{"id":4470,"date":"2012-09-29T07:54:08","date_gmt":"2012-09-29T07:54:08","guid":{"rendered":"http:\/\/@WEBSITE_1@\/?page_id=4470"},"modified":"2018-06-04T18:20:33","modified_gmt":"2018-06-04T18:20:33","slug":"offerte_ipt_zaakvoerder","status":"publish","type":"page","link":"https:\/\/www.gbwoluwe.be\/en\/offerte_ipt_zaakvoerder\/","title":{"rendered":"Quotation IP Manager"},"content":{"rendered":"<p>\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_30' style='display:none'><div id='gf_30' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_30'  action=\"\/en\/wp-json\/wp\/v2\/pages\/4470#gf_30\" data-formid='30' novalidate>\n        <div id='gf_progressbar_wrapper_30' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<h3 class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>5<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/h3>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_20' style='width:20%;'><span>20%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_30_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><ul id='gform_fields_30' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_30_60\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_60' class='gfield_label gform-field-label' for='input_30_60'><span class='gform-field-label__text'>Instagram<\/span><\/label><div class='ginput_container'><input name='input_60' id='input_30_60' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_30_60'>This field is for validation purposes and should be left unchanged.<\/div><\/li><li id=\"field_30_2\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">Policyholder<\/h2><\/li><li id=\"field_30_4\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_4' class='gfield_label gform-field-label' for='input_30_4'><span class='gform-field-label__text'>Company name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_30_4' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_30_5\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_5' class='gfield_label gform-field-label' for='input_30_5'><span class='gform-field-label__text'>Legal form<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_5' id='input_30_5' class='medium gfield_select'     aria-invalid=\"false\" ><option value='LTD' >LTD<\/option><option value='PLC' >PLC<\/option><option value='LLP' >LLP<\/option><option value='CCLL' >CCLL<\/option><option value='Limited partnership' >Limited partnership<\/option><option value='Other' >Other<\/option><\/select><\/div><\/li><li id=\"field_30_6\" class=\"gfield gfield--type-address field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_6' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Address<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip ginput_container_address gform-grid-row' id='input_30_6' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_30_6_1_container' >\n                                        <label for='input_30_6_1' id='input_30_6_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_6.1' id='input_30_6_1' value=''    aria-required='false'    aria-labelledby=\"input_30_6_1_label gfield_label_30_6\"\/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_30_6_3_container' >\n                                    <label for='input_30_6_3' id='input_30_6_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_6.3' id='input_30_6_3' value=''    aria-required='false'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_6.4' id='input_30_6_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_30_6_5_container' >\n                                    <label for='input_30_6_5' id='input_30_6_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                    <input type='text' name='input_6.5' id='input_30_6_5' value=''    aria-required='false'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_6.6' id='input_30_6_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_30_7\" class=\"gfield gfield--type-text field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_7' class='gfield_label gform-field-label' for='input_30_7'><span class='gform-field-label__text'>Company number<\/span><\/label><div class='ginput_container ginput_container_text' data-text-counter-max='10' data-text-counter-template='{current} of {max} max characters'><input name='input_7' id='input_30_7' type='text' value='' class='medium' maxlength='10' aria-describedby=\"gfield_description_30_7\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_30_7'>(If in formation: type IF)<\/div><\/li><li id=\"field_30_8\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_8' class='gfield_label gform-field-label' for='input_30_8'><span class='gform-field-label__text'>Start date company<\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='dd\/mm\/yyyy'\n\t\t\t\t\tid='input_30_8'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_8'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_30_8' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_30_8' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_30_8' aria-label='Start date company: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer left_label'>\n                         <button type='button' id='gform_next_button_30_1' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_30_2' class='gform_page' data-js='page-field-id-1' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_30_2' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_30_9\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">Beneficiary (manager)<\/h2><\/li><li id=\"field_30_10\" class=\"gfield gfield--type-name field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_10' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Name<\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_30_10'>\n                            \n                            <span id='input_30_10_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_30_10_3' id='input_30_10_3_label' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_10.3' id='input_30_10_3' value=''   aria-required='false'     aria-labelledby=\"input_30_10_3_label gfield_label_30_10\"\/>\n                                                <\/span>\n                            \n                            <span id='input_30_10_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_30_10_6' id='input_30_10_6_label' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_10.6' id='input_30_10_6' value=''   aria-required='false'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/li><li id=\"field_30_11\" class=\"gfield gfield--type-address field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_11' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Address<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip ginput_container_address gform-grid-row' id='input_30_11' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_30_11_1_container' >\n                                        <label for='input_30_11_1' id='input_30_11_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_11.1' id='input_30_11_1' value=''    aria-required='false'    aria-labelledby=\"input_30_11_1_label gfield_label_30_11\"\/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_30_11_3_container' >\n                                    <label for='input_30_11_3' id='input_30_11_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_11.3' id='input_30_11_3' value=''    aria-required='false'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_11.4' id='input_30_11_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_30_11_5_container' >\n                                    <label for='input_30_11_5' id='input_30_11_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                    <input type='text' name='input_11.5' id='input_30_11_5' value=''    aria-required='false'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_11.6' id='input_30_11_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_30_12\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_12' class='gfield_label gform-field-label' for='input_30_12'><span class='gform-field-label__text'>Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_12' id='input_30_12' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_30_13\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_13' class='gfield_label gform-field-label' for='input_30_13'><span class='gform-field-label__text'>Date of birth<\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='dd\/mm\/yyyy'\n\t\t\t\t\tid='input_30_13'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_13'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_30_13' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_30_13' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_30_13' aria-label='Date of birth: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_30_14\" class=\"gfield gfield--type-text field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_14' class='gfield_label gform-field-label' for='input_30_14'><span class='gform-field-label__text'>Place of birth<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_30_14' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_30_15\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_15' class='gfield_label gform-field-label' for='input_30_15'><span class='gform-field-label__text'>Sex<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_15' id='input_30_15' class='medium gfield_select'     aria-invalid=\"false\" ><option value='M' >M<\/option><option value='F' >F<\/option><option value='X' >X<\/option><\/select><\/div><\/li><li id=\"field_30_16\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_16' class='gfield_label gform-field-label' for='input_30_16'><span class='gform-field-label__text'>Marital status<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_16' id='input_30_16' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Married' >Married<\/option><option value='Legally cohabiting' >Legally cohabiting<\/option><option value='Practically living together' >Practically living together<\/option><option value='Single' >Single<\/option><\/select><\/div><\/li><li id=\"field_30_17\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_17' class='gfield_label gform-field-label' for='input_30_17'><span class='gform-field-label__text'>Smoker<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_17' id='input_30_17' class='medium gfield_select'     aria-invalid=\"false\" ><option value='No' >No<\/option><option value='Yes' >Yes<\/option><\/select><\/div><\/li><li id=\"field_30_19\" class=\"gfield gfield--type-number field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_19' class='gfield_label gform-field-label' for='input_30_19'><span class='gform-field-label__text'>Employment (%)<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_19' id='input_30_19' type='text' step='any' min='0' max='100' value='' class='medium'      aria-invalid=\"false\" aria-describedby=\"gfield_instruction_30_19 gfield_description_30_19\" \/><div class='gfield_description instruction ' id='gfield_instruction_30_19'>Please enter a number less than or equal to <strong>100<\/strong>.<\/div><\/div><div class='gfield_description' id='gfield_description_30_19'>eg. 100%<\/div><\/li><li id=\"field_30_20\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_20' class='gfield_label gform-field-label' for='input_30_20'><span class='gform-field-label__text'>You are employed in the company since (date)<\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='dd\/mm\/yyyy'\n\t\t\t\t\tid='input_30_20'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_20'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_30_20' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_30_20' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_30_20' aria-label='You are employed in the company since (date): Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_30_21\" class=\"gfield gfield--type-number field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_21' class='gfield_label gform-field-label' for='input_30_21'><span class='gform-field-label__text'>How much time do you spent on administration \/ management<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_21' id='input_30_21' type='text' step='any'   value='' class='medium'      aria-invalid=\"false\" aria-describedby=\"gfield_description_30_21\" \/><\/div><div class='gfield_description' id='gfield_description_30_21'>(relative to your total hours that you make for the company)<\/div><\/li><li id=\"field_30_22\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_22' class='gfield_label gform-field-label' for='input_30_22'><span class='gform-field-label__text'>When do you plan to retire<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_22' id='input_30_22' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Age of 65' >Age of 65<\/option><option value='Age of 60' >Age of 60<\/option><\/select><\/div><\/li><li id=\"field_30_23\" class=\"gfield gfield--type-textarea field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_23' class='gfield_label gform-field-label' for='input_30_23'><span class='gform-field-label__text'>Detailed description profession<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_23' id='input_30_23' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_30_24\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"><label id='gfield_label_30_24' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Sports activities<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_30_24'><li class='gchoice gchoice_30_24_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.1' type='checkbox'  value='None or harmless sport'  id='choice_30_24_1'    aria-labelledby=\"label_30_24_1 gfield_label_30_24\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_30_24_1' id='label_30_24_1' class='gform-field-label gform-field-label--type-inline'>None or harmless sport<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_30_24_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.2' type='checkbox'  value='Scuba diving'  id='choice_30_24_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_24_2' id='label_30_24_2' class='gform-field-label gform-field-label--type-inline'>Scuba diving<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_30_24_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.3' type='checkbox'  value='Martial arts'  id='choice_30_24_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_24_3' id='label_30_24_3' class='gform-field-label gform-field-label--type-inline'>Martial arts<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_30_24_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.4' type='checkbox'  value='Climbing sports'  id='choice_30_24_4'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_24_4' id='label_30_24_4' class='gform-field-label gform-field-label--type-inline'>Climbing sports<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_30_24_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.5' type='checkbox'  value='Parachuting'  id='choice_30_24_5'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_24_5' id='label_30_24_5' class='gform-field-label gform-field-label--type-inline'>Parachuting<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_30_24_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.6' type='checkbox'  value='Sports with airplane'  id='choice_30_24_6'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_24_6' id='label_30_24_6' class='gform-field-label gform-field-label--type-inline'>Sports with airplane<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_30_24_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.7' type='checkbox'  value='Bungee jumping'  id='choice_30_24_7'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_24_7' id='label_30_24_7' class='gform-field-label gform-field-label--type-inline'>Bungee jumping<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_30_24_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.8' type='checkbox'  value='Automobile or motorcycle racing'  id='choice_30_24_8'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_24_8' id='label_30_24_8' class='gform-field-label gform-field-label--type-inline'>Automobile or motorcycle racing<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_30_24_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.9' type='checkbox'  value='Water racing'  id='choice_30_24_9'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_24_9' id='label_30_24_9' class='gform-field-label gform-field-label--type-inline'>Water racing<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_30_24_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.11' type='checkbox'  value='Sailing trips on long distance'  id='choice_30_24_11'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_24_11' id='label_30_24_11' class='gform-field-label gform-field-label--type-inline'>Sailing trips on long distance<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_30_24_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.12' type='checkbox'  value='Stuntman'  id='choice_30_24_12'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_24_12' id='label_30_24_12' class='gform-field-label gform-field-label--type-inline'>Stuntman<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer left_label'>\n                        <button type='button' id='gform_previous_button_30_25' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='button' id='gform_next_button_30_25' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_30_3' class='gform_page' data-js='page-field-id-25' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_30_3' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_30_26\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">Career<\/h2><\/li><li id=\"field_30_28\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_28' class='gfield_label gform-field-label' for='input_30_28'><span class='gform-field-label__text'>Started to work<\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='dd\/mm\/yyyy'\n\t\t\t\t\tid='input_30_28'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_28'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_30_28' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_30_28' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_30_28' aria-label='Started to work: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_30_29\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_29' class='gfield_label gform-field-label' for='input_30_29'><span class='gform-field-label__text'>Till<\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='dd\/mm\/yyyy'\n\t\t\t\t\tid='input_30_29'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_29'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_30_29' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_30_29' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_30_29' aria-label='Till: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_30_30\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_30' class='gfield_label gform-field-label' for='input_30_30'><span class='gform-field-label__text'>Statute<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_30' id='input_30_30' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Employee' >Employee<\/option><option value='Ind\u00e9pendant' >Ind\u00e9pendant<\/option><\/select><\/div><\/li><li id=\"field_30_31\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_31' class='gfield_label gform-field-label' for='input_30_31'><span class='gform-field-label__text'>From<\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='dd\/mm\/yyyy'\n\t\t\t\t\tid='input_30_31'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_31'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_30_31' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_30_31' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_30_31' aria-label='From: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_30_32\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_32' class='gfield_label gform-field-label' for='input_30_32'><span class='gform-field-label__text'>Till<\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='dd\/mm\/yyyy'\n\t\t\t\t\tid='input_30_32'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_32'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_30_32' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_30_32' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_30_32' aria-label='Till: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_30_33\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_33' class='gfield_label gform-field-label' for='input_30_33'><span class='gform-field-label__text'>Statute<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_33' id='input_30_33' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Employee' >Employee<\/option><option value='Ind\u00e9pendant' >Ind\u00e9pendant<\/option><\/select><\/div><\/li><li id=\"field_30_34\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_34' class='gfield_label gform-field-label' for='input_30_34'><span class='gform-field-label__text'>From<\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='dd\/mm\/yyyy'\n\t\t\t\t\tid='input_30_34'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_34'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_30_34' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_30_34' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_30_34' aria-label='From: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_30_36\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_36' class='gfield_label gform-field-label' for='input_30_36'><span class='gform-field-label__text'>Till<\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='dd\/mm\/yyyy'\n\t\t\t\t\tid='input_30_36'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_36'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_30_36' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_30_36' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_30_36' aria-label='Till: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_30_38\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_38' class='gfield_label gform-field-label' for='input_30_38'><span class='gform-field-label__text'>Statute<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_38' id='input_30_38' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Employee' >Employee<\/option><option value='Ind\u00e9pendant' >Ind\u00e9pendant<\/option><\/select><\/div><\/li><li id=\"field_30_35\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_35' class='gfield_label gform-field-label' for='input_30_35'><span class='gform-field-label__text'>From<\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='dd\/mm\/yyyy'\n\t\t\t\t\tid='input_30_35'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_35'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_30_35' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_30_35' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_30_35' aria-label='From: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_30_37\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_37' class='gfield_label gform-field-label' for='input_30_37'><span class='gform-field-label__text'>Till<\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='dd\/mm\/yyyy'\n\t\t\t\t\tid='input_30_37'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_37'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_30_37' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_30_37' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_30_37' aria-label='Till: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_30_39\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_39' class='gfield_label gform-field-label' for='input_30_39'><span class='gform-field-label__text'>Statute<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_39' id='input_30_39' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Employee' >Employee<\/option><option value='Ind\u00e9pendant' >Ind\u00e9pendant<\/option><\/select><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer left_label'>\n                        <button type='button' id='gform_previous_button_30_40' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='button' id='gform_next_button_30_40' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_30_4' class='gform_page' data-js='page-field-id-40' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_30_4' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_30_41\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">Preferred guarantee<\/h2><\/li><li id=\"field_30_42\" class=\"gfield gfield--type-html gfield_html gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h3>Pension build-up<\/h3><\/li><li id=\"field_30_43\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_43' class='gfield_label gform-field-label' for='input_30_43'><span class='gform-field-label__text'>Do you wish to build up a pension?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_43' id='input_30_43' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/li><li id=\"field_30_44\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"><label id='gfield_label_30_44' class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><span class='gform-field-label__text'><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_30_44'><li class='gchoice gchoice_30_44_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.1' type='checkbox'  value='Tax maximum'  id='choice_30_44_1'    aria-labelledby=\"label_30_44_1 gfield_label_30_44\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_30_44_1' id='label_30_44_1' class='gform-field-label gform-field-label--type-inline'>Tax maximum<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_30_45\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\">or<\/li><li id=\"field_30_46\" class=\"gfield gfield--type-number field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_46' class='gfield_label gform-field-label' for='input_30_46'><span class='gform-field-label__text'>Fixed amount<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_46' id='input_30_46' type='text' step='any'   value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_30_47\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h3>Guaranteed Income (Sickness & Accident)<\/h3><\/li><li id=\"field_30_48\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_48' class='gfield_label gform-field-label' for='input_30_48'><span class='gform-field-label__text'>Do you want to insure for Guaranteed Income?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_48' id='input_30_48' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/li><li id=\"field_30_49\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_49' class='gfield_label gform-field-label' for='input_30_49'><span class='gform-field-label__text'>Until when do you want to insure for this?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_49' id='input_30_49' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Age of 65' >Age of 65<\/option><option value='Age of 60' >Age of 60<\/option><\/select><\/div><\/li><li id=\"field_30_50\" class=\"gfield gfield--type-select field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_50' class='gfield_label gform-field-label' for='input_30_50'><span class='gform-field-label__text'>Own risk period<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_50' id='input_30_50' class='medium gfield_select'  aria-describedby=\"gfield_description_30_50\"   aria-invalid=\"false\" ><option value='1 month' >1 month<\/option><option value='2 months' >2 months<\/option><option value='3 months' >3 months<\/option><option value='6 months' >6 months<\/option><option value='12 months' >12 months<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_30_50'>Period that you may\/wish to bridge yourself in the event of incapacity for work, without the intervention of this insurance.\n(Of course: premium-setting)<\/div><\/li><li id=\"field_30_51\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h3>Passing away<\/h3><\/li><li id=\"field_30_52\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_52' class='gfield_label gform-field-label' for='input_30_52'><span class='gform-field-label__text'>Do you wish to subscribe for a Life Insurance?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_52' id='input_30_52' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/li><li id=\"field_30_53\" class=\"gfield gfield--type-number field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_53' class='gfield_label gform-field-label' for='input_30_53'><span class='gform-field-label__text'>Desired capital<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_53' id='input_30_53' type='text' step='any'   value='' class='medium'      aria-invalid=\"false\" aria-describedby=\"gfield_description_30_53\" \/><\/div><div class='gfield_description' id='gfield_description_30_53'>Eg: Single: 25.000 \u20ac \/ Family: 200.000 \u20ac<\/div><\/li><li id=\"field_30_54\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_54' class='gfield_label gform-field-label' for='input_30_54'><span class='gform-field-label__text'>Double capital Life Insurance if you die due to a sudden accident?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_54' id='input_30_54' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/li><li id=\"field_30_55\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h3>Premium exemption<\/h3><\/li><li id=\"field_30_56\" class=\"gfield gfield--type-select field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_56' class='gfield_label gform-field-label' for='input_30_56'><span class='gform-field-label__text'>Do you wish to insure the guarantee &#039;premium exemption&#039;?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_56' id='input_30_56' class='medium gfield_select'  aria-describedby=\"gfield_description_30_56\"   aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_30_56'>If you are unfit for work: the company will pay your premiums for pension formation + death for you, as you may then have less income.<\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer left_label'>\n                        <button type='button' id='gform_previous_button_30_57' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='button' id='gform_next_button_30_57' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_30_5' class='gform_page' data-js='page-field-id-57' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_30_5' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_30_58\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">Payments<\/h2><\/li><li id=\"field_30_59\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_30_59' class='gfield_label gform-field-label' for='input_30_59'><span class='gform-field-label__text'>Distribution<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_59' id='input_30_59' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Monthly' >Monthly<\/option><option value='Quarterly' >Quarterly<\/option><option value='Half-yearly' >Half-yearly<\/option><option value='Yearly' >Yearly<\/option><\/select><\/div><\/li><\/ul><\/div>\n        <div class='gform-page-footer gform_page_footer left_label'><button type='submit' id='gform_previous_button_30' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='submit' id='gform_submit_button_30' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Send<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_30' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_30' id='gform_theme_30' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_30' id='gform_style_settings_30' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_30' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='30' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='EUR' value='yX9Apk2KlduztSp\/l6p6hOZ9ST2X0\/Y8mDbuEME\/1XPCrako6\/wSAiZuWgpujUoZC76LvEAZeoXKtF5jYzz3uqnwcOA6R4xwHgCLS07jjgZuCn8=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_30' value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_30' id='gform_target_page_number_30' value='2' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_30' id='gform_source_page_number_30' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n             <\/div><\/div>\n                        <\/form>\n                        <\/div><\/p>","protected":false},"excerpt":{"rendered":"Step 1 of 5 20% NameThis field is for validation purposes and should be left unchanged.PolicyholderCompany name*Legal formLTDPLCLLPCCLLLimited partnershipOtherAddress Street Address City ZIP \/ Postal Code Company number(If in formation: type IF)Start date company Volgende Beneficiary (manager)Name First Last Address Street Address City ZIP \/ Postal Code Email* Date of birth Place of birthSexMFXMarital statusMarriedLegally cohabitingPractically living togetherSingleSmokerNoYesEmployment (%)Please 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