From info not matching email

We cloned a form then deleted several sections of the form and added other choices.

The info that comes in on the email does not match the info submitted on the form.

Here is the info from a completed form....

MHC

1029 Crysler Ave

Independence, MO 64052

Phone: 816-254-5671 Fax: 816-254-7714

www.MortonKC.com

Date
Technician Name
Customer Name
Contact Person
Customer Address
Billing Address if different than Customer Address
Phone Number
2nd Phone Number
E-mail
Service Call Charge
Services

WORK AUTHORIZATION: I, the undersigned, am owner/authorized representative/tenant/agent of the premises at which the work above is being done. I hereby authorize you to perform the above solutions recommended, and to use such labor and materials as you deem advisable. Unless prior-authorization for billing and documented on this page, payment for all work is due upon completion (C.O.D.). An office billing charge and/or finance charge of 1.75% per month (21% per annum) will be added after 10 days past due. I agree to pay reasonable attorney fees, court costs, and collection fees in the event of legal action. I have read this contract, including the terms and conditions on the following page hereof and agree to be bound to all the terms contained herein. *,** Customer agrees to term listed on the following page when method is chosen.

I accept the price and authorize the work to be done
Total amount to be charged 9.95
Signature
Payment #1 Amount
Payment #1 method
Payment #1 Information #s
Payment #2 Amount
Payment #2 method Credit Card
Payment #2 Information #s
Work Process 1234
Date Scheduled to Return and Finish 10-28-2014
Appointment Time