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<p style="text-align: justify;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"><span class="titre_p" style="font-size: 18px; font-weight: 900;">SITUATION - D&Eacute;SIGNATION ET CONSISTANCE DES LOCAUX</span></span><br />
<span style="font-size:14px;"><span style="font-family: ITCAvantGardePro; font-weight: 200;"><span style="font-weight:600;">Type de bien lou&eacute;&nbsp;:<span style="font-size: 12px; font-weight: 200;">&nbsp;</span></span></span></span><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">{% radio_tag name=&quot;df4c9693&quot; data_label=&quot;Type de bien lou&eacute;&quot; data_help=&quot;Type de bien lou&eacute;&quot; data_choices=&quot;Appartement&nbsp; &nbsp; |Appartement; Maison&nbsp; &nbsp; |Maison; Boutique&nbsp; &nbsp; |Boutique; Autre :&nbsp; &nbsp; |Autre;&quot; %}</span></p>

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
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			<td>{% textarea_tag name=&quot;1bb819b2&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;D&eacute;signation local : autre&quot; data_help=&quot;D&eacute;signation local&quot; data_ancien_ids=&quot;9e619632&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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			<td style="vertical-align: middle; width: 20%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Nombre de pi&egrave;ces :</span></td>
			<td style="vertical-align: middle; width: 20%;">{% textinput_tag name=&quot;7e5e3edd&quot; data_label=&quot;Nombre de pi&egrave;ces&quot; data_help=&quot;Nombre de pi&egrave;ces&quot; maxlength=&quot;20&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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			<td style="vertical-align: middle; width: 20%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Superficie :</span></td>
			<td style="vertical-align: middle; width: 20%;">{% textinput_tag name=&quot;73339e13&quot; data_label=&quot;Superficie&quot; data_help=&quot;Superficie&quot; maxlength=&quot;20&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family: ITCAvantGardePro; font-weight: 200;"><span style="font-weight:600;">Annexe(s) :</span></span></span></p>

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			<td style="vertical-align: middle; width: 11%;">{% checkbox_tag name=&quot;e9d68161&quot; data_label=&quot;Garage&quot; data_help=&quot;Garage&quot; data_ancien_ids=&quot;9283&quot; %}<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&nbsp;Garage n&deg;</span></td>
			<td style="width: 12%;">
			<p>{% textinput_tag name=&quot;ed2502ed&quot; data_label=&quot;Garage n&deg;&quot; data_help=&quot;Garage n&deg;&quot; maxlength=&quot;15&quot; data_ancien_ids=&quot;9306&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</p>
			</td>
			<td style="vertical-align: middle; width: 10%;">&nbsp;{% checkbox_tag name=&quot;608ba1ea&quot; data_label=&quot;Cave&quot; data_help=&quot;Cave&quot; data_ancien_ids=&quot;9352&quot; %}&nbsp;<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Cave n&deg; </span></td>
			<td style="vertical-align: middle; width: 12%;">{% textinput_tag name=&quot;01b7e1f3&quot; data_label=&quot;Cave n&deg;&quot; data_help=&quot;Cave n&deg;&quot; maxlength=&quot;15&quot; data_ancien_ids=&quot;9376&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="width: 3%; vertical-align: middle;">&nbsp;{% checkbox_tag name=&quot;9322c089&quot; data_label=&quot;Annexe autre&quot; data_help=&quot;Annexe autre&quot; data_ancien_ids=&quot;9237&quot; %}</td>
			<td style="width: 52%;">{% textinput_tag name=&quot;be58f753&quot; data_label=&quot;Annexe autre&quot; data_help=&quot;Annexe autre&quot; maxlength=&quot;60&quot; data_ancien_ids=&quot;9214&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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<p style="text-align: justify;"><span style="font-family: ITCAvantGardePro; font-size: 12px;">Immeuble sis &agrave;</span></p>

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			<td>{% textarea_tag name=&quot;202bd211&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Adresse du bien&quot; data_help=&quot;Adresse du bien&quot; data_ancien_ids=&quot;6337,1362,4080&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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<p style="text-align: justify;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"><strong>D&eacute;signation</strong> (en cas de copropri&eacute;t&eacute;, pr&eacute;ciser le num&eacute;ro de lot pour chacun des biens objet du mandat ainsi que les tanti&egrave;mes attach&eacute;s) :</span></p>

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			<td>{% textarea_tag name=&quot;5b38495c&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;D&eacute;signation du bien &quot; data_help=&quot;D&eacute;signation du bien &quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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<p style="text-align: justify;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Le mandant s&#39;oblige &agrave; faire conna&icirc;tre par &eacute;crit au mandataire s&#39;il existe des suj&eacute;tions particuli&egrave;res, notamment d&#39;ordre r&eacute;glementaire, concernant le(s) bien(s) g&eacute;r&eacute;(s) (limitation &agrave; la fixation du loyer, plafond de ressources...).</span></p>

<p style="text-align: justify;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">En outre, le mandant d&eacute;clare, sous sa responsabilit&eacute;, ne faire l&rsquo;objet, d&rsquo;aucune mesure de protection de la personne (curatelle, tutelle&hellip;) ni d&rsquo;aucune proc&eacute;dure collective, et notamment de redressement ou de liquidation judiciaires, et que les biens, objet du pr&eacute;sent mandat, ne font l&rsquo;objet d&rsquo;aucune proc&eacute;dure de saisie immobili&egrave;re.</span></p>

<p style="text-align: justify;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Le mandant s&rsquo;oblige &eacute;galement &agrave; faire conna&icirc;tre au mandataire toute modification se rapportant &agrave; la propri&eacute;t&eacute; du bien (d&eacute;membrement, usufruit, etc.) intervenant au cours du pr&eacute;sent mandat.</span></p>

<p style="text-align: justify;"><span style="font-family: ITCAvantGardePro; font-weight: 600; font-size: 14px;">D&eacute;claration du mandant</span></p>

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				<li><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Le bien, objet des pr&eacute;sentes, a-t-il subi un sinistre ayant donn&eacute; lieu au versement d&#39;une indemnit&eacute; d&#39;assurance garantissant :&nbsp;</span><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">les risques de catastrophes mini&egrave;res, &nbsp;naturelles ou technologiques, vis&eacute;es &agrave; l&#39;art. L 125-2 du Code des assurances ? :</span></li>
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			<td style="vertical-align: middle; width: 15%; text-align: right;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">{% radio_tag name=&quot;12471ebf&quot; data_label=&quot;Le bien, objet des pr&eacute;sentes, a-t-il subi un sinistre ayant donn&eacute; lieu au versement d&#39;une indemnit&eacute; d&#39;assurance garantissant :&nbsp;les risques de catastrophes mini&egrave;res, &nbsp;naturelles ou technologiques, vis&eacute;es &agrave; l&#39;art. L 125-2 du Code des assurances ? :&quot; data_help=&quot;Indemnit&eacute; d&#39;assurance&quot; data_choices=&quot;Oui|oui; Non|non;&quot; %}</span></td>
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			<td style="vertical-align: middle; width: 20%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Si oui indiquer l&#39;origine :</span></td>
			<td>{% textinput_tag name=&quot;a6a456b7&quot; data_label=&quot;Origine du sinistre &quot; data_help=&quot;Origine du sinistre &quot; maxlength=&quot;80&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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<ul>
	<li style="text-align: justify;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Indiquer la nature et le montant des travaux effectu&eacute;s depuis la fin du dernier contrat ou depuis le dernier renouvellement du bail :</span></li>
</ul>

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			<td>{% textarea_tag name=&quot;eaad6432&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Nature et montant des travaux depuis le dernier contrat&quot; data_help=&quot;Nature et montant des travaux depuis le dernier contrat&quot; data_ancien_ids=&quot;7542,1628,8663&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family: ITCAvantGardePro; font-weight: 200;"><span style="font-weight:600;">&Eacute;quipements d&#39;acc&egrave;s aux technologies de l&#39;information et de la communication :</span></span></span></p>

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				<li><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Information concernant les modalit&eacute;s de r&eacute;ception des services de t&eacute;l&eacute;vision, conform&eacute;ment &agrave; la loi n&deg;89-462 du 06/07/89, art. 3-2 :&nbsp;</span><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">possibilit&eacute; de recevoir en clair les services nationaux de t&eacute;l&eacute;vision par voie hertzienne terrestre en mode num&eacute;rique :&nbsp;</span></li>
			</ul>
			</td>
			<td style="text-align: right; vertical-align: middle; width: 15%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">{% radio_tag name=&quot;9a3aa67d&quot; data_label=&quot;Possibilit&eacute; de recevoir en clair les services nationaux de t&eacute;l&eacute;vision par voie hertzienne terrestre en mode num&eacute;rique&quot; data_help=&quot;Possibilit&eacute; de recevoir en clair les services nationaux de t&eacute;l&eacute;vision par voie hertzienne terrestre en mode num&eacute;rique&quot; data_choices=&quot;Oui|oui; Non|non;&quot; %}</span></td>
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<p style="text-align: justify;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">A d&eacute;faut, et &agrave; titre informatif, coordonn&eacute;es d&rsquo;un distributeur de services (pour b&eacute;n&eacute;ficier du service antenne num&eacute;rique) :</span></p>

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
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			<td>{% textarea_tag name=&quot;5d12ad71&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Coordonn&eacute;es d&rsquo;un distributeur de services&quot; data_help=&quot;Coordonn&eacute;es d&rsquo;un distributeur de services&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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