ebocooperative.freshdesk.com
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172.66.0.145
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Submitted URL: https://support.easy-buyandowncooperative.com/
Effective URL: https://ebocooperative.freshdesk.com/support/tickets/new
Submission: On December 16 via automatic, source certstream-suspicious — Scanned from CA
Effective URL: https://ebocooperative.freshdesk.com/support/tickets/new
Submission: On December 16 via automatic, source certstream-suspicious — Scanned from CA
Form analysis 1 forms found in the DOM
POST /support/tickets
<form class="form-portal ticket-form w-100" rel="validate" novalidate="novalidate" id="new_helpdesk_ticket" enctype="multipart/form-data" action="/support/tickets" accept-charset="UTF-8" method="post"><input name="utf8" type="hidden" value="✓"><input
type="hidden" name="authenticity_token" value="UH7d28q0pbWrx4xtm08nAiwM9ho569Z+Pq7NNBXnErBt/n3tmdQDaAnLorntH06W9fVbZDjLW8weSbWYHxKGwQ==">
<div class="form-group helpdesk_ticket_email">
<label for="helpdesk_ticket_email" class=" form-label"> Enter your email address <span class="fw-asterisk">*</span>
</label>
<input type="email" class="form-control " id="helpdesk_ticket_email" placeholder="" name="helpdesk_ticket[email]" value="" required="" data-user-email="" data-user-contractor="false" data-not-allow-others="false">
<div class="invalid-feedback helpdesk_ticket_email"></div>
</div>
<div class="form-group d-none requester-name">
<input type="text" class="form-control " id="" placeholder="Your name" name="helpdesk_ticket[name]">
<div class="invalid-feedback "></div>
</div>
<div class="form-group helpdesk_ticket_custom_field_cf_app_3707147">
<label for="helpdesk_ticket_custom_field_cf_app_3707147" class=" form-label"> App <span class="fw-asterisk">*</span>
<div class="fw-hint hint--no-arrow hint--rounded hint--top-right ms-4 align-middle" data-test-id="info-icon" aria-label="Choose the App you are having issues with">
<span class="icon-info"></span>
</div>
</label>
<div class="choices form-select" data-type="select-one" tabindex="0" role="listbox" aria-haspopup="true" aria-expanded="false" aria-label="
App
*
">
<div class="choices__inner"><select class="form-control new_ticket_dynamic_sections choices choices__input" id="helpdesk_ticket_custom_field_cf_app_3707147" name="helpdesk_ticket[custom_field][cf_app_3707147]" data-placeholder="" required=""
hidden="" tabindex="-1" data-choice="active">
<option value="">Choose...</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true">Choose...</div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false">
<div class="choices__list" role="listbox">
<div id="choices--helpdesk_ticket_custom_field_cf_app_3707147-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1"
data-value="" data-select-text="Press to select" data-choice-selectable="" aria-selected="true">Choose...</div>
<div id="choices--helpdesk_ticket_custom_field_cf_app_3707147-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="EBO Cooperative"
data-select-text="Press to select" data-choice-selectable=""> EBO Cooperative </div>
<div id="choices--helpdesk_ticket_custom_field_cf_app_3707147-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="EBO wallet"
data-select-text="Press to select" data-choice-selectable=""> EBO wallet </div>
</div>
</div>
</div>
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_app_3707147"></div>
</div>
<div class="helpdesk_ticket_custom_field_cf_app_3707147_section_wrapper"></div>
<div class="form-group ">
<label for="helpdesk_ticket_subject" class=" form-label"> Subject <span class="fw-asterisk">*</span>
</label>
<input type="text" class="form-control " id="helpdesk_ticket_subject" placeholder="" name="helpdesk_ticket[subject]" required="" data-allow-solution-suggester="true">
<div class="invalid-feedback helpdesk_ticket_subject"></div>
</div>
<div class="form-group helpdesk_ticket_ticket_type">
<label for="helpdesk_ticket_ticket_type" class=" form-label"> Type <div class="fw-hint hint--no-arrow hint--rounded hint--top-right ms-4 align-middle" data-test-id="info-icon" aria-label="Select from the list of issues you are facing">
<span class="icon-info"></span>
</div>
</label>
<div class="choices form-select" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="form-control new_ticket_dynamic_sections choices choices__input" id="helpdesk_ticket_ticket_type" name="helpdesk_ticket[ticket_type]" data-placeholder="" hidden="" tabindex="-1" data-choice="active">
<option value="">Choose...</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true">Choose...</div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="Choose..." placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--helpdesk_ticket_ticket_type-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1" data-value=""
data-select-text="Press to select" data-choice-selectable="" aria-selected="true">Choose...</div>
<div id="choices--helpdesk_ticket_ticket_type-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="Account Activation Issue"
data-select-text="Press to select" data-choice-selectable=""> Account Activation Issue </div>
<div id="choices--helpdesk_ticket_ticket_type-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="Change phone number" data-select-text="Press to select"
data-choice-selectable=""> Change phone number </div>
<div id="choices--helpdesk_ticket_ticket_type-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="Cashout Issues" data-select-text="Press to select"
data-choice-selectable=""> Cashout Issues </div>
<div id="choices--helpdesk_ticket_ticket_type-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="Failed Transaction" data-select-text="Press to select"
data-choice-selectable=""> Failed Transaction </div>
<div id="choices--helpdesk_ticket_ticket_type-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="Incoming Transfer Issue"
data-select-text="Press to select" data-choice-selectable=""> Incoming Transfer Issue </div>
<div id="choices--helpdesk_ticket_ticket_type-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="Shares activation" data-select-text="Press to select"
data-choice-selectable=""> Shares activation </div>
<div id="choices--helpdesk_ticket_ticket_type-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="Others" data-select-text="Press to select"
data-choice-selectable=""> Others </div>
</div>
</div>
</div>
<div class="invalid-feedback helpdesk_ticket_ticket_type"></div>
</div>
<div class="helpdesk_ticket_ticket_type_section_wrapper"></div>
<textarea class="helpdesk_ticket_ticket_type-section-ticket-field-203000112695 d-none">
<div class="form-group ">
<label for="helpdesk_ticket_custom_field_cf_username29854_3707147" class=" form-label">
Username
<span class="fw-asterisk">*</span>
</label>
<input
type="text"
class="form-control "
id="helpdesk_ticket_custom_field_cf_username29854_3707147"
placeholder=""
name="helpdesk_ticket[custom_field][cf_username29854_3707147]"
required
>
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_username29854_3707147"></div>
</div>
<div class="form-group ">
<label for="helpdesk_ticket_custom_field_cf_description_3707147" class="form-label">
Description
<span class="fw-asterisk">*</span>
</label>
<textarea
class="form-control section-field"
id="helpdesk_ticket_custom_field_cf_description_3707147"
name="helpdesk_ticket[custom_field][cf_description_3707147]"
rows="6"
cols=""
required
placeholder=""
>&lt/textarea&gt
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_description_3707147"></div>
</div>
</textarea>
<textarea class="helpdesk_ticket_ticket_type-section-ticket-field-203000112696 d-none">
<div class="form-group ">
<label for="helpdesk_ticket_custom_field_cf_account_no158120_3707147" class=" form-label">
Account No
<span class="fw-asterisk">*</span>
</label>
<input
type="text"
class="form-control "
id="helpdesk_ticket_custom_field_cf_account_no158120_3707147"
placeholder=""
name="helpdesk_ticket[custom_field][cf_account_no158120_3707147]"
required
data-number = "true"
>
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_account_no158120_3707147"></div>
</div>
<div class="form-group ">
<label for="helpdesk_ticket_custom_field_cf_old_phone_number_3707147" class=" form-label">
Old phone no
</label>
<input
type="text"
class="form-control "
id="helpdesk_ticket_custom_field_cf_old_phone_number_3707147"
placeholder=""
name="helpdesk_ticket[custom_field][cf_old_phone_number_3707147]"
data-number = "true"
>
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_old_phone_number_3707147"></div>
</div>
<div class="form-group ">
<label for="helpdesk_ticket_custom_field_cf_new_phone_no_3707147" class=" form-label">
New phone no
<span class="fw-asterisk">*</span>
</label>
<input
type="text"
class="form-control "
id="helpdesk_ticket_custom_field_cf_new_phone_no_3707147"
placeholder=""
name="helpdesk_ticket[custom_field][cf_new_phone_no_3707147]"
required
data-number = "true"
>
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_new_phone_no_3707147"></div>
</div>
</textarea>
<textarea class="helpdesk_ticket_ticket_type-section-ticket-field-203000112699 d-none">
<div class="form-group ">
<label for="helpdesk_ticket_custom_field_cf_username350618_3707147" class=" form-label">
Username
<span class="fw-asterisk">*</span>
</label>
<input
type="text"
class="form-control "
id="helpdesk_ticket_custom_field_cf_username350618_3707147"
placeholder=""
name="helpdesk_ticket[custom_field][cf_username350618_3707147]"
required
>
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_username350618_3707147"></div>
</div>
<div class="form-group ">
<label for="helpdesk_ticket_custom_field_cf_description674107_3707147" class="form-label">
Description
</label>
<textarea
class="form-control section-field"
id="helpdesk_ticket_custom_field_cf_description674107_3707147"
name="helpdesk_ticket[custom_field][cf_description674107_3707147]"
rows="6"
cols=""
placeholder=""
>&lt/textarea&gt
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_description674107_3707147"></div>
</div>
</textarea>
<textarea class="helpdesk_ticket_ticket_type-section-ticket-field-203000112697 d-none">
<div class="form-group ">
<label for="helpdesk_ticket_custom_field_cf_account_no891411_3707147" class=" form-label">
Account No
</label>
<input
type="text"
class="form-control "
id="helpdesk_ticket_custom_field_cf_account_no891411_3707147"
placeholder=""
name="helpdesk_ticket[custom_field][cf_account_no891411_3707147]"
data-number = "true"
>
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_account_no891411_3707147"></div>
</div>
<div class="form-group ">
<label for="helpdesk_ticket_custom_field_cf_transaction_reference_no750952_3707147" class=" form-label">
Transaction Reference No
<span class="fw-asterisk">*</span>
</label>
<input
type="text"
class="form-control "
id="helpdesk_ticket_custom_field_cf_transaction_reference_no750952_3707147"
placeholder=""
name="helpdesk_ticket[custom_field][cf_transaction_reference_no750952_3707147]"
required
>
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_transaction_reference_no750952_3707147"></div>
</div>
<div class="form-group ">
<label for="helpdesk_ticket_custom_field_cf_date_of_transaction_3707147" class=" form-label">
Date of Transaction
<span class="fw-asterisk">*</span>
</label>
<input
type="date"
class="form-control "
id="helpdesk_ticket_custom_field_cf_date_of_transaction_3707147"
placeholder=""
name="helpdesk_ticket[custom_field][cf_date_of_transaction_3707147]"
required
>
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_date_of_transaction_3707147"></div>
</div>
<div class="form-group ">
<label for="helpdesk_ticket_custom_field_cf_amount_3707147" class=" form-label">
Amount
<span class="fw-asterisk">*</span>
</label>
<input
type="text"
class="form-control "
id="helpdesk_ticket_custom_field_cf_amount_3707147"
placeholder=""
name="helpdesk_ticket[custom_field][cf_amount_3707147]"
required
data-number = "true"
>
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_amount_3707147"></div>
</div>
</textarea>
<textarea class="helpdesk_ticket_ticket_type-section-ticket-field-203000113435 d-none">
<div class="form-group ">
<label for="helpdesk_ticket_custom_field_cf_account_no239359_3707147" class=" form-label">
Account No
<span class="fw-asterisk">*</span>
</label>
<input
type="text"
class="form-control "
id="helpdesk_ticket_custom_field_cf_account_no239359_3707147"
placeholder=""
name="helpdesk_ticket[custom_field][cf_account_no239359_3707147]"
required
data-number = "true"
>
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_account_no239359_3707147"></div>
</div>
<div class="form-group ">
<label for="helpdesk_ticket_custom_field_cf_session_id_3707147" class=" form-label">
Session ID
</label>
<input
type="text"
class="form-control "
id="helpdesk_ticket_custom_field_cf_session_id_3707147"
placeholder=""
name="helpdesk_ticket[custom_field][cf_session_id_3707147]"
>
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_session_id_3707147"></div>
</div>
<div class="form-group ">
<label for="helpdesk_ticket_custom_field_cf_transaction_date_3707147" class=" form-label">
Transaction Date
<span class="fw-asterisk">*</span>
</label>
<input
type="date"
class="form-control "
id="helpdesk_ticket_custom_field_cf_transaction_date_3707147"
placeholder=""
name="helpdesk_ticket[custom_field][cf_transaction_date_3707147]"
required
>
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_transaction_date_3707147"></div>
</div>
<div class="form-group ">
<label for="helpdesk_ticket_custom_field_cf_amount675773_3707147" class=" form-label">
Amount
<span class="fw-asterisk">*</span>
</label>
<input
type="text"
class="form-control "
id="helpdesk_ticket_custom_field_cf_amount675773_3707147"
placeholder=""
name="helpdesk_ticket[custom_field][cf_amount675773_3707147]"
required
data-number = "true"
>
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_amount675773_3707147"></div>
</div>
</textarea>
<textarea class="helpdesk_ticket_ticket_type-section-ticket-field-203000112698 d-none">
<div class="form-group ">
<label for="helpdesk_ticket_custom_field_cf_username_3707147" class=" form-label">
Username
<span class="fw-asterisk">*</span>
</label>
<input
type="text"
class="form-control "
id="helpdesk_ticket_custom_field_cf_username_3707147"
placeholder=""
name="helpdesk_ticket[custom_field][cf_username_3707147]"
required
>
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_username_3707147"></div>
</div>
<div class="form-group ">
<label for="helpdesk_ticket_custom_field_cf_description190179_3707147" class="form-label">
Description
<span class="fw-asterisk">*</span>
</label>
<textarea
class="form-control section-field"
id="helpdesk_ticket_custom_field_cf_description190179_3707147"
name="helpdesk_ticket[custom_field][cf_description190179_3707147]"
rows="6"
cols=""
required
placeholder=""
>&lt/textarea&gt
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_description190179_3707147"></div>
</div>
</textarea>
<textarea class="helpdesk_ticket_ticket_type-section-ticket-field-203000113424 d-none">
<div class="form-group ">
<label for="helpdesk_ticket_custom_field_cf_description622272_3707147" class="form-label">
Description
<span class="fw-asterisk">*</span>
</label>
<textarea
class="form-control section-field"
id="helpdesk_ticket_custom_field_cf_description622272_3707147"
name="helpdesk_ticket[custom_field][cf_description622272_3707147]"
rows="6"
cols=""
required
placeholder=""
>&lt/textarea&gt
<div class="invalid-feedback helpdesk_ticket_custom_field_cf_description622272_3707147"></div>
</div>
</textarea>
<div class="form-group attachments-container">
<span class="d-none">
<input id="upload_file" type="file" multiple="true">
<input id="files_list" type="file" name="helpdesk_ticket[attachments][][resource]" multiple="true">
</span>
<div class="dropdown">
<button class="btn btn-link " type="button" id="attach_btn" data-attach-type="file">
<span class="file-upload-btn" tabindex="0">
<img data-src="/glyphs/vectors/attachment.svg" loading="lazy" alt="Attachment" class="icon ls-is-cached lazyloaded" src="/glyphs/vectors/attachment.svg"> Attachment </span>
</button>
<ul class="dropdown-menu" aria-labelledby="attach_btn">
<li><a class="dropdown-item" href="#" data-attach-type="file">Attach a file</a></li>
</ul>
</div>
<div id="attachments_list" class="files-container"></div>
<div>
<div id="cumulative_error_heading" class="error-heading"></div>
<div id="cumulative_error_attachments_list" class="files-container"></div>
</div>
<div>
<div id="individual_error_heading" class="error-heading"></div>
<div id="individual_error_attachments_list" class="files-container"></div>
</div>
</div>
<div class="form-group">
<div class="controls recaptcha-control">
<script src="https://static.freshdev.io/fdk/2.0/assets/fresh_parent.js"></script>
<script src="https://www.recaptcha.net/recaptcha/enterprise.js" async="" defer=""></script>
<div data-sitekey="6LdvejUUAAAAAEn6wjOFcPVRyQr4KtAJ03ltA1SQ" class="g-recaptcha " display="{:theme=>" white"}"="">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-4jt5dp2av50m" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.recaptcha.net/recaptcha/enterprise/anchor?ar=1&k=6LdvejUUAAAAAEn6wjOFcPVRyQr4KtAJ03ltA1SQ&co=aHR0cHM6Ly9lYm9jb29wZXJhdGl2ZS5mcmVzaGRlc2suY29tOjQ0Mw..&hl=en&v=zIriijn3uj5Vpknvt_LnfNbF&size=normal&cb=iuvw17jzrivt"></iframe>
</div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div>
<noscript>
<div>
<div style="width: 302px; height: 422px; position: relative;">
<div style="width: 302px; height: 422px; position: absolute;">
<iframe src="https://www.recaptcha.net/recaptcha/enterprise/fallback?k=6LdvejUUAAAAAEn6wjOFcPVRyQr4KtAJ03ltA1SQ" name="ReCAPTCHA" style="width: 302px; height: 422px; border-style: none; border: 0; overflow: hidden;">
</iframe>
</div>
</div>
<div style="width: 300px; height: 60px; border-style: none;
bottom: 12px; left: 25px; margin: 0px; padding: 0px; right: 25px;
background: #f9f9f9; border: 1px solid #c1c1c1; border-radius: 3px;">
<textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response" style="width: 250px; height: 40px; border: 1px solid #c1c1c1;
margin: 10px 25px; padding: 0px; resize: none;"> </textarea>
</div>
</div>
</noscript>
</div>
</div>
<input type="hidden" name="meta[user_agent]" id="meta_user_agent" value="Mozilla/5.0 (X11; Linux x86_64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/131.0.0.0 Safari/537.36">
<input type="hidden" name="meta[seen_articles]" id="meta_seen_articles">
<input type="hidden" name="meta[enterprise_enabled]" id="meta_enterprise_enabled" value="false"> <input type="hidden" name="meta[referrer]" id="meta_referrer" value="https://www.google.com/">
<input type="hidden" name="helpdesk_ticket[form_id]" id="helpdesk_ticket_form_id" value="203000050588">
<a id="" href="/support/home" class="btn fw-secondary-button">Cancel</a>
<button type="submit" class="btn fw-primary-button new-ticket-submit-button" data-recaptcha-enterprise="false" data-submit-text="Please Wait..."> Submit </button>
</form>Text Content
Skip to main content EBO cooperative * Home * Submit a ticket * Login * Sign up * 1. Home 2. Submit a ticket SUBMIT A TICKET Enter your email address * App * Choose... Choose... Choose... EBO Cooperative EBO wallet Subject * Type Choose... Choose... Choose... Account Activation Issue Change phone number Cashout Issues Failed Transaction Incoming Transfer Issue Shares activation Others <div class="form-group "> <label for="helpdesk_ticket_custom_field_cf_username29854_3707147" class=" form-label"> Username <span class="fw-asterisk">*</span> </label> <input type="text" class="form-control " id="helpdesk_ticket_custom_field_cf_username29854_3707147" placeholder="" name="helpdesk_ticket[custom_field][cf_username29854_3707147]" required > <div class="invalid-feedback helpdesk_ticket_custom_field_cf_username29854_3707147"></div> </div> <div class="form-group "> <label for="helpdesk_ticket_custom_field_cf_description_3707147" class="form-label"> Description <span class="fw-asterisk">*</span> </label> <textarea class="form-control section-field" id="helpdesk_ticket_custom_field_cf_description_3707147" name="helpdesk_ticket[custom_field][cf_description_3707147]" rows="6" cols="" required placeholder="" ></textarea> <div class="invalid-feedback helpdesk_ticket_custom_field_cf_description_3707147"></div> </div> <div class="form-group "> <label for="helpdesk_ticket_custom_field_cf_account_no158120_3707147" class=" form-label"> Account No <span class="fw-asterisk">*</span> </label> <input type="text" class="form-control " id="helpdesk_ticket_custom_field_cf_account_no158120_3707147" placeholder="" name="helpdesk_ticket[custom_field][cf_account_no158120_3707147]" required data-number = "true" > <div class="invalid-feedback helpdesk_ticket_custom_field_cf_account_no158120_3707147"></div> </div> <div class="form-group "> <label for="helpdesk_ticket_custom_field_cf_old_phone_number_3707147" class=" form-label"> Old phone no </label> <input type="text" class="form-control " id="helpdesk_ticket_custom_field_cf_old_phone_number_3707147" placeholder="" name="helpdesk_ticket[custom_field][cf_old_phone_number_3707147]" data-number = "true" > <div class="invalid-feedback helpdesk_ticket_custom_field_cf_old_phone_number_3707147"></div> </div> <div class="form-group "> <label for="helpdesk_ticket_custom_field_cf_new_phone_no_3707147" class=" form-label"> New phone no <span class="fw-asterisk">*</span> </label> <input type="text" class="form-control " id="helpdesk_ticket_custom_field_cf_new_phone_no_3707147" placeholder="" name="helpdesk_ticket[custom_field][cf_new_phone_no_3707147]" required data-number = "true" > <div class="invalid-feedback helpdesk_ticket_custom_field_cf_new_phone_no_3707147"></div> </div> <div class="form-group "> <label for="helpdesk_ticket_custom_field_cf_username350618_3707147" class=" form-label"> Username <span class="fw-asterisk">*</span> </label> <input type="text" class="form-control " id="helpdesk_ticket_custom_field_cf_username350618_3707147" placeholder="" name="helpdesk_ticket[custom_field][cf_username350618_3707147]" required > <div class="invalid-feedback helpdesk_ticket_custom_field_cf_username350618_3707147"></div> </div> <div class="form-group "> <label for="helpdesk_ticket_custom_field_cf_description674107_3707147" class="form-label"> Description </label> <textarea class="form-control section-field" id="helpdesk_ticket_custom_field_cf_description674107_3707147" name="helpdesk_ticket[custom_field][cf_description674107_3707147]" rows="6" cols="" placeholder="" ></textarea> <div class="invalid-feedback helpdesk_ticket_custom_field_cf_description674107_3707147"></div> </div> <div class="form-group "> <label for="helpdesk_ticket_custom_field_cf_account_no891411_3707147" class=" form-label"> Account No </label> <input type="text" class="form-control " id="helpdesk_ticket_custom_field_cf_account_no891411_3707147" placeholder="" name="helpdesk_ticket[custom_field][cf_account_no891411_3707147]" data-number = "true" > <div class="invalid-feedback helpdesk_ticket_custom_field_cf_account_no891411_3707147"></div> </div> <div class="form-group "> <label for="helpdesk_ticket_custom_field_cf_transaction_reference_no750952_3707147" class=" form-label"> Transaction Reference No <span class="fw-asterisk">*</span> </label> <input type="text" class="form-control " id="helpdesk_ticket_custom_field_cf_transaction_reference_no750952_3707147" placeholder="" name="helpdesk_ticket[custom_field][cf_transaction_reference_no750952_3707147]" required > <div class="invalid-feedback helpdesk_ticket_custom_field_cf_transaction_reference_no750952_3707147"></div> </div> <div class="form-group "> <label for="helpdesk_ticket_custom_field_cf_date_of_transaction_3707147" class=" form-label"> Date of Transaction <span class="fw-asterisk">*</span> </label> <input type="date" class="form-control " id="helpdesk_ticket_custom_field_cf_date_of_transaction_3707147" placeholder="" name="helpdesk_ticket[custom_field][cf_date_of_transaction_3707147]" required > <div class="invalid-feedback helpdesk_ticket_custom_field_cf_date_of_transaction_3707147"></div> </div> <div class="form-group "> <label for="helpdesk_ticket_custom_field_cf_amount_3707147" class=" form-label"> Amount <span class="fw-asterisk">*</span> </label> <input type="text" class="form-control " id="helpdesk_ticket_custom_field_cf_amount_3707147" placeholder="" name="helpdesk_ticket[custom_field][cf_amount_3707147]" required data-number = "true" > <div class="invalid-feedback helpdesk_ticket_custom_field_cf_amount_3707147"></div> </div> <div class="form-group "> <label for="helpdesk_ticket_custom_field_cf_account_no239359_3707147" class=" form-label"> Account No <span class="fw-asterisk">*</span> </label> <input type="text" class="form-control " id="helpdesk_ticket_custom_field_cf_account_no239359_3707147" placeholder="" name="helpdesk_ticket[custom_field][cf_account_no239359_3707147]" required data-number = "true" > <div class="invalid-feedback helpdesk_ticket_custom_field_cf_account_no239359_3707147"></div> </div> <div class="form-group "> <label for="helpdesk_ticket_custom_field_cf_session_id_3707147" class=" form-label"> Session ID </label> <input type="text" class="form-control " id="helpdesk_ticket_custom_field_cf_session_id_3707147" placeholder="" name="helpdesk_ticket[custom_field][cf_session_id_3707147]" > <div class="invalid-feedback helpdesk_ticket_custom_field_cf_session_id_3707147"></div> </div> <div class="form-group "> <label for="helpdesk_ticket_custom_field_cf_transaction_date_3707147" class=" form-label"> Transaction Date <span class="fw-asterisk">*</span> </label> <input type="date" class="form-control " id="helpdesk_ticket_custom_field_cf_transaction_date_3707147" placeholder="" name="helpdesk_ticket[custom_field][cf_transaction_date_3707147]" required > <div class="invalid-feedback helpdesk_ticket_custom_field_cf_transaction_date_3707147"></div> </div> <div class="form-group "> <label for="helpdesk_ticket_custom_field_cf_amount675773_3707147" class=" form-label"> Amount <span class="fw-asterisk">*</span> </label> <input type="text" class="form-control " id="helpdesk_ticket_custom_field_cf_amount675773_3707147" placeholder="" name="helpdesk_ticket[custom_field][cf_amount675773_3707147]" required data-number = "true" > <div class="invalid-feedback helpdesk_ticket_custom_field_cf_amount675773_3707147"></div> </div> <div class="form-group "> <label for="helpdesk_ticket_custom_field_cf_username_3707147" class=" form-label"> Username <span class="fw-asterisk">*</span> </label> <input type="text" class="form-control " id="helpdesk_ticket_custom_field_cf_username_3707147" placeholder="" name="helpdesk_ticket[custom_field][cf_username_3707147]" required > <div class="invalid-feedback helpdesk_ticket_custom_field_cf_username_3707147"></div> </div> <div class="form-group "> <label for="helpdesk_ticket_custom_field_cf_description190179_3707147" class="form-label"> Description <span class="fw-asterisk">*</span> </label> <textarea class="form-control section-field" id="helpdesk_ticket_custom_field_cf_description190179_3707147" name="helpdesk_ticket[custom_field][cf_description190179_3707147]" rows="6" cols="" required placeholder="" ></textarea> <div class="invalid-feedback helpdesk_ticket_custom_field_cf_description190179_3707147"></div> </div> <div class="form-group "> <label for="helpdesk_ticket_custom_field_cf_description622272_3707147" class="form-label"> Description <span class="fw-asterisk">*</span> </label> <textarea class="form-control section-field" id="helpdesk_ticket_custom_field_cf_description622272_3707147" name="helpdesk_ticket[custom_field][cf_description622272_3707147]" rows="6" cols="" required placeholder="" ></textarea> <div class="invalid-feedback helpdesk_ticket_custom_field_cf_description622272_3707147"></div> </div> Attachment * Attach a file Cancel Submit RELATED ARTICLES CODE SNIPPET Select Language Html Html Html Css JavaScript Sass Xml Ruby PHP Java C# C++ ObjectiveC Perl Python VB SQL Generic Language Cancel Save Helpdesk Software by Freshdesk Cookie policy WHY WE LOVE COOKIES We use cookies to try and give you a better experience in Freshdesk. 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