phd.blm.gov
Open in
urlscan Pro
2001:49c8:8004:20fc::92:195
Public Scan
URL:
https://phd.blm.gov/
Submission Tags: falconsandbox
Submission: On October 28 via api from US — Scanned from DE
Submission Tags: falconsandbox
Submission: On October 28 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
POST /
<form class="node-ticket-form node-form" data-drupal-selector="node-ticket-form" enctype="multipart/form-data" action="/" method="post" id="node-ticket-form" accept-charset="UTF-8" data-once="form-updated"
data-drupal-form-fields="edit-field-application-0-target-id,edit-field-report-0-value,edit-field-page-url-0-uri,edit-field-comments-0-value,edit-field-application-permit-number-0-value,edit-field-serial-number-0-value,edit-field-admin-state,edit-field-land-description-0-value,edit-field-comm-site-bill-number-0-value,edit-field-comm-site-bill-number-0-actions-delete,edit-field-comm-site-bill-number-0-weight,edit-field-comm-site-bill-number-add-more,edit-field-comm-site-serial-number-0-value,edit-field-comm-site-serial-number-0-actions-delete,edit-field-comm-site-serial-number-0-weight,edit-field-comm-site-serial-number-add-more,edit-field-holder-name-0-value,edit-field-glo-identifier-0-value,edit-field-user-attachments-0-upload,edit-field-user-attachments-0-upload-button,edit-field-full-name-0-value,edit-field-email-0-value,edit-field-phone-0-value,edit-field-company-0-value,edit-submit,edit-address">
<input data-drupal-selector="edit-changed" type="hidden" name="changed" value="1730145463"><input autocomplete="off" data-drupal-selector="form-imuv3ber2ioi4m9b9rln8z9ceh-gkvuk1oxq7g5z3cy" type="hidden" name="form_build_id"
value="form-imUV3beR2IOI4m9B9rLn8Z9ceH-GKVUK1OxQ7g5Z3cY"><input data-drupal-selector="edit-node-ticket-form" type="hidden" name="form_id" value="node_ticket_form"><input data-drupal-selector="edit-honeypot-time" type="hidden" name="honeypot_time"
value="ZgGnaqojLYTDeOKuxysVd5e0z55b_yXFDZBpXZuwbVk">
<div class="field--type-string field--name-title field--widget-string-textfield form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-title-wrapper" id="edit-title-wrapper"> <input class="js-text-full text-full"
data-drupal-selector="edit-title-0-value" type="hidden" name="title[0][value]" value="%AutoEntityLabel%">
</div>
<div class="field--type-language field--name-langcode field--widget-language-select form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-langcode-wrapper" id="edit-langcode-wrapper">
</div>
<section id="ticket-information" class="col-xs-12" data-drupal-selector="edit-group-ticket-information">
<div class="field--type-entity-reference field--name-field-application field--widget-cshs form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-field-application-wrapper" id="edit-field-application-wrapper">
<div class="form-item js-form-item form-type-cshs js-form-type-cshs form-item-field-application-0-target-id js-form-item-field-application-0-target-id form-group">
<label for="edit-field-application-0-target-id" class="control-label js-form-required form-required">Application</label>
<select data-drupal-selector="edit-field-application-0-target-id" class="simpler-select-root form-element form-element--type-select required form-select" required="required" aria-required="true" id="edit-field-application-0-target-id"
name="field_application[0][target_id]" data-once="cshs" style="display: none;">
<option value="All" data-parent="" selected="selected"> - Please select - </option>
<optgroup label="Applications">
<option value="5" data-parent=""> AFMSS </option>
<option value="37" data-parent="5"> General Support </option>
<option value="38" data-parent="5"> New Account </option>
<option value="39" data-parent="5"> Password Reset </option>
<option value="155" data-parent="5"> Section 508 Accessibility Issue </option>
<option value="87" data-parent=""> Communication Sites </option>
<option value="64" data-parent=""> ePlanning </option>
<option value="158" data-parent="64"> General Support </option>
<option value="159" data-parent="64"> Section 508 Accessibility Issue </option>
<option value="88" data-parent=""> GLO </option>
<option value="114" data-parent="88"> Bulk Download issue </option>
<option value="99" data-parent="88"> Can't find record I'm looking for </option>
<option value="100" data-parent="99"> Patents </option>
<option value="101" data-parent="99"> Surveys </option>
<option value="102" data-parent="99"> LSR </option>
<option value="103" data-parent="99"> CDI </option>
<option value="104" data-parent="99"> Tract Books </option>
<option value="153" data-parent="88"> Case File </option>
<option value="89" data-parent="88"> Image not loading </option>
<option value="90" data-parent="89"> Image Viewer issue </option>
<option value="91" data-parent="89"> Download Image issue </option>
<option value="106" data-parent="88"> Indexing error </option>
<option value="95" data-parent="88"> Land Catalog </option>
<option value="96" data-parent="95"> Not returning expected results </option>
<option value="97" data-parent="95"> Error with the data </option>
<option value="98" data-parent="95"> Map tool issue </option>
<option value="92" data-parent="88"> Mapping Feature </option>
<option value="93" data-parent="92"> Not visible </option>
<option value="94" data-parent="92"> Not returning expected results </option>
<option value="151" data-parent="88"> Pathfinder </option>
<option value="108" data-parent="88"> Records Interpretation </option>
<option value="109" data-parent="108"> Patents </option>
<option value="110" data-parent="108"> Surveys </option>
<option value="111" data-parent="108"> LSR </option>
<option value="112" data-parent="108"> CDI </option>
<option value="113" data-parent="108"> Tract Books </option>
<option value="105" data-parent="88"> Shopping Cart </option>
<option value="107" data-parent="88"> Web Services </option>
<option value="160" data-parent="88"> Section 508 Accessibility Issue </option>
<option value="74" data-parent=""> Mineral and Land Records System (MLRS) </option>
<option value="75" data-parent="74"> General Support </option>
<option value="76" data-parent="74"> Mining Claims - Payments </option>
<option value="154" data-parent="74"> Reports </option>
<option value="152" data-parent="74"> GIS Support </option>
<option value="162" data-parent="74"> Section 508 Accessibility Issue </option>
<option value="85" data-parent="74"> eSF299 - Communications Use Application </option>
<option value="53" data-parent=""> NFLSS </option>
<option value="163" data-parent="53"> General Support </option>
<option value="164" data-parent="53"> Section 508 Accessibility Issue </option>
<option value="65" data-parent=""> RAPTOR </option>
<option value="115" data-parent="65"> Special Recreation Permit </option>
<option value="66" data-parent="115"> Application </option>
<option value="67" data-parent="115"> Attachments </option>
<option value="68" data-parent="115"> Dashboard </option>
<option value="69" data-parent="115"> Map/GIS </option>
<option value="70" data-parent="115"> Password Help/Registration </option>
<option value="71" data-parent="115"> Pre-application </option>
<option value="116" data-parent="115"> Reports </option>
<option value="165" data-parent="115"> Section 508 Accessibility Issue </option>
<option value="72" data-parent="115"> Suggestions/Improvements </option>
<option value="73" data-parent="115"> Other </option>
<option value="117" data-parent="65"> Paleontological Resource Use Authorization </option>
<option value="118" data-parent="117"> Application </option>
<option value="119" data-parent="117"> Attachments </option>
<option value="120" data-parent="117"> Dashboard </option>
<option value="121" data-parent="117"> Map/GIS </option>
<option value="122" data-parent="117"> Password Help/Registration </option>
<option value="123" data-parent="117"> Pre-application </option>
<option value="124" data-parent="117"> Reports </option>
<option value="170" data-parent="117"> Section 508 Accessibility Issue </option>
<option value="125" data-parent="117"> Suggestions/Improvements </option>
<option value="126" data-parent="117"> Other </option>
<option value="127" data-parent="65"> Scientific Research Authorization </option>
<option value="128" data-parent="127"> Application </option>
<option value="129" data-parent="127"> Attachments </option>
<option value="130" data-parent="127"> Dashboard </option>
<option value="131" data-parent="127"> Map/GIS </option>
<option value="132" data-parent="127"> Password Help/Registration </option>
<option value="133" data-parent="127"> Pre-application </option>
<option value="134" data-parent="127"> Reports </option>
<option value="171" data-parent="127"> Section 508 Accessibility Issue </option>
<option value="135" data-parent="127"> Suggestions/Improvements </option>
<option value="136" data-parent="127"> Other </option>
<option value="2" data-parent=""> RAS Public Reports </option>
<option value="166" data-parent="2"> General Support </option>
<option value="167" data-parent="2"> Section 508 Accessibility Issue </option>
<option value="57" data-parent=""> www.blm.gov </option>
<option value="156" data-parent="57"> General Support </option>
<option value="168" data-parent="57"> Section 508 Accessibility Issue </option>
</optgroup>
</select>
<div class="select-wrapper select-wrapper--level-0" data-level="0"><label for="edit-field-application-0-target-id--level-0">Application</label><select class="simpler-select form-element form-element--type-select required form-select"
id="edit-field-application-0-target-id--level-0">
<option value="All">- Please select -</option>
<option value="5" class="has-children">AFMSS</option>
<option value="87">Communication Sites</option>
<option value="64" class="has-children">ePlanning</option>
<option value="88" class="has-children">GLO</option>
<option value="74" class="has-children">Mineral and Land Records System (MLRS)</option>
<option value="53" class="has-children">NFLSS</option>
<option value="65" class="has-children">RAPTOR</option>
<option value="2" class="has-children">RAS Public Reports</option>
<option value="57" class="has-children">www.blm.gov</option>
</select></div>
</div>
</div>
<div class="field--type-string field--name-field-report field--widget-string-textfield form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-field-report-wrapper"
data-drupal-states="{"visible":{"[name=\u0022field_application[0][target_id]\u0022]":[{"value":"154"}]},"required":{"[name=\u0022field_application[0][target_id]\u0022]":{"value":"154"}}}"
id="edit-field-report-wrapper" style="display: none;">
<div class="form-item js-form-item form-type-textfield js-form-type-textfield form-item-field-report-0-value js-form-item-field-report-0-value form-group">
<label for="edit-field-report-0-value" class="control-label">Report</label>
<input class="js-text-full text-full form-text form-control" data-drupal-selector="edit-field-report-0-value" type="text" id="edit-field-report-0-value" name="field_report[0][value]" value="" size="60" maxlength="255" placeholder="">
</div>
</div>
<div class="field--type-link field--name-field-page-url field--widget-link-default form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-field-page-url-wrapper"
data-drupal-states="{"visible":{"[name=\u0022field_application[0][target_id]\u0022]":[{"value":"155"},{"value":"157"},{"value":"159"},{"value":"160"},{"value":"161"},{"value":"162"},{"value":"164"},{"value":"165"},{"value":"167"},{"value":"168"},{"value":"170"},{"value":"171"}]},"required":{"[name=\u0022field_application[0][target_id]\u0022]":[{"value":"155"},{"value":"157"},{"value":"159"},{"value":"160"},{"value":"161"},{"value":"162"},{"value":"164"},{"value":"165"},{"value":"167"},{"value":"168"},{"value":"170"},{"value":"171"}]}}"
id="edit-field-page-url-wrapper" style="display: none;">
<div class="form-item js-form-item form-type-url js-form-type-url form-item-field-page-url-0-uri js-form-item-field-page-url-0-uri form-group">
<label for="edit-field-page-url-0-uri" class="control-label">Page URL</label>
<input data-drupal-selector="edit-field-page-url-0-uri" aria-describedby="edit-field-page-url-0-uri--description" class="form-url form-control" type="url" id="edit-field-page-url-0-uri" name="field_page_url[0][uri]" value="" size="60"
maxlength="2048" placeholder="" title="" data-toggle="tooltip" data-html="true" data-original-title="This must be an external URL such as <em class="placeholder">http://example.com</em>.">
</div>
</div>
<div class="field--type-string-long field--name-field-comments field--widget-string-textarea form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-field-comments-wrapper" id="edit-field-comments-wrapper">
<div class="form-item js-form-item form-type-textarea js-form-type-textarea form-item-field-comments-0-value js-form-item-field-comments-0-value form-group">
<label for="edit-field-comments-0-value" class="control-label js-form-required form-required">Description of Issue/Request/Comments</label>
<div class="form-textarea-wrapper">
<textarea class="js-text-full text-full form-textarea required form-control resize-vertical" data-drupal-selector="edit-field-comments-0-value" id="edit-field-comments-0-value" name="field_comments[0][value]" rows="5" cols="60"
placeholder="" required="required" aria-required="true"></textarea>
</div>
</div>
</div>
<div class="field--type-string field--name-field-application-permit-number field--widget-string-textfield form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-field-application-permit-number-wrapper"
data-drupal-states="{"visible":{"[name=\u0022field_application[0][target_id]\u0022]":[{"value":"66"},{"value":"67"},{"value":"68"},{"value":"69"},{"value":"70"},{"value":"71"},{"value":"72"},{"value":"73"},{"value":"116"},{"value":"118"},{"value":"119"},{"value":"120"},{"value":"121"},{"value":"122"},{"value":"123"},{"value":"124"},{"value":"125"},{"value":"126"},{"value":"128"},{"value":"129"},{"value":"130"},{"value":"131"},{"value":"132"},{"value":"133"},{"value":"134"},{"value":"135"},{"value":"136"}]}}"
id="edit-field-application-permit-number-wrapper" style="display: none;">
<div class="form-item js-form-item form-type-textfield js-form-type-textfield form-item-field-application-permit-number-0-value js-form-item-field-application-permit-number-0-value form-group">
<label for="edit-field-application-permit-number-0-value" class="control-label">Application/Permit Number</label>
<input class="js-text-full text-full form-text form-control" data-drupal-selector="edit-field-application-permit-number-0-value" type="text" id="edit-field-application-permit-number-0-value" name="field_application_permit_number[0][value]"
value="" size="60" maxlength="10" placeholder="xxxx-xxxxx">
</div>
</div>
<div class="field--type-string field--name-field-serial-number field--widget-string-textfield form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-field-serial-number-wrapper"
data-drupal-states="{"visible":{"[name=\u0022field_application[0][target_id]\u0022]":[{"value":"75"},{"value":"76"},{"value":"77"},{"value":"78"},{"value":"79"},{"value":"80"},{"value":"81"},{"value":"82"},{"value":"83"},{"value":"84"},{"value":"137"},{"value":"138"},{"value":"139"},{"value":"140"},{"value":"141"},{"value":"142"},{"value":"143"},{"value":"144"},{"value":"145"},{"value":"146"},{"value":"147"},{"value":"148"},{"value":"149"},{"value":"150"},{"value":"152"},{"value":"154"}]}}"
id="edit-field-serial-number-wrapper" style="display: none;">
<div class="form-item js-form-item form-type-textfield js-form-type-textfield form-item-field-serial-number-0-value js-form-item-field-serial-number-0-value form-group">
<label for="edit-field-serial-number-0-value" class="control-label">Serial Number(s)</label>
<input class="js-text-full text-full form-text form-control" data-drupal-selector="edit-field-serial-number-0-value" type="text" id="edit-field-serial-number-0-value" name="field_serial_number[0][value]" value="" size="60" maxlength="255"
placeholder="">
</div>
</div>
<div class="field--type-list-string field--name-field-admin-state field--widget-options-select form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-field-admin-state-wrapper"
data-drupal-states="{"visible":{"[name=\u0022field_application[0][target_id]\u0022]":[{"value":"75"},{"value":"76"},{"value":"77"},{"value":"78"},{"value":"79"},{"value":"80"},{"value":"81"},{"value":"82"},{"value":"83"},{"value":"84"},{"value":"85"},{"value":"137"},{"value":"138"},{"value":"139"},{"value":"140"},{"value":"141"},{"value":"142"},{"value":"143"},{"value":"144"},{"value":"145"},{"value":"146"},{"value":"147"},{"value":"148"},{"value":"149"},{"value":"150"},{"value":"152"},{"value":"154"}]}}"
id="edit-field-admin-state-wrapper" style="display: none;">
<div class="form-item js-form-item form-type-select js-form-type-select form-item-field-admin-state js-form-item-field-admin-state form-group">
<label for="edit-field-admin-state" class="control-label">Administrative State(s)</label>
<select data-drupal-selector="edit-field-admin-state" aria-describedby="edit-field-admin-state--description" multiple="multiple" name="field_admin_state[]" class="form-select form-control" id="edit-field-admin-state" title=""
data-toggle="tooltip" data-original-title="Hold Ctrl and click on multiple State Options to select more than one state.">
<option value="_none" selected="selected">- None -</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="ES">Eastern States</option>
<option value="ID">Idaho</option>
<option value="MT">Montana</option>
<option value="NV">Nevada</option>
<option value="NM">New Mexico</option>
<option value="OR">Oregon</option>
<option value="UT">Utah</option>
<option value="WY">Wyoming</option>
</select>
</div>
</div>
<div class="field--type-string field--name-field-land-description field--widget-string-textfield form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-field-land-description-wrapper"
data-drupal-states="{"visible":{"[name=\u0022field_application[0][target_id]\u0022]":[{"value":"75"},{"value":"76"},{"value":"77"},{"value":"78"},{"value":"79"},{"value":"80"},{"value":"81"},{"value":"82"},{"value":"83"},{"value":"84"},{"value":"85"},{"value":"137"},{"value":"138"},{"value":"139"},{"value":"140"},{"value":"141"},{"value":"142"},{"value":"143"},{"value":"144"},{"value":"145"},{"value":"146"},{"value":"147"},{"value":"148"},{"value":"149"},{"value":"150"},{"value":"152"},{"value":"154"}]}}"
id="edit-field-land-description-wrapper" style="display: none;">
<div class="form-item js-form-item form-type-textfield js-form-type-textfield form-item-field-land-description-0-value js-form-item-field-land-description-0-value form-group">
<label for="edit-field-land-description-0-value" class="control-label">Land Description(s)</label>
<input class="js-text-full text-full form-text form-control" data-drupal-selector="edit-field-land-description-0-value" type="text" id="edit-field-land-description-0-value" name="field_land_description[0][value]" value="" size="60"
maxlength="255" placeholder="">
</div>
</div>
<div class="field--type-string field--name-field-comm-site-bill-number field--widget-string-textfield form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-field-comm-site-bill-number-wrapper"
data-drupal-states="{"visible":{"[name=\u0022field_application[0][target_id]\u0022]":[{"value":"87"}]},"required":{"[name=\u0022field_application[0][target_id]\u0022]":[{"value":"87"}],"[name=\u0022field_comm_site_serial_number[0][value]\u0022]":{"empty":true}}}"
id="edit-field-comm-site-bill-number-wrapper" style="display: none;">
<div id="field-comm-site-bill-number-add-more-wrapper">
<div class="form-item">
<button class="tabledrag-toggle-weight btn-sm btn btn-default" data-drupal-selector="tabledrag-toggle-weight" title="" data-toggle="tooltip" type="button" data-original-title="Re-order rows by numerical weight instead of dragging.">Show row
weights</button>
<div class="tableresponsive-toggle-columns"><button type="button" class="link tableresponsive-toggle" title="Show table cells that were hidden to make the table fit within a small screen." style="display: none;">Hide lower priority
columns</button></div>
<table id="field-comm-site-bill-number-values" class="field-multiple-table responsive-enabled table table-bordered table-hover table-striped" data-striping="1" data-once="tabledrag tableresponsive">
<thead>
<tr>
<th colspan="2" class="field-label"><label class="label">
<h4 class="label">Bill Number</h4>
</label></th>
<th></th>
<th class="tabledrag-hide" style="display: none;"></th>
</tr>
</thead>
<tbody>
<tr class="draggable odd">
<td class="field-multiple-drag"><a href="#" class="tabledrag-handle" title="" data-toggle="tooltip" data-original-title="Drag to re-order"><span class="icon glyphicon glyphicon-move" aria-hidden="true"></span></a></td>
<td>
<div class="form-item js-form-item form-type-textfield js-form-type-textfield form-item-field-comm-site-bill-number-0-value js-form-item-field-comm-site-bill-number-0-value form-no-label form-group">
<label for="edit-field-comm-site-bill-number-0-value" class="control-label sr-only">Bill Number (value 1)</label>
<input class="js-text-full text-full form-text form-control" data-drupal-selector="edit-field-comm-site-bill-number-0-value" type="text" id="edit-field-comm-site-bill-number-0-value" name="field_comm_site_bill_number[0][value]"
value="" size="60" maxlength="10" placeholder="">
</div>
</td>
<td><button data-drupal-selector="edit-field-comm-site-bill-number-0-actions-delete" formnovalidate="formnovalidate" class="button js-form-submit form-submit btn-danger btn icon-before" type="submit"
id="edit-field-comm-site-bill-number-0-actions-delete" name="field_comm_site_bill_number_0_remove_button" value="Remove" data-once="drupal-ajax"><span class="icon glyphicon glyphicon-trash" aria-hidden="true"></span>
Remove</button></td>
<td class="delta-order tabledrag-hide" style="display: none;">
<div class="form-item js-form-item form-type-select js-form-type-select form-item-field-comm-site-bill-number-0--weight js-form-item-field-comm-site-bill-number-0--weight form-no-label form-group">
<label for="edit-field-comm-site-bill-number-0-weight" class="control-label sr-only">Weight for row 1</label>
<div class="select-wrapper"><select data-drupal-selector="edit-field-comm-site-bill-number-0-weight" class="field_comm_site_bill_number-delta-order form-select form-control" id="edit-field-comm-site-bill-number-0-weight"
name="field_comm_site_bill_number[0][_weight]">
<option value="0" selected="selected">0</option>
</select></div>
</div>
</td>
</tr>
</tbody>
</table>
<div class="clearfix"><button class="field-add-more-submit button js-form-submit form-submit btn-info btn" data-drupal-selector="edit-field-comm-site-bill-number-add-more" formnovalidate="formnovalidate" type="submit"
id="edit-field-comm-site-bill-number-add-more" name="field_comm_site_bill_number_add_more" value="Add another item" data-once="drupal-ajax">Add another item</button></div>
</div>
</div>
</div>
<div class="field--type-string field--name-field-comm-site-serial-number field--widget-string-textfield form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-field-comm-site-serial-number-wrapper"
data-drupal-states="{"visible":{"[name=\u0022field_application[0][target_id]\u0022]":[{"value":"87"}]},"required":{"[name=\u0022field_application[0][target_id]\u0022]":[{"value":"87"}],"[name=\u0022field_comm_site_bill_number[0][value]\u0022]":{"empty":true}}}"
id="edit-field-comm-site-serial-number-wrapper" style="display: none;">
<div id="field-comm-site-serial-number-add-more-wrapper">
<div class="form-item">
<button class="tabledrag-toggle-weight btn-sm btn btn-default" data-drupal-selector="tabledrag-toggle-weight" title="" data-toggle="tooltip" type="button" data-original-title="Re-order rows by numerical weight instead of dragging.">Show row
weights</button>
<div class="tableresponsive-toggle-columns"><button type="button" class="link tableresponsive-toggle" title="Show table cells that were hidden to make the table fit within a small screen." style="display: none;">Hide lower priority
columns</button></div>
<table id="field-comm-site-serial-number-values" class="field-multiple-table responsive-enabled table table-bordered table-hover table-striped" data-striping="1" data-once="tabledrag tableresponsive">
<thead>
<tr>
<th colspan="2" class="field-label"><label class="label">
<h4 class="label">Serial Number</h4>
</label></th>
<th></th>
<th class="tabledrag-hide" style="display: none;"></th>
</tr>
</thead>
<tbody>
<tr class="draggable odd">
<td class="field-multiple-drag"><a href="#" class="tabledrag-handle" title="" data-toggle="tooltip" data-original-title="Drag to re-order"><span class="icon glyphicon glyphicon-move" aria-hidden="true"></span></a></td>
<td>
<div class="form-item js-form-item form-type-textfield js-form-type-textfield form-item-field-comm-site-serial-number-0-value js-form-item-field-comm-site-serial-number-0-value form-no-label form-group">
<label for="edit-field-comm-site-serial-number-0-value" class="control-label sr-only">Serial Number (value 1)</label>
<input class="js-text-full text-full form-text form-control" data-drupal-selector="edit-field-comm-site-serial-number-0-value" type="text" id="edit-field-comm-site-serial-number-0-value"
name="field_comm_site_serial_number[0][value]" value="" size="60" maxlength="24" placeholder="">
</div>
</td>
<td><button data-drupal-selector="edit-field-comm-site-serial-number-0-actions-delete" formnovalidate="formnovalidate" class="button js-form-submit form-submit btn-danger btn icon-before" type="submit"
id="edit-field-comm-site-serial-number-0-actions-delete" name="field_comm_site_serial_number_0_remove_button" value="Remove" data-once="drupal-ajax"><span class="icon glyphicon glyphicon-trash" aria-hidden="true"></span>
Remove</button></td>
<td class="delta-order tabledrag-hide" style="display: none;">
<div class="form-item js-form-item form-type-select js-form-type-select form-item-field-comm-site-serial-number-0--weight js-form-item-field-comm-site-serial-number-0--weight form-no-label form-group">
<label for="edit-field-comm-site-serial-number-0-weight" class="control-label sr-only">Weight for row 1</label>
<div class="select-wrapper"><select data-drupal-selector="edit-field-comm-site-serial-number-0-weight" class="field_comm_site_serial_number-delta-order form-select form-control" id="edit-field-comm-site-serial-number-0-weight"
name="field_comm_site_serial_number[0][_weight]">
<option value="0" selected="selected">0</option>
</select></div>
</div>
</td>
</tr>
</tbody>
</table>
<div class="clearfix"><button class="field-add-more-submit button js-form-submit form-submit btn-info btn" data-drupal-selector="edit-field-comm-site-serial-number-add-more" formnovalidate="formnovalidate" type="submit"
id="edit-field-comm-site-serial-number-add-more" name="field_comm_site_serial_number_add_more" value="Add another item" data-once="drupal-ajax">Add another item</button></div>
</div>
</div>
</div>
<div class="field--type-string field--name-field-holder-name field--widget-string-textfield form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-field-holder-name-wrapper"
data-drupal-states="{"visible":{"[name=\u0022field_application[0][target_id]\u0022]":[{"value":"87"}]}}" id="edit-field-holder-name-wrapper" style="display: none;">
<div class="form-item js-form-item form-type-textfield js-form-type-textfield form-item-field-holder-name-0-value js-form-item-field-holder-name-0-value form-group">
<label for="edit-field-holder-name-0-value" class="control-label">Holder Name</label>
<input class="js-text-full text-full form-text form-control" data-drupal-selector="edit-field-holder-name-0-value" type="text" id="edit-field-holder-name-0-value" name="field_holder_name[0][value]" value="" size="60" maxlength="255"
placeholder="">
</div>
</div>
<div class="field--type-string field--name-field-glo-identifier field--widget-string-textfield form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-field-glo-identifier-wrapper"
data-drupal-states="{"visible":{"[name=\u0022field_application[0][target_id]\u0022]":[{"value":"89"},{"value":"90"},{"value":"91"},{"value":"106"},{"value":"108"},{"value":"109"},{"value":"110"},{"value":"111"},{"value":"112"},{"value":"113"}]},"required":{"[name=\u0022field_application[0][target_id]\u0022]":[{"value":"89"},{"value":"90"},{"value":"91"},{"value":"106"},{"value":"108"},{"value":"109"},{"value":"110"},{"value":"111"},{"value":"112"},{"value":"113"}]}}"
id="edit-field-glo-identifier-wrapper" style="display: none;">
<div class="form-item js-form-item form-type-textfield js-form-type-textfield form-item-field-glo-identifier-0-value js-form-item-field-glo-identifier-0-value form-group">
<label for="edit-field-glo-identifier-0-value" class="control-label">Unique Identifier (Accession Nr, DM ID, Doc ID)</label>
<input class="js-text-full text-full form-text form-control" data-drupal-selector="edit-field-glo-identifier-0-value" type="text" id="edit-field-glo-identifier-0-value" name="field_glo_identifier[0][value]" value="" size="60" maxlength="255"
placeholder="">
</div>
</div>
<div class="field--type-file field--name-field-user-attachments field--widget-file-generic form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-field-user-attachments-wrapper" id="edit-field-user-attachments-wrapper">
<div id="edit-field-user-attachments-ajax-wrapper">
<div class="js-form-wrapper form-wrapper form-item js-form-item panel panel-default" data-drupal-selector="edit-field-user-attachments" aria-describedby="edit-field-user-attachments--description" id="edit-field-user-attachments">
<div class="panel-heading">
<a aria-controls="edit-field-user-attachments--content" aria-expanded="true" aria-pressed="true" data-toggle="collapse" role="button" class="panel-title" href="#edit-field-user-attachments--content">Attachments</a>
</div>
<div id="edit-field-user-attachments--content" class="panel-body panel-collapse collapse fade in">
<div id="edit-field-user-attachments--description" class="help-block">Please upload relevant file(s) or screenshot(s) needed for processing your request, e.g. error messages, pictures, audio recordings, forms, or documents.</div>
<div class="form-item js-form-item form-type-managed-file js-form-type-managed-file form-item-field-user-attachments-0 js-form-item-field-user-attachments-0 form-group">
<label for="edit-field-user-attachments-0-upload" id="edit-field-user-attachments-0--label" class="control-label">Add a new file</label>
<div id="edit-field-user-attachments-0" class="js-form-managed-file form-managed-file">
<input data-drupal-selector="edit-field-user-attachments-0-upload" multiple="multiple" class="js-form-file form-file form-control" type="file" id="edit-field-user-attachments-0-upload" name="files[field_user_attachments_0][]"
size="22" data-once="fileValidate auto-file-upload"><button class="js-hide button js-form-submit form-submit btn-primary btn icon-before" data-drupal-selector="edit-field-user-attachments-0-upload-button"
formnovalidate="formnovalidate" type="submit" id="edit-field-user-attachments-0-upload-button" name="field_user_attachments_0_upload_button" value="Upload" data-once="drupal-ajax"><span class="icon glyphicon glyphicon-upload"
aria-hidden="true"></span> Upload</button><input data-drupal-selector="edit-field-user-attachments-0-weight" type="hidden" name="field_user_attachments[0][_weight]" value="0"><input
data-drupal-selector="edit-field-user-attachments-0-fids" type="hidden" name="field_user_attachments[0][fids]"><input data-drupal-selector="edit-field-user-attachments-0-display" type="hidden"
name="field_user_attachments[0][display]" value="1">
</div>
<div id="edit-field-user-attachments-0--description" class="description help-block">
<a href="#upload-instructions--2" class="icon-before" data-toggle="popover" data-html="true" data-placement="bottom" data-title="File Restrictions" data-original-title="" title=""><span class="icon glyphicon glyphicon-question-sign" aria-hidden="true"></span>File Restrictions</a>
<div id="upload-instructions--2" class="hidden help-block form-group" aria-hidden="true">
<ul>
<li>Maximum 4 files.</li>
</ul>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</section>
<section id="submitter-information" class="col-xs-12" data-drupal-selector="edit-group-submitter-information">
<div class="col-xs-12 col-md-6 submitter-field" data-drupal-selector="edit-group-name">
<div class="field--type-string field--name-field-full-name field--widget-string-textfield form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-field-full-name-wrapper" id="edit-field-full-name-wrapper">
<div class="form-item js-form-item form-type-textfield js-form-type-textfield form-item-field-full-name-0-value js-form-item-field-full-name-0-value form-group">
<label for="edit-field-full-name-0-value" class="control-label js-form-required form-required">Full Name</label>
<input class="js-text-full text-full form-text required form-control" data-drupal-selector="edit-field-full-name-0-value" type="text" id="edit-field-full-name-0-value" name="field_full_name[0][value]" value="" size="60" maxlength="255"
placeholder="" required="required" aria-required="true">
</div>
</div>
</div>
<div class="col-xs-12 col-md-6 submitter-field" data-drupal-selector="edit-group-email">
<div class="field--type-email field--name-field-email field--widget-email-default form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-field-email-wrapper" id="edit-field-email-wrapper">
<div class="form-item js-form-item form-type-email js-form-type-email form-item-field-email-0-value js-form-item-field-email-0-value form-group">
<label for="edit-field-email-0-value" class="control-label js-form-required form-required">Email Address</label>
<input data-drupal-selector="edit-field-email-0-value" class="form-email required form-control" type="email" id="edit-field-email-0-value" name="field_email[0][value]" value="" size="60" maxlength="254" placeholder="" required="required"
aria-required="true">
</div>
</div>
</div>
<div class="col-xs-12 col-md-6 submitter-field" data-drupal-selector="edit-group-phone">
<div class="field--type-telephone field--name-field-phone field--widget-telephone-default form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-field-phone-wrapper" id="edit-field-phone-wrapper">
<div class="form-inline form-item js-form-item form-type-tel js-form-type-tel form-item-field-phone-0-value js-form-item-field-phone-0-value form-group">
<label for="edit-field-phone-0-value" class="control-label js-form-required form-required">Phone Number</label>
<input data-drupal-selector="edit-field-phone-0-value" aria-describedby="edit-field-phone-0-value--description" class="form-tel required form-control" type="tel" id="edit-field-phone-0-value" name="field_phone[0][value]" value="" size="30"
maxlength="256" placeholder="" required="required" aria-required="true" title="" data-toggle="tooltip"
data-original-title="For non-US phone numbers, please use an international phone number format (i.e. + or 011 followed by country code and phone number). If you encounter difficulties submitting your phone number, please include it in the Comments section.">
</div>
</div>
</div>
<div class="col-xs-12 col-md-6 submitter-field" data-drupal-selector="edit-group-company">
<div class="field--type-string field--name-field-company field--widget-string-textfield form-group js-form-wrapper form-wrapper" data-drupal-selector="edit-field-company-wrapper"
data-drupal-states="{"required":{"1":[{"[name=\u0022field_application[0][target_id]\u0022]":[{"value":"3"},{"value":"33"},{"value":"34"},{"value":"35"},{"value":"37"},{"value":"38"},{"value":"39"}]}]}}"
id="edit-field-company-wrapper">
<div class="form-item js-form-item form-type-textfield js-form-type-textfield form-item-field-company-0-value js-form-item-field-company-0-value form-group">
<label for="edit-field-company-0-value" class="control-label">Business/Organization Name</label>
<input class="js-text-full text-full form-text form-control" data-drupal-selector="edit-field-company-0-value" type="text" id="edit-field-company-0-value" name="field_company[0][value]" value="" size="60" maxlength="255" placeholder="">
</div>
</div>
</div>
<div id="disclaimer" class="description help-block">
<a href="#disclaimer" class="icon-before" tabindex="0" data-toggle="popover" data-trigger="manual" data-html="true" data-placement="bottom" data-title="Disclaimer" data-content="Your information will only be used for our records and to contact you. The reason that we ask for your information is to help us get in contact with you." data-original-title="" title=""> <span class="icon glyphicon glyphicon-info-sign" aria-hidden="true"></span>Site Disclaimer </a>
</div>
</section>
<div class="form-item js-form-item form-type-vertical-tabs js-form-type-vertical-tabs form-item- js-form-item- form-no-label form-group">
<label for="edit-advanced" class="control-label sr-only">Vertical Tabs</label>
<div class="entity-meta tab-content vertical-tabs-panes" data-drupal-selector="edit-advanced" data-vertical-tabs-panes="" data-once="vertical-tabs"><input class="vertical-tabs__active-tab" data-drupal-selector="edit-advanced-active-tab"
type="hidden" name="advanced__active_tab" value="edit-revision-information"></div>
</div>
<div data-drupal-selector="edit-actions" class="form-actions form-group js-form-wrapper form-wrapper" id="edit-actions"><button data-drupal-selector="edit-submit" class="button button--primary js-form-submit form-submit btn-success btn icon-before"
type="submit" id="edit-submit" name="op" value="Save"><span class="icon glyphicon glyphicon-ok" aria-hidden="true"></span> Save</button></div>
<div class="address-textfield form-group js-form-wrapper form-wrapper" style="display: none !important;">
<div class="form-item js-form-item form-type-textfield js-form-type-textfield form-item-address js-form-item-address form-group">
<label for="edit-address" class="control-label">Leave this field blank</label>
<input autocomplete="off" data-drupal-selector="edit-address" class="form-text form-control" type="text" id="edit-address" name="address" value="" size="20" maxlength="128">
</div>
</div>
</form>Text Content
Skip to main content BLM Public Help Desk CREATE TICKET Please complete the form and submit. All required fields are marked with a red asterisk (*). Application - Please select - AFMSS General Support New Account Password Reset Section 508 Accessibility Issue Communication Sites ePlanning General Support Section 508 Accessibility Issue GLO Bulk Download issue Can't find record I'm looking for Patents Surveys LSR CDI Tract Books Case File Image not loading Image Viewer issue Download Image issue Indexing error Land Catalog Not returning expected results Error with the data Map tool issue Mapping Feature Not visible Not returning expected results Pathfinder Records Interpretation Patents Surveys LSR CDI Tract Books Shopping Cart Web Services Section 508 Accessibility Issue Mineral and Land Records System (MLRS) General Support Mining Claims - Payments Reports GIS Support Section 508 Accessibility Issue eSF299 - Communications Use Application NFLSS General Support Section 508 Accessibility Issue RAPTOR Special Recreation Permit Application Attachments Dashboard Map/GIS Password Help/Registration Pre-application Reports Section 508 Accessibility Issue Suggestions/Improvements Other Paleontological Resource Use Authorization Application Attachments Dashboard Map/GIS Password Help/Registration Pre-application Reports Section 508 Accessibility Issue Suggestions/Improvements Other Scientific Research Authorization Application Attachments Dashboard Map/GIS Password Help/Registration Pre-application Reports Section 508 Accessibility Issue Suggestions/Improvements Other RAS Public Reports General Support Section 508 Accessibility Issue www.blm.gov General Support Section 508 Accessibility Issue Application- Please select -AFMSSCommunication SitesePlanningGLOMineral and Land Records System (MLRS)NFLSSRAPTORRAS Public Reportswww.blm.gov Report Page URL Description of Issue/Request/Comments Application/Permit Number Serial Number(s) Administrative State(s) - None -AlaskaArizonaCaliforniaColoradoEastern StatesIdahoMontanaNevadaNew MexicoOregonUtahWyoming Land Description(s) Show row weights Hide lower priority columns BILL NUMBER Bill Number (value 1) Remove Weight for row 1 0 Add another item Show row weights Hide lower priority columns SERIAL NUMBER Serial Number (value 1) Remove Weight for row 1 0 Add another item Holder Name Unique Identifier (Accession Nr, DM ID, Doc ID) Attachments Please upload relevant file(s) or screenshot(s) needed for processing your request, e.g. error messages, pictures, audio recordings, forms, or documents. Add a new file Upload File Restrictions * Maximum 4 files. Full Name Email Address Phone Number Business/Organization Name Site Disclaimer Vertical Tabs Save Leave this field blank FOOTER MENU * BLM Home * DOI Home * Disclaimer * Privacy Policy * Accessibility * Notices * Vulnerability Disclosure