www.support.tamarix.co.ke Open in urlscan Pro
144.76.43.28  Public Scan

Form analysis
1 forms found in the DOM

POST https://www.support.tamarix.co.ke

<form method="post" action="https://www.support.tamarix.co.ke" enctype="multipart/form-data">
  <input type="hidden" name="_token" value="V5bupiUwHddLKy9CDUC15MZuAUVZhd3nGwRz3YyU">
  <div class="form-row">
    <div class="form-group col-md-4">
      <label for="Support Ticket Number" class="col-form-label">Support Ticket Number<span style="color:red;">*</span></label>
      <input type="text" required="" readonly="" value=" 20211002021020 " class="form-control" id="support_ticket_no" name="support_ticket_no" placeholder="support_ticket_no">
    </div>
    <div class="form-group col-md-4">
      <label for="created_by" class="col-form-label">Ticket Created by<span style="color:red;">*</span></label>
      <input type="text" class="form-control" id="created_by" required="" placeholder="Ticket Created by" name="created_by">
    </div>
    <div class="form-group col-md-4">
      <label for="contact_email" class="col-form-label">Contact Email<span style="color:red;">*</span></label>
      <input type="email" required="" class="form-control" id="contact_email" placeholder="Contact Email" name="contact_email">
    </div>
  </div>
  <div class="form-row">
    <div class="form-group col-md-4">
      <label for="company" class="col-form-label">Select Company<span style="color:red;">*</span></label>
      <select id="company" class="form-control" name="company">
        <option>Choose Company</option>
        <option value="Britam">Britam</option>
        <option value="Britam">Britam</option>
      </select>
    </div>
    <div class="form-group col-md-4">
      <label for="application" class="col-form-label">Select Application/Project<span style="color:red;">*</span></label>
      <select id="application" class="form-control" name="application">
        <option>Choose Application/Project</option>
        <option value="Compliance Module">Compliance Module</option>
        <option value="Financial Agents Management System">Financial Agents Management System</option>
      </select>
    </div>
    <div class="form-group col-md-4">
      <label for="priority" class="col-form-label">Priority<span style="color:red;">*</span></label>
      <select id="priority" class="form-control" name="priority">
        <option value="">Choose Priority</option>
        <option value="high">High (System Completely Unavailable | Response: &lt; 2 Hours)</option>
        <option value="medium">Medium (Critical System Functionality Unavailable | Response: 2-6 Hours)</option>
        <option value="low">Low (General System Issue | Response: &lt; 24 Hours)</option>
      </select>
    </div>
  </div>
  <div class="form-row">
    <div class="form-group col-md-8">
      <label for="Support Request Title" class="col-form-label">Support Request Title<span style="color:red;">*</span></label>
      <input type="text" class="form-control" id="support Request Title" placeholder="Support Request Title" name="support_category">
    </div>
    <div class="form-group col-md-4">
      <label for="inputPassword4" class="col-form-label">Attachement</label>
      <input type="file" class="form-control" id="attachement" placeholder="Attach File (Files max 5Mb)" name="attachement">
    </div>
  </div>
  <div class="form-row">
    <div class="form-group col-md-12">
      <label for="inputAddress2" class="col-form-label">Support Request Description: Max Characters: 1000<span style="color:red;">*</span></label>
      <textarea class="form-control" name="support_description" rows="11" cols="50" maxlength="1000" required=""></textarea>
    </div>
    <div class="form-group">
      <input type="text" value="1" readonly="" class="form-control" hidden="" id="status" name="status">
    </div>
  </div>
  <button type="submit" class="btn btn-primary">Submit Ticket</button>
</form>

Text Content

Guest
Guest Account
   
 * Account
 * Login




TAMARIX SUPPORT

 * Today
 * Setting

Oct 2, 2021 Saturday
Schedule
 * 09.00AM
   
   Briefing with product division New York, NA
 * 11.00AM
   
   Meeting with client Client office
 * 01.30PM
   
   Project commisioning Office
 * 04.00AM
   
   Public discussion at office Cafetaria

Activity Log
 * Photo profile has been updated2 min ago
 * New email to John Cenna sent4 hrs ago
 * You compose new email 6 hrs ago
 * You compose new email 1 day ago

 * Main system
 * Notifications
   
 * Auto updates
   
 * Location
   
 * Assistant
 * Show Assistant
   
 * Appearances
 * Save history
   
 * Quick results
   





CREATE SUPPORT TICKET

NOTE: (For new users, the system will automatically create a follow up account
for you using your contact email)
Support Ticket Number*
Ticket Created by*
Contact Email*
Select Company* Choose Company Britam Britam
Select Application/Project* Choose Application/Project Compliance Module
Financial Agents Management System
Priority* Choose Priority High (System Completely Unavailable | Response: < 2
Hours) Medium (Critical System Functionality Unavailable | Response: 2-6 Hours)
Low (General System Issue | Response: < 24 Hours)
Support Request Title*
Attachement
Support Request Description: Max Characters: 1000*

Submit Ticket
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