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<p><span style="font-size:14px;"><span style="font-family: ITCAvantGardePro; font-weight: 200;"><span class="titre_p" style="font-weight: 900;">Logement concern&eacute; par le cong&eacute; :</span></span></span></p>

<p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&bull; <span style="font-weight:900;">localisation du logement</span> [adresse / b&acirc;timent / &eacute;tage / porte, etc.] : </span></p>

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
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			<td>{% textarea_tag name=&quot;74ec0904&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Adresse du logement&quot; data_map_field=&quot;full_address&quot; data_help=&quot;Adresse du logement (adresse / b&acirc;timent / &eacute;tage / porte, etc)&quot; data_ancien_ids=&quot;24687&quot; relation_ids_list=&quot;202bd211&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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<p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&bull; </span><span style="font-family: ITCAvantGardePro; font-size: 12px;"><b>d&eacute;signation :</b></span></p>

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
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			<td>{% textarea_tag name=&quot;826da781&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;D&eacute;signation du bien&quot; data_map_field=&quot;realty_name&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><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"><span style="font-weight:900;">&bull; type d&rsquo;habitat :</span>&nbsp; &nbsp;{% radio_tag name=&quot;dadb644d&quot; data_label=&quot;type d&#39;habitat&quot; data_map_field=&quot;nomap&quot; data_help=&quot;type d&#39;habitat&quot; data_choices=&quot;immeuble collectif&nbsp; &nbsp; &nbsp; &nbsp; |immeuble collectif;immeuble individuel| immeuble individuel;&quot; data_ancien_ids=&quot;26143,25884&quot; %}</span></p>

<p><span style="font-weight:900;"><span style="font-family: ITCAvantGardePro; font-size: 12px;">&bull; r&eacute;gime juridique de l&rsquo;immeuble :&nbsp;<span style="font-weight: 200;">&nbsp;</span></span></span><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">{% radio_tag name=&quot;9013ce82&quot; data_label=&quot;r&eacute;gime juridique&quot; data_map_field=&quot;nomap&quot; data_help=&quot;r&eacute;gime juridique&quot; data_choices=&quot;monopropri&eacute;t&eacute;&nbsp; &nbsp; &nbsp; |monopropri&eacute;t&eacute;;copropri&eacute;t&eacute;|copropri&eacute;t&eacute;;&quot; data_ancien_ids=&quot;26215,26191&quot; %}</span></p>

<table border="0" cellpadding="1" cellspacing="1" style="width:100%;">
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			<td style="width: 7%; vertical-align: middle;"><span style="font-weight:900;"><span style="font-family: ITCAvantGardePro; font-size: 12px;">&bull; lot n&deg;</span></span></td>
			<td style="width: 20%;">{% textinput_tag name=&quot;146ef49b&quot; data_label=&quot;n&deg; de lot&quot; data_map_field=&quot;parcel_numero&quot; data_help=&quot;n&deg; de lot&quot; maxlength=&quot;20&quot; data_ancien_ids=&quot;25776&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="width: 13%; vertical-align: middle;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&nbsp;et repr&eacute;sentant&nbsp;</span></td>
			<td style="width: 20%;">{% textinput_tag name=&quot;e7accfb7&quot; data_label=&quot;tanti&egrave;me g&eacute;n&eacute;raux&quot; data_map_field=&quot;directors_fees&quot; data_help=&quot;tanti&egrave;me g&eacute;n&eacute;raux&quot; maxlength=&quot;20&quot; data_ancien_ids=&quot;25829&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="width: 28%; vertical-align: middle;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&nbsp;tanti&egrave;mes g&eacute;n&eacute;raux de l&rsquo;immeuble</span></td>
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<p style="text-align: justify;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"><span style="font-weight:900;">&bull; p&eacute;riode de construction :&nbsp;</span>{% radio_tag name=&quot;6925ff1c&quot; data_label=&quot;P&eacute;riode de contruction&quot; data_map_field=&quot;nomap&quot; data_help=&quot;P&eacute;riode de contruction&quot; data_choices=&quot;avant 1949&nbsp;&nbsp;&nbsp;|avant 1949;de 1949 &agrave; 1974&nbsp; |de 1949 &agrave; 1974;de 1975 &agrave; 1989&nbsp; |de 1975 &agrave; 1989;de 1989 &agrave; 2005&nbsp;&nbsp;|de 1989 &agrave; 2005;depuis 2005&nbsp; |depuis 2005;&quot; data_ancien_ids=&quot;25672,25624,25574,25181&quot; %}</span></p>

<table border="0" cellpadding="1" cellspacing="1" style="width:100%;">
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			<td style="width: 20%; white-space: nowrap; vertical-align: middle;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"><span style="font-weight:900;">&bull; surface habitable :&nbsp;</span></span></td>
			<td style="width: 25%;">{% textinput_tag name=&quot;f2a36bc9&quot; data_label=&quot;Surface habitable&quot; data_map_field=&quot;area&quot; data_help=&quot;Surface habitable&quot; maxlength=&quot;25&quot; data_ancien_ids=&quot;40728&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="width: 30%; white-space: nowrap; vertical-align: middle;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"><span style="font-weight:900;">&bull; nombre de pi&egrave;ces principales :</span></span></td>
			<td style="width: 25%;">{% textinput_tag name=&quot;d854de0a&quot; data_label=&quot;nombre de pi&egrave;ces principales&quot; data_map_field=&quot;nb_room&quot; data_help=&quot;nombre de pi&egrave;ces principales&quot; maxlength=&quot;25&quot; data_ancien_ids=&quot;40752&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;">&bull; <span style="font-weight:900;">Autres parties du logement</span> (le cas &eacute;ch&eacute;ant) </span><span style="font-size:10px;"><span style="font-family: ITCAvantGardePro; font-weight: 200;">[ex&nbsp;: grenier, combles am&eacute;nag&eacute;s ou non, terrasse, loggia, balcon, jardin, etc.] :</span></span><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&nbsp;</span></p>

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
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			<td>{% textarea_tag name=&quot;e1698dcd&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Autres parties du logements&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Autres parties du logements, ex&nbsp;grenier, combles am&eacute;nag&eacute;s ou non, terrasse, balcon, loggia, jardin, etc &quot; data_ancien_ids=&quot;24687&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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