>
        <input type="number" name="sp" value="0" data-dtype="Number"/>
    </div>
    <div class="form-group">
        <label>{{localize "PF2E.CurrencyCP"}}:</label>
        <input type="number" name="cp" value="0" data-dtype="Number"/>
    </div>
    <div class="form-group">
    <label>{{localize "PF2E.RemoveCoinsByValueLabel"}}:</label>
        <input type="checkbox" name="removeByValue" data-dtype="Boolean"/>
    </div>
    <button type="submit"><i class="far fa-save"></i>{{localize "PF2E.RemoveCoinsTitle"}}</button>
</form>