Invite a Supplier to the DSMP : Disney Purchase to Pay Customer Service Inquiry

Sign up for your Purchase to Pay account

Requester Email

Subject

Area of Concern

<div class="control-group ticket_section">
                     <label class=" required control-label cf_type_dsmp_registration_and_maintenan_2211666-label " for="helpdesk_ticket_cf_type_dsmp_registration_and_maintenan_2211666">Type</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_type_dsmp_registration_and_maintenan_2211666]" id="helpdesk_ticket_custom_field_cf_type_dsmp_registration_and_maintenan_2211666"><option value="">...</option>
<option data-id="73000329156" value="Alternate Payee (Factor/Agency)">Alternate Payee (Factor/Agency)</option>
<option data-id="73001078543" value="Archive Vendor Request">Archive Vendor Request</option>
<option data-id="73001078544" value="Company Code Extension Issue">Company Code Extension Issue</option>
<option data-id="73001078545" value="Coupa Supplier Portal Invite">Coupa Supplier Portal Invite</option>
<option data-id="73000329158" value="DSMP Access for Existing Supplier">DSMP Access for Existing Supplier</option>
<option data-id="73000329155" value="Status of New Supplier Set-Up">Status of New Supplier Set-Up</option>
<option data-id="73000329157" value="Vendor Record Maintenance Issue">Vendor Record Maintenance Issue</option></select>
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_vendorsupplier_number_2211666-label " for="helpdesk_ticket_cf_vendorsupplier_number_2211666">Vendor/Supplier Number</label>
            <div class="controls   ">
              <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendorsupplier_number_2211666]" id="helpdesk_ticket_custom_field_cf_vendorsupplier_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_vendor_supplier_name_2211666-label " for="helpdesk_ticket_cf_vendor_supplier_name_2211666">Vendor/Supplier Name</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendor_supplier_name_2211666]" id="helpdesk_ticket_custom_field_cf_vendor_supplier_name_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_dba_name_2211666-label " for="helpdesk_ticket_cf_dba_name_2211666">DBA Name</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_dba_name_2211666]" id="helpdesk_ticket_custom_field_cf_dba_name_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_einfeinss_tax_id_number_2211666-label " for="helpdesk_ticket_cf_einfeinss_tax_id_number_2211666">EIN/FEIN/SS/ - Tax ID Number</label>
            <div class="controls   ">
              <input class=" required number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_einfeinss_tax_id_number_2211666]" id="helpdesk_ticket_custom_field_cf_einfeinss_tax_id_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_vatincountry_tax_number_2211666-label " for="helpdesk_ticket_cf_vatincountry_tax_number_2211666"> VAT/In-country tax Number </label>
            <div class="controls   ">
              <input class=" required number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vatincountry_tax_number_2211666]" id="helpdesk_ticket_custom_field_cf_vatincountry_tax_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_alternate_payee_vendor_number_2211666-label " for="helpdesk_ticket_cf_alternate_payee_vendor_number_2211666">Alternate Payee Vendor Number</label>
            <div class="controls   ">
              <input class=" required number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_alternate_payee_vendor_number_2211666]" id="helpdesk_ticket_custom_field_cf_alternate_payee_vendor_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_alternate_payee_vendor_name_2211666-label " for="helpdesk_ticket_cf_alternate_payee_vendor_name_2211666">Alternate Payee Vendor Name</label>
            <div class="controls   ">
              <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_alternate_payee_vendor_name_2211666]" id="helpdesk_ticket_custom_field_cf_alternate_payee_vendor_name_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_vendorsupplier_email_2211666-label " for="helpdesk_ticket_cf_vendorsupplier_email_2211666">Vendor/Supplier Email</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendorsupplier_email_2211666]" id="helpdesk_ticket_custom_field_cf_vendorsupplier_email_2211666" />
            </div> 
                  </div>

<div class="control-group ticket_section">
                     <label class=" required control-label cf_type_of_invoice_2211666-label " for="helpdesk_ticket_cf_type_of_invoice_2211666">Type</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_type_of_invoice_2211666]" id="helpdesk_ticket_custom_field_cf_type_of_invoice_2211666"><option value="">...</option>
<option data-id="73000329484" value="Invoice Status">Invoice Status</option>
<option data-id="73000329485" value="B, M, R Blocks / GRIR / My Actions Working File">B, M, R Blocks / GRIR / My Actions Working File</option>
<option data-id="73000860320" value="C Blocks/Foreign (USA Legal Entities)">C Blocks/Foreign (USA Legal Entities)</option>
<option data-id="73000860321" value="X Blocks">X Blocks</option>
<option data-id="73001080025" value="Z Blocks">Z Blocks</option></select>
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_vendorsupplier_number_2211666-label " for="helpdesk_ticket_cf_vendorsupplier_number_2211666">Vendor/Supplier Number</label>
            <div class="controls   ">
              <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendorsupplier_number_2211666]" id="helpdesk_ticket_custom_field_cf_vendorsupplier_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_vendor_supplier_name_2211666-label " for="helpdesk_ticket_cf_vendor_supplier_name_2211666">Vendor/Supplier Name</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendor_supplier_name_2211666]" id="helpdesk_ticket_custom_field_cf_vendor_supplier_name_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_invoice_number_2211666-label " for="helpdesk_ticket_cf_invoice_number_2211666">Invoice Number</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_invoice_number_2211666]" id="helpdesk_ticket_custom_field_cf_invoice_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_invoice_date_2211666-label " for="helpdesk_ticket_cf_invoice_date_2211666">Invoice Date</label>
            <div class="controls  support-date-field ">
              <input type="text" name="helpdesk_ticket[custom_field][cf_invoice_date_2211666]" id="helpdesk_ticket_custom_field_cf_invoice_date_2211666" class="  date section_field datepicker_popover" readonly="readonly" data-show-image="true" data-date-format="M d, yy" placeholder="" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_invoice_amount_2211666-label " for="helpdesk_ticket_cf_invoice_amount_2211666">Invoice Amount</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_invoice_amount_2211666]" id="helpdesk_ticket_custom_field_cf_invoice_amount_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_zap_request_number_2211666-label " for="helpdesk_ticket_cf_zap_request_number_2211666">ZAP/ZGUFI Request Number</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_zap_request_number_2211666]" id="helpdesk_ticket_custom_field_cf_zap_request_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_purchase_order_number_2211666-label " for="helpdesk_ticket_cf_purchase_order_number_2211666">Purchase Order Number</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_purchase_order_number_2211666]" id="helpdesk_ticket_custom_field_cf_purchase_order_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_vendorsupplier_email_2211666-label " for="helpdesk_ticket_cf_vendorsupplier_email_2211666">Vendor/Supplier Email</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendorsupplier_email_2211666]" id="helpdesk_ticket_custom_field_cf_vendorsupplier_email_2211666" />
            </div> 
                  </div>

<div class="control-group ticket_section">
                     <label class=" required control-label cf_payment_type_2211666-label " for="helpdesk_ticket_cf_payment_type_2211666">Type</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_payment_type_2211666]" id="helpdesk_ticket_custom_field_cf_payment_type_2211666"><option value="">...</option>
<option data-id="73000329493" value="Accelerated Cash Discount Issue (USA)">Accelerated Cash Discount Issue (USA)</option>
<option data-id="73000329488" value="Direct Debit Payments (Europe Only)">Direct Debit Payments (Europe Only)</option>
<option data-id="73000329489" value="Multiple Bank Account Selection">Multiple Bank Account Selection</option>
<option data-id="73000807849" value="Overnight Slip (USA Only)">Overnight Slip (USA Only)</option>
<option data-id="73000329490" value="Payment Amount Incorrect">Payment Amount Incorrect</option>
<option data-id="73000329491" value="Payment Not Received">Payment Not Received</option>
<option data-id="73000329492" value="Refunds/Credits">Refunds/Credits</option>
<option data-id="73000329487" value="Remittance Inquiry">Remittance Inquiry</option>
<option data-id="73000329494" value="Request Proof of Electronic Payment">Request Proof of Electronic Payment</option></select>
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_vendorsupplier_number_2211666-label " for="helpdesk_ticket_cf_vendorsupplier_number_2211666">Vendor/Supplier Number</label>
            <div class="controls   ">
              <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendorsupplier_number_2211666]" id="helpdesk_ticket_custom_field_cf_vendorsupplier_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_vendor_supplier_name_2211666-label " for="helpdesk_ticket_cf_vendor_supplier_name_2211666">Vendor/Supplier Name</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendor_supplier_name_2211666]" id="helpdesk_ticket_custom_field_cf_vendor_supplier_name_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_invoice_number_2211666-label " for="helpdesk_ticket_cf_invoice_number_2211666">Invoice Number</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_invoice_number_2211666]" id="helpdesk_ticket_custom_field_cf_invoice_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_invoice_date_2211666-label " for="helpdesk_ticket_cf_invoice_date_2211666">Invoice Date</label>
            <div class="controls  support-date-field ">
              <input type="text" name="helpdesk_ticket[custom_field][cf_invoice_date_2211666]" id="helpdesk_ticket_custom_field_cf_invoice_date_2211666" class="  date section_field datepicker_popover" readonly="readonly" data-show-image="true" data-date-format="M d, yy" placeholder="" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_invoice_amount_2211666-label " for="helpdesk_ticket_cf_invoice_amount_2211666">Invoice Amount</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_invoice_amount_2211666]" id="helpdesk_ticket_custom_field_cf_invoice_amount_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_zap_request_number_2211666-label " for="helpdesk_ticket_cf_zap_request_number_2211666">ZAP/ZGUFI Request Number</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_zap_request_number_2211666]" id="helpdesk_ticket_custom_field_cf_zap_request_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_purchase_order_number_2211666-label " for="helpdesk_ticket_cf_purchase_order_number_2211666">Purchase Order Number</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_purchase_order_number_2211666]" id="helpdesk_ticket_custom_field_cf_purchase_order_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_purchase_requisition_2211666-label " for="helpdesk_ticket_cf_purchase_requisition_2211666">Purchase Requisition</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_purchase_requisition_2211666]" id="helpdesk_ticket_custom_field_cf_purchase_requisition_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_vendorsupplier_email_2211666-label " for="helpdesk_ticket_cf_vendorsupplier_email_2211666">Vendor/Supplier Email</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendorsupplier_email_2211666]" id="helpdesk_ticket_custom_field_cf_vendorsupplier_email_2211666" />
            </div> 
                  </div>

<div class="control-group ticket_section">
                     <label class=" required control-label cf_type_of_change_purchase_order_2211666-label " for="helpdesk_ticket_cf_type_of_change_purchase_order_2211666">Type</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_type_of_change_purchase_order_2211666]" id="helpdesk_ticket_custom_field_cf_type_of_change_purchase_order_2211666"><option value="">...</option>
<option data-id="73000329172" value="Change Purchase Order">Change Purchase Order</option>
<option data-id="73000978113" value="Close Full Purchase Order (Visit FS HELP- Submit Purchase Orders for Closure)">Close Full Purchase Order (Visit FS HELP- Submit Purchase Orders for Closure)</option>
<option data-id="73000329173" value="Close Purchase Order Individual Line">Close Purchase Order Individual Line</option>
<option data-id="73001078541" value="Contracts">Contracts</option>
<option data-id="73001078542" value="Payment Terms">Payment Terms</option>
<option data-id="73000329174" value="Process Purchase Requisition">Process Purchase Requisition</option>
<option data-id="73000329175" value="Send/Re-Send Purchase Order">Send/Re-Send Purchase Order</option>
<option data-id="73000329176" value="General Inquiry">General Inquiry</option></select>
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_vendorsupplier_number_2211666-label " for="helpdesk_ticket_cf_vendorsupplier_number_2211666">Vendor/Supplier Number</label>
            <div class="controls   ">
              <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendorsupplier_number_2211666]" id="helpdesk_ticket_custom_field_cf_vendorsupplier_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_vendor_supplier_name_2211666-label " for="helpdesk_ticket_cf_vendor_supplier_name_2211666">Vendor/Supplier Name</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendor_supplier_name_2211666]" id="helpdesk_ticket_custom_field_cf_vendor_supplier_name_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_purchase_order_number_2211666-label " for="helpdesk_ticket_cf_purchase_order_number_2211666">Purchase Order Number</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_purchase_order_number_2211666]" id="helpdesk_ticket_custom_field_cf_purchase_order_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_purchase_requisition_2211666-label " for="helpdesk_ticket_cf_purchase_requisition_2211666">Purchase Requisition</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_purchase_requisition_2211666]" id="helpdesk_ticket_custom_field_cf_purchase_requisition_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_vendorsupplier_email_2211666-label " for="helpdesk_ticket_cf_vendorsupplier_email_2211666">Vendor/Supplier Email</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendorsupplier_email_2211666]" id="helpdesk_ticket_custom_field_cf_vendorsupplier_email_2211666" />
            </div> 
                  </div>

<div class="control-group ticket_section">
                     <label class=" required control-label cf_type_tax_and_audit_compliance_2211666-label " for="helpdesk_ticket_cf_type_tax_and_audit_compliance_2211666">Type</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_type_tax_and_audit_compliance_2211666]" id="helpdesk_ticket_custom_field_cf_type_tax_and_audit_compliance_2211666"><option value="">...</option>
<option data-id="73000329159" value="C Block (Non PO - USA Legal Entities)">C Block (Non PO - USA Legal Entities)</option>
<option data-id="73000329160" value="California State Tax (USA)">California State Tax (USA)</option>
<option data-id="73000329161" value="IRS B-Notices (USA)">IRS B-Notices (USA)</option>
<option data-id="73000329162" value="Levies/Liens (All Regions)">Levies/Liens (All Regions)</option>
<option data-id="73000329163" value="Taxes (All Regions)">Taxes (All Regions)</option>
<option data-id="73000329164" value="1042 Foreign Audit (USA)">1042 Foreign Audit (USA)</option>
<option data-id="73000329165" value="Withholding Tax (All Regions)">Withholding Tax (All Regions)</option>
<option data-id="73000329166" value="1042 Year End Reporting (USA)">1042 Year End Reporting (USA)</option>
<option data-id="73000329167" value="One Time Vendor (All Regions)">One Time Vendor (All Regions)</option></select>
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_vendorsupplier_number_2211666-label " for="helpdesk_ticket_cf_vendorsupplier_number_2211666">Vendor/Supplier Number</label>
            <div class="controls   ">
              <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendorsupplier_number_2211666]" id="helpdesk_ticket_custom_field_cf_vendorsupplier_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_vendor_supplier_name_2211666-label " for="helpdesk_ticket_cf_vendor_supplier_name_2211666">Vendor/Supplier Name</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendor_supplier_name_2211666]" id="helpdesk_ticket_custom_field_cf_vendor_supplier_name_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_invoice_number_2211666-label " for="helpdesk_ticket_cf_invoice_number_2211666">Invoice Number</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_invoice_number_2211666]" id="helpdesk_ticket_custom_field_cf_invoice_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_invoice_amount_2211666-label " for="helpdesk_ticket_cf_invoice_amount_2211666">Invoice Amount</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_invoice_amount_2211666]" id="helpdesk_ticket_custom_field_cf_invoice_amount_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_invoice_date_2211666-label " for="helpdesk_ticket_cf_invoice_date_2211666">Invoice Date</label>
            <div class="controls  support-date-field ">
              <input type="text" name="helpdesk_ticket[custom_field][cf_invoice_date_2211666]" id="helpdesk_ticket_custom_field_cf_invoice_date_2211666" class="  date section_field datepicker_popover" readonly="readonly" data-show-image="true" data-date-format="M d, yy" placeholder="" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_zap_request_number_2211666-label " for="helpdesk_ticket_cf_zap_request_number_2211666">ZAP/ZGUFI Request Number</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_zap_request_number_2211666]" id="helpdesk_ticket_custom_field_cf_zap_request_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_purchase_order_number_2211666-label " for="helpdesk_ticket_cf_purchase_order_number_2211666">Purchase Order Number</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_purchase_order_number_2211666]" id="helpdesk_ticket_custom_field_cf_purchase_order_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_business_unit_contact_2211666-label " for="helpdesk_ticket_cf_business_unit_contact_2211666">Business Unit Contact</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_business_unit_contact_2211666]" id="helpdesk_ticket_custom_field_cf_business_unit_contact_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_business_unit_contact_phone_number_2211666-label " for="helpdesk_ticket_cf_business_unit_contact_phone_number_2211666">Business Unit Contact phone number</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_business_unit_contact_phone_number_2211666]" id="helpdesk_ticket_custom_field_cf_business_unit_contact_phone_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_vendorsupplier_email_2211666-label " for="helpdesk_ticket_cf_vendorsupplier_email_2211666">Vendor/Supplier Email</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendorsupplier_email_2211666]" id="helpdesk_ticket_custom_field_cf_vendorsupplier_email_2211666" />
            </div> 
                  </div>

<div class="control-group ticket_section">
                     <label class=" required control-label cf_type_zap_or_zgufi_submission_2211666-label " for="helpdesk_ticket_cf_type_zap_or_zgufi_submission_2211666">Type</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_type_zap_or_zgufi_submission_2211666]" id="helpdesk_ticket_custom_field_cf_type_zap_or_zgufi_submission_2211666"><option value="">...</option>
<option data-id="73000329151" value="Form/Approval Issue">Form/Approval Issue</option>
<option data-id="73000329153" value="Incorrect Information Submitted">Incorrect Information Submitted</option>
<option data-id="73000329152" value="Rejected Request">Rejected Request</option>
<option data-id="73000329154" value="Status of Approved/Posted Request">Status of Approved/Posted Request</option></select>
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_vendorsupplier_number_2211666-label " for="helpdesk_ticket_cf_vendorsupplier_number_2211666">Vendor/Supplier Number</label>
            <div class="controls   ">
              <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendorsupplier_number_2211666]" id="helpdesk_ticket_custom_field_cf_vendorsupplier_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_vendor_supplier_name_2211666-label " for="helpdesk_ticket_cf_vendor_supplier_name_2211666">Vendor/Supplier Name</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendor_supplier_name_2211666]" id="helpdesk_ticket_custom_field_cf_vendor_supplier_name_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_invoice_number_2211666-label " for="helpdesk_ticket_cf_invoice_number_2211666">Invoice Number</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_invoice_number_2211666]" id="helpdesk_ticket_custom_field_cf_invoice_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_invoice_date_2211666-label " for="helpdesk_ticket_cf_invoice_date_2211666">Invoice Date</label>
            <div class="controls  support-date-field ">
              <input type="text" name="helpdesk_ticket[custom_field][cf_invoice_date_2211666]" id="helpdesk_ticket_custom_field_cf_invoice_date_2211666" class="  date section_field datepicker_popover" readonly="readonly" data-show-image="true" data-date-format="M d, yy" placeholder="" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_invoice_amount_2211666-label " for="helpdesk_ticket_cf_invoice_amount_2211666">Invoice Amount</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_invoice_amount_2211666]" id="helpdesk_ticket_custom_field_cf_invoice_amount_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_vendorsupplier_email_2211666-label " for="helpdesk_ticket_cf_vendorsupplier_email_2211666">Vendor/Supplier Email</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendorsupplier_email_2211666]" id="helpdesk_ticket_custom_field_cf_vendorsupplier_email_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_zap_request_number_2211666-label " for="helpdesk_ticket_cf_zap_request_number_2211666">ZAP/ZGUFI Request Number</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_zap_request_number_2211666]" id="helpdesk_ticket_custom_field_cf_zap_request_number_2211666" />
            </div> 
                  </div>

<div class="control-group ticket_section">
                     <label class=" required control-label cf_type_1099_2211666-label " for="helpdesk_ticket_cf_type_1099_2211666">Type</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_type_1099_2211666]" id="helpdesk_ticket_custom_field_cf_type_1099_2211666"><option value="">...</option>
<option data-id="73000329168" value="Request for 1099">Request for 1099</option>
<option data-id="73000329169" value="Request for corrected 1099">Request for corrected 1099</option>
<option data-id="73000329170" value="Year End Consolidation Files for 1099">Year End Consolidation Files for 1099</option></select>
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_business_unit_contact_2211666-label " for="helpdesk_ticket_cf_business_unit_contact_2211666">Business Unit Contact</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_business_unit_contact_2211666]" id="helpdesk_ticket_custom_field_cf_business_unit_contact_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_business_unit_contact_phone_number_2211666-label " for="helpdesk_ticket_cf_business_unit_contact_phone_number_2211666">Business Unit Contact phone number</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_business_unit_contact_phone_number_2211666]" id="helpdesk_ticket_custom_field_cf_business_unit_contact_phone_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_vendorsupplier_email_2211666-label " for="helpdesk_ticket_cf_vendorsupplier_email_2211666">Vendor/Supplier Email</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendorsupplier_email_2211666]" id="helpdesk_ticket_custom_field_cf_vendorsupplier_email_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_vendorsupplier_number_2211666-label " for="helpdesk_ticket_cf_vendorsupplier_number_2211666">Vendor/Supplier Number</label>
            <div class="controls   ">
              <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendorsupplier_number_2211666]" id="helpdesk_ticket_custom_field_cf_vendorsupplier_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_vendor_supplier_name_2211666-label " for="helpdesk_ticket_cf_vendor_supplier_name_2211666">Vendor/Supplier Name</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendor_supplier_name_2211666]" id="helpdesk_ticket_custom_field_cf_vendor_supplier_name_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_individual_name_business_name_2211666-label " for="helpdesk_ticket_cf_individual_name_business_name_2211666">Individual Name /Business Name</label>
            <div class="controls   ">
              <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_individual_name_business_name_2211666]" id="helpdesk_ticket_custom_field_cf_individual_name_business_name_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_social_security_number_or_employer_identification_number_2211666-label " for="helpdesk_ticket_cf_social_security_number_or_employer_identification_number_2211666">Social Security Number (Last 4) or Employer Identification Number (No Dash)</label>
            <div class="controls   ">
              <input class=" required number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_social_security_number_or_employer_identification_number_2211666]" id="helpdesk_ticket_custom_field_cf_social_security_number_or_employer_identification_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_complete_address_2211666-label " for="helpdesk_ticket_cf_complete_address_2211666">Complete Address</label>
            <div class="controls   ">
              <textarea class=" required paragraph section_field span12" rows="6" placeholder="" name="helpdesk_ticket[custom_field][cf_complete_address_2211666]" id="helpdesk_ticket_custom_field_cf_complete_address_2211666">
&lt/textarea&gt
            </div> 
                  </div>

<div class="control-group ticket_section">
                     <label class=" required control-label cf_vendorsupplier_number_2211666-label " for="helpdesk_ticket_cf_vendorsupplier_number_2211666">Vendor/Supplier Number</label>
            <div class="controls   ">
              <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_vendorsupplier_number_2211666]" id="helpdesk_ticket_custom_field_cf_vendorsupplier_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_invoice_number_2211666-label " for="helpdesk_ticket_cf_invoice_number_2211666">Invoice Number</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_invoice_number_2211666]" id="helpdesk_ticket_custom_field_cf_invoice_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_invoice_date_2211666-label " for="helpdesk_ticket_cf_invoice_date_2211666">Invoice Date</label>
            <div class="controls  support-date-field ">
              <input type="text" name="helpdesk_ticket[custom_field][cf_invoice_date_2211666]" id="helpdesk_ticket_custom_field_cf_invoice_date_2211666" class="  date section_field datepicker_popover" readonly="readonly" data-show-image="true" data-date-format="M d, yy" placeholder="" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_purchase_order_number_2211666-label " for="helpdesk_ticket_cf_purchase_order_number_2211666">Purchase Order Number</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_purchase_order_number_2211666]" id="helpdesk_ticket_custom_field_cf_purchase_order_number_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_isinvoice_2211666-label " for="helpdesk_ticket_cf_isinvoice_2211666">isInvoice</label>
            <div class="controls   ">
              <select class="  dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_isinvoice_2211666]" id="helpdesk_ticket_custom_field_cf_isinvoice_2211666"><option value="">...</option>
<option data-id="73000329510" value="True">True</option>
<option data-id="73000329511" value="False">False</option></select>
            </div> 
                  </div>

<div class="control-group ticket_section">
                     <label class=" required control-label cf_full_name_2211666-label " for="helpdesk_ticket_cf_full_name_2211666">Full Name</label>
            <div class="controls   ">
              <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_full_name_2211666]" id="helpdesk_ticket_custom_field_cf_full_name_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_work_phone_2211666-label " for="helpdesk_ticket_cf_work_phone_2211666">Work Phone</label>
            <div class="controls   ">
              <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_work_phone_2211666]" id="helpdesk_ticket_custom_field_cf_work_phone_2211666" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_region_2211666-label " for="helpdesk_ticket_cf_region_2211666">Country/Region</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_region_2211666]" id="helpdesk_ticket_custom_field_cf_region_2211666"><option value="">...</option>
<option data-id="73000329550" value="Argentina - AR">Argentina - AR</option>
<option data-id="73000329520" value="Australia - AU">Australia - AU</option>
<option data-id="73000329521" value="Austria - AT">Austria - AT</option>
<option data-id="73000329522" value="Belgium - BE">Belgium - BE</option>
<option data-id="73000329566" value="Bermuda- BM">Bermuda- BM</option>
<option data-id="73000329551" value="Brazil - BR">Brazil - BR</option>
<option data-id="73000526726" value="Bulgaria - BG">Bulgaria - BG</option>
<option data-id="73000329523" value="Canada - CA">Canada - CA</option>
<option data-id="73000329567" value="Cayman Islands- KY">Cayman Islands- KY</option>
<option data-id="73000329552" value="Chile - CL">Chile - CL</option>
<option data-id="73000329524" value="China - CN">China - CN</option>
<option data-id="73000329553" value="Colombia - CO">Colombia - CO</option>
<option data-id="73000526727" value="Croatia - HR">Croatia - HR</option>
<option data-id="73001008954" value="Czech Republic - CZ">Czech Republic - CZ</option>
<option data-id="73000329525" value="Denmark - DK">Denmark - DK</option>
<option data-id="73001058364" value="El Salvador - SV">El Salvador - SV</option>
<option data-id="73000329526" value="Finland - FI">Finland - FI</option>
<option data-id="73000329549" value="France - FR">France - FR</option>
<option data-id="73000329527" value="Germany - DE">Germany - DE</option>
<option data-id="73000329560" value="Greece - GR">Greece - GR</option>
<option data-id="73000329528" value="Hong Kong - HK">Hong Kong - HK</option>
<option data-id="73000329559" value="Hungary - HU">Hungary - HU</option>
<option data-id="73000329529" value="India - IN">India - IN</option>
<option data-id="73000329530" value="Indonesia - ID">Indonesia - ID</option>
<option data-id="73000329531" value="Ireland - IE">Ireland - IE</option>
<option data-id="73000329561" value="Israel - IL">Israel - IL</option>
<option data-id="73000329532" value="Italy - IT">Italy - IT</option>
<option data-id="73000329533" value="Japan - JP">Japan - JP</option>
<option data-id="73001010719" value="Jordan - JO">Jordan - JO</option>
<option data-id="73000329534" value="Malaysia - MY">Malaysia - MY</option>
<option data-id="73001008186" value="Malta - MT">Malta - MT</option>
<option data-id="73000329554" value="Mexico - MX">Mexico - MX</option>
<option data-id="73000329535" value="Netherlands - NL">Netherlands - NL</option>
<option data-id="73000329536" value="New Zealand - NZ">New Zealand - NZ</option>
<option data-id="73000329537" value="Norway - NO">Norway - NO</option>
<option data-id="73000329562" value="Panama- PA">Panama- PA</option>
<option data-id="73000329555" value="Peru - PE">Peru - PE</option>
<option data-id="73000329538" value="Philippines - PH">Philippines - PH</option>
<option data-id="73000329563" value="Poland - PL">Poland - PL</option>
<option data-id="73000329558" value="Portugal - PT">Portugal - PT</option>
<option data-id="73000329564" value="Russia- RU">Russia- RU</option>
<option data-id="73000526728" value="Serbia - RS">Serbia - RS</option>
<option data-id="73000329539" value="Singapore - SG">Singapore - SG</option>
<option data-id="73000526729" value="Slovenia - SI">Slovenia - SI</option>
<option data-id="73000329540" value="South Africa - ZA">South Africa - ZA</option>
<option data-id="73000329541" value="South Korea - KR">South Korea - KR</option>
<option data-id="73000329542" value="Spain - ES">Spain - ES</option>
<option data-id="73000329543" value="Sweden - SE">Sweden - SE</option>
<option data-id="73000329544" value="Switzerland - CH">Switzerland - CH</option>
<option data-id="73000329545" value="Taiwan - TW">Taiwan - TW</option>
<option data-id="73000329546" value="Thailand - TH">Thailand - TH</option>
<option data-id="73000329570" value="Turkey - TR">Turkey - TR</option>
<option data-id="73000329557" value="United Arab Emirates - UAE">United Arab Emirates - UAE</option>
<option data-id="73000329547" value="United Kingdom - GB">United Kingdom - GB</option>
<option data-id="73000329548" value="USA - US">USA - US</option>
<option data-id="73000329556" value="Venezuela - VE">Venezuela - VE</option>
<option data-id="73000329565" value="Vietnam - VN">Vietnam - VN</option>
<option data-id="73000329568" value="British Virgin Islands - VG">British Virgin Islands - VG</option>
<option data-id="73000329569" value="US Virgin Islands - VI">US Virgin Islands - VI</option></select>
            </div> 
                  </div>

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