diff --git a/src/inputs/input.txt b/src/inputs/input.txt
index faa55cd..e68385c 100644
--- a/src/inputs/input.txt
+++ b/src/inputs/input.txt
@@ -1 +1,10 @@
-Officer Voldemort here, at an incident reported at 456 Oak Street. Two victims, Mark Smith and Jane Doe. Medical aid rendered for minor lacerations. Handed off to Sheriff's Deputy Alvarez. End of transmission.
+UC Vaccine Declination Statement
+
+Name/SID: Sarah Johnson, SID 4527891
+Job Title: Research Scientist
+Department: Microbiology
+Phone Number: 831-555-0142
+Email: sjohnson@ucsc.edu
+Date: 03/15/2026
+
+Signature: ________________________
\ No newline at end of file