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			<td><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"><span class="titre_p" style="font-size: 18px; font-weight: 900;">Points&nbsp;juridiques</span><br />
			Origine de propri&eacute;t&eacute; :&nbsp;</span></td>
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			<td>{% textarea_tag name=&quot;39f2c1c3&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Origine de propri&eacute;t&eacute;&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Origine de propri&eacute;t&eacute;&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;">Servitudes :</span></td>
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			<td>{% textarea_tag name=&quot;b231c55e&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Servitudes&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Servitudes&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;">Assurances (dommages-ouvrage,...) :</span></td>
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			<td>{% textarea_tag name=&quot;eae6209c&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Assurances&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Assurances&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;">Si oui, pr&eacute;ciser l&#39;objet du litige :</span></td>
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			<td>{% textarea_tag name=&quot;ab1db864&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Objet du litige&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Objet du litige&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;">Trace ou pr&eacute;sence de termites et insectes xylophages</span></td>
			<td style="text-align: right;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">{% radio_tag name=&quot;d0368f79&quot; data_label=&quot;Trace ou pr&eacute;sence de termites et insectes xylophages&quot; data_map_field=&quot;nomap&quot; data_choices=&quot;OUI|oui; NON|non; *NC|non communiqu&eacute; non concern&eacute;;&quot; %}</span></td>
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			<td><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Pr&eacute;sence d&#39;un risque de champignons lignivores dans votre bien ou &agrave; proximit&eacute; (m&eacute;rule, ...)</span></td>
			<td style="text-align: right;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">{% radio_tag name=&quot;46f5296a&quot; data_label=&quot;Pr&eacute;sence d&#39;un risque de champignons lignivores dans votre bien ou &agrave; proximit&eacute; (m&eacute;rule, ...)&quot; data_map_field=&quot;nomap&quot; data_choices=&quot;OUI|oui; NON|non; *NC|non communiqu&eacute; non concern&eacute;;&quot; %}</span></td>
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			<p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">ERP&nbsp;: le bien a-t-il fait l&rsquo;objet, depuis 1982, d&rsquo;une ou plusieurs indemnisations apr&egrave;s un &eacute;v&eacute;nement</span></p>

<p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">reconnu comme catastrophe naturelle ? </span></p>
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			<td style="text-align: right;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">{% radio_tag name=&quot;a504b7d5&quot; data_label=&quot;ERP : indemnisations apr&egrave;s une catastrophe naturelle&quot; data_map_field=&quot;nomap&quot; data_help=&quot;apr&egrave;s 1982&quot; data_choices=&quot;OUI|oui; NON|non; *NC|non communiqu&eacute; non concern&eacute;;&quot; %}</span></td>
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			<td><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Situation locative :&nbsp;</span></td>
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			<td>{% textarea_tag name=&quot;c62ff846&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;&nbsp;Situation locative&quot; data_map_field=&quot;nomap&quot; data_help=&quot;&nbsp;Situation locative&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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<p>{% checkbox_tag name=&quot;edcc4a84&quot; data_label=&quot;Bien vendu occup&eacute;&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Bien vendu occup&eacute;&quot; %}&nbsp;<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Le bien est actuellement occup&eacute; par un locataire, et sera vendu occup&eacute;. </span></p>

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			<td style="vertical-align: middle; width: 15%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Montant du loyer :</span></td>
			<td>{% textinput_tag name=&quot;d48dd9c6&quot; data_label=&quot;montant du loyer&quot; data_map_field=&quot;rent_price&quot; data_help=&quot;montant du loyer&quot; maxlength=&quot;75&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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<p>{% checkbox_tag name=&quot;747c2253&quot; data_label=&quot;Bien actuellement occup&eacute; vendu vide&quot; data_help=&quot;Bien actuellement occup&eacute;&nbsp;vendu vide&quot; data_map_field=&quot;nomap&quot; %}&nbsp;<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Le bien est actuellement occup&eacute; par un locataire et sera vendu vide. Cong&eacute; d&eacute;livr&eacute; le :&nbsp;</span>{% dateinput_tag name=&quot;8f795d03&quot; placeholder=&quot;jj/mm/aaaa&quot; data_label=&quot;Date du cong&eacute;&quot; data_help=&quot;Date du cong&eacute;&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; data_map_field=&quot;nomap&quot; %}</p>

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			<td style="vertical-align: middle; width: 5%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Par :&nbsp;</span></td>
			<td style="width: 25%;">{% textinput_tag name=&quot;ab0a6a5a&quot; data_label=&quot;Cong&eacute; d&eacute;livr&eacute; par&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Cong&eacute; d&eacute;livr&eacute; par&quot; maxlength=&quot;25&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="vertical-align: middle; width: 15%; text-align: right;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Montant du loyer : </span></td>
			<td>{% textinput_tag name=&quot;e8a5d259&quot; data_label=&quot;Montant du loyer&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Montant du loyer&quot; maxlength=&quot;20&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;">Si oui, pr&eacute;ciser :</span></td>
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			<td>{% textarea_tag name=&quot;45f37e49&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;litige&quot; data_map_field=&quot;nomap&quot; data_help=&quot;litige&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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			<td style="width: 75%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Le bien &eacute;tait lou&eacute; ant&eacute;rieurement ?</span></td>
			<td style="text-align: right; width: 25%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">{% radio_tag name=&quot;2185e0ee&quot; data_label=&quot;Le bien &eacute;tait lou&eacute; ant&eacute;rieurement ?&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Le bien &eacute;tait lou&eacute; ant&eacute;rieurement ?&quot; data_choices=&quot;OUI|oui; NON|non; *NC|non communiqu&eacute; non concern&eacute;;&quot; %}</span></td>
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			<td style="width: 75%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Avez-vous d&eacute;livr&eacute; un cong&eacute; &agrave; votre pr&eacute;c&eacute;dent locataire ?</span></td>
			<td style="text-align: right; width: 20%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">{% radio_tag name=&quot;cbe8fcf9&quot; data_label=&quot;Cong&eacute; au locataire&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Cong&eacute; au locataire&quot; data_choices=&quot;OUI|oui; NON|non; *NC|non communiqu&eacute; non concern&eacute;;&quot; %}</span></td>
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