If you didn't get the first four times the template you have to use is this one:
Name - What is your in-game name?
STEAM-ID - What is your STEAM-ID?
Staff Members Name - Who warned you?
Punishment Reason - What was the reason of the punishment(s)?
Server - Which server did this occur on?
Story/Situation - What happened?
Extra Information - Anything you would find relevant to your punishments(s)?