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Hacking attempt report form

If this originates from the Wanadoo/Energis/Pol network please provide the following details. We can only deal with hacking attempts that originate from the Wanadoo/Energis/Pol network. We only request your email address for the purpose of dealing with your abuse report.We'll do all we can to keep your data safe, but please note that information you submit in a Webform is vulnerable during electronic transport.

Your name
Your email address* (We will use this to reply to you.)	Please enter your email address!
Confirm email address*	Please confirm your email address!
Offending IP address* (This can be obtained from your firewall software)	: : :
	Please enter a valid IP address!
Date* (This can be obtained from your firewall software)
	Date is required!
Time of incident*
	Please enter the approx time of the incident!
Your Time zone*
	Please select a time zone!



	* Please enter information into these required fields.