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			<p><span style="font-size:14px;"><span class="titre_p" style="font-family: ITCAvantGardePro; font-weight: 900;">D. Modalit&eacute;s de paiement :</span></span></p>

<p><span class="titre_p" style="font-family:ITCAvantGardePro;font-size:18px;font-weight:900;"><span style="font-size: 12px; font-weight: 200;">&bull; p&eacute;riodicit&eacute; du paiement<sup>(8)</sup> : </span></span><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">{% radio_tag name=&quot;75e6439b&quot; data_label=&quot;p&eacute;riodicit&eacute; de paiement&quot; data_map_field=&quot;nomap&quot; data_help=&quot;p&eacute;riodicit&eacute; de paiement&quot; data_choices=&quot;trimestrielle&nbsp; &nbsp; |trimestrielle; mensuelle|mensuelle;&quot; data_ancien_ids=&quot;30893,30279&quot; %}</span><span class="titre_p" style="font-family:ITCAvantGardePro;font-size:18px;font-weight:900;"><span style="font-size: 12px; font-weight: 200;"> &nbsp; &nbsp; &nbsp; &nbsp;&bull; paiement : &nbsp;</span></span><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">{% radio_tag name=&quot;c7ed3f43&quot; data_label=&quot;paiement&quot; data_map_field=&quot;nomap&quot; data_help=&quot;paiement&quot; data_choices=&quot;&agrave; &eacute;choir &nbsp; &nbsp; &nbsp; |&agrave; &eacute;choir; &agrave; terme &eacute;chu|&agrave; terme &eacute;chu;&quot; data_ancien_ids=&quot;31223,31199&quot; %}</span></p>
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			<td style="white-space: nowrap; width: 30%; vertical-align: middle;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&bull; date ou p&eacute;riode de paiement :</span></td>
			<td style="width: 70%;">{% textinput_tag name=&quot;e8c1d8bf&quot; data_label=&quot;Date ou p&eacute;riode de paiment&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Date ou p&eacute;riode de paiment&quot; maxlength=&quot;70&quot; data_ancien_ids=&quot;30202&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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			<td style="white-space: nowrap; width: 30%; vertical-align: middle;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&bull; le cas &eacute;ch&eacute;ant, lieu de paiement :</span></td>
			<td style="width: 70%;">{% textinput_tag name=&quot;89d677bf&quot; data_label=&quot;Lieu de paiement&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Lieu de paiement&quot; maxlength=&quot;70&quot; data_ancien_ids=&quot;30052&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; Montant total d&ucirc; &agrave; la premi&egrave;re &eacute;ch&eacute;ance de paiement pour une p&eacute;riode compl&egrave;te de location :</span></p>

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			<td>{% textarea_tag name=&quot;d9ec838b&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Montant total d&ucirc; &agrave; la premi&egrave;re &eacute;ch&eacute;ance&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Montant total d&ucirc; &agrave; la premi&egrave;re &eacute;ch&eacute;ance&quot; data_ancien_ids=&quot;29734&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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			<td style="text-align: right; white-space: nowrap; width: 60%;"><span style="font-family: ITCAvantGardePro; font-size: 12px;"><span style="font-weight:600;">D&eacute;tail :&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</span>&nbsp;&bull; Loyer mensuel hors compl&eacute;ment de loyer &eacute;ventuel :&nbsp;</span></td>
			<td style="width: 40%;">{% textinput_tag name=&quot;500e1003&quot; data_label=&quot;Montant du Loyer mensuel hors compl&eacute;ment&quot; data_map_field=&quot;rent_price&quot; data_help=&quot;Montant du loyer mensuel hors compl&eacute;ment de loyer &eacute;ventuel&quot; maxlength=&quot;40&quot; data_ancien_ids=&quot;29434&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;true&quot; %}</td>
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			<td style="text-align: right; white-space: nowrap; width: 60%;"><span style="font-family: ITCAvantGardePro; font-size: 12px;">&bull; Compl&eacute;ment de loyer &eacute;ventuel :<br />
			(contribution pour le partage des &eacute;conomies de charges)&nbsp;</span></td>
			<td style="width: 40%;">{% textinput_tag name=&quot;c7951731&quot; data_label=&quot;Montant du compl&eacute;ment de loyer &eacute;ventuel&quot; data_map_field=&quot;rent_price_comp&quot; data_help=&quot;Compl&eacute;ment de loyer &eacute;ventuel&quot; maxlength=&quot;40&quot; data_ancien_ids=&quot;29386&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;true&quot; %}</td>
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			<td style="text-align: right; white-space: nowrap; width: 60%;"><span style="font-family: ITCAvantGardePro; font-size: 12px;">&bull; Provisions/forfait de charges :</span></td>
			<td style="width: 40%;">{% textinput_tag name=&quot;4d1b02c3&quot; data_label=&quot;Montant des provisions/forfait de charges&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Provisions/forfait de charges&quot; maxlength=&quot;40&quot; data_ancien_ids=&quot;29338&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;true&quot; %}</td>
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			<td style="text-align: right; white-space: nowrap; width: 60%;"><span style="font-family: ITCAvantGardePro; font-size: 12px;">&bull; Assurance r&eacute;cup&eacute;rable pour le compte du locataire :&nbsp;<br />
			(en cas de colocation)&nbsp;</span></td>
			<td style="width: 40%;">{% textinput_tag name=&quot;4fd1fde7&quot; data_label=&quot;Montant de l&#39;assurance r&eacute;cup&eacute;rable pour le compte du locataire&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Assurance r&eacute;cup&eacute;rable pour le compte du locataire&quot; maxlength=&quot;40&quot; data_ancien_ids=&quot;29263&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;true&quot; %}</td>
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			<td style="text-align: right; white-space: nowrap; width: 60%;"><span style="font-weight:600;"><span style="font-size:14px;"><span style="font-family: ITCAvantGardePro;">Soit un total de :</span></span></span></td>
			<td style="width: 40%;">{% textinput_tag name=&quot;19d4caeb&quot; data_label=&quot;Soit un total de&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Soit un total de&quot; maxlength=&quot;40&quot; data_ancien_ids=&quot;29166&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;true&quot; %}</td>
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			<p style="text-align: justify;"><span style="font-size:14px;"><span class="titre_p" style="font-family: ITCAvantGardePro; font-weight: 900;">E. Exclusivement lors d&rsquo;un renouvellement de contrat, modalit&eacute;s de r&eacute;&eacute;valuation d&rsquo;un loyer manifestement sous-&eacute;valu&eacute;</span></span></p>

<p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"><span class="titre_p"><span style="font-weight:600;">1. Montant de la hausse ou de la baisse de loyer mensuel</span>&nbsp; (en Euros) :</span></span></p>
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			<td>{% textarea_tag name=&quot;aed63b63&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Lors d&#39;un renouvellement de contrat : montant de la hausse ou de la baisse de loyer mensuel&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Montant de la hausse ou de la baisse de loyer mensuel&quot; data_ancien_ids=&quot;29006&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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			<td><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"><span class="titre_p"><span style="font-weight:600;">2. Modalit&eacute; d&rsquo;application annuelle de la hausse</span> </span></span><span style="font-size:10px;"><span style="font-family: ITCAvantGardePro; font-weight: 200;"><span class="titre_p"><em>[par tiers ou par sixi&egrave;me selon la dur&eacute;e du contrat et le montant de la hausse de loyer] </em></span></span></span><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"><span class="titre_p">:</span></span></td>
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			<td>{% textarea_tag name=&quot;b895bf32&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Modalit&eacute; d&rsquo;application annuelle de la hausse&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Modalit&eacute; d&rsquo;application annuelle de la hausse&quot; data_ancien_ids=&quot;28957&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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			<p><span style="font-size:14px;"><span style="font-weight:900;"><span style="font-family: ITCAvantGardePro;">F. D&eacute;penses &eacute;nerg&eacute;tiques (pour information)</span></span></span></p>

<p style="text-align: justify;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Montant estim&eacute; des d&eacute;penses annuelles d&#39;&eacute;nergie pour un usage standard de l&#39;ensemble des usages &eacute;num&eacute;r&eacute;s dans le diagnostic de performance &eacute;nerg&eacute;tique (chauffage, refroidissement, production d&#39;eau chaude sanitaire, &eacute;clairage et auxiliaires de chauffage, de refroidissement, d&#39;eau chaude sanitaire et de ventilation) mentionn&eacute; &agrave; l&#39;article L. 126-26 du code de la construction et de l&#39;habitation :</span></p>
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			<td>{% textarea_tag name=&quot;caa93e73&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;montant ou fourchette inscrit dans le diagnostic de performance &eacute;nerg&eacute;tique&quot; data_map_field=&quot;energy_consumption&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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			<td style="width: 62%; vertical-align: bottom;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">estimation r&eacute;alis&eacute;e &agrave; partir des prix &eacute;nerg&eacute;tiques de r&eacute;f&eacute;rence de l&#39;ann&eacute;e :&nbsp;</span></td>
			<td>{% textinput_tag name=&quot;d802daf1&quot; data_label=&quot;ann&eacute;e de r&eacute;f&eacute;rence des prix &eacute;nerg&eacute;tiques du diagnostic &eacute;nerg&eacute;tique &agrave; l&#39;origine de l&#39;estimation&quot; data_map_field=&quot;nomap&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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			<p><span style="font-size:18px;"><span class="titre_p" style="font-family: ITCAvantGardePro; font-weight: 900;">TRAVAUX </span></span></p>

<p style="text-align: justify;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"><span class="titre_p"><span style="font-weight:600;">A.</span> Montant et nature des travaux d&rsquo;am&eacute;lioration ou de mise en conformit&eacute; avec les caract&eacute;ristiques de d&eacute;cence effectu&eacute;s depuis la fin du dernier contrat de location ou depuis le dernier renouvellement :</span></span></p>
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			<td>{% textarea_tag name=&quot;6ebdbcab&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Montant et nature des travaux d&rsquo;am&eacute;lioration&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Montant et nature des travaux d&rsquo;am&eacute;lioration&quot; data_ancien_ids=&quot;34785&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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			<td style="text-align: justify;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"><span class="titre_p">Montant et nature des travaux d&rsquo;am&eacute;lioration effectu&eacute;s au cours des six derniers mois</span></span></td>
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			<td>{% textarea_tag name=&quot;b602a85d&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Montant et nature des travaux effectu&eacute;s au cours des six derniers mois&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Montant et nature des travaux depuis six mois&quot; data_ancien_ids=&quot;34735&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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			<td style="text-align: justify;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"><span class="titre_p"><span style="font-weight:600;">B.</span> Majoration du loyer en cours de bail cons&eacute;cutive &agrave; des travaux d&rsquo;am&eacute;lioration entrepris par le bailleur [nature des travaux, modalit&eacute;s d&rsquo;ex&eacute;cution, d&eacute;lai de r&eacute;alisation ainsi que montant de la majoration du loyer]<sup>(9)</sup> :</span></span></td>
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			<td>{% textarea_tag name=&quot;34eaee39&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Majoration du loyer cons&eacute;cutive &agrave; des travaux d&#39;am&eacute;lioration&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Majoration du loyer&quot; data_ancien_ids=&quot;34893&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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			<td style="text-align: justify;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"><span class="titre_p"><span style="font-weight:600;">C.</span> Diminution de loyer en cours de bail cons&eacute;cutive &agrave; des travaux entrepris par le locataire [dur&eacute;e de cette diminution et, en cas de d&eacute;part anticip&eacute; du locataire, modalit&eacute;s de son d&eacute;dommagement sur justification des d&eacute;penses effectu&eacute;es] :</span></span></td>
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			<td>{% textarea_tag name=&quot;a729ee03&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Diminution de loyer cons&eacute;cutive &agrave; des travaux entremis par le locataire&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Diminution de loyer&quot; data_ancien_ids=&quot;34948&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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