Form 345: Request for Bureaucratic Reporting

Name: Reason for Request:

<label for="deadline">Deadline:</label>
			<input type="date" id="deadline" name="deadline" style="width: 200px; padding: 10px; border: 4px solid #000000;"/>
			<div id="buttons">
				<button type="submit" style="width: 100px; padding: 5px; border: 2px solid #000000; background-color: #ff69b4; color: #000000;">Submit</button>
				<a href="/services/bureaucratic-reporting/confirm" style="text-decoration: none; color: #000000; padding: 10px 20px;">Confirm and Submit</a>
			</div>
		</form>
		<p style="font-size: 12px; text-align: left; padding: 5px; border: 1px solid #000000; background-color: #ff69b4; border-radius: 0; font-family: monospace;">Note: Please fill out this form completely, or your request may be denied.</p>
	</div>
	<div style="text-align: center; padding: 10px 20px; background-color: #ffffff; border: 4px solid #000000; border-radius: 0;">
		<a href="/services/bureaucratic-reporting/rules" style="text-decoration: none; color: #000000;">View Rules</a>
		<a href="/services/bureaucratic-reporting/submit" style="text-decoration: none; color: #000000;">Submit Another Request</a>
	</div>
</body>
</html>