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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;">Le forfait de charges fait l&rsquo;objet d&rsquo;une r&eacute;vision annuelle dans les m&ecirc;mes conditions que le loyer principal soit(2) :</span></td>
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			<td><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">{% textarea_tag name=&quot;3f88e325&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Condition de r&eacute;vision&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Condition de r&eacute;vision&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</span></td>
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</table>

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			<td style="white-space: nowrap; width: 15%; vertical-align: bottom;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Date de r&eacute;vision :&nbsp;</span></td>
			<td><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">{% textinput_tag name=&quot;23a1163f&quot; data_label=&quot;Date de r&eacute;vision&quot; data_help=&quot;Date de r&eacute;vision&quot; maxlength=&quot;99&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</span></td>
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</table>

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
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			<td style="width: 32%; vertical-align: middle;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Date ou trimestre de r&eacute;f&eacute;rence de l&rsquo;IRL&nbsp;:</span></td>
			<td><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">{% textinput_tag name=&quot;8eec54d8&quot; data_label=&quot;Date ou trimestre de r&eacute;f&eacute;rence&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Date ou trimestre de r&eacute;f&eacute;rence&quot; maxlength=&quot;70&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</span></td>
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