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[b]Your Name/Master Account Name:[/b] --Text--
[b]Faction Name:[/b] --Text--
[b]Reported Faction:[/b] --Text--
[b]Date & Time of Incident:[/b] --Text--
[b]Incident Type:[/b] --Text--
[b]Rule Broken:[/b] --Text--
[b]Description:[/b] --Text--
[b]Evidence (Screenshots/Logs):[/b] --Text--