Simple Joomla Extension needed

I need a simple Joomla Extension that allows the administrator to gather details from specific users as follows. Record the following data fields: Entered by administrator: 1. Date - date field 2. Admin field 1 - text field 3. Admin field 2 - text field 4. Admin field 3 - text field 5. Admin field 4 - text field 6. Admin field 5 - text field 9. Admin field 6 - text field 10. Admin field 7 - text field 11. Comment field - text field 12. Assigned user - list of Joomla registered UserID's and pick one from list or enter ID 13. Status - open or closed Entered by User: 12. Date - date field 13. User field 1 - text field 14. User field 2 - text field 15. User field 3 - text field 16. User field 4 - text field 17. User field 5 - text field 18. Comment field - text field Administrator logs to back end, sees a list of ALL records with filters on Status amd Assigned User, can add new or edit existing records. Should be able to print individual record, list of records or export to csv. User logs into Joomla front end, sees a list of records assigned to their ID only along with details entered by the administrator. Not able to change any of the data entered by the administrator. Not able to delete records, not able to edit "closed" records but able to view. Select a record to edit and enter their side of the record data. Must be CSS. Field names must be editable. Title must be editable. Must be Joomla 1.5 native. Please PM questions.