<input type="hidden" name="reporttype" value="custom">
<input type="hidden" name="co_street" value="[% HTML.escape(co_street) %]">
<input type="hidden" name="co_city" value="[% HTML.escape(co_city) %]">
- <input type="hidden" name="login" value="[% HTML.escape(login) %]">
- <input type="hidden" name="password" value="[% HTML.escape(password) %]">
<table width="100%">
<tr>
<td align="left">