| Customer Name: |
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| Email: |
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| Domain Name: |
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| Userid: |
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| Password: |
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| Category: |
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| Relevant files: |
(Please specify exact paths; e.g., xyz.com/abc/uvw.html, or directory xyz/cgibin/script.cgi) |
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| Description: (Please type normally. Text will word-wrap automatically) |
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| Error Message/Output: (will appear as entered) |
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| Priority: (All issues will be addressed in order received, but high priority issues will be handled accordingly) |
High (Site/server down)
As soon as possible
Standard/Routine
Not a priority
Information Only
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