You can change it into:
Server Name: Server 1
Domain: yourdomain.com *
IP Address: 126.96.36.199
Admin Email: email@example.com
* = your domain name of your server.
For example, if your full qualified domain name is: server1.mydomain.com, you should use here: yourdomain.com
Make sure that the mentioned IP Address belongs to that domain name
** = you can change this into the emailaddress of the ISPConfig system administrator. (root@localhost is the default emailaddress within this field of ISPConfig).
Within the IP List, you can add the IP-addresses which you've received from your provider. This is uselful, if a domain needs its own IP-address.
I think these tips are useful to you as you have more than one IP available, however, i do not think that this will solve your problem.