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<table border="0" cellpadding="5" cellspacing="5" style="width: 100%;">
	<tbody>
		<tr>
			<td style="width: 7%;">&nbsp; 4&nbsp;|</td>
			<td>Conditions 
			financi&egrave;res</td>
		</tr>
	</tbody>
</table>

&nbsp;

A. MODALIT&Eacute;S DE PAIEMENT

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
	<tbody>
		<tr>
			<td style="width: 38%; vertical-align: middle;">LOYER MENSUEL HORS CHARGES</td>
			<td style="width: 46%; vertical-align: middle;">{% textinput_tag name=&quot;696fceb5&quot; placeholder=&quot;en lettres euros&quot; data_label=&quot;Montant du loyer hors charges hors charges en lettres&quot; data_map_field=&quot;rent_price_hc&quot; data_help=&quot;Montant du loyer hors charges hors charges en lettres&quot; maxlength=&quot;60&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="width: 1%; vertical-align: middle;">&nbsp;</td>
			<td style="width: 13%; vertical-align: middle;">{% textinput_tag name=&quot;2614734e&quot; placeholder=&quot;en chiffres euros&quot; data_label=&quot;Montant du loyer hors charges hors charges en chiffres&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Montant du loyer hors charges hors charges en chiffres&quot; maxlength=&quot;40&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="width: 2%; vertical-align: middle;">&nbsp;&euro;</td>
		</tr>
		<tr>
			<td style="width: 38%;">CHARGES MENSUELLES</td>
			<td style="width: 46%;">{% radio_tag name=&quot;64a5a04d&quot; data_label=&quot;charges mensuelles&quot; data_choices=&quot;Charges forfaitaires|forfaitaires; Provisions sur charges|provisions;&quot; %}</td>
			<td style="width: 1%;">&nbsp;</td>
			<td style="width: 13%; text-align: right;">&nbsp;</td>
		</tr>
		<tr>
			<td style="width: 38%; vertical-align: middle;">&nbsp;</td>
			<td style="width: 46%; vertical-align: middle;">{% textinput_tag name=&quot;696fceb6&quot; placeholder=&quot;en lettres euros&quot; data_label=&quot;Montant des charges mensuelles en lettres&quot; data_map_field=&quot;fixed_charges_price&quot; data_help=&quot;Montant des charges mensuelles en lettres&quot; maxlength=&quot;60&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="width: 1%; vertical-align: middle;">&nbsp;</td>
			<td style="width: 13%; vertical-align: middle;">{% textinput_tag name=&quot;ae57a662&quot; placeholder=&quot;en chiffres euros&quot; data_label=&quot;Montant des charges mensuelles en chiffres&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Montant des charges mensuelles en chiffres&quot; maxlength=&quot;40&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="width: 13%; vertical-align: middle;">&nbsp;&euro;</td>
		</tr>
		<tr>
			<td style="width: 38%; vertical-align: middle;">PROVISIONS MENSUELLES ORDURES M&Eacute;NAG&Egrave;RES</td>
			<td style="width: 46%; vertical-align: middle;">{% textinput_tag name=&quot;696fceb7&quot; placeholder=&quot;en lettres euros&quot; data_label=&quot;Montant des provisions mensuelles ordures m&eacute;nag&egrave;res en lettres&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Montant des provisions mensuelles ordures m&eacute;nag&egrave;res en lettres&quot; maxlength=&quot;60&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="width: 1%; vertical-align: middle;">&nbsp;</td>
			<td style="width: 13%; vertical-align: middle;">{% textinput_tag name=&quot;ae57a663&quot; placeholder=&quot;en chiffres euros&quot; data_label=&quot;Montant des provisions mensuelles ordures m&eacute;nag&egrave;res en chiffres&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Montant des provisions mensuelles ordures m&eacute;nag&egrave;res en chiffres&quot; maxlength=&quot;40&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="width: 13%; vertical-align: middle;">&nbsp;&euro;</td>
		</tr>
		<tr>
			<td style="width: 38%; vertical-align: middle;">TOTAL MENSUEL CHARGES COMPRISES</td>
			<td style="width: 46%; vertical-align: middle;">{% textinput_tag name=&quot;696fceb8&quot; placeholder=&quot;en lettres euros&quot; data_label=&quot;Total mensuel charges comprises en lettres&quot; data_map_field=&quot;rent_price&quot; data_help=&quot;Total mensuel charges comprises en lettres&quot; maxlength=&quot;60&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;true&quot; %}</td>
			<td style="width: 1%; vertical-align: middle;">&nbsp;</td>
			<td style="width: 13%; vertical-align: middle;">{% textinput_tag name=&quot;ae57a664&quot; placeholder=&quot;en chiffres euros&quot; data_label=&quot;Total mensuel charges comprises en chiffres&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Total mensuel charges comprises en chiffres&quot; maxlength=&quot;40&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;true&quot; %}</td>
			<td style="width: 13%; vertical-align: middle;">&nbsp;&euro;</td>
		</tr>
	</tbody>
</table>

&nbsp;

B. TERME DE PAIEMENT

<table border="0" cellpadding="0" cellspacing="0" style="width:100%;">
	<tbody>
		<tr>
			<td style="white-space: nowrap;">Cette somme sera payable d&rsquo;avance et en totalit&eacute; le&nbsp;{% select_tag name=&quot;078a72e8&quot; data_label=&quot;Loyer payable d&#39;avance le X du mois&quot; data_map_field=&quot;nomap&quot; data_choices=&quot;1er|1er; 2|2; 3|3; 4|4; 5|5; 6|6; 7|7; 8|8; 9|9; 10|10;&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}&nbsp;de chaque&nbsp;{% select_tag name=&quot;fd8fa323&quot; data_label=&quot;P&eacute;riodicit&eacute; de paiement du loyer&quot; data_map_field=&quot;nomap&quot; data_choices=&quot;mois|mois;&nbsp;trimestre|trimestre;&nbsp;semestre|semestre;&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}&nbsp;&agrave; Paris entre les mains :&nbsp;{% select_tag name=&quot;c6d94807&quot; data_label=&quot;Le loyer est pay&eacute; &agrave;&quot; data_map_field=&quot;nomap&quot; data_choices=&quot;du bailleur|du bailleur; de Junot|de Junot;&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
		</tr>
	</tbody>
</table>

&nbsp;

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