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value="aeLFk0uVae1icPjhWAIlRwQPd3bfTSyX" /> <input type="hidden" name="actionType" value="Q2FzZXM=" /> <input type="hidden" id="property(module)" value="Cases" /> <input type="hidden" id="dependent_field_values_Cases" value="{&quot;JSON_VALUES&quot;:{&quot;Category&quot;:{&quot;Sub Category&quot;:{&quot;General&quot;:[&quot;Sub General&quot;],&quot;Defects&quot;:[&quot;Sub Defects&quot;]}}},&quot;JSON_SELECT_VALUES&quot;:{&quot;Status&quot;:[&quot;Open&quot;,&quot;On Hold&quot;,&quot;Escalated&quot;,&quot;Closed&quot;],&quot;Category&quot;:[&quot;General&quot;,&quot;Defects&quot;],&quot;Priority&quot;:[&quot;-None-&quot;,&quot;High&quot;,&quot;Medium&quot;,&quot;Low&quot;],&quot;Mode&quot;:[&quot;Phone&quot;,&quot;Twitter&quot;,&quot;Facebook&quot;,&quot;Email&quot;,&quot;Web&quot;,&quot;Chat&quot;,&quot;Forums&quot;,&quot;Feedback Widget&quot;],&quot;Classification&quot;:[&quot;-None-&quot;,&quot;Question&quot;,&quot;Problem&quot;,&quot;Feature&quot;,&quot;Others&quot;],&quot;Sub Category&quot;:[&quot;Sub General&quot;,&quot;Sub Defects&quot;]},&quot;JSON_MAP_DEP_LABELS&quot;:[&quot;Category&quot;]}" /> <input type="hidden" name="returnURL" value="https://www.vicenzoleather.com" /> <table border="0" cellspacing="0" cellpadding="5" class="zsFormClass"> <tr> <td colspan="2" class="zsFontClass"><strong>Vicenzo Leather Support</strong></td> </tr> <br /> <tr> <td nowrap="nowrap" class="zsFontClass " width="25%" align="left">Name  </td> <td align="left" width="75%"><input type="text" maxlength="120" name="Contact Name" class="manfieldbdr" /></td> </tr> <tr> <td nowrap="nowrap" class="zsFontClass " width="25%" align="left">Email  </td> <td align="left" width="75%"><input type="text" maxlength="120" name="Email" value="" class="manfieldbdr" /></td> </tr> <tr> <td nowrap="nowrap" class="zsFontClass " width="25%" align="left">Phone  </td> <td align="left" width="75%"><input type="text" maxlength="120" name="Phone" value="" /></td> </tr> <tr> <td nowrap="nowrap" class="zsFontClass " width="25%" align="left">Attachment   </td> <td align="left" width="75%"><span class="zsFontClass wtcuploadfile" id="zsBrowseAttachment">Attach files</span><input class="wtcuploadinput" type="file" name="attachment_1" id="zsattachment_1" style="display:block;" onclick="zsOpenFileBrowseAttachment(event)" onchange="zsRenderBrowseFileAttachment(this.value, this)" /><input class="wtcuploadinput" type="file" name="attachment_2" id="zsattachment_2" style="display:none;" onclick="zsOpenFileBrowseAttachment(event)" onchange="zsRenderBrowseFileAttachment(this.value, this)" /> <input class="wtcuploadinput" type="file" name="attachment_3" id="zsattachment_3" style="display:none;" onclick="zsOpenFileBrowseAttachment(event)" onchange="zsRenderBrowseFileAttachment(this.value, this)" /> <input class="wtcuploadinput" type="file" name="attachment_4" id="zsattachment_4" style="display:none;" onclick="zsOpenFileBrowseAttachment(event)" 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<input type="button" class="zsFontClass" value="Reset" onclick="zsResetWebForm('212714000000074280')" /></td> </tr> <br /></table> </form> </div> </html>
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