{include file="header.html"}

<div id="form_container">
<h1>{$lng.useraccount.request_removal}</h1>

<div class="form_content">

{if isset($error) && $error}<div class="error"><p>{$error}</p></div>{/if}

{if isset($info) && $info}<div id="status">{$info}</div>
{/if}

</div>
</div>
{include file="footer.html"}