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<div id="rn_SelectionInput_7" class="rn_SelectionInput rn_Input rn_Radio">
<fieldset>
<legend id="rn_SelectionInput_7_Label" class="rn_Label">
Escalated Gift Card - Devalue </legend>
<input type="radio" name="Incident.CustomFields.c.escalated_gift_card_devalue" id="rn_SelectionInput_7_Incident.CustomFields.c.escalated_gift_card_devalue_1" value="1"/>
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Yes </label>
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No </label>
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</div>
<div id="rn_SelectionInput_9" class="rn_SelectionInput rn_Input rn_Radio">
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<legend id="rn_SelectionInput_9_Label" class="rn_Label">
Escalated - Catering Sales </legend>
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Yes </label>
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No </label>
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<div id="rn_DateInput_11" class="rn_DateInput rn_Input">
<fieldset>
<legend id="rn_DateInput_11_Legend" class="rn_Label">PA Team Escalated Team Assign </legend>
<label for="rn_DateInput_11_Incident.CustomFields.c.pa_team_escalated_team_assign_Month" class="rn_ScreenReaderOnly">Month</label>
<select id="rn_DateInput_11_Incident.CustomFields.c.pa_team_escalated_team_assign_Month" name="Incident.CustomFields.c.pa_team_escalated_team_assign.month">
<option value=''>--</option>
<option value="1" >1</option>
<option value="2" >2</option>
<option value="3" >3</option>
<option value="4" >4</option>
<option value="5" >5</option>
<option value="6" >6</option>
<option value="7" >7</option>
<option value="8" >8</option>
<option value="9" >9</option>
<option value="10" >10</option>
<option value="11" >11</option>
<option value="12" >12</option>
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<label for="rn_DateInput_11_Incident.CustomFields.c.pa_team_escalated_team_assign_Day" class="rn_ScreenReaderOnly">Day</label>
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<option value=''>--</option>
<option value="1" >1</option>
<option value="2" >2</option>
<option value="3" >3</option>
<option value="4" >4</option>
<option value="5" >5</option>
<option value="6" >6</option>
<option value="7" >7</option>
<option value="8" >8</option>
<option value="9" >9</option>
<option value="10" >10</option>
<option value="11" >11</option>
<option value="12" >12</option>
<option value="13" >13</option>
<option value="14" >14</option>
<option value="15" >15</option>
<option value="16" >16</option>
<option value="17" >17</option>
<option value="18" >18</option>
<option value="19" >19</option>
<option value="20" >20</option>
<option value="21" >21</option>
<option value="22" >22</option>
<option value="23" >23</option>
<option value="24" >24</option>
<option value="25" >25</option>
<option value="26" >26</option>
<option value="27" >27</option>
<option value="28" >28</option>
<option value="29" >29</option>
<option value="30" >30</option>
<option value="31" >31</option>
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<label for="rn_DateInput_11_Incident.CustomFields.c.pa_team_escalated_team_assign_Year" class="rn_ScreenReaderOnly">Year</label>
<select id="rn_DateInput_11_Incident.CustomFields.c.pa_team_escalated_team_assign_Year" name="Incident.CustomFields.c.pa_team_escalated_team_assign.year">
<option value=''>--</option>
<option value="2017" >2017</option>
<option value="2016" >2016</option>
<option value="2015" >2015</option>
<option value="2014" >2014</option>
<option value="2013" >2013</option>
<option value="2012" >2012</option>
<option value="2011" >2011</option>
<option value="2010" >2010</option>
<option value="2009" >2009</option>
<option value="2008" >2008</option>
<option value="2007" >2007</option>
<option value="2006" >2006</option>
<option value="2005" >2005</option>
<option value="2004" >2004</option>
<option value="2003" >2003</option>
<option value="2002" >2002</option>
<option value="2001" >2001</option>
<option value="2000" >2000</option>
<option value="1999" >1999</option>
<option value="1998" >1998</option>
<option value="1997" >1997</option>
<option value="1996" >1996</option>
<option value="1995" >1995</option>
<option value="1994" >1994</option>
<option value="1993" >1993</option>
<option value="1992" >1992</option>
<option value="1991" >1991</option>
<option value="1990" >1990</option>
<option value="1989" >1989</option>
<option value="1988" >1988</option>
<option value="1987" >1987</option>
<option value="1986" >1986</option>
<option value="1985" >1985</option>
<option value="1984" >1984</option>
<option value="1983" >1983</option>
<option value="1982" >1982</option>
<option value="1981" >1981</option>
<option value="1980" >1980</option>
<option value="1979" >1979</option>
<option value="1978" >1978</option>
<option value="1977" >1977</option>
<option value="1976" >1976</option>
<option value="1975" >1975</option>
<option value="1974" >1974</option>
<option value="1973" >1973</option>
<option value="1972" >1972</option>
<option value="1971" >1971</option>
<option value="1970" >1970</option>
</select>
<label for="rn_DateInput_11_Incident.CustomFields.c.pa_team_escalated_team_assign_Hour" class="rn_ScreenReaderOnly">Hour</label>
<select id="rn_DateInput_11_Incident.CustomFields.c.pa_team_escalated_team_assign_Hour" name="Incident.CustomFields.c.pa_team_escalated_team_assign.hour">
<option value=''>--</option>
<option value="0" >0</option>
<option value="1" >1</option>
<option value="2" >2</option>
<option value="3" >3</option>
<option value="4" >4</option>
<option value="5" >5</option>
<option value="6" >6</option>
<option value="7" >7</option>
<option value="8" >8</option>
<option value="9" >9</option>
<option value="10" >10</option>
<option value="11" >11</option>
<option value="12" >12</option>
<option value="13" >13</option>
<option value="14" >14</option>
<option value="15" >15</option>
<option value="16" >16</option>
<option value="17" >17</option>
<option value="18" >18</option>
<option value="19" >19</option>
<option value="20" >20</option>
<option value="21" >21</option>
<option value="22" >22</option>
<option value="23" >23</option>
</select>
<label for="rn_DateInput_11_Incident.CustomFields.c.pa_team_escalated_team_assign_Minute" class="rn_ScreenReaderOnly">Minute</label>
<select id="rn_DateInput_11_Incident.CustomFields.c.pa_team_escalated_team_assign_Minute" name="Incident.CustomFields.c.pa_team_escalated_team_assign.minute">
<option value=''>--</option>
<option value="0" >0</option>
<option value="1" >1</option>
<option value="2" >2</option>
<option value="3" >3</option>
<option value="4" >4</option>
<option value="5" >5</option>
<option value="6" >6</option>
<option value="7" >7</option>
<option value="8" >8</option>
<option value="9" >9</option>
<option value="10" >10</option>
<option value="11" >11</option>
<option value="12" >12</option>
<option value="13" >13</option>
<option value="14" >14</option>
<option value="15" >15</option>
<option value="16" >16</option>
<option value="17" >17</option>
<option value="18" >18</option>
<option value="19" >19</option>
<option value="20" >20</option>
<option value="21" >21</option>
<option value="22" >22</option>
<option value="23" >23</option>
<option value="24" >24</option>
<option value="25" >25</option>
<option value="26" >26</option>
<option value="27" >27</option>
<option value="28" >28</option>
<option value="29" >29</option>
<option value="30" >30</option>
<option value="31" >31</option>
<option value="32" >32</option>
<option value="33" >33</option>
<option value="34" >34</option>
<option value="35" >35</option>
<option value="36" >36</option>
<option value="37" >37</option>
<option value="38" >38</option>
<option value="39" >39</option>
<option value="40" >40</option>
<option value="41" >41</option>
<option value="42" >42</option>
<option value="43" >43</option>
<option value="44" >44</option>
<option value="45" >45</option>
<option value="46" >46</option>
<option value="47" >47</option>
<option value="48" >48</option>
<option value="49" >49</option>
<option value="50" >50</option>
<option value="51" >51</option>
<option value="52" >52</option>
<option value="53" >53</option>
<option value="54" >54</option>
<option value="55" >55</option>
<option value="56" >56</option>
<option value="57" >57</option>
<option value="58" >58</option>
<option value="59" >59</option>
</select>
</fieldset>
</div>
<div id="rn_DateInput_13" class="rn_DateInput rn_Input">
<fieldset>
<legend id="rn_DateInput_13_Legend" class="rn_Label">PA Team Initial Tracking </legend>
<label for="rn_DateInput_13_Incident.CustomFields.c.pa_team_initial_tracking_Month" class="rn_ScreenReaderOnly">Month</label>
<select id="rn_DateInput_13_Incident.CustomFields.c.pa_team_initial_tracking_Month" name="Incident.CustomFields.c.pa_team_initial_tracking.month">
<option value=''>--</option>
<option value="1" >1</option>
<option value="2" >2</option>
<option value="3" >3</option>
<option value="4" >4</option>
<option value="5" >5</option>
<option value="6" >6</option>
<option value="7" >7</option>
<option value="8" >8</option>
<option value="9" >9</option>
<option value="10" >10</option>
<option value="11" >11</option>
<option value="12" >12</option>
</select>
<label for="rn_DateInput_13_Incident.CustomFields.c.pa_team_initial_tracking_Day" class="rn_ScreenReaderOnly">Day</label>
<select id="rn_DateInput_13_Incident.CustomFields.c.pa_team_initial_tracking_Day" name="Incident.CustomFields.c.pa_team_initial_tracking.day">
<option value=''>--</option>
<option value="1" >1</option>
<option value="2" >2</option>
<option value="3" >3</option>
<option value="4" >4</option>
<option value="5" >5</option>
<option value="6" >6</option>
<option value="7" >7</option>
<option value="8" >8</option>
<option value="9" >9</option>
<option value="10" >10</option>
<option value="11" >11</option>
<option value="12" >12</option>
<option value="13" >13</option>
<option value="14" >14</option>
<option value="15" >15</option>
<option value="16" >16</option>
<option value="17" >17</option>
<option value="18" >18</option>
<option value="19" >19</option>
<option value="20" >20</option>
<option value="21" >21</option>
<option value="22" >22</option>
<option value="23" >23</option>
<option value="24" >24</option>
<option value="25" >25</option>
<option value="26" >26</option>
<option value="27" >27</option>
<option value="28" >28</option>
<option value="29" >29</option>
<option value="30" >30</option>
<option value="31" >31</option>
</select>
<label for="rn_DateInput_13_Incident.CustomFields.c.pa_team_initial_tracking_Year" class="rn_ScreenReaderOnly">Year</label>
<select id="rn_DateInput_13_Incident.CustomFields.c.pa_team_initial_tracking_Year" name="Incident.CustomFields.c.pa_team_initial_tracking.year">
<option value=''>--</option>
<option value="2017" >2017</option>
<option value="2016" >2016</option>
<option value="2015" >2015</option>
<option value="2014" >2014</option>
<option value="2013" >2013</option>
<option value="2012" >2012</option>
<option value="2011" >2011</option>
<option value="2010" >2010</option>
<option value="2009" >2009</option>
<option value="2008" >2008</option>
<option value="2007" >2007</option>
<option value="2006" >2006</option>
<option value="2005" >2005</option>
<option value="2004" >2004</option>
<option value="2003" >2003</option>
<option value="2002" >2002</option>
<option value="2001" >2001</option>
<option value="2000" >2000</option>
<option value="1999" >1999</option>
<option value="1998" >1998</option>
<option value="1997" >1997</option>
<option value="1996" >1996</option>
<option value="1995" >1995</option>
<option value="1994" >1994</option>
<option value="1993" >1993</option>
<option value="1992" >1992</option>
<option value="1991" >1991</option>
<option value="1990" >1990</option>
<option value="1989" >1989</option>
<option value="1988" >1988</option>
<option value="1987" >1987</option>
<option value="1986" >1986</option>
<option value="1985" >1985</option>
<option value="1984" >1984</option>
<option value="1983" >1983</option>
<option value="1982" >1982</option>
<option value="1981" >1981</option>
<option value="1980" >1980</option>
<option value="1979" >1979</option>
<option value="1978" >1978</option>
<option value="1977" >1977</option>
<option value="1976" >1976</option>
<option value="1975" >1975</option>
<option value="1974" >1974</option>
<option value="1973" >1973</option>
<option value="1972" >1972</option>
<option value="1971" >1971</option>
<option value="1970" >1970</option>
</select>
<label for="rn_DateInput_13_Incident.CustomFields.c.pa_team_initial_tracking_Hour" class="rn_ScreenReaderOnly">Hour</label>
<select id="rn_DateInput_13_Incident.CustomFields.c.pa_team_initial_tracking_Hour" name="Incident.CustomFields.c.pa_team_initial_tracking.hour">
<option value=''>--</option>
<option value="0" >0</option>
<option value="1" >1</option>
<option value="2" >2</option>
<option value="3" >3</option>
<option value="4" >4</option>
<option value="5" >5</option>
<option value="6" >6</option>
<option value="7" >7</option>
<option value="8" >8</option>
<option value="9" >9</option>
<option value="10" >10</option>
<option value="11" >11</option>
<option value="12" >12</option>
<option value="13" >13</option>
<option value="14" >14</option>
<option value="15" >15</option>
<option value="16" >16</option>
<option value="17" >17</option>
<option value="18" >18</option>
<option value="19" >19</option>
<option value="20" >20</option>
<option value="21" >21</option>
<option value="22" >22</option>
<option value="23" >23</option>
</select>
<label for="rn_DateInput_13_Incident.CustomFields.c.pa_team_initial_tracking_Minute" class="rn_ScreenReaderOnly">Minute</label>
<select id="rn_DateInput_13_Incident.CustomFields.c.pa_team_initial_tracking_Minute" name="Incident.CustomFields.c.pa_team_initial_tracking.minute">
<option value=''>--</option>
<option value="0" >0</option>
<option value="1" >1</option>
<option value="2" >2</option>
<option value="3" >3</option>
<option value="4" >4</option>
<option value="5" >5</option>
<option value="6" >6</option>
<option value="7" >7</option>
<option value="8" >8</option>
<option value="9" >9</option>
<option value="10" >10</option>
<option value="11" >11</option>
<option value="12" >12</option>
<option value="13" >13</option>
<option value="14" >14</option>
<option value="15" >15</option>
<option value="16" >16</option>
<option value="17" >17</option>
<option value="18" >18</option>
<option value="19" >19</option>
<option value="20" >20</option>
<option value="21" >21</option>
<option value="22" >22</option>
<option value="23" >23</option>
<option value="24" >24</option>
<option value="25" >25</option>
<option value="26" >26</option>
<option value="27" >27</option>
<option value="28" >28</option>
<option value="29" >29</option>
<option value="30" >30</option>
<option value="31" >31</option>
<option value="32" >32</option>
<option value="33" >33</option>
<option value="34" >34</option>
<option value="35" >35</option>
<option value="36" >36</option>
<option value="37" >37</option>
<option value="38" >38</option>
<option value="39" >39</option>
<option value="40" >40</option>
<option value="41" >41</option>
<option value="42" >42</option>
<option value="43" >43</option>
<option value="44" >44</option>
<option value="45" >45</option>
<option value="46" >46</option>
<option value="47" >47</option>
<option value="48" >48</option>
<option value="49" >49</option>
<option value="50" >50</option>
<option value="51" >51</option>
<option value="52" >52</option>
<option value="53" >53</option>
<option value="54" >54</option>
<option value="55" >55</option>
<option value="56" >56</option>
<option value="57" >57</option>
<option value="58" >58</option>
<option value="59" >59</option>
</select>
</fieldset>
</div>
<div id="rn_DateInput_15" class="rn_DateInput rn_Input">
<fieldset>
<legend id="rn_DateInput_15_Legend" class="rn_Label">PA Team Analyst Assignment </legend>
<label for="rn_DateInput_15_Incident.CustomFields.c.pa_team_analyst_assignment_Month" class="rn_ScreenReaderOnly">Month</label>
<select id="rn_DateInput_15_Incident.CustomFields.c.pa_team_analyst_assignment_Month" name="Incident.CustomFields.c.pa_team_analyst_assignment.month">
<option value=''>--</option>
<option value="1" >1</option>
<option value="2" >2</option>
<option value="3" >3</option>
<option value="4" >4</option>
<option value="5" >5</option>
<option value="6" >6</option>
<option value="7" >7</option>
<option value="8" >8</option>
<option value="9" >9</option>
<option value="10" >10</option>
<option value="11" >11</option>
<option value="12" >12</option>
</select>
<label for="rn_DateInput_15_Incident.CustomFields.c.pa_team_analyst_assignment_Day" class="rn_ScreenReaderOnly">Day</label>
<select id="rn_DateInput_15_Incident.CustomFields.c.pa_team_analyst_assignment_Day" name="Incident.CustomFields.c.pa_team_analyst_assignment.day">
<option value=''>--</option>
<option value="1" >1</option>
<option value="2" >2</option>
<option value="3" >3</option>
<option value="4" >4</option>
<option value="5" >5</option>
<option value="6" >6</option>
<option value="7" >7</option>
<option value="8" >8</option>
<option value="9" >9</option>
<option value="10" >10</option>
<option value="11" >11</option>
<option value="12" >12</option>
<option value="13" >13</option>
<option value="14" >14</option>
<option value="15" >15</option>
<option value="16" >16</option>
<option value="17" >17</option>
<option value="18" >18</option>
<option value="19" >19</option>
<option value="20" >20</option>
<option value="21" >21</option>
<option value="22" >22</option>
<option value="23" >23</option>
<option value="24" >24</option>
<option value="25" >25</option>
<option value="26" >26</option>
<option value="27" >27</option>
<option value="28" >28</option>
<option value="29" >29</option>
<option value="30" >30</option>
<option value="31" >31</option>
</select>
<label for="rn_DateInput_15_Incident.CustomFields.c.pa_team_analyst_assignment_Year" class="rn_ScreenReaderOnly">Year</label>
<select id="rn_DateInput_15_Incident.CustomFields.c.pa_team_analyst_assignment_Year" name="Incident.CustomFields.c.pa_team_analyst_assignment.year">
<option value=''>--</option>
<option value="2017" >2017</option>
<option value="2016" >2016</option>
<option value="2015" >2015</option>
<option value="2014" >2014</option>
<option value="2013" >2013</option>
<option value="2012" >2012</option>
<option value="2011" >2011</option>
<option value="2010" >2010</option>
<option value="2009" >2009</option>
<option value="2008" >2008</option>
<option value="2007" >2007</option>
<option value="2006" >2006</option>
<option value="2005" >2005</option>
<option value="2004" >2004</option>
<option value="2003" >2003</option>
<option value="2002" >2002</option>
<option value="2001" >2001</option>
<option value="2000" >2000</option>
<option value="1999" >1999</option>
<option value="1998" >1998</option>
<option value="1997" >1997</option>
<option value="1996" >1996</option>
<option value="1995" >1995</option>
<option value="1994" >1994</option>
<option value="1993" >1993</option>
<option value="1992" >1992</option>
<option value="1991" >1991</option>
<option value="1990" >1990</option>
<option value="1989" >1989</option>
<option value="1988" >1988</option>
<option value="1987" >1987</option>
<option value="1986" >1986</option>
<option value="1985" >1985</option>
<option value="1984" >1984</option>
<option value="1983" >1983</option>
<option value="1982" >1982</option>
<option value="1981" >1981</option>
<option value="1980" >1980</option>
<option value="1979" >1979</option>
<option value="1978" >1978</option>
<option value="1977" >1977</option>
<option value="1976" >1976</option>
<option value="1975" >1975</option>
<option value="1974" >1974</option>
<option value="1973" >1973</option>
<option value="1972" >1972</option>
<option value="1971" >1971</option>
<option value="1970" >1970</option>
</select>
<label for="rn_DateInput_15_Incident.CustomFields.c.pa_team_analyst_assignment_Hour" class="rn_ScreenReaderOnly">Hour</label>
<select id="rn_DateInput_15_Incident.CustomFields.c.pa_team_analyst_assignment_Hour" name="Incident.CustomFields.c.pa_team_analyst_assignment.hour">
<option value=''>--</option>
<option value="0" >0</option>
<option value="1" >1</option>
<option value="2" >2</option>
<option value="3" >3</option>
<option value="4" >4</option>
<option value="5" >5</option>
<option value="6" >6</option>
<option value="7" >7</option>
<option value="8" >8</option>
<option value="9" >9</option>
<option value="10" >10</option>
<option value="11" >11</option>
<option value="12" >12</option>
<option value="13" >13</option>
<option value="14" >14</option>
<option value="15" >15</option>
<option value="16" >16</option>
<option value="17" >17</option>
<option value="18" >18</option>
<option value="19" >19</option>
<option value="20" >20</option>
<option value="21" >21</option>
<option value="22" >22</option>
<option value="23" >23</option>
</select>
<label for="rn_DateInput_15_Incident.CustomFields.c.pa_team_analyst_assignment_Minute" class="rn_ScreenReaderOnly">Minute</label>
<select id="rn_DateInput_15_Incident.CustomFields.c.pa_team_analyst_assignment_Minute" name="Incident.CustomFields.c.pa_team_analyst_assignment.minute">
<option value=''>--</option>
<option value="0" >0</option>
<option value="1" >1</option>
<option value="2" >2</option>
<option value="3" >3</option>
<option value="4" >4</option>
<option value="5" >5</option>
<option value="6" >6</option>
<option value="7" >7</option>
<option value="8" >8</option>
<option value="9" >9</option>
<option value="10" >10</option>
<option value="11" >11</option>
<option value="12" >12</option>
<option value="13" >13</option>
<option value="14" >14</option>
<option value="15" >15</option>
<option value="16" >16</option>
<option value="17" >17</option>
<option value="18" >18</option>
<option value="19" >19</option>
<option value="20" >20</option>
<option value="21" >21</option>
<option value="22" >22</option>
<option value="23" >23</option>
<option value="24" >24</option>
<option value="25" >25</option>
<option value="26" >26</option>
<option value="27" >27</option>
<option value="28" >28</option>
<option value="29" >29</option>
<option value="30" >30</option>
<option value="31" >31</option>
<option value="32" >32</option>
<option value="33" >33</option>
<option value="34" >34</option>
<option value="35" >35</option>
<option value="36" >36</option>
<option value="37" >37</option>
<option value="38" >38</option>
<option value="39" >39</option>
<option value="40" >40</option>
<option value="41" >41</option>
<option value="42" >42</option>
<option value="43" >43</option>
<option value="44" >44</option>
<option value="45" >45</option>
<option value="46" >46</option>
<option value="47" >47</option>
<option value="48" >48</option>
<option value="49" >49</option>
<option value="50" >50</option>
<option value="51" >51</option>
<option value="52" >52</option>
<option value="53" >53</option>
<option value="54" >54</option>
<option value="55" >55</option>
<option value="56" >56</option>
<option value="57" >57</option>
<option value="58" >58</option>
<option value="59" >59</option>
</select>
</fieldset>
</div>
<div id="rn_TextInput_17" class="rn_TextInput rn_TextInput rn_Input">
<div id="rn_TextInput_17_LabelContainer">
<label for="rn_TextInput_17_Incident.CustomFields.c.pa_external_reference_nbr" id="rn_TextInput_17_Label" class="rn_Label">
PA External Reference <span class="rn_Optional">Optional</span><span class="rn_ScreenReaderOnly"> Optional</span>
</label>
</div>
<input type="text" id="rn_TextInput_17_Incident.CustomFields.c.pa_external_reference_nbr" name="Incident.CustomFields.c.pa_external_reference_nbr" class="rn_Text" maxlength='20' placeholder=" "/>
</div>
<div id="rn_SelectionInput_19" class="rn_SelectionInput rn_Input rn_Radio">
<fieldset>
<legend id="rn_SelectionInput_19_Label" class="rn_Label">
PA Tracking Monitor Control </legend>
<input type="radio" name="Incident.CustomFields.c.pa_tracking_monitor_control" id="rn_SelectionInput_19_Incident.CustomFields.c.pa_tracking_monitor_control_1" value="1"/>
<label for="rn_SelectionInput_19_Incident.CustomFields.c.pa_tracking_monitor_control_1">
Yes </label>
<input type="radio" name="Incident.CustomFields.c.pa_tracking_monitor_control" id="rn_SelectionInput_19_Incident.CustomFields.c.pa_tracking_monitor_control_0" checked="checked" value="0"/>
<label for="rn_SelectionInput_19_Incident.CustomFields.c.pa_tracking_monitor_control_0">
No </label>
</fieldset>
</div>
<div id="rn_SelectionInput_21" class="rn_SelectionInput rn_Input rn_Radio">
<fieldset>
<legend id="rn_SelectionInput_21_Label" class="rn_Label">
Gift Card Agent </legend>
<input type="radio" name="Incident.CustomFields.c.gift_card_super_agent" id="rn_SelectionInput_21_Incident.CustomFields.c.gift_card_super_agent_1" value="1"/>
<label for="rn_SelectionInput_21_Incident.CustomFields.c.gift_card_super_agent_1">
Yes </label>
<input type="radio" name="Incident.CustomFields.c.gift_card_super_agent" id="rn_SelectionInput_21_Incident.CustomFields.c.gift_card_super_agent_0" value="0"/>
<label for="rn_SelectionInput_21_Incident.CustomFields.c.gift_card_super_agent_0">
No </label>
</fieldset>
</div>
<div id="rn_SelectionInput_23" class="rn_SelectionInput rn_Input">
<div id="rn_SelectionInput_23_LabelContainer">
<label for="rn_SelectionInput_23_Incident.CustomFields.c.gift_card_request_type" id="rn_SelectionInput_23_Label" class="rn_Label">Gift Card Request Type </label>
</div>
<select id="rn_SelectionInput_23_Incident.CustomFields.c.gift_card_request_type" name="Incident.CustomFields.c.gift_card_request_type">
<option value="">--</option>
<option value="591" >Frozen Card</option>
<option value="592" >Mag Swipe Restricted</option>
<option value="593" >Other</option>
</select>
</div>
<div id="rn_SelectionInput_25" class="rn_SelectionInput rn_Input">
<div id="rn_SelectionInput_25_LabelContainer">
<label for="rn_SelectionInput_25_Incident.CustomFields.c.gift_card_action" id="rn_SelectionInput_25_Label" class="rn_Label">Gift Card Action </label>
</div>
<select id="rn_SelectionInput_25_Incident.CustomFields.c.gift_card_action" name="Incident.CustomFields.c.gift_card_action">
<option value="">--</option>
<option value="589" >Devalue</option>
<option value="590" >Add Value</option>
<option value="594" >Devalue and Add Value</option>
<option value="595" >Combine Cards</option>
</select>
</div>
<div id="rn_SelectionInput_27" class="rn_SelectionInput rn_Input">
<div id="rn_SelectionInput_27_LabelContainer">
<label for="rn_SelectionInput_27_Incident.CustomFields.c.gift_card_issuer_person" id="rn_SelectionInput_27_Label" class="rn_Label">Gift Card Issuer (person) </label>
</div>
<select id="rn_SelectionInput_27_Incident.CustomFields.c.gift_card_issuer_person" name="Incident.CustomFields.c.gift_card_issuer_person">
<option value="">--</option>
<option value="588" selected="selected">Jane</option>
</select>
</div>
<div id="rn_TextInput_29" class="rn_TextInput rn_TextInput rn_Input">
<div id="rn_TextInput_29_LabelContainer">
<label for="rn_TextInput_29_Incident.CustomFields.c.gift_card_appeasement_amt" id="rn_TextInput_29_Label" class="rn_Label">
Gift Card Appeasement $ <span class="rn_Optional">Optional</span><span class="rn_ScreenReaderOnly"> Optional</span>
</label>
</div>
<input type="text" id="rn_TextInput_29_Incident.CustomFields.c.gift_card_appeasement_amt" name="Incident.CustomFields.c.gift_card_appeasement_amt" class="rn_Text" maxlength='10' placeholder=" "/>
</div>
<div id="rn_TextInput_31" class="rn_TextInput rn_TextInput rn_Input">
<div id="rn_TextInput_31_LabelContainer">
<label for="rn_TextInput_31_Incident.CustomFields.c.gift_card_amount_new" id="rn_TextInput_31_Label" class="rn_Label">
Gift Card Amount (new) <span class="rn_Optional">Optional</span><span class="rn_ScreenReaderOnly"> Optional</span>
</label>
</div>
<input type="text" id="rn_TextInput_31_Incident.CustomFields.c.gift_card_amount_new" name="Incident.CustomFields.c.gift_card_amount_new" class="rn_Text" maxlength='10' placeholder=" "/>
</div>
<div id="rn_TextInput_33" class="rn_TextInput rn_TextInput rn_Input">
<div id="rn_TextInput_33_LabelContainer">
<label for="rn_TextInput_33_Incident.CustomFields.c.gift_card_new_card" id="rn_TextInput_33_Label" class="rn_Label">
Gift Card - New Card # <span class="rn_Optional">Optional</span><span class="rn_ScreenReaderOnly"> Optional</span>
</label>
</div>
<input type="text" id="rn_TextInput_33_Incident.CustomFields.c.gift_card_new_card" name="Incident.CustomFields.c.gift_card_new_card" class="rn_Text" maxlength='19' placeholder=" "/>
</div>
<div id="rn_TextInput_35" class="rn_TextInput rn_TextInput rn_Input">
<div id="rn_TextInput_35_LabelContainer">
<label for="rn_TextInput_35_Incident.CustomFields.c.gift_card_box_number" id="rn_TextInput_35_Label" class="rn_Label">
Gift Card Box # <span class="rn_Optional">Optional</span><span class="rn_ScreenReaderOnly"> Optional</span>
</label>
</div>
<input type="text" id="rn_TextInput_35_Incident.CustomFields.c.gift_card_box_number" name="Incident.CustomFields.c.gift_card_box_number" class="rn_Text" maxlength='20' placeholder=" "/>
</div>
<div id="rn_TextInput_37" class="rn_TextInput rn_TextInput rn_Input">
<div id="rn_TextInput_37_LabelContainer">
<label for="rn_TextInput_37_Incident.CustomFields.c.gift_card_frozen_amount" id="rn_TextInput_37_Label" class="rn_Label">
Gift Card Amount (frozen) <span class="rn_Optional">Optional</span><span class="rn_ScreenReaderOnly"> Optional</span>
</label>
</div>
<input type="text" id="rn_TextInput_37_Incident.CustomFields.c.gift_card_frozen_amount" name="Incident.CustomFields.c.gift_card_frozen_amount" class="rn_Text" maxlength='10' placeholder=" "/>
</div>
<div id="rn_TextInput_39" class="rn_TextInput rn_TextInput rn_Input">
<div id="rn_TextInput_39_LabelContainer">
<label for="rn_TextInput_39_Incident.CustomFields.c.gift_card_frozen_card_number" id="rn_TextInput_39_Label" class="rn_Label">
Gift Card Frozen Card # <span class="rn_Optional">Optional</span><span class="rn_ScreenReaderOnly"> Optional</span>
</label>
</div>
<input type="text" id="rn_TextInput_39_Incident.CustomFields.c.gift_card_frozen_card_number" name="Incident.CustomFields.c.gift_card_frozen_card_number" class="rn_Text" maxlength='19' placeholder=" "/>
</div>
<div id="rn_TextInput_41" class="rn_TextInput rn_TextInput rn_Input">
<div id="rn_TextInput_41_LabelContainer">
<label for="rn_TextInput_41_Incident.CustomFields.c.gift_card_issuing_location" id="rn_TextInput_41_Label" class="rn_Label">
Gift Card Issuing Location <span class="rn_Optional">Optional</span><span class="rn_ScreenReaderOnly"> Optional</span>
</label>
</div>
<input type="text" id="rn_TextInput_41_Incident.CustomFields.c.gift_card_issuing_location" name="Incident.CustomFields.c.gift_card_issuing_location" class="rn_Text" maxlength='30' placeholder=" "/>
</div>
<div id="rn_SelectionInput_43" class="rn_SelectionInput rn_Input">
<div id="rn_SelectionInput_43_LabelContainer">
<label for="rn_SelectionInput_43_Incident.CustomFields.c.chat_type" id="rn_SelectionInput_43_Label" class="rn_Label">Chat Topic <span class="rn_ScreenReaderOnly">Please select the Chat topic that best fits the issue</span>
</label>
</div>
<select id="rn_SelectionInput_43_Incident.CustomFields.c.chat_type" name="Incident.CustomFields.c.chat_type">
<option value="">--</option>
<option value="96" >Online Ordering Support</option>
<option value="308" >Catering Website Support</option>
<option value="309" >Account Support</option>
</select>
</div>
<div id="rn_TextInput_45" class="rn_TextInput rn_TextInput rn_Input">
<div id="rn_TextInput_45_LabelContainer">
<label for="rn_TextInput_45_Incident.CustomFields.c.last_4_digits" id="rn_TextInput_45_Label" class="rn_Label">
last 4 digits <span class="rn_Optional">Optional</span><span class="rn_ScreenReaderOnly"> Optional</span>
<span class="rn_ScreenReaderOnly">Enter the last 4 digits of the customer's credit card</span>
</label>
</div>
<input type="text" id="rn_TextInput_45_Incident.CustomFields.c.last_4_digits" name="Incident.CustomFields.c.last_4_digits" class="rn_Text" maxlength='4' placeholder=" "/>
</div>
<div id="rn_SelectionInput_47" class="rn_SelectionInput rn_Input rn_Radio">
<fieldset>
<legend id="rn_SelectionInput_47_Label" class="rn_Label">
Which location did you visit? </legend>
<input type="radio" name="Incident.CustomFields.c.pertains_to_cafe" id="rn_SelectionInput_47_Incident.CustomFields.c.pertains_to_cafe_1" value="1"/>
<label for="rn_SelectionInput_47_Incident.CustomFields.c.pertains_to_cafe_1">
Yes <span class="rn_ScreenReaderOnly">Does your question or comment pertain to a specific bakery-cafe? If it does, please select this option so we can be sure we are addressing the correct bakery-cafe.</span>
</label>
<input type="radio" name="Incident.CustomFields.c.pertains_to_cafe" id="rn_SelectionInput_47_Incident.CustomFields.c.pertains_to_cafe_0" checked="checked" value="0"/>
<label for="rn_SelectionInput_47_Incident.CustomFields.c.pertains_to_cafe_0">
No </label>
</fieldset>
</div>
<div id="rn_SelectionInput_49" class="rn_SelectionInput rn_Input rn_Radio">
<fieldset>
<legend id="rn_SelectionInput_49_Label" class="rn_Label">
Send to Franchise </legend>
<input type="radio" name="Incident.CustomFields.c.send_to_franchise" id="rn_SelectionInput_49_Incident.CustomFields.c.send_to_franchise_1" value="1"/>
<label for="rn_SelectionInput_49_Incident.CustomFields.c.send_to_franchise_1">
Yes </label>
<input type="radio" name="Incident.CustomFields.c.send_to_franchise" id="rn_SelectionInput_49_Incident.CustomFields.c.send_to_franchise_0" value="0"/>
<label for="rn_SelectionInput_49_Incident.CustomFields.c.send_to_franchise_0">
No </label>
</fieldset>
</div>
<div id="rn_SelectionInput_51" class="rn_SelectionInput rn_Input rn_Radio">
<fieldset>
<legend id="rn_SelectionInput_51_Label" class="rn_Label">
Order Cancellation </legend>
<input type="radio" name="Incident.CustomFields.c.order_cancellation" id="rn_SelectionInput_51_Incident.CustomFields.c.order_cancellation_1" value="1"/>
<label for="rn_SelectionInput_51_Incident.CustomFields.c.order_cancellation_1">
Yes </label>
<input type="radio" name="Incident.CustomFields.c.order_cancellation" id="rn_SelectionInput_51_Incident.CustomFields.c.order_cancellation_0" value="0"/>
<label for="rn_SelectionInput_51_Incident.CustomFields.c.order_cancellation_0">
No </label>
</fieldset>
</div>
<div id="rn_SelectionInput_53" class="rn_SelectionInput rn_Input">
<div id="rn_SelectionInput_53_LabelContainer">
<label for="rn_SelectionInput_53_Incident.CustomFields.c.admin_workspace_selection" id="rn_SelectionInput_53_Label" class="rn_Label">Workspace selection </label>
</div>
<select id="rn_SelectionInput_53_Incident.CustomFields.c.admin_workspace_selection" name="Incident.CustomFields.c.admin_workspace_selection">
<option value="">--</option>
<option value="598" >Customer Care Standard Agent</option>
<option value="599" >Gift Card Specialist</option>
<option value="600" >Cafe ReDirect Specialist</option>
<option value="601" >Preventative Analysis</option>
<option value="602" >Program Management</option>
<option value="605" >prePROD Test Workspace</option>
</select>
</div>
<div id="rn_SelectionInput_55" class="rn_SelectionInput rn_Input">
<div id="rn_SelectionInput_55_LabelContainer">
<label for="rn_SelectionInput_55_Incident.CustomFields.c.esc_reasonforrefund" id="rn_SelectionInput_55_Label" class="rn_Label">Reason for Refund v2 <span class="rn_ScreenReaderOnly">Reason for providing the guest a refund.</span>
</label>
</div>
<select id="rn_SelectionInput_55_Incident.CustomFields.c.esc_reasonforrefund" name="Incident.CustomFields.c.esc_reasonforrefund">
<option value="">--</option>
<option value="610" >Double Charged</option>
<option value="608" >eCommerce Issue</option>
<option value="611" >No Intended Sale</option>
<option value="613" >Removing Tax</option>
<option value="609" >Removing Tip</option>
<option value="612" >Service Issue</option>
</select>
</div>
<div id="rn_SelectionInput_57" class="rn_SelectionInput rn_Input">
<div id="rn_SelectionInput_57_LabelContainer">
<label for="rn_SelectionInput_57_Incident.CustomFields.c.esc_paymentmethod" id="rn_SelectionInput_57_Label" class="rn_Label">Payment Method </label>
</div>
<select id="rn_SelectionInput_57_Incident.CustomFields.c.esc_paymentmethod" name="Incident.CustomFields.c.esc_paymentmethod">
<option value="">--</option>
<option value="628" >Android Pay</option>
<option value="626" >Apple Pay</option>
<option value="625" >Credit Card</option>
<option value="627" >PayPal</option>
</select>
</div>
<div id="rn_SelectionInput_59" class="rn_SelectionInput rn_Input rn_Radio">
<fieldset>
<legend id="rn_SelectionInput_59_Label" class="rn_Label">
Email Opt In </legend>
<input type="radio" name="Incident.CustomFields.c.email_opt_in" id="rn_SelectionInput_59_Incident.CustomFields.c.email_opt_in_1" value="1"/>
<label for="rn_SelectionInput_59_Incident.CustomFields.c.email_opt_in_1">
Yes </label>
<input type="radio" name="Incident.CustomFields.c.email_opt_in" id="rn_SelectionInput_59_Incident.CustomFields.c.email_opt_in_0" value="0"/>
<label for="rn_SelectionInput_59_Incident.CustomFields.c.email_opt_in_0">
No </label>
</fieldset>
</div>
<div id="rn_SelectionInput_61" class="rn_SelectionInput rn_Input rn_Radio">
<fieldset>
<legend id="rn_SelectionInput_61_Label" class="rn_Label">
Franchise Forward </legend>
<input type="radio" name="Incident.CustomFields.c.franchise_forward" id="rn_SelectionInput_61_Incident.CustomFields.c.franchise_forward_1" value="1"/>
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Yes </label>
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No </label>
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<div id="rn_TextInput_63" class="rn_TextInput rn_TextInput rn_Input">
<div id="rn_TextInput_63_LabelContainer">
<label for="rn_TextInput_63_Incident.CustomFields.c.passthrough_textarea" id="rn_TextInput_63_Label" class="rn_Label">
Pass Through Text Area <span class="rn_Optional">Optional</span><span class="rn_ScreenReaderOnly"> Optional</span>
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<textarea id="rn_TextInput_63_Incident.CustomFields.c.passthrough_textarea" class="rn_TextArea" rows="7" cols="60" name="Incident.CustomFields.c.passthrough_textarea" maxlength='4000' placeholder=" "></textarea>
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<div id="rn_TextInput_65" class="rn_TextInput rn_TextInput rn_Input">
<div id="rn_TextInput_65_LabelContainer">
<label for="rn_TextInput_65_Incident.Subject" id="rn_TextInput_65_Label" class="rn_Label">
Subject <span class="rn_Optional">Optional</span><span class="rn_ScreenReaderOnly"> Optional</span>
</label>
</div>
<input type="text" id="rn_TextInput_65_Incident.Subject" name="Incident.Subject" class="rn_Text" maxlength='240' placeholder=" "/>
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</div>
<div id="rn_TextInput_66" class="rn_TextInput rn_TextInput rn_Input">
<div id="rn_TextInput_66_LabelContainer">
<label for="rn_TextInput_66_Contact.Name.First" id="rn_TextInput_66_Label" class="rn_Label">
First Name <span class="rn_Required"> *</span><span class="rn_ScreenReaderOnly"> Required</span>
</label>
</div>
<input type="text" id="rn_TextInput_66_Contact.Name.First" name="Contact.Name.First" class="rn_Text" maxlength='80' required placeholder=" "/>
</div>
<div id="rn_TextInput_68" class="rn_TextInput rn_TextInput rn_Input">
<div id="rn_TextInput_68_LabelContainer">
<label for="rn_TextInput_68_Contact.Name.Last" id="rn_TextInput_68_Label" class="rn_Label">
Last Name <span class="rn_Required"> *</span><span class="rn_ScreenReaderOnly"> Required</span>
</label>
</div>
<input type="text" id="rn_TextInput_68_Contact.Name.Last" name="Contact.Name.Last" class="rn_Text" maxlength='80' required placeholder=" "/>
</div>
<div id="rn_TextInput_70" class="rn_TextInput rn_TextInput rn_Input">
<div id="rn_TextInput_70_LabelContainer">
<label for="rn_TextInput_70_Contact.Emails.PRIMARY.Address" id="rn_TextInput_70_Label" class="rn_Label">
Email Address <span class="rn_Required"> *</span><span class="rn_ScreenReaderOnly"> Required</span>
</label>
</div>
<input type="email" id="rn_TextInput_70_Contact.Emails.PRIMARY.Address" name="Contact.Emails.PRIMARY.Address" class="rn_Email" maxlength='80' required value='' placeholder=" "/>
</div>
<div class='pn_AskFormCategoryContainer'>
<div id="rn_TextInput_72" class="rn_TextInput rn_TextInput rn_Input">
<div id="rn_TextInput_72_LabelContainer">
<label for="rn_TextInput_72_Contact.Phones.HOME.Number" id="rn_TextInput_72_Label" class="rn_Label">
Phone Number <span class="rn_Optional">Optional</span><span class="rn_ScreenReaderOnly"> Optional</span>
</label>
</div>
<input type="text" id="rn_TextInput_72_Contact.Phones.HOME.Number" name="Contact.Phones.HOME.Number" class="rn_Text" maxlength='40' placeholder=" "/>
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<div id="rn_TextInput_74" class="rn_TextInput rn_TextInput rn_Input">
<div id="rn_TextInput_74_LabelContainer">
<label for="rn_TextInput_74_Contact.CustomFields.c.panera_my_panera_number" id="rn_TextInput_74_Label" class="rn_Label">
MyPanera Card Number <span class="rn_Optional">Optional</span><span class="rn_ScreenReaderOnly"> Optional</span>
</label>
</div>
<input type="text" id="rn_TextInput_74_Contact.CustomFields.c.panera_my_panera_number" name="Contact.CustomFields.c.panera_my_panera_number" class="rn_Text" maxlength='13' placeholder=" "/>
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<div class='pn_Divider'></div>
<div id="rn_ProductCategoryInput_75" class="rn_ProductCategoryInput rn_Input">
<a href="javascript:void(0);" class="rn_ScreenReaderOnly" id="rn_ProductCategoryInput_75_LinksTrigger">Screen Reader users press enter to select a Select the option that best describes why you're contacting us.. <span id="rn_ProductCategoryInput_75_TreeDescription"></span></a>
<span class="rn_Label" id="rn_ProductCategoryInput_75_Label">
Select the option that best describes why you're contacting us. <span id="rn_ProductCategoryInput_75_RequiredLabel" class="rn_Required rn_Hidden"> *</span><span id="rn_ProductCategoryInput_75_ErrorLabel" class="rn_ErrorLabel">
<span class="rn_ScreenReaderOnly">
Required </span>
</span>
</span>
<button type="button" id="rn_ProductCategoryInput_75_Product_Button" class="rn_DisplayButton"><span class="rn_ScreenReaderOnly">This button does not work with screen readers. Please use the previous link instead.</span> <span id="rn_ProductCategoryInput_75_Button_Visible_Text">Options</span></button>
<div class="rn_ProductCategoryLinks rn_Hidden" id="rn_ProductCategoryInput_75_Links"></div>
<div id="rn_ProductCategoryInput_75_TreeContainer" class="rn_PanelContainer rn_Hidden">
<div id="rn_ProductCategoryInput_75_Tree" class="rn_Panel">
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<div id="rn_ProductCategoryInput_76" class="rn_ProductCategoryInput rn_Input">
<a href="javascript:void(0);" class="rn_ScreenReaderOnly" id="rn_ProductCategoryInput_76_LinksTrigger">Screen Reader users press enter to select a Please share a bit more detail. This will help us assist you more quickly.. <span id="rn_ProductCategoryInput_76_TreeDescription"></span></a>
<span class="rn_Label" id="rn_ProductCategoryInput_76_Label">
Please share a bit more detail. This will help us assist you more quickly. <span id="rn_ProductCategoryInput_76_RequiredLabel" class="rn_Required rn_Hidden"> *</span><span id="rn_ProductCategoryInput_76_ErrorLabel" class="rn_ErrorLabel">
<span class="rn_ScreenReaderOnly">
Required </span>
</span>
</span>
<button type="button" id="rn_ProductCategoryInput_76_Category_Button" class="rn_DisplayButton"><span class="rn_ScreenReaderOnly">This button does not work with screen readers. Please use the previous link instead.</span> <span id="rn_ProductCategoryInput_76_Button_Visible_Text">Details</span></button>
<div class="rn_ProductCategoryLinks rn_Hidden" id="rn_ProductCategoryInput_76_Links"></div>
<div id="rn_ProductCategoryInput_76_TreeContainer" class="rn_PanelContainer rn_Hidden">
<div id="rn_ProductCategoryInput_76_Tree" class="rn_Panel">
</div>
</div>
</div>
<div class='pn_Divider'></div>
<div id="rn_AskAQuestion_77" class="rn_AskAQuestion">
<!-- PERTAINS TO CAFE ============================================= -->
<div class='pn_CheckboxInput'>
<div id="rn_SelectionInput_79" class="rn_SelectionInput rn_Input">
<div id="rn_SelectionInput_79_LabelContainer">
<label for="rn_SelectionInput_79_Incident.CustomFields.c.pertains_to_cafe" id="rn_SelectionInput_79_Label" class="rn_Label">Does your question pertain to a specific bakery-cafe? </label>
</div>
<input type="checkbox" id="rn_SelectionInput_79_Incident.CustomFields.c.pertains_to_cafe" name="Incident.CustomFields.c.pertains_to_cafe" value="1"/>
</div>
</div>
<!-- State Field =================================================== -->
<div id="rn_HierarchyInput_80" class="rn_HierarchyInput rn_SelectionInput rn_Input rn_Hidden">
<div id="rn_HierarchyInput_80_LabelContainer" class="">
<label for="rn_HierarchyInput_80_Z.CafeInfo.CafeState.ID" id="rn_HierarchyInput_80_Label" class="rn_Label"> </label>
</div>
<select id="rn_HierarchyInput_80_Z.CafeInfo.CafeState.ID" name="Z.CafeInfo.CafeState.ID">
<option value="">State</option>
<option value="2" >AL</option>
<option value="3" >AR</option>
<option value="4" >AZ</option>
<option value="5" >CA</option>
<option value="6" >CO</option>
<option value="7" >CT</option>
<option value="8" >DC</option>
<option value="9" >DE</option>
<option value="10" >FL</option>
<option value="11" >GA</option>
<option value="12" >IA</option>
<option value="13" >ID</option>
<option value="14" >IL</option>
<option value="15" >IN</option>
<option value="16" >KS</option>
<option value="17" >KY</option>
<option value="18" >LA</option>
<option value="19" >MA</option>
<option value="20" >MD</option>
<option value="21" >ME</option>
<option value="22" >MI</option>
<option value="23" >MN</option>
<option value="24" >MO</option>
<option value="25" >MS</option>
<option value="26" >NC</option>
<option value="27" >ND</option>
<option value="28" >NE</option>
<option value="29" >NH</option>
<option value="30" >NJ</option>
<option value="31" >NM</option>
<option value="33" >NV</option>
<option value="34" >NY</option>
<option value="35" >OH</option>
<option value="36" >OK</option>
<option value="37" >ON</option>
<option value="38" >OR</option>
<option value="39" >PA</option>
<option value="40" >RI</option>
<option value="41" >SC</option>
<option value="42" >SD</option>
<option value="43" >TN</option>
<option value="44" >TX</option>
<option value="45" >UT</option>
<option value="46" >VA</option>
<option value="47" >VT</option>
<option value="48" >WA</option>
<option value="49" >WI</option>
<option value="50" >WV</option>
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</div>
<!-- City Field =================================================== -->
<div id="rn_HierarchyInput_81" class="rn_HierarchyInput rn_SelectionInput rn_Input rn_Hidden">
<div id="rn_HierarchyInput_81_LabelContainer" class="">
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</div>
<select id="rn_HierarchyInput_81_Z.CafeInfo.CafeCity.ID" name="Z.CafeInfo.CafeCity.ID">
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</select>
</div>
<!-- Location Field =================================================== -->
<div id="rn_HierarchyInput_82" class="rn_HierarchyInput rn_SelectionInput rn_Input rn_Hidden">
<div id="rn_HierarchyInput_82_LabelContainer" class="rn_Hidden">
<label for="rn_HierarchyInput_82_X.Incident.CustomFields.CafeInfo.AssociatedCafe.ID" id="rn_HierarchyInput_82_Label" class="rn_Label">Bakery-Cafe </label>
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<div class='pn_Divider'></div>
</div>
<div class='pn_Textarea'>
<div id="rn_TextInput_83" class="rn_TextInput rn_TextInput rn_Input">
<div id="rn_TextInput_83_LabelContainer">
<label for="rn_TextInput_83_Incident.Threads" id="rn_TextInput_83_Label" class="rn_Label">
We’d love to hear your feedback. Please share your comments, questions or suggestions here. <span class="rn_Required"> *</span><span class="rn_ScreenReaderOnly"> Required</span>
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<textarea id="rn_TextInput_83_Incident.Threads" class="rn_TextArea" rows="7" cols="60" name="Incident.Threads" maxlength='500' required placeholder="Your Feedback"></textarea>
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<label for="rn_SelectionInput_85_Incident.CustomFields.c.email_opt_in" id="rn_SelectionInput_85_Label" class="rn_Label">If you would like a response from our Customer Care Team, please make sure this box is checked. </label>
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<input type="checkbox" id="rn_SelectionInput_85_Incident.CustomFields.c.email_opt_in" name="Incident.CustomFields.c.email_opt_in" checked="checked" value="1"/>
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<div id="rn_FormSubmit_86" class="rn_FormSubmit">
<button type="submit" id="rn_FormSubmit_86_Button" disabled>
Send </button>
<span class="rn_Hidden">
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<div class="rn_MessageBox rn_InfoMessage">
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</form>
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</div>
<div class='pn_Divider'></div>
<div class="pn_Shortcuts">
<div>
<h1>
Quick Links
</h1>
<div>
<ul>
<li><a href='//www.panerabread.com'>Panera Bread</a></li>
<li><a href='//delivery.panerabread.com/#!/'>Order Online</a></li>
<li><a href='//cater.panerabread.com/'>Panera Catering</a></li>
</ul>
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</div>
</div>
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<div class='pn_AppStoresContainer'>
<div>
<h1>
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</h1>
<p>
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</p>
<div class='pn_AppStoresIconsContainer'>
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<img src='images/panera/download-on-the-app-store-badge.png'/>
</a>
<a href='//play.google.com/store/apps/details?id=com.panera.bread&hl=en'>
<img src='images/panera/google-play-badge.png'/>
</a>
</div>
</div>
</div>
<div class='pn_Divider'></div>
<div class='rn_PaneraHelp rn_Hidden' id='ContactChannels'>
<h1>
How Can We Help?
</h1>
<p>
Connect with a member of our Customer Care Team
</p>
<ul>
<li class='rn_Hidden' data-channel='chat'>
<a href='/app/chat/chat_launch'>
<img src='images/panera/chat.png'/>
<h5>
Live Chat
</h5>
<p>
Chat support is available Monday - Friday 7 AM - 6PM CDT. </p>
</a>
</li>
<li class='rn_Hidden' data-channel='email'>
<a href='/app/ask'>
<img src='images/panera/email.png'/>
<h5>
Email Us
</h5>
<p>
Our Customer Care Team will reply as soon as possible.
</p>
</a>
</li>
<li class='rn_Hidden' data-channel='call'>
<a href='/app/call'>
<img src='images/panera/phone.png'/>
<h5>Call Us</h5>
<p>
Phone support is available every day from 5 AM - 10 PM CDT </p>
</a>
</li>
</ul>
</div>
<div class='pn_SupportHours'>
<div id="rn_ChatHours_88" class="rn_ChatHours">
<div id="rn_ChatHours_88_HoursLabel" class="rn_HoursLabel">
Customer Care Support Hours </div>
<div id="rn_ChatHours_88_HoursBlock" class="rn_HoursBlock">
<div>
<span id="rn_ChatHours_88_HoursPrefix_0" class="rn_HoursPrefix">
Monday - Friday:
</span>
<span id="rn_ChatHours_88_Hours_0" class="rn_Hours">
07:00 AM - 06:00 PM CDT </span>
</div>
<div>
<span id="rn_ChatHours_88_HoursPrefix_1" class="rn_HoursPrefix">
Saturday - Sunday:
</span>
<span id="rn_ChatHours_88_Hours_1" class="rn_Hours">
Closed </span>
</div>
</div>
<div id="rn_ChatHours_88_CurrentTime" class="rn_CurrentTime">
It is currently Thursday, Aug. 10, 2017 11:24 AM CDT </div>
</div>
</div>
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RightNow.Interface.Constants =
{"API_VALIDATION_REGEX_EMAIL":"((([-_!#$%&'*+\/=?^~`{|}\\w]+([.][-_!#$%&'*+\/=?^~`{|}\\w]*)*)|(\"[^\"]+\"))@[0-9A-Za-z]+([\\-]+[0-9A-Za-z]+)*(\\.[0-9A-Za-z]+([\\-]+[0-9A-Za-z]+)*)+[;, ]*)+"};
YUI().use('event-base',function(Y){Y.on('domready',function(){var n=RightNow.namespace,W=RightNow.Widgets,c='createWidgetInstance';
n('RightNow.Widgets.SelectionInput').templates={"label":"<% if (label) { %> <label for=\"rn_<%= instanceID %>_<%= fieldName %>\" id=\"rn_<%= instanceID %>_Label\" class=\"rn_Label\"> <%= label %> <% if (required) { %> <span class=\"rn_Required\"> <%= requiredMarkLabel %><\/span><span class=\"rn_ScreenReaderOnly\"><%= requiredLabel %><\/span> <% } %> <% if (hint) { %> <span class=\"rn_ScreenReaderOnly\"><%= hint %><\/span> <% } %> <\/label> <% } %>","legend":"<% if (label) { %> <%= label %> <% if (required) { %> <span class=\"rn_Required\"><%= requiredMarkLabel %><\/span><span class=\"rn_ScreenReaderOnly\"><%= requiredLabel %><\/span> <% } %> <% } %>"};
n('RightNow.Widgets.DateInput').templates={"legend":"<% if (label) { %> <%= label %> <% if (required) { %> <span class=\"rn_Required\"><%= requiredMarkLabel %><\/span><span class=\"rn_ScreenReaderOnly\"><%= requiredLabel %><\/span> <% } %> <% } %>"};
n('Custom.Widgets.input.TextInput').requires=["anim"];
n('RightNow.Widgets.ProductCategoryInput').templates={"label":"<%= label %><% if(requiredLevel) { %><span class=\"rn_Required\"> <%= requiredMarkLabel %><\/span><span id=\"rn_<%= instanceID %>_ErrorLabel\" class=\"rn_ErrorLabel\"> <span class=\"rn_ScreenReaderOnly\"> <%= requiredLabel %> <\/span><\/span><% } %>"};
n('RightNow.Widgets.ProductCategoryInput').requires=["panel","overlay","gallery-treeview","RightNowTreeView","RightNowTreeViewDialog","RightNowTreeViewDropdown"];
n('Custom.Widgets.input.HierarchyInput').templates={"label":"<% if (label) { %> <label for=\"rn_<%= instanceID %>_<%= fieldName %>\" id=\"rn_<%= instanceID %>_Label\" class=\"rn_Label\"> <%= label %> <% if (required) { %> <span class=\"rn_Required\"> <%= requiredMarkLabel %><\/span><span class=\"rn_ScreenReaderOnly\"><%= requiredLabel %><\/span> <% } %> <% if (hint) { %> <span class=\"rn_ScreenReaderOnly\"><%= hint %><\/span> <% } %> <\/label> <% } %>","legend":"<% if (label) { %> <%= label %> <% if (required) { %> <span class=\"rn_Required\"><%= requiredMarkLabel %><\/span><span class=\"rn_ScreenReaderOnly\"><%= requiredLabel %><\/span> <% } %> <% } %>"};
n('RightNow.Widgets.FormSubmit').requires=["anim-scroll"];
n('RightNow.Widgets.SmartAssistantDialog').templates={"answerContent":"<span id=\"<%= spanID %>\" class=\"rn_Answer rn_AnswerDetail rn_Hidden\"> <% if(question) { %> <span class=\"rn_AnswerSummary\"><%= question %><\/span> <% } %> <span class=\"rn_AnswerSolution\"><%= contents %><\/span><\/span>","answerLink":"<a target=\"_blank\" href=\"<%= href %>\" onclick='RightNow.ActionCapture.record(\"smartAssistantResult\", \"view\", <%= answerID %>);'> <%= text %><\/a>","discussionContent":"<div id=\"<%= spanID %>\" class=\"rn_Answer rn_AnswerDetail rn_Hidden\"> <% if(discussion) { %> <span class=\"rn_UserAvatar rn_UserAvatarLeft rn_SocialQuestionAuthor\"> <%= getDefaultAvatar({'avatarUrl': avatarURL, 'size': 48, 'displayName': displayName, 'isActive': !(userStatus in js.statuses.suspended), 'className': 'rn_Medium'})%> <span class=\"rn_DisplayName\" itemprop=\"name\"><%= displayName %><\/span> <\/span> <span class=\"rn_OpenDiscussionLinkText\"> <a href=\"<%= '\/app\/' + RightNow.Interface.getConfig('CP_SOCIAL_QUESTIONS_DETAIL_URL') + '\/qid\/' + objectID + sessionParam %>\"> <%= RightNow.Interface.getMessage('OPEN_THIS_ENTIRE_DISCUSSION_NEW_WINDOW_MSG') %> <\/a> <\/span> <span class=\"rn_AnswerDiscussionSummary\"><%= discussion %><\/span> <% } %> <% if(bestAnswerExists) { %> <ul class=\"rn_Solution_List\"> <% for(var objKey in solution) { %> <% if(solution[objKey].SocialQuestionComment.Body) { %> <li class=\"rn_BestAnswerImage\"> <span class=\"rn_UserAvatar rn_UserAvatarLeft rn_SocialQuestionCommentAuthor\"> <%= getDefaultAvatar({'avatarUrl': solution[objKey].SocialQuestionComment.CreatedBySocialUser.AvatarURL, 'size': 48, 'displayName': solution[objKey].SocialQuestionComment.CreatedBySocialUser.DisplayName, 'isActive': !(solution[objKey].SocialQuestionComment.CreatedBySocialUser.StatusWithType.Status.ID in js.statuses.suspended), 'className': 'rn_Medium'})%> <span class=\"rn_DisplayName\" itemprop=\"name\"><%= solution[objKey].SocialQuestionComment.CreatedBySocialUser.DisplayName %><\/span> <\/span> <span class=\"rn_DiscussionSolution\"><%= solution[objKey].SocialQuestionComment.Body %><\/span> <\/li> <% } } %> <\/ul> <% } %> <span class=\"rn_OpenDiscussionLinkText\"> <a href=\"<%= '\/app\/' + RightNow.Interface.getConfig('CP_SOCIAL_QUESTIONS_DETAIL_URL') + '\/qid\/' + objectID + sessionParam %>\"> <%= RightNow.Interface.getMessage('OPEN_THIS_ENTIRE_DISCUSSION_NEW_WINDOW_MSG') %> <\/a> <\/span><\/div>","displayResults":"<% var promptDisplayed = false, accessKeyNumber = 0; %><% for(var i = 0, suggestion; i < suggestions.length; i++) { suggestion = suggestions[i]; if(!promptDisplayed && (suggestion.type === 'AnswerSummary' || suggestion.type === 'QuestionSummary')) { promptDisplayed = true; %> <div class=\"rn_Prompt\"><%= attrs.label_prompt %> <% if(attrs.accesskeys_enabled && attrs.label_accesskey && attrs.display_inline) { %> <div class=\"rn_AccesskeyPrompt\"><%= accessKeyPrompt %><\/div> <% } %> <\/div> <% } if(suggestion.type === 'AnswerSummary') { %> <ul class=\"rn_List <%= (attrs.display_inline) ? 'rn_InlineAnswers' : '' %>\"> <% for(var j = 0; j < suggestion.list.length; j++) { var answerID = suggestion.list[j].ID ? suggestion.list[j].ID : j; if(attrs.display_inline) { %> <li> <% if(attrs.accesskeys_enabled) { %> <a href=\"javascript:void(0)\" accesskey=\"<%=++accessKeyNumber%>\" data-id=\"<%=answerID%>\" data-url=\"<%=suggestion.list[j].url%>\" class=\"rn_InlineAnswerLink rn_ExpandAnswer\" id=\"<%=baseDomID + '_Answer' + answerID %>\" data-object-type=\"answer\"> <% } else { %> <a href=\"javascript:void(0)\" data-id=\"<%=answerID%>\" data-url=\"<%=suggestion.list[j].url%>\" class=\"rn_InlineAnswerLink rn_ExpandAnswer\" id=\"<%=baseDomID + '_Answer' + answerID %>\" data-object-type=\"answer\"> <% } %> <span class=\"rn_KBAnswerImage\"><\/span> <%= suggestion.list[j].title %> <span class=\"rn_ScreenReaderOnly\" role=\"alert\" id=\"<%=baseDomID + '_Answer' + answerID + '_Alternative'%>\"> <%= attrs.label_collapsed %> <\/span> <\/a> <\/li> <% } else { %> <li> <a target=\"_blank\" href=\"<%= '\/app\/' + answerUrl + '\/a_id\/' + answerID + sessionParam %>\" onclick='RightNow.ActionCapture.record(\"smartAssistantResult\", \"view\", <%=answerID%>);'><%=suggestion.list[j].title%><\/a> <\/li> <% } %> <% } %> <\/ul> <% } else if(suggestion.type === 'Answer') { %> <div class=\"rn_Answer\"> <% if(suggestion.FileAttachments === null || suggestion.FileAttachments === undefined) { %> <div class=\"rn_Summary\"><%=suggestion.title%><\/div> <div class=\"rn_Solution\"><%=suggestion.content%><\/div> <% } else { %> <a target=\"_blank\" href=\"<%= '\/app\/' + answerUrl + '\/a_id\/' + suggestion.ID + sessionParam %>\" onclick='RightNow.ActionCapture.record(\"smartAssistantResult\", \"view\", <%=suggestion.ID%>);'><%=suggestion.title%><\/a> <% } %> <\/div> <% } else if(suggestion.type === 'QuestionSummary') { %> <ul class=\"rn_List <%= (attrs.display_inline) ? 'rn_InlineAnswers' : '' %>\"> <% for(var j = 0; j < suggestion.list.length; j++) { %> <% if(attrs.display_inline) { %> <li> <% if(attrs.accesskeys_enabled) { %> <a href=\"javascript:void(0)\" accesskey=\"<%=++accessKeyNumber%>\" data-id=\"<%=suggestion.list[j].ID%>\" data-object-type=\"discussion\" class=\"rn_InlineAnswerLink rn_ExpandAnswer\" id=\"<%=baseDomID + '_Answer' + suggestion.list[j].ID %>\"> <% } else { %> <a href=\"javascript:void(0)\" data-id=\"<%=suggestion.list[j].ID%>\" data-object-type=\"discussion\" class=\"rn_InlineAnswerLink rn_ExpandAnswer\" id=\"<%=baseDomID + '_Answer' + suggestion.list[j].ID %>\"> <% } %> <span class=\"rn_SocialDiscussionImage\"><\/span> <%= suggestion.list[j].title %> <span class=\"rn_ScreenReaderOnly\" role=\"alert\" id=\"<%=baseDomID + '_Answer' + suggestion.list[j].ID + '_Alternative'%>\"> <%= attrs.label_collapsed %> <\/span> <\/a> <\/li> <% } else { %> <li> <a target=\"_blank\" href=\"<%= '\/app\/' + RightNow.Interface.getConfig('CP_SOCIAL_QUESTIONS_DETAIL_URL') + '\/qid\/' + suggestion.list[j].ID + sessionParam %>\" onclick='RightNow.ActionCapture.record(\"smartAssistantResult\", \"view\", <%=suggestion.list[j].ID%>);'> <%=suggestion.list[j].title%> <\/a> <\/li> <% } %> <% } %> <\/ul> <% } else { %> <div class=\"rn_Response\"><%=suggestion.content%><\/div> <% } %><% } %>"};
W.setInitialWidgetCount(48);
W[c]({"i":{"c":"KeywordText","n":"KeywordText","w":3},"a":{"report_id":"176","source_id":"","label_text":"Search by Keyword","initial_focus":true,"label_placeholder":"Search for answers","rn_container_id":"rnc_1","rn_container":"true"},"j":{"initialValue":"","rnSearchType":"keyword","searchName":"keyword"}},'W10=','fU1j3Zgp9a1p86EuBbz_AaeqZGnqQ7RxMJ~Xer4~h4W65pSv06cmWvo2_kjX5p47pRXx6Qdv477FY5GhLP_Gek62XYsI4E9RwO9JVQEI4~pTqclvdGtEhHySf01m3Fw4k~j95v2yBfujY!',1502382271,'KeywordText_3','standard/search/KeywordText','RightNow.Widgets.KeywordText','3');
W[c]({"i":{"c":"SearchButton","n":"SearchButton","w":4},"a":{"report_id":"176","source_id":"","label_button":"Search","report_page_url":"\/app\/answers\/list","icon_path":"","icon_alt_text":"Search","target":"_self","popup_window":false,"popup_window_width_percent":30,"popup_window_height_percent":42,"force_page_flip":true,"rn_container_id":"rnc_1","rn_container":"true"},"j":[]},'W10=','fUgt~d_2WUwDP8aSPH0P4nA52ENncmbkrywv3oV1uuujCl5f0iuSQefn8Orvee7GksSj6wZibT3oQOK05oP~Lq2lLZkhLFiYUXZyhLmzsLkbEM_CQBm6uHLZ6Z_M54CS769kyt8kpeZyE!',1502382271,'SearchButton_4','standard/search/SearchButton','RightNow.Widgets.SearchButton','4');
W[c]({"i":{"c":"SelectionInput","n":"SelectionInput","w":7},"a":{"label_input":"Escalated Gift Card - Devalue","label_required":"%s is required","name":"Incident.CustomFields.c.escalated_gift_card_devalue","required":false,"hint":"","always_show_hint":false,"initial_focus":false,"validate_on_blur":false,"default_value":"","allow_external_login_updates":false,"hide_hint":false,"display_as_checkbox":false,"hide_on_load":false,"read_only":false,"sub_id":"selection","table":"Incident","always_show_mask":"false"},"j":{"type":"Boolean","name":"Incident.CustomFields.c.escalated_gift_card_devalue","custom":true,"constraints":[],"mask":null,"readOnly":false}},'W10=','fUvAcE7C7Qp~i7qFvALf9uclLhz1WmXzijgO5boCbzqMoCsxK_kJcYizt_EvFVihxjIGEkK58G_AjyGvJvbwXTK0vvPqAdLPGef38m2ogQIB~SV6bHgyO65I5PXC9WS5WkK1YOLgK00eg!',1502382271,'SelectionInput_7','standard/input/SelectionInput','RightNow.Widgets.SelectionInput','7');
W[c]({"i":{"c":"SelectionInput","n":"SelectionInput","w":9},"a":{"label_input":"Escalated - Catering Sales","label_required":"%s is required","name":"Incident.CustomFields.c.escalated_catering_sales","required":false,"hint":"","always_show_hint":false,"initial_focus":false,"validate_on_blur":false,"default_value":"","allow_external_login_updates":false,"hide_hint":false,"display_as_checkbox":false,"hide_on_load":false,"read_only":false,"sub_id":"selection","table":"Incident","always_show_mask":"false"},"j":{"type":"Boolean","name":"Incident.CustomFields.c.escalated_catering_sales","custom":true,"constraints":[],"mask":null,"readOnly":false}},'W10=','fUCx1hfqLQBkBVLsN44zjULw~KsHgvx1BlvuLfaSpJj26DJbw8hr2n1XzXapWBXSTyfqSDku16lwPpE4F1Geh6z5atQoAidTZFewgR7~WZ0rMVDGDpf8RnlmGo8Xis65KJQ0~mFAxI20Y!',1502382271,'SelectionInput_9','standard/input/SelectionInput','RightNow.Widgets.SelectionInput','9');
W[c]({"i":{"c":"DateInput","n":"DateInput","w":11},"a":{"label_input":"PA Team Escalated Team Assign","label_error":"","label_required":"%s is required","name":"Incident.CustomFields.c.pa_team_escalated_team_assign","required":false,"hint":"","always_show_hint":false,"initial_focus":false,"validate_on_blur":false,"default_value":"","allow_external_login_updates":false,"hide_hint":false,"min_year":1970,"max_year":2017,"hide_on_load":false,"read_only":false,"sub_id":"date","table":"Incident","always_show_mask":"false"},"j":{"type":"DateTime","name":"Incident.CustomFields.c.pa_team_escalated_team_assign","custom":true,"constraints":{"minValue":86400,"maxValue":2147385599},"mask":null,"readOnly":false,"min":{"year":1970,"month":1,"day":3,"hour":0,"time":"00:00:00","date":"1970-1-3 00:00:00"},"min_val":"1\/3\/1970 00:00:00"}},'W10=','fUJNcxbkia3pYKeNrsZfwmrJuh_62kTQBL4hbhM2zqEW4reeHdl~fJl8UW9DEAX25eESMyOUNQTmztceHnR_katMZOOZKZrrCvKGuinPT~FJx7OiqzF22ZCY1PoX3S3IwGc_ZLzelzxpg!',1502382271,'DateInput_11','standard/input/DateInput','RightNow.Widgets.DateInput','11');
W[c]({"i":{"c":"DateInput","n":"DateInput","w":13},"a":{"label_input":"PA Team Initial Tracking","label_error":"","label_required":"%s is required","name":"Incident.CustomFields.c.pa_team_initial_tracking","required":false,"hint":"","always_show_hint":false,"initial_focus":false,"validate_on_blur":false,"default_value":"","allow_external_login_updates":false,"hide_hint":false,"min_year":1970,"max_year":2017,"hide_on_load":false,"read_only":false,"sub_id":"date","table":"Incident","always_show_mask":"false"},"j":{"type":"DateTime","name":"Incident.CustomFields.c.pa_team_initial_tracking","custom":true,"constraints":{"minValue":86400,"maxValue":2147385599},"mask":null,"readOnly":false,"min":{"year":1970,"month":1,"day":3,"hour":0,"time":"00:00:00","date":"1970-1-3 00:00:00"},"min_val":"1\/3\/1970 00:00:00"}},'W10=','fUazXA2Jlv5FaofCF9HiwNLZNWV_q6f7D49GqdMMdX3DT97IumJY9gFa1E4SAMFsQW3f_ar6yyPWoDXxf9TXUHpa~755HrhLjlvKKP0w_M0QMAABn24BGQeBbFx2~EgdhDLvRPaHpqYGg!',1502382271,'DateInput_13','standard/input/DateInput','RightNow.Widgets.DateInput','13');
W[c]({"i":{"c":"DateInput","n":"DateInput","w":15},"a":{"label_input":"PA Team Analyst Assignment","label_error":"","label_required":"%s is required","name":"Incident.CustomFields.c.pa_team_analyst_assignment","required":false,"hint":"","always_show_hint":false,"initial_focus":false,"validate_on_blur":false,"default_value":"","allow_external_login_updates":false,"hide_hint":false,"min_year":1970,"max_year":2017,"hide_on_load":false,"read_only":false,"sub_id":"date","table":"Incident","always_show_mask":"false"},"j":{"type":"DateTime","name":"Incident.CustomFields.c.pa_team_analyst_assignment","custom":true,"constraints":{"minValue":86400,"maxValue":2147385599},"mask":null,"readOnly":false,"min":{"year":1970,"month":1,"day":3,"hour":0,"time":"00:00:00","date":"1970-1-3 00:00:00"},"min_val":"1\/3\/1970 00:00:00"}},'W10=','fUQr_7tqdSuN3Yk5FmPHW4hSynnGBayqFwqmhAnCa720GZk0~QZvq5noaQ~_lr7WIGOCpWo79j2MZysr7gUiGyav2rdgHrAZ_WiEhDMNL180KE9UqHDG4~m5~tsY5az1MO0DDMIhCku~M!',1502382271,'DateInput_15','standard/input/DateInput','RightNow.Widgets.DateInput','15');
W[c]({"i":{"c":"TextInput","n":"TextInput","w":17},"a":{"placeholder_text":" ","label_input":"PA External Reference","label_error":"","label_required":"%s is required","name":"Incident.CustomFields.c.pa_external_reference_nbr","required":false,"hint":"","always_show_hint":false,"initial_focus":false,"validate_on_blur":false,"always_show_mask":false,"default_value":"","allow_external_login_updates":false,"hide_hint":false,"existing_contact_check_ajax":"\/ci\/ajaxRequest\/checkForExistingContact","require_validation":false,"maximum_length":0,"minimum_length":0,"maximum_value":null,"minimum_value":null,"label_validation_incorrect":"Validation for the field '%s' failed","label_validation":"Re-enter a value for the field '%s'","textarea":false,"hide_on_load":false,"read_only":false,"sub_id":"text","table":"Incident"},"j":{"type":"String","name":"Incident.CustomFields.c.pa_external_reference_nbr","custom":true,"constraints":{"maxLength":20},"mask":null,"readOnly":false,"contactToken":"ZlVuTGl1QTFkUUJBWGlIamtRYVF5Vl9mOG5fck4zMVMyZGNuU0hVTnVyNG1qa2xOY0VxQzRtZ2YwRERHa05IWWMyTk9lQ3h2Y2RUNkw0ejFJdE9BTU54ODRhb0o1YWJjN2NvWVlyWWwwUkJZRkxzX01SRHh1WmlPOGIyamJaZTJLeVBDNzNrc0NwMzB3IQ!!"}},'W10=','fU5aQxYO3DkKCzcT9icnPP89SRNoOZ98YqPD_7uni0qSrcHyPJF~0PJAUQeaE3lP2rapnxwlBW5FiKk~mn0BorJsLtpUYWUGfv05pFOHCjRbi4Qlwv0u0KD589EAiYQiQDRMB44q8bavY!',1502382271,'TextInput_17','custom/input/TextInput','Custom.Widgets.input.TextInput','17');
W[c]({"i":{"c":"SelectionInput","n":"SelectionInput","w":19},"a":{"label_input":"PA Tracking Monitor Control","label_required":"%s is required","name":"Incident.CustomFields.c.pa_tracking_monitor_control","required":false,"hint":"","always_show_hint":false,"initial_focus":false,"validate_on_blur":false,"default_value":"","allow_external_login_updates":false,"hide_hint":false,"display_as_checkbox":false,"hide_on_load":false,"read_only":false,"sub_id":"selection","table":"Incident","always_show_mask":"false"},"j":{"type":"Boolean","name":"Incident.CustomFields.c.pa_tracking_monitor_control","custom":true,"constraints":[],"mask":null,"readOnly":false}},'W10=','fUC_reMJLxwrkSn4jNVWGhOoeSgouofNOpZYoGCZZlWsjFjaz~8mX6rWmNnetsLzOpm_BCyAulm4kR~T7E9hwDG5lhdEWICERxZLWNdDEeJUfQFnX6Xk7X2~DqxyqMPqk~oipvC3vzBhI!',1502382271,'SelectionInput_19','standard/input/SelectionInput','RightNow.Widgets.SelectionInput','19');
W[c]({"i":{"c":"SelectionInput","n":"SelectionInput","w":21},"a":{"label_input":"Gift Card Agent","label_required":"%s is required","name":"Incident.CustomFields.c.gift_card_super_agent","required":false,"hint":"","always_show_hint":false,"initial_focus":false,"validate_on_blur":false,"default_value":"","allow_external_login_updates":false,"hide_hint":false,"display_as_checkbox":false,"hide_on_load":false,"read_only":false,"sub_id":"selection","table":"Incident","always_show_mask":"false"},"j":{"type":"Boolean","name":"Incident.CustomFields.c.gift_card_super_agent","custom":true,"constraints":[],"mask":null,"readOnly":false}},'W10=','fUXWMfIXtZjsJXwWSJQBm5kasd4ejEdh~dlmp4Yll2RntczJ0e_IM~XQr85eeNAajVBCr0kVgCY8bC~RIE7IMENGRti3Exdh7Rfgnn1g6IS0vWgav3WJKi~8C~ZDqjLAIyJhijmV_HEgA!',1502382271,'SelectionInput_21','standard/input/SelectionInput','RightNow.Widgets.SelectionInput','21');
W[c]({"i":{"c":"SelectionInput","n":"SelectionInput","w":23},"a":{"label_input":"Gift Card Request Type","label_required":"%s is required","name":"Incident.CustomFields.c.gift_card_request_type","required":false,"hint":"","always_show_hint":false,"initial_focus":false,"validate_on_blur":false,"default_value":"","allow_external_login_updates":false,"hide_hint":false,"display_as_checkbox":false,"hide_on_load":false,"read_only":false,"sub_id":"selection","table":"Incident","always_show_mask":"false"},"j":{"type":"NamedIDLabel","name":"Incident.CustomFields.c.gift_card_request_type","custom":true,"constraints":[],"mask":null,"readOnly":false}},'W10=','fUB95_k~58Hcy9Gd9bEMgbj0ECFxFEryx7n4bQ6pVNsu6oqonlhCMxtdCFYWSX8JHEB0pqpmm7TzUGeKq4zwRC1jFjBIggLh_DX2nIrnebsOk3kudw6kmPyMHlYPeEshxd3jjyedFEZ~s!',1502382271,'SelectionInput_23','standard/input/SelectionInput','RightNow.Widgets.SelectionInput','23');
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