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Contenu

<table border="0" cellpadding="1" cellspacing="2" style="width:100%;">
	<tbody>
		<tr>
			<td style="width: 30%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Type de soci&eacute;t&eacute; :</span></td>
			<td style="width: 30%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">au capital de :</span></td>
		</tr>
		<tr>
			<td style="width: 30%;">{% textinput_tag name=&quot;efb4a22a&quot; data_label=&quot;Type&quot; data_map_field=&quot;company_type&quot; data_help=&quot;SCI, SA, SARL...&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="width: 30%;">{% textinput_tag name=&quot;c5dc6c9c&quot; data_label=&quot;Capital social&quot; data_map_field=&quot;capital&quot; data_help=&quot;capital&quot; maxlength=&quot;70&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
		</tr>
	</tbody>
</table>

<table border="0" cellpadding="1" cellspacing="2" style="width:100%;">
	<tbody>
		<tr>
			<td style="vertical-align: middle; width: 50%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Immatricul&eacute;e au RCS de :</span></td>
			<td style="vertical-align: middle; width: 50%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Sous le num&eacute;ro :</span></td>
		</tr>
		<tr>
			<td style="vertical-align: middle; width: 50%;">{% textinput_tag name=&quot;66cded07&quot; data_label=&quot;Lieu d&#39;immatriculation RCS&quot; data_map_field=&quot;rcs_place&quot; data_help=&quot;Lieu RCS&quot; maxlength=&quot;50&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="vertical-align: middle; width: 50%;">{% textinput_tag name=&quot;79bc8f8a&quot; data_label=&quot;Num&eacute;ro RCS&quot; data_map_field=&quot;rcs_num&quot; data_help=&quot;Num&eacute;ro RCS&quot; maxlength=&quot;50&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
		</tr>
		<tr>
			<td style="vertical-align: middle; width: 50%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">N&deg; de CPI :</span></td>
			<td style="vertical-align: middle; width: 50%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">D&eacute;livr&eacute; par :</span></td>
		</tr>
		<tr>
			<td style="vertical-align: middle; width: 50%;">{% textinput_tag name=&quot;dff13da5&quot; data_label=&quot;n&deg; de CPI&quot; data_map_field=&quot;nomap&quot; data_help=&quot;n&deg; de CPI&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="vertical-align: middle; width: 50%;">{% textinput_tag name=&quot;a14c3f96&quot; data_label=&quot;CPI d&eacute;livr&eacute;e par&quot; data_help=&quot;CPI d&eacute;livr&eacute;e par&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
		</tr>
	</tbody>
</table>

<table border="0" cellpadding="1" cellspacing="2" style="width:100%;">
	<tbody>
		<tr>
			<td style="vertical-align: middle; width: 70%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Assurance RCP :</span></td>
			<td style="vertical-align: middle; width: 30%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&nbsp;n&deg; assurance RCP :</span></td>
		</tr>
		<tr>
			<td style="vertical-align: middle; width: 70%;">{% textinput_tag name=&quot;faaebeba&quot; data_label=&quot;nom assurance RCP&quot; data_map_field=&quot;nomap&quot; data_help=&quot;nom assurance RCP&quot; maxlength=&quot;50&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="vertical-align: middle; width: 30%;">{% textinput_tag name=&quot;2c2de434&quot; data_label=&quot;n&deg; assurance RCP&quot; data_map_field=&quot;nomap&quot; data_help=&quot;n&deg; assurance RCP&quot; maxlength=&quot;20&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
		</tr>
	</tbody>
</table>

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