[%# This Source Code Form is subject to the terms of the Mozilla Public
  # License, v. 2.0. If a copy of the MPL was not distributed with this
  # file, You can obtain one at http://mozilla.org/MPL/2.0/.
  #
  # This Source Code Form is "Incompatible With Secondary Licenses", as
  # defined by the Mozilla Public License, v. 2.0.
  #%]
[% PROCESS global/variables.none.tmpl %]
[% USE Bugzilla %]
[% cgi = Bugzilla.cgi +%]
> Company Name
[%+ cgi.param('company_name') %]

> Device Description
[%+ cgi.param('device_desc') %]

> Firefox OS Release
[%+ cgi.param('ffos_release') %]

> Branding Tier
[%+ cgi.param('branding_tier') %]

> Distribution Countries
[%+ cgi.param('dist_countries') %]

> Distribution Channel
[%+ cgi.param('dist_channel') %]

> Reason for Waiver Request
[%+ cgi.param('reason') %]

> Rationale for Granting Waiver Request
[%+ cgi.param('rationale') %]

> Impact Analysis
[%+ cgi.param('impact') %]