-<label id="crepair-request-label" for="crepair-request">$label_request</label>
-<input type="text" id="crepair-request" name="request" value="$request" />
+<label id="crepair-attag-label" class="crepair-label" for="crepair-attag">$label_attag</label>
+<input type="text" id="crepair-attag" class="crepair-input" name="attag" value="$contact_attag" />
+<div class="clear"></div>
+
+<label id="crepair-url-label" class="crepair-label" for="crepair-url">$label_url</label>
+<input type="text" id="crepair-url" class="crepair-input" name="url" value="$contact_url" />
+<div class="clear"></div>
+
+<label id="crepair-request-label" class="crepair-label" for="crepair-request">$label_request</label>
+<input type="text" id="crepair-request" class="crepair-input" name="request" value="$request" />