I pasted the HTML below, please try at your end once.
<html>
<head>
<title></title>
</head>
<body>
<div class="formWrap left">
<div class="formCont left">
<h1>
<img src="http://10.100.169.225/Content/images/IAA_logo.gif" /> Title Transmittal
</h1>
<div class="headerDate">
Date: <strong>1/11/2024</strong>
</div>
</div>
<div class="formCont left">
<h4>General Information</h4>
<fieldset class="col1 left">
<label for="lblSalvageProviderName" class="txt_top">Provider:</label>
<span class="valOnly">Insurance Auto Auctions - Manchester</span>
<br/>
<label for="lblSalvageProviderAddress" class="txt_top">Address: </label>
<span class="valOnly">75 Lowell Rd. Salem, NH . 03079</span>
<br/>
<label for="lblAdjuster" class="txt_top">Adjuster:</label>
<span class="valOnly">Slensky, Ed</span>
</fieldset>
<fieldset class="col2 left">
<label for="lblStockNo" class="txt_top">Stock # / Branch:</label>
<span class="valOnly">35753212 / Phoenix</span>
<br/>
<label for="lblClaim1" class="txt_top">Claim #: </label>
<span class="valOnly">23244224</span>
<br/>
<label for="lblPolicy" class="txt_top">Policy #: </label>
<span class="valOnly"> </span>
</fieldset>
</div>
<div class="formCont left">
<h4>Vehicle Information</h4>
<fieldset class="col1 left">
<label for="lblVIN" class="txt_top">VIN:</label>
<span class="valOnly">1B7GG2AN9YS629756</span>
<br/>
<label for="lblYearMakeModel" class="txt_top">Year/Make/Model:</label>
<span class="valOnly">2000 / DODGE / DAKOTA</span>
<br/>
<label for="txtMileage" class="txt_top">Mileage:</label>
<br />
<label for="lblInsuredName" class="txt_top">Insured:</label>
<span class="valOnly">Test, Test</span>
<br/>
<label for="lblOwnerName" class="txt_top">Owner:</label>
<span class="valOnly">Test, Test</span>
</fieldset>
<fieldset class="col2 left">
<label for="txtAcv">ACV $:</label>
<br/>
<label for="txtEstCostOfRepair">ECR $:</label>
<br/>
<label for="lblLossType" class="txt_top">Loss Type:</label>
<span class="valOnly">Other</span>
<br/>
<label for="lblLossDate" class="txt_top">Date of Loss:</label>
<span class="valOnly">01/02/2024</span>
<br/>
</fieldset>
</div>
<div class="formCont left">
<h4>Document Information </h4>
<fieldset class="col1 left">
<label class="extended">Please process an application for a:</label>
<div class="r_options">
<label>Salvage Title / Certificate</label><br/>
<label></label>
</div>
<br />
<h4><font style="color: #000;">Enclosed Documents</font></h4>
<div class="r_options">
</div>
</fieldset>
<fieldset class="col2 left">
<label>Application State:</label>
<span class="valOnly">Arizona
</span>
<label>Company Name:</label>
<span class="valOnly">Insurance Auto Auctions - Manchester</span>
<label class="extended">Comments:</label>
<div class="r_options">
<label></label><br/>
</div>
</fieldset>
</div>
<div class="formCont left">
<div class="col1 left">
<h4><font style="color: #000;">Mail to:</font> Insurance Auto Auctions</h4>
<div class="branchDetails">
<span class="branchName">Title Center (AZ)</span>
<div id="BranchInfo">
2299 West Broadway Road<br>
Phoenix, AZ. 85041<br>
(855) 686-7813<br>
(602) 305-5360 <span>Fax</span>
</div>
</div>
</div>
<div class="col2 left">
<h4>Provider Contact</h4>
<div class="providerInfo">
<span class="name">Ed Slensky</span><br>
qaproviderservices@iaai.com<br>
9898379674
<span> Ext. 123</span>
</div>
</div>
</div>
</div>
<!--end of formWrap div-->
</body>
</html>
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