<fieldset>
    <legend>{REPORT_LEGEND}</legend>
    <table class="formFields" cellspacing="0" width="100%">
        <tr {RECIPIENT_ERROR}>
            <td class="name"><label for="fid-recipient">{RECIPIENT_TEXT}</label></td>
            <td>
                {RECIPIENT_SELECT}
                <input type="text" name="email" id="fid-email" value="{EMAIL_VALUE}" size="15" maxlength="254" {EMAIL_DISABLED}>
            </td>
        </tr>
        <!-- BEGIN DYNAMIC BLOCK: report_on_dropdown -->
        <tr {SELECT_ERROR}>
            <td class="name"><label for="fid-select">{SELECT_TEXT}</label></td>
            <td>
                {SELECT_SELECT}
            </td>
        </tr>
        <!-- END DYNAMIC BLOCK: report_on_dropdown -->
        <tr>
            <td class="name"><label for="fid-auto">{AUTO_TEXT}</label></td>
            <td>
                {AUTO_SELECT}
            </td>
        </tr>
    </table>
</fieldset>

<input type="hidden" name="id" value="{REPORT_AUTO_ID}">
