Auto Poulate Field

I have a auto populate script below that allows the user to make a choice as he/she types in the text box similar to doing a Google search. When the user makes a choice I need the next two sections to auto populate with data from the users choice!

Thanks - nmsinc

<!-- 1 -->
               
                <td class="auto-style3" bgcolor="<?php echo $bgColor ?>" style="width: 25%">
                <label for="payroll_accounting_group_ot_1"></label>
                <input name="description" size="100%" style="width: 100%" id="payroll_accounting_group_ot_1" />
                <script>
                $( "#payroll_accounting_group_ot_1" ).autocomplete({  source: [
                <?php foreach (mysql_select("invoice_types", "company ORDER BY title") as $Groups): ?>
                <?php if ($CURRENT_USER['member_company_accounts'] == $Groups['company'] OR $CURRENT_USER['isAdmin']): ?>
                "(<?php echo $Groups['taxable'];?>)<?php echo $Groups['title'];?> - <?php echo $Groups['description'];?> - File: <?php echo htmlspecialchars($claims_submissionRecord['num']); ?> - INS: <?php echo htmlencode($claims_submissionRecord['member_company_claim_id']) ?> - IND/PUB: <?php echo htmlencode($claims_submissionRecord['expedient_claim_id_number']) ?>",
                <?php endif; ?>
                <?php endforeach ?>
                ]});
                </script>   
                </td>
<!-- 2 -->
    <td class="auto-style3" bgcolor="<?php echo $bgColor ?>" style="width: 5%">
    <input type="text" name="count" value="" size="100" style="width: 100%" />
                </td>
<!-- 3 -->
    <td class="auto-style3" bgcolor="<?php echo $bgColor ?>" style="width: 5%">
    <input type="text" name="rate" value="" size="100" style="width: 100%" />
    </td>