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<table border="0" cellpadding="2" cellspacing="5" style="width:100%;">
	<tbody>
		<tr>
			<td style="text-align: right; width: 32%; vertical-align: bottom;">D&Eacute;SIGNATION DE L&#39;OBJET&nbsp;</td>
			<td style="width: 34%; vertical-align: bottom;">&nbsp;Genre d&#39;objet :</td>
			<td style="width: 34%;">&nbsp;</td>
		</tr>
		<tr>
			<td style="width: 32%;">&nbsp;</td>
			<td colspan="2" rowspan="1" style="width: 34%;">{% textarea_tag name=&quot;d86ab654&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Genre d&#39;objet&quot; data_map_field=&quot;realty_name&quot; data_help=&quot;Genre d&#39;objet&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
		</tr>
		<tr>
			<td style="width: 32%;">&nbsp;</td>
			<td style="width: 34%;">&nbsp;Adresse :</td>
			<td style="width: 34%;">&nbsp;</td>
		</tr>
		<tr>
			<td style="width: 32%;">&nbsp;</td>
			<td colspan="2" rowspan="1" style="width: 34%;">{% textarea_tag name=&quot;d354694f&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Adresse de l&#39;objet&quot; data_map_field=&quot;full_address&quot; data_help=&quot;Adresse de l&#39;objet&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
		</tr>
		<tr>
			<td style="width: 32%;">&nbsp;</td>
			<td style="width: 34%; vertical-align: bottom;">N&deg; Parcelle(s) :&nbsp;{% textinput_tag name=&quot;7457a4a9&quot; data_label=&quot;N&deg; Parcelle(s)&quot; data_map_field=&quot;parcel_numero&quot; data_help=&quot;N&deg; Parcelle(s)&quot; maxlength=&quot;70&quot; style=&quot;max-width:157px;min-width:140px;width:140px;&quot; fixedwidth=&quot;140&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="width: 34%; vertical-align: bottom;">Unit&eacute; PPE :&nbsp;{% textinput_tag name=&quot;7457axx9&quot; data_label=&quot;Unit&eacute; PPE&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Unit&eacute; PPE&quot; maxlength=&quot;70&quot; style=&quot;max-width:170px;min-width:170px;width:170px;&quot; fixedwidth=&quot;170&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
		</tr>
		<tr>
			<td style="width: 32%;">&nbsp;</td>
			<td style="width: 34%;">Surface parcelle :&nbsp;{% textinput_tag name=&quot;76a241be&quot; data_label=&quot;Surface parcelle&quot; data_map_field=&quot;area&quot; data_help=&quot;Surface parcelle&quot; maxlength=&quot;70&quot; style=&quot;max-width:140px;min-width:140px;width:140px;&quot; fixedwidth=&quot;140&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="width: 34%;">&nbsp;</td>
		</tr>
		<tr>
			<td style="width: 32%;">&nbsp;</td>
			<td style="width: 34%;">Propri&eacute;taire inscrit au RF :</td>
			<td style="width: 34%;">&nbsp;</td>
		</tr>
		<tr>
			<td style="width: 32%;">&nbsp;</td>
			<td colspan="2" rowspan="1" style="width: 34%;">{% textarea_tag name=&quot;fa017e7d&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Propri&eacute;taire inscrit au RF&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Propri&eacute;taire inscrit au RF&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
		</tr>
	</tbody>
</table>

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