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

<form class="loot-actor-popup" autocomplete="off" onsubmit="event.preventDefault();">
    <div class="checkboxes">
        <h1>{{localize "PF2E.loot.SplitCoinsPopupHeader"}}</h1>
        {{#each actorInfo as |info|}}
            <p>
                <label>
                    <input type="checkbox" name="actorIds" value="{{info.id}}" {{checked info.checked}} />
                    <span>{{info.name}}</span>
                </label>
            </p>
        {{/each}}
        <hr />
        <p>
            <label class="break-coins" for="breakCoins">
                <input type="checkbox" name="breakCoins" />
                <span>Allow coin type conversion</span>
            </label>
        </p>
    </div>
    <p>
        <button class="confirm-button" type="submit">
            <i class="far fa-save"></i>
            {{localize "PF2E.loot.SplitCoinsLabel"}}
        </button>
    </p>
</form>