<form action="{$this->ipsclass->base_url}automodule=gallery&amp;req=mod&amp;op=doreportimg" method="post" name="REPLIER">
<input type="hidden" name="img" value="{$img}">
	<div class="borderwrap">
		<div class="maintitle">{$this->ipsclass->lang['report_img_page']}</div>
		
		<table class='ipbtable' cellspacing='0'>
			<tr>
				<td class="pformleft" width="30%" valign="top"><b>{$this->ipsclass->lang['report_img_title']}</b></td>
				<td class="pformright" width="80%"><a href="{$this->ipsclass->base_url}automodule=gallery&amp;req=si&amp;img={$img}">{$title}</a></td>
			</tr>
			<tr>
				<td class="pformleft" width="30%" valign="top">{$this->ipsclass->lang['report_img_msg']}</td>
				<td class="pformright" width="80%"><textarea cols="60" rows="12" wrap="soft" name="message" class="textarea"></textarea></td>
			</tr>
			<tr>
				<td class="formbuttonrow" colspan="2"><input type="submit" value="{$this->ipsclass->lang['report_submit']}" class='button' /></td>
			</tr>
		</table>
	</div>
</form>