Indian Oil Corporation — Complaint filing web form is non-functional

Following is the location from which a complaint can be filed on the IOCL website http://webapp.indianoil.co.in/paribhavam/ This web form is broken (see attachment). It accepts all the inputs but on trying to submit, I see an error and all the entered data is lost. Please fix it; without this, no body will be able to submit any grievance on your website. Please provide an alternate email to which the queries / grievances can be sent in case the web form is not functional.