{L_REPORT_POST_EXPLAIN}{L_REPORT_MESSAGE_EXPLAIN}

{L_REASON}:

selected="selected">{reason.DESCRIPTION}

{L_REPORT_NOTIFY}:
{L_REPORT_NOTIFY_EXPLAIN}

checked="checked" /> {L_YES} checked="checked" /> {L_NO}

{L_MORE_INFO}:
{L_CAN_LEAVE_BLANK}

{REPORT_TEXT}

  {S_FORM_TOKEN}