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<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
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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;">El&eacute;ments juridiques</span></span></td>
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			<td><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">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 style="width: 80%; text-align: justify;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">La construction existante est-elle int&eacute;gralement conforme aux autorisations d&#39;urbanisme obtenues ?&nbsp;</span></td>
			<td style="text-align: right; white-space: nowrap;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">{% radio_tag name=&quot;ee3b497c&quot; data_label=&quot;Construction conforme&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Construction conforme&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;ciser&nbsp;:</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;Pr&eacute;cisions&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Pr&eacute;cisions&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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			<td style="width: 80%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Certificat de conformit&eacute; ?</span></td>
			<td style="width: 20%; text-align: right; white-space: nowrap;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">{% radio_tag name=&quot;fee22f45&quot; data_label=&quot;Certificat de conformit&eacute;&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Certificat de conformit&eacute;&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: 80%; text-align: justify;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Litiges ou sinistres en cours ?</span></td>
			<td style="width: 20%; text-align: right;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">{% radio_tag name=&quot;a4f0267d&quot; data_label=&quot;Litiges ou sinistres en cours&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Litiges ou sinistres en cours&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;">Si oui pr&eacute;ciser :</span></td>
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			<td>{% textarea_tag name=&quot;114538b0&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Litiges ou sinistres en cours&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Litiges ou sinistres en cours&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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<table border="0" cellpadding="1" cellspacing="1" style="width:100%;">
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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 xylophage&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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			<td style="text-align: justify;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Le bien a-t-il fait l&#39;objet d&#39;indemnisation apr&egrave;s un &eacute;v&egrave;nement reconnu comme catastrophe naturelle ?</span></td>
			<td style="width: 25%; text-align: right;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">{% radio_tag name=&quot;a504b7d5&quot; data_label=&quot;Le bien a-t-il fait l&#39;objet d&#39;indemnisation apr&egrave;s un &eacute;v&egrave;nement reconnu comme 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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</table>

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