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Contient un/plusieurs signataires

Reprise des signataires

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Contenu

<table border="0" cellpadding="1" cellspacing="2" style="width:100%;">
	<tbody>
		<tr>
			<td style="vertical-align: middle; width: 50%;">{% select_tag name=&quot;a6e3a684&quot; data_label=&quot;Civilit&eacute; &quot; data_map_field=&quot;civilite&quot; data_help=&quot;Choisissez la civilit&eacute;&quot; data_choices=&quot;Civilit&eacute;|civilite; Monsieur|Monsieur; Madame|Madame;&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"><strong>&nbsp;</strong>Nom :</span></td>
			<td style="vertical-align: bottom; width: 50%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Pr&eacute;nom :</span></td>
		</tr>
		<tr>
			<td style="vertical-align: middle; width: 50%;">{% textinput_tag name=&quot;3a83994c&quot; data_label=&quot;Nom&quot; data_map_field=&quot;nom&quot; data_help=&quot;Nom&quot; maxlength=&quot;50&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="vertical-align: middle; width: 50%;">{% textinput_tag name=&quot;863d332e&quot; data_label=&quot;Pr&eacute;nom&quot; data_map_field=&quot;prenom&quot; data_help=&quot;Pr&eacute;nom&quot; maxlength=&quot;50&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
		</tr>
	</tbody>
</table>

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
	<tbody>
		<tr>
			<td style="vertical-align: middle; width: 50%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Profession&nbsp;:</span></td>
			<td style="vertical-align: middle; width: 50%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Nationalit&eacute;&nbsp;:</span></td>
		</tr>
		<tr>
			<td style="vertical-align: middle; width: 50%;">{% textinput_tag name=&quot;6981f7df&quot; data_label=&quot;Profession &quot; data_map_field=&quot;job&quot; data_help=&quot;Profession &quot; maxlength=&quot;50&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="vertical-align: middle; width: 50%;">{% textinput_tag name=&quot;e3bc61fb&quot; data_label=&quot;Nationalit&eacute; &quot; data_map_field=&quot;nationality&quot; data_help=&quot;Nationalit&eacute; &quot; maxlength=&quot;50&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
		</tr>
	</tbody>
</table>

<table border="0" cellpadding="1" cellspacing="2" style="width:100%;">
	<tbody>
		<tr>
			<td style="vertical-align: middle; width: 50%;">{% select_tag name=&quot;25732082&quot; data_label=&quot;Civilit&eacute; &quot; data_map_field=&quot;civilite&quot; data_help=&quot;Choisissez la civilit&eacute;&quot; data_choices=&quot;Civilit&eacute;|civilite; Monsieur|Monsieur; Madame|Madame;&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}&nbsp;<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&nbsp;Nom :</span></td>
			<td style="vertical-align: bottom; width: 50%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Pr&eacute;nom :</span></td>
		</tr>
		<tr>
			<td style="vertical-align: middle; width: 50%;">{% textinput_tag name=&quot;0f5254e4&quot; data_label=&quot;Nom du signataire&quot; data_map_field=&quot;nom&quot; data_help=&quot;Nom&quot; maxlength=&quot;50&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="vertical-align: middle; width: 50%;">{% textinput_tag name=&quot;f1341fab&quot; data_label=&quot;Pr&eacute;nom&quot; data_map_field=&quot;prenom&quot; data_help=&quot;Nom&quot; maxlength=&quot;50&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
		</tr>
	</tbody>
</table>

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
	<tbody>
		<tr>
			<td style="vertical-align: middle; width: 50%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Profession&nbsp;:</span></td>
			<td style="vertical-align: middle; width: 50%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Nationalit&eacute;&nbsp;:</span></td>
		</tr>
		<tr>
			<td style="vertical-align: middle; width: 50%;">{% textinput_tag name=&quot;8d8075c9&quot; data_label=&quot;Profession &quot; data_map_field=&quot;job&quot; data_help=&quot;Profession &quot; maxlength=&quot;50&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="vertical-align: middle; width: 50%;">{% textinput_tag name=&quot;1f8af9ec&quot; data_label=&quot;Nationalit&eacute; &quot; data_map_field=&quot;nationality&quot; data_help=&quot;Nationalit&eacute; &quot; maxlength=&quot;50&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
		</tr>
	</tbody>
</table>

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
	<tbody>
		<tr>
			<td><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Documents annex&eacute;s :</span></td>
		</tr>
		<tr>
			<td>{% checkbox_tag name=&quot;48f43b1c&quot; data_label=&quot;copie d&#39;une pi&egrave;ce d&#39;identit&eacute; en cours de validit&eacute;, comportant photo et signature&quot; data_map_field=&quot;nomap&quot; %} {% checkbox_tag name=&quot;568a269b&quot; data_label=&quot;copie d&#39;une pi&egrave;ce d&#39;identit&eacute; en cours de validit&eacute;, comportant photo et signature&quot; data_map_field=&quot;nomap&quot; %}&nbsp;<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">copie d&#39;une pi&egrave;ce d&#39;identit&eacute; en cours de validit&eacute;, comportant photo et signature</span></td>
		</tr>
		<tr>
			<td>{% checkbox_tag name=&quot;e89a7854&quot; data_label=&quot;justificatif r&eacute;cent de domicile&quot; data_map_field=&quot;nomap&quot; %}<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&nbsp;</span>{% checkbox_tag name=&quot;3ec11c28&quot; data_label=&quot;justificatif r&eacute;cent de domicile&quot; data_map_field=&quot;nomap&quot; %}&nbsp;<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">justificatif r&eacute;cent de domicile</span></td>
		</tr>
		<tr>
			<td>{% checkbox_tag name=&quot;b5a9f975&quot; data_label=&quot;justificatifs sur les revenus et le patrimoine (avis d&#39;imposition)&quot; data_map_field=&quot;nomap&quot; %}<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&nbsp;</span>{% checkbox_tag name=&quot;7720f3fd&quot; data_label=&quot;justificatifs sur les revenus et le patrimoine (avis d&#39;imposition)&quot; data_map_field=&quot;nomap&quot; %}&nbsp;<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">justificatifs sur les revenus et le patrimoine (avis d&#39;imposition)</span></td>
		</tr>
		<tr>
			<td>{% checkbox_tag name=&quot;77d08238&quot; data_label=&quot;le client n&#39;est pas une personnalit&eacute; politiquement expos&eacute;e&quot; data_map_field=&quot;nomap&quot; %}&nbsp;{% checkbox_tag name=&quot;8292e093&quot; data_label=&quot;le client n&#39;est pas une personnalit&eacute; politiquement expos&eacute;e&quot; data_map_field=&quot;nomap&quot; %}&nbsp;<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">le client n&#39;est pas une personnalit&eacute; politiquement expos&eacute;e :&nbsp;</span></td>
		</tr>
		<tr>
			<td>{% textarea_tag name=&quot;f5a0fa64&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;justifier la personnalit&eacute; politiquement expos&eacute;e&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; data_map_field=&quot;nomap&quot; %}</td>
		</tr>
	</tbody>
</table>

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