<?xml version="1.0" encoding="UTF-8"?>

<form url="complaints.php"
 window="_self"
 method="POST"
 fontname="MS Sans Serif"
 width="487"
 height="505"
 bkcolor="0xFFFFFF"
 transparent="f"
 fontcolor="0x000000"
 outlinecolor="0xFFFFFF"
 themecolor="0xFFFF99"
 fontcolor2="#000000"
 bkcolor2="#FFFFFF"
 includeresults="false"
 emailuser="false"
 verifymessage="The E-Mail address you entered does not match !"
 reqmessage="One or More Fields are Required !"
 invalidemailmsg="is an invalid address, please correct it."
 transition="0"
 autoresponseincluderesults="f"
 autoresponseaddtotop="f"
 usephp="true"
 disableclicktoactiveprompt="true"
 extensions="*.txt;*.gif;*.jpg;*.jpeg;*.zip;*.doc;*.png;*.pdf;*.rtf;*.html;*.docx;*.xslx"
>

<hidden
 name="subject"
 value=""
></hidden>

<textinput
 name="Name"
 x="71"
 y="12"
 w="390"
 h="22"
 initvalue=""
 maxchars="25"
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 required="true"
 editable="true"
>
</textinput>

<textinput
 name="Email"
 x="71"
 y="52"
 w="390"
 h="22"
 initvalue=""
 maxchars="25"
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 required="true"
 emailbox="true"
 editable="true"
  restrict="email"
>
</textinput>

<textinput
 name="Phone"
 x="71"
 y="92"
 w="390"
 h="22"
 initvalue=""
 maxchars="25"
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 editable="true"
>
</textinput>

<browsebutton
 name="Upload File Button"
 x="71"
 y="166"
 w="89"
 h="27"
 label="Upload File"
 fontname="Arial"
 fontcolor="0x000000"
 image="browsegrey.png"
  fontsize="12"
></browsebutton>

<textarea
 name="Notes"
 x="71"
 y="214"
 w="394"
 h="118"
 initvalue=""
 wordwrap="true"
 required="true"
 editable="true"
 bkcolor="0xFFFFFF"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x000000"
></textarea>

<submitbutton
 name="Reset Button"
 x="215"
 y="457"
 w="89"
 h="27"
 label="Submit"
 fontname="Arial"
 fontcolor="0x000000"
 image="submit-grey.png"
  fontsize="12"
></submitbutton>

<label
 name="My Text 2"
 x="1"
 y="12"
 w="41"
 h="16"
 text="Name"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x6B7171"
  fontsize="13"
></label>

<label
 name="My Text 3"
 x="1"
 y="52"
 w="44"
 h="16"
 text="E-mail"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x6B7171"
  fontsize="13"
></label>

<label
 name="My Text 4"
 x="1"
 y="92"
 w="45"
 h="16"
 text="Phone"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x6B7171"
  fontsize="13"
></label>

<label
 name="My Text 5"
 x="71"
 y="127"
 w="388"
 h="18"
 text="Upload Your Document/Photo relevant to your complaint"
  fontname="Arial"
  fontcolor="0x3C312F"
  fontsize="16"
></label>

<label
 name="My Text 8"
 x="1"
 y="221"
 w="69"
 h="16"
 text="Complaint"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x6B7171"
  fontsize="13"
></label>

<captcha
 name="My Captcha 1"
 x="193"
 y="337"
 w="133"
 h="100"
 text="Enter Key Here:"
 fnt="Arial"
 fntclr="0x000000"
 fntsize="11"
 bkbdrcolor="0x000000"
 bkfillclr="0xFFFFFF"
 bkdobdr="t"
 bkbdrsolid="t"
 bkdobk="t"
 bkfillalpha="100"
 message="Incorrect key!"
></captcha>

</form>