{"id":9141,"date":"2023-04-11T17:39:28","date_gmt":"2023-04-11T15:39:28","guid":{"rendered":"https:\/\/staging.avixi.be\/?page_id=9141"},"modified":"2023-04-12T12:14:04","modified_gmt":"2023-04-12T10:14:04","slug":"affiliation-dun-independant-par-le-comptable-conseiller-2","status":"publish","type":"page","link":"https:\/\/staging.avixi.be\/fr\/partenaires\/affiliation-dun-independant-par-le-comptable-conseiller-2\/","title":{"rendered":"Affiliation d&rsquo;un ind\u00e9pendant par le comptable\/conseiller"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1560px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_3_4 3_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:75%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.56%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:2.56%;--awb-width-medium:75%;--awb-order-medium:0;--awb-spacing-right-medium:2.56%;--awb-spacing-left-medium:2.56%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><nav class=\"fusion-breadcrumbs fusion-breadcrumbs-1\" style=\"--awb-breadcrumb-sep:&#039;\/&#039;;\" aria-label=\"Breadcrumb\"><ol class=\"awb-breadcrumb-list\"><li class=\"fusion-breadcrumb-item awb-breadcrumb-sep awb-home\" ><a href=\"https:\/\/staging.avixi.be\/fr\/\" class=\"fusion-breadcrumb-link\"><span >Home<\/span><\/a><\/li><\/ol><\/nav><div class=\"fusion-text fusion-text-1\" style=\"--awb-text-transform:none;\"><h1 class=\"fusion-responsive-typography-calculated\" style=\"--fontsize: 36; line-height: 1.16; --minfontsize: 36;\" data-fontsize=\"36\" data-lineheight=\"41.76px\">D\u00e9claration d&rsquo;affiliation en ligne d&rsquo;un ind\u00e9pendant<\/h1>\n<hr \/>\n<p><span style=\"background-color: rgba(255, 255, 255, 0); color: var(--body_typography-color); font-family: var(--body_typography-font-family); font-size: var(--body_typography-font-size); font-style: var(--body_typography-font-style,normal); font-weight: var(--body_typography-font-weight); letter-spacing: var(--body_typography-letter-spacing);\">Vous pouvez mettre en ordre ici l&rsquo;affiliation de votre client comme ind\u00e9pendant aupr\u00e8s de la caisse sociale avixi.<\/span><\/p>\n<p><span style=\"background-color: rgba(255, 255, 255, 0); color: var(--body_typography-color); font-family: var(--body_typography-font-family); font-size: var(--body_typography-font-size); font-style: var(--body_typography-font-style,normal); font-weight: var(--body_typography-font-weight); letter-spacing: var(--body_typography-letter-spacing);\">Pour l&rsquo;inscription de l&rsquo;entreprise\/de l&rsquo;activit\u00e9 \u00e0 la BCE via le Guichet d&rsquo;Entreprises prenez contact avec nos collaborateurs <\/span>du Guichet d&rsquo;Entreprises: <a href=\"mailto:OLmechelen@avixi.be\" target=\"_blank\" rel=\"noopener noreferrer\">Guichet d&rsquo;Entreprises Mechelen<\/a> &#8211; <a href=\"mailto:OLbrugge@avixi.be\" target=\"_blank\" rel=\"noopener noreferrer\">Guichet d&rsquo;Entreprises Brugge <\/a>&#8211; <a href=\"mailto:eunomia.bruxelles@avixi.be\" target=\"_blank\" rel=\"noopener noreferrer\">Guichet d&rsquo;entreprises Bruxelles<\/a><\/p>\n<\/div><script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\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_146' style='display:none'><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_146' id='gform_146'  action='\/fr\/wp-json\/wp\/v2\/pages\/9141' data-formid='146' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_146' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_146_181\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Donn\u00e9es du demandeur<\/h2><\/li><li id=\"field_146_154\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_154'><span class='gform-field-label__text'>Nom<\/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_154' id='input_146_154' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_146_155\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_155'><span class='gform-field-label__text'>Pr\u00e9nom<\/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_155' id='input_146_155' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_146_166\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Le demandeur dispose-t-il\/elle d&#039;un num\u00e9ro de registre national en Belgique?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_146_166'>\n\t\t\t<li class='gchoice gchoice_146_166_0'>\n\t\t\t\t<input name='input_166' type='radio' value='Oui'  id='choice_146_166_0'    \/>\n\t\t\t\t<label for='choice_146_166_0' id='label_146_166_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_166_1'>\n\t\t\t\t<input name='input_166' type='radio' value='Non'  id='choice_146_166_1'    \/>\n\t\t\t\t<label for='choice_146_166_1' id='label_146_166_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_146_2\" class=\"gfield gfield--type-text gf_left_third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_2'><span class='gform-field-label__text'>Num\u00e9ro de registre national (age minimum 18 ans)<\/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_2' id='input_146_2' type='text' value='' class='large'    placeholder='99.99.99-999.99' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"99.99.99-999.99\"\/><\/div><\/li><li id=\"field_146_163\" class=\"gfield gfield--type-date gfield--input-type-datedropdown gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Date de naissance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div id='input_146_163' class='ginput_container ginput_complex gform-grid-row'><div class=\"clear-multi\"><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_146_163_2_container'><label for='input_146_163_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Jour<\/label><select name='input_163[]' id='input_146_163_2'   aria-required='true'  ><option value=''>Jour<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_146_163_1_container'><label for='input_146_163_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Mois<\/label><select name='input_163[]' id='input_146_163_1'   aria-required='true'  ><option value=''>Mois<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_146_163_3_container'><label for='input_146_163_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Ann\u00e9e<\/label><select name='input_163[]' id='input_146_163_3'   aria-required='true'  ><option value=''>Ann\u00e9e<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/div><\/li><li id=\"field_146_167\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_167'><span class='gform-field-label__text'>Rue + num\u00e9ro<\/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_167' id='input_146_167' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_146_168\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_168'><span class='gform-field-label__text'>Code postal + commune<\/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_168' id='input_146_168' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_146_169\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_169'><span class='gform-field-label__text'>Pays<\/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_169' id='input_146_169' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_146_160\" class=\"gfield gfield--type-email gf_middle_third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_160'><span class='gform-field-label__text'>Adresse e-mail<\/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_160' id='input_146_160' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_146_130\" class=\"gfield gfield--type-phone gfield--phone-format-international gf_right_third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_130'><span class='gform-field-label__text'>T\u00e9l\u00e9phone\/GSM<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_130' id='input_146_130' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"    \/><\/div><\/li><li id=\"field_146_131\" class=\"gfield gfield--type-date gfield--input-type-datedropdown gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Date de d\u00e9but de l&#039;activit\u00e9<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div id='input_146_131' class='ginput_container ginput_complex gform-grid-row'><div class=\"clear-multi\"><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_146_131_2_container'><label for='input_146_131_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Jour<\/label><select name='input_131[]' id='input_146_131_2'   aria-required='true'  ><option value=''>Jour<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_146_131_1_container'><label for='input_146_131_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Mois<\/label><select name='input_131[]' id='input_146_131_1'   aria-required='true'  ><option value=''>Mois<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_146_131_3_container'><label for='input_146_131_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Ann\u00e9e<\/label><select name='input_131[]' id='input_146_131_3'   aria-required='true'  ><option value=''>Ann\u00e9e<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/div><\/li><li id=\"field_146_45\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_45'><span class='gform-field-label__text'>Description de l&#039;activit\u00e9<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_45' id='input_146_45' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_146_170\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Y a-t-il d\u00e9j\u00e0 un num\u00e9ro d&#039;entreprise?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_146_170'>\n\t\t\t<li class='gchoice gchoice_146_170_0'>\n\t\t\t\t<input name='input_170' type='radio' value='Oui'  id='choice_146_170_0'    \/>\n\t\t\t\t<label for='choice_146_170_0' id='label_146_170_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_170_1'>\n\t\t\t\t<input name='input_170' type='radio' value='Non, la demande est en cours.'  id='choice_146_170_1'    \/>\n\t\t\t\t<label for='choice_146_170_1' id='label_146_170_1' class='gform-field-label gform-field-label--type-inline'>Non, la demande est en cours.<\/label>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_146_170'>\n<\/div><\/li><li id=\"field_146_171\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_171'><span class='gform-field-label__text'>Num\u00e9ro d&#039;entreprise<\/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_171' id='input_146_171' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_146_149\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_149'><span class='gform-field-label__text'>Num\u00e9ro de compte professionnel (IBAN)<\/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_149' id='input_146_149' type='text' value='' class='medium'    placeholder='BE99 9999 9999 9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"BE99 9999 9999 9999\"\/><\/div><\/li><li id=\"field_146_182\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Affiliation caisse d&#039;assurances sociales<\/h2><\/li><li id=\"field_146_119\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Choix du statut d&#039;ind\u00e9pendant:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_146_119'>\n\t\t\t<li class='gchoice gchoice_146_119_0'>\n\t\t\t\t<input name='input_119' type='radio' value='A titre principal'  id='choice_146_119_0'    \/>\n\t\t\t\t<label for='choice_146_119_0' id='label_146_119_0' class='gform-field-label gform-field-label--type-inline'>A titre principal<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_119_1'>\n\t\t\t\t<input name='input_119' type='radio' value='A titre compl\u00e9mentaire'  id='choice_146_119_1'    \/>\n\t\t\t\t<label for='choice_146_119_1' id='label_146_119_1' class='gform-field-label gform-field-label--type-inline'>A titre compl\u00e9mentaire<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_119_2'>\n\t\t\t\t<input name='input_119' type='radio' value='Pensionn\u00e9'  id='choice_146_119_2'    \/>\n\t\t\t\t<label for='choice_146_119_2' id='label_146_119_2' class='gform-field-label gform-field-label--type-inline'>Pensionn\u00e9<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_119_3'>\n\t\t\t\t<input name='input_119' type='radio' value='Syst\u00e8me avantageux mari\u00e9(e)s\/veuf(ve) (art.37)*'  id='choice_146_119_3'    \/>\n\t\t\t\t<label for='choice_146_119_3' id='label_146_119_3' class='gform-field-label gform-field-label--type-inline'>Syst\u00e8me avantageux mari\u00e9(e)s\/veuf(ve) (art.37)*<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_119_4'>\n\t\t\t\t<input name='input_119' type='radio' value='Etudiant-ind\u00e9pendant'  id='choice_146_119_4'    \/>\n\t\t\t\t<label for='choice_146_119_4' id='label_146_119_4' class='gform-field-label gform-field-label--type-inline'>Etudiant-ind\u00e9pendant<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_119_5'>\n\t\t\t\t<input name='input_119' type='radio' value='Aidant(e)'  id='choice_146_119_5'    \/>\n\t\t\t\t<label for='choice_146_119_5' id='label_146_119_5' class='gform-field-label gform-field-label--type-inline'>Aidant(e)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_119_6'>\n\t\t\t\t<input name='input_119' type='radio' value='Conjoint aidant(e)'  id='choice_146_119_6'    \/>\n\t\t\t\t<label for='choice_146_119_6' id='label_146_119_6' class='gform-field-label gform-field-label--type-inline'>Conjoint aidant(e)<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_146_187\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >* excer\u00e7ant \u00e0 titre principal une activit\u00e9 assimil\u00e9e \u00e0 une activit\u00e9 compl\u00e9mentaire<\/li><li id=\"field_146_120\" class=\"gfield gfield--type-date gfield--input-type-datedropdown gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Date de d\u00e9but de la pension de retraite<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div id='input_146_120' class='ginput_container ginput_complex gform-grid-row'><div class=\"clear-multi\"><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_146_120_2_container'><label for='input_146_120_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Jour<\/label><select name='input_120[]' id='input_146_120_2'   aria-required='true'  ><option value=''>Jour<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_146_120_1_container'><label for='input_146_120_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Mois<\/label><select name='input_120[]' id='input_146_120_1'   aria-required='true'  ><option value=''>Mois<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_146_120_3_container'><label for='input_146_120_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Ann\u00e9e<\/label><select name='input_120[]' id='input_146_120_3'   aria-required='true'  ><option value=''>Ann\u00e9e<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/div><\/li><li id=\"field_146_81\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_81'><span class='gform-field-label__text'>Nom de l&#039;ind\u00e9pendant(e) qu&#039;il\/elle va aider<\/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_81' id='input_146_81' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_146_82\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_82'><span class='gform-field-label__text'>Num\u00e9ro de registre national de l&#039;ind\u00e9pendant(e) qu&#039;il\/elle va aider<\/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_82' id='input_146_82' type='text' value='' class='medium'    placeholder='99.99.99-999.99' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"99.99.99-999.99\"\/><\/div><\/li><li id=\"field_146_173\" class=\"gfield gfield--type-fileupload gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_146_173'><span class='gform-field-label__text'>L&#039;affiliation d&#039;un ind\u00e9pendant aidant n\u00e9cessite une d\u00e9claration sur l&#039;honneur sign\u00e9 par l&#039;ind\u00e9pendant principal (l&#039;aid\u00e9(e))<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_146_173' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_146_173&quot;,&quot;container&quot;:&quot;gform_multifile_upload_146_173&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_146_173&quot;,&quot;filelist&quot;:&quot;gform_preview_146_173&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/staging.avixi.be\\\/?gf_page=f51d946b4550319&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/staging.avixi.be\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/staging.avixi.be\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Fichiers autoris\\u00e9s&quot;,&quot;extensions&quot;:&quot;doc,docx,txt,rtf,pdf,jpg,png,xlsx&quot;}],&quot;max_file_size&quot;:&quot;15728640b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:146,&quot;field_id&quot;:173,&quot;_gform_file_upload_nonce_146_173&quot;:&quot;4dc19b6df3&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;10&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_146_173&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_146_173' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>D\u00e9posez les fichiers ici ou <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_146_173' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_146_173\"  >S\u00e9lectionnez des fichiers<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_146_173'>Types de fichiers accept\u00e9s\u00a0: doc, docx, txt, rtf, pdf, jpg, png, xlsx, Taille max. des fichiers\u00a0: 15 MB, Max. des fichiers\u00a0: 10.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_146_173'><\/ul> <div id='gform_preview_146_173' class='ginput_preview_list'><\/div><\/div><\/li><li id=\"field_146_184\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Joignez la d\u00e9claration sur l'honneur compl\u00e9t\u00e9e et sign\u00e9e en annexe \u00e0 votre demande d'affiliation. https:\/\/avixi.be\/wp-content\/uploads\/2021\/03\/declaration-sur-lhonneur-aidant.pdf \nou vous trouverez le lien vers ce document en haut \u00e0 droite de cette page.<\/li><li id=\"field_146_83\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_83'><span class='gform-field-label__text'>Nom et pr\u00e9nom du conjoint(e)<\/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_83' id='input_146_83' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_146_128\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_128'><span class='gform-field-label__text'>Num\u00e9ro de registre national du\/de la conjoint(e)<\/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_128' id='input_146_128' type='text' value='' class='medium'    placeholder='99.99.99-999.99' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"99.99.99-999.99\"\/><\/div><\/li><li id=\"field_146_125\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Le demandeur est-il\/elle mari\u00e9(e) ou veuf(ve)?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_146_125'>\n\t\t\t<li class='gchoice gchoice_146_125_0'>\n\t\t\t\t<input name='input_125' type='radio' value='Mari\u00e9(e)'  id='choice_146_125_0'    \/>\n\t\t\t\t<label for='choice_146_125_0' id='label_146_125_0' class='gform-field-label gform-field-label--type-inline'>Mari\u00e9(e)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_125_1'>\n\t\t\t\t<input name='input_125' type='radio' value='Veuf(ve)'  id='choice_146_125_1'    \/>\n\t\t\t\t<label for='choice_146_125_1' id='label_146_125_1' class='gform-field-label gform-field-label--type-inline'>Veuf(ve)<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_146_126\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_126'><span class='gform-field-label__text'>Nom et pr\u00e9nom de l&#039;\u00e9poux(se)\/de l&#039;\u00e9poux(se) d\u00e9c\u00e9d\u00e9(e)<\/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_126' id='input_146_126' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_146_127\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_127'><span class='gform-field-label__text'>Num\u00e9ro de registre national de l&#039;\u00e9poux(se)\/de l&#039;\u00e9poux(se) d\u00e9c\u00e9d\u00e9(e)<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_127' id='input_146_127' type='text' value='' class='medium'    placeholder='99.99.99-999.99'  aria-invalid=\"false\"   data-mask=\"99.99.99-999.99\"\/><\/div><\/li><li id=\"field_146_84\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Le demandeur excerce-t-il\/elle d&#039;autres activit\u00e9s professionelles?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_146_84'>\n\t\t\t<li class='gchoice gchoice_146_84_0'>\n\t\t\t\t<input name='input_84' type='radio' value='Oui'  id='choice_146_84_0'    \/>\n\t\t\t\t<label for='choice_146_84_0' id='label_146_84_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_84_1'>\n\t\t\t\t<input name='input_84' type='radio' value='Non'  id='choice_146_84_1'    \/>\n\t\t\t\t<label for='choice_146_84_1' id='label_146_84_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_146_85\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Nature de l&#039;autre emploi<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_146_85'>\n\t\t\t<li class='gchoice gchoice_146_85_0'>\n\t\t\t\t<input name='input_85' type='radio' value='Fonctionnaire'  id='choice_146_85_0'    \/>\n\t\t\t\t<label for='choice_146_85_0' id='label_146_85_0' class='gform-field-label gform-field-label--type-inline'>Fonctionnaire<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_85_1'>\n\t\t\t\t<input name='input_85' type='radio' value='Salari\u00e9'  id='choice_146_85_1'    \/>\n\t\t\t\t<label for='choice_146_85_1' id='label_146_85_1' class='gform-field-label gform-field-label--type-inline'>Salari\u00e9<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_146_86\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_86'><span class='gform-field-label__text'>Fraction d&#039;emploi<\/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_86' id='input_146_86' type='text' value='' class='medium'  aria-describedby=\"gfield_description_146_86\"  placeholder='99\/99' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"99\/99\"\/><\/div><div class='gfield_description' id='gfield_description_146_86'>Veuiller indiquer ici la fraction de l'emploi en dhors de l'activit\u00e9 ind\u00e9pendante.  Par exemple: un mi-temps comme salari\u00e9 s'indique comme 19\/38 ou 18\/36, ...<\/div><\/li><li id=\"field_146_176\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Le demandeur a-t-il\/elle une fonction dans une entreprise?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_146_176'>\n\t\t\t<li class='gchoice gchoice_146_176_0'>\n\t\t\t\t<input name='input_176' type='radio' value='Oui'  id='choice_146_176_0'    \/>\n\t\t\t\t<label for='choice_146_176_0' id='label_146_176_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_176_1'>\n\t\t\t\t<input name='input_176' type='radio' value='Non'  id='choice_146_176_1'    \/>\n\t\t\t\t<label for='choice_146_176_1' id='label_146_176_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_146_175\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Dans l&#039;affirmative, quelle fonction?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_146_175'>\n\t\t\t<li class='gchoice gchoice_146_175_0'>\n\t\t\t\t<input name='input_175' type='radio' value='Administrateur'  id='choice_146_175_0'    \/>\n\t\t\t\t<label for='choice_146_175_0' id='label_146_175_0' class='gform-field-label gform-field-label--type-inline'>Administrateur<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_175_1'>\n\t\t\t\t<input name='input_175' type='radio' value='Associ\u00e9 actif'  id='choice_146_175_1'    \/>\n\t\t\t\t<label for='choice_146_175_1' id='label_146_175_1' class='gform-field-label gform-field-label--type-inline'>Associ\u00e9 actif<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_146_178\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_178'><span class='gform-field-label__text'>Nom de l&#039;entreprise<\/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_178' id='input_146_178' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_146_179\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_179'><span class='gform-field-label__text'>Num\u00e9ro d&#039;entreprise<\/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_179' id='input_146_179' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_146_180\" class=\"gfield gfield--type-date gfield--input-type-datedropdown gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Date la nomination au Moniteur Belge<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div id='input_146_180' class='ginput_container ginput_complex gform-grid-row'><div class=\"clear-multi\"><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_146_180_2_container'><label for='input_146_180_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Jour<\/label><select name='input_180[]' id='input_146_180_2'   aria-required='true'  ><option value=''>Jour<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_146_180_1_container'><label for='input_146_180_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Mois<\/label><select name='input_180[]' id='input_146_180_1'   aria-required='true'  ><option value=''>Mois<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_146_180_3_container'><label for='input_146_180_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Ann\u00e9e<\/label><select name='input_180[]' id='input_146_180_3'   aria-required='true'  ><option value=''>Ann\u00e9e<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/div><\/li><li id=\"field_146_177\" class=\"gfield gfield--type-fileupload gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_146_177'><span class='gform-field-label__text'>L&#039;affiliation d&#039;un associ\u00e9 actif n\u00e9cessite une d\u00e9claration sur l&#039;honneur sign\u00e9 par l&#039;administrateur de la soci\u00e9t\u00e9.  Veuillez \u00e9galement joindre une copie du livre de participations.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_146_177' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_146_177&quot;,&quot;container&quot;:&quot;gform_multifile_upload_146_177&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_146_177&quot;,&quot;filelist&quot;:&quot;gform_preview_146_177&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/staging.avixi.be\\\/?gf_page=f51d946b4550319&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/staging.avixi.be\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/staging.avixi.be\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Fichiers autoris\\u00e9s&quot;,&quot;extensions&quot;:&quot;doc,docx,txt,rtf,pdf,jpg,png,xlsx&quot;}],&quot;max_file_size&quot;:&quot;15728640b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:146,&quot;field_id&quot;:177,&quot;_gform_file_upload_nonce_146_177&quot;:&quot;d4e7a62107&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;10&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_146_177&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_146_177' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>D\u00e9posez les fichiers ici ou <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_146_177' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_146_177\"  >S\u00e9lectionnez des fichiers<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_146_177'>Types de fichiers accept\u00e9s\u00a0: doc, docx, txt, rtf, pdf, jpg, png, xlsx, Taille max. des fichiers\u00a0: 15 MB, Max. des fichiers\u00a0: 10.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_146_177'><\/ul> <div id='gform_preview_146_177' class='ginput_preview_list'><\/div><\/div><\/li><li id=\"field_146_185\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Joignez la d\u00e9claration sur l'honneur compl\u00e9t\u00e9e et sign\u00e9e en annexe \u00e0 votre demande d'affiliation. https:\/\/avixi.be\/wp-content\/uploads\/2021\/03\/declaration-sur-lhonneur-associe-actif.pdf ou vous trouverez le lien vers ce document en haut \u00e0 droite de cette page.<\/li><li id=\"field_146_87\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Le demandeur b\u00e9n\u00e9ficie-t-il\/elle d&#039;un revenu de remplacement?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_146_87'>\n\t\t\t<li class='gchoice gchoice_146_87_0'>\n\t\t\t\t<input name='input_87' type='radio' value='Oui'  id='choice_146_87_0'    \/>\n\t\t\t\t<label for='choice_146_87_0' id='label_146_87_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_87_1'>\n\t\t\t\t<input name='input_87' type='radio' value='Non'  id='choice_146_87_1'    \/>\n\t\t\t\t<label for='choice_146_87_1' id='label_146_87_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_146_88\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Nature du revenu de remplacement?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_146_88'>\n\t\t\t<li class='gchoice gchoice_146_88_0'>\n\t\t\t\t<input name='input_88' type='radio' value='Pension de retraite'  id='choice_146_88_0'    \/>\n\t\t\t\t<label for='choice_146_88_0' id='label_146_88_0' class='gform-field-label gform-field-label--type-inline'>Pension de retraite<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_88_1'>\n\t\t\t\t<input name='input_88' type='radio' value='Interruption de carri\u00e8re'  id='choice_146_88_1'    \/>\n\t\t\t\t<label for='choice_146_88_1' id='label_146_88_1' class='gform-field-label gform-field-label--type-inline'>Interruption de carri\u00e8re<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_88_2'>\n\t\t\t\t<input name='input_88' type='radio' value='Allocations de ch\u00f4mage'  id='choice_146_88_2'    \/>\n\t\t\t\t<label for='choice_146_88_2' id='label_146_88_2' class='gform-field-label gform-field-label--type-inline'>Allocations de ch\u00f4mage<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_88_3'>\n\t\t\t\t<input name='input_88' type='radio' value='Allocations de ch\u00f4mage avec compl\u00e9ment d&#039;entreprise'  id='choice_146_88_3'    \/>\n\t\t\t\t<label for='choice_146_88_3' id='label_146_88_3' class='gform-field-label gform-field-label--type-inline'>Allocations de ch\u00f4mage avec compl\u00e9ment d'entreprise<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_88_4'>\n\t\t\t\t<input name='input_88' type='radio' value='Indemnit\u00e9s de maladie ou d&#039;invalidit\u00e9'  id='choice_146_88_4'    \/>\n\t\t\t\t<label for='choice_146_88_4' id='label_146_88_4' class='gform-field-label gform-field-label--type-inline'>Indemnit\u00e9s de maladie ou d'invalidit\u00e9<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_88_5'>\n\t\t\t\t<input name='input_88' type='radio' value='gf_other_choice'  id='choice_146_88_5'   onfocus=\"jQuery(this).next('input').focus();\" \/>\n\t\t\t\t<input class='small' id='input_146_88_other' name='input_88_other' type='text' value='Autre' aria-label='Autre' onfocus='jQuery(this).prev(\"input\")[0].click(); if(jQuery(this).val() == \"Autre\") { jQuery(this).val(\"\"); }' onblur='if(jQuery(this).val().replace(\" \", \"\") == \"\") { jQuery(this).val(\"Autre\"); }'   \/>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_146_109\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Les cotisations sociales provisoires peuvent \u00eatre calcul\u00e9es sur base<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_146_109'>\n\t\t\t<li class='gchoice gchoice_146_109_0'>\n\t\t\t\t<input name='input_109' type='radio' value='du minimum l\u00e9gal'  id='choice_146_109_0'    \/>\n\t\t\t\t<label for='choice_146_109_0' id='label_146_109_0' class='gform-field-label gform-field-label--type-inline'>du minimum l\u00e9gal<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_109_1'>\n\t\t\t\t<input name='input_109' type='radio' value='d&#039;un revenu imposable net estim\u00e9'  id='choice_146_109_1'    \/>\n\t\t\t\t<label for='choice_146_109_1' id='label_146_109_1' class='gform-field-label gform-field-label--type-inline'>d'un revenu imposable net estim\u00e9<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_146_110\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_110'><span class='gform-field-label__text'>le revenu imposable net estim\u00e9 (en euros) est<\/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_110' id='input_146_110' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_146_111\" class=\"gfield gfield--type-radio gfield--type-choice infoballon gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Le\/la conjoint(e) aide-t-il\/elle dans l&#039;activit\u00e9 ind\u00e9pendante?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_146_111'>\n\t\t\t<li class='gchoice gchoice_146_111_0'>\n\t\t\t\t<input name='input_111' type='radio' value='Oui'  id='choice_146_111_0'    \/>\n\t\t\t\t<label for='choice_146_111_0' id='label_146_111_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_111_1'>\n\t\t\t\t<input name='input_111' type='radio' value='Non'  id='choice_146_111_1'    \/>\n\t\t\t\t<label for='choice_146_111_1' id='label_146_111_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_146_121\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_121'><span class='gform-field-label__text'>Non et pr\u00e9nom du\/de la conjoint(e)<\/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_121' id='input_146_121' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_146_122\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_122'><span class='gform-field-label__text'>Num\u00e9ro de registre national du\/de la conjoint(e)<\/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_122' id='input_146_122' type='text' value='' class='medium'    placeholder='99.99.99-999.99' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"99.99.99-999.99\"\/><\/div><\/li><li id=\"field_146_183\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Donn\u00e9es du comptable ou du conseiller<\/h2><\/li><li id=\"field_146_94\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_94'><span class='gform-field-label__text'>Nom<\/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_94' id='input_146_94' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_146_157\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_157'><span class='gform-field-label__text'>Rue + Num\u00e9ro<\/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_157' id='input_146_157' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_146_113\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_113'><span class='gform-field-label__text'>Code postal + Commune<\/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_113' id='input_146_113' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_146_159\" class=\"gfield gfield--type-phone gfield--phone-format-international gf_right_third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_159'><span class='gform-field-label__text'>T\u00e9l\u00e9phone\/GSM<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_159' id='input_146_159' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"    \/><\/div><\/li><li id=\"field_146_129\" class=\"gfield gfield--type-email gf_middle_third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_129'><span class='gform-field-label__text'>E-mail<\/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_129' id='input_146_129' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_146_93\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden gfield--choice-align-vertical\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00cates-vous le repr\u00e9sentant autoris\u00e9 du demandeur?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_146_93'>\n\t\t\t<li class='gchoice gchoice_146_93_0'>\n\t\t\t\t<input name='input_93' type='radio' value='Oui'  id='choice_146_93_0'    \/>\n\t\t\t\t<label for='choice_146_93_0' id='label_146_93_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_146_93_1'>\n\t\t\t\t<input name='input_93' type='radio' value='Non'  id='choice_146_93_1'    \/>\n\t\t\t\t<label for='choice_146_93_1' id='label_146_93_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_146_158\" class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_146_158'><span class='gform-field-label__text'>T\u00e9l\u00e9chargez la procuration ici ou la lettre de mission<\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_146_158' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_146_158&quot;,&quot;container&quot;:&quot;gform_multifile_upload_146_158&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_146_158&quot;,&quot;filelist&quot;:&quot;gform_preview_146_158&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/staging.avixi.be\\\/?gf_page=f51d946b4550319&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/staging.avixi.be\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/staging.avixi.be\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Fichiers autoris\\u00e9s&quot;,&quot;extensions&quot;:&quot;doc,docx,txt,rtf,pdf,jpg,png,xlsx&quot;}],&quot;max_file_size&quot;:&quot;15728640b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:146,&quot;field_id&quot;:158,&quot;_gform_file_upload_nonce_146_158&quot;:&quot;14cada28ce&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;10&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_146_158&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_146_158' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>D\u00e9posez les fichiers ici ou <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_146_158' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_146_158\"  >S\u00e9lectionnez des fichiers<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_146_158'>Types de fichiers accept\u00e9s\u00a0: doc, docx, txt, rtf, pdf, jpg, png, xlsx, Taille max. des fichiers\u00a0: 15 MB, Max. des fichiers\u00a0: 10.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_146_158'><\/ul> <div id='gform_preview_146_158' class='ginput_preview_list'><\/div><\/div><\/li><li id=\"field_146_161\" class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_146_161'><span class='gform-field-label__text'>T\u00e9l\u00e9chargez toute autre pi\u00e8ce jointe ici<\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_146_161' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_146_161&quot;,&quot;container&quot;:&quot;gform_multifile_upload_146_161&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_146_161&quot;,&quot;filelist&quot;:&quot;gform_preview_146_161&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/staging.avixi.be\\\/?gf_page=f51d946b4550319&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/staging.avixi.be\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/staging.avixi.be\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Fichiers 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class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_146_161' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>D\u00e9posez les fichiers ici ou <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_146_161' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_146_161\"  >S\u00e9lectionnez des fichiers<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_146_161'>Types de fichiers accept\u00e9s\u00a0: doc, docx, txt, rtf, pdf, jpg, png, xlsx, Taille max. des fichiers\u00a0: 15 MB, Max. des fichiers\u00a0: 10.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_146_161'><\/ul> <div id='gform_preview_146_161' class='ginput_preview_list'><\/div><\/div><\/li><li id=\"field_146_162\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_146_162'><span class='gform-field-label__text'>Remarques<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_162' id='input_146_162' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_146_145\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >En tant que comptable\/conseiller agr\u00e9\u00e9 de l'ind\u00e9pendant mentionn\u00e9 ci-dessus, je prends note des informations suivantes : les donn\u00e9es que vous fournissez \u00e0 Avixi seront trait\u00e9es et stock\u00e9es dans des fichiers informatis\u00e9s. Avixi traite ces donn\u00e9es, ainsi que les donn\u00e9es que vous fournissez ult\u00e9rieurement, pour effectuer ses t\u00e2ches administratives. Ces t\u00e2ches comprennent la gestion du statut social des travailleurs ind\u00e9pendants dans le cadre de l'arr\u00eat\u00e9 royal n\u00b0 38 du 27 juillet 1967 portant organisation du statut social des travailleurs ind\u00e9pendants et de tous les droits et obligations y aff\u00e9rents. Le traitement est effectu\u00e9 conform\u00e9ment au R\u00e8glement (UE) 2016\/679 du Parlement europ\u00e9en et du Conseil du 27 avril 2016 relatif \u00e0 la protection des personnes physiques \u00e0 l'\u00e9gard du traitement des donn\u00e9es \u00e0 caract\u00e8re personnel et \u00e0 la libre circulation de ces donn\u00e9es (R\u00e8glement g\u00e9n\u00e9ral R\u00e8glement sur la protection des donn\u00e9es). Sur la base de ces r\u00e9glementations, vous avez le droit d'obtenir des informations sur le traitement de vos donn\u00e9es personnelles, de les consulter, de les faire rectifier ou effacer, de limiter leur traitement, de vous opposer au traitement ou de demander que les donn\u00e9es soient transf\u00e9r\u00e9es \u00e0 un autre contr\u00f4leur. Des informations d\u00e9taill\u00e9es sur le traitement des donn\u00e9es personnelles peuvent \u00eatre trouv\u00e9es sur le site Web d'Avixi sous \u00ab\u00a0D\u00e9claration de confidentialit\u00e9\u00a0\u00bb. Si vous avez des questions sur la protection des donn\u00e9es personnelles, vous pouvez contacter le d\u00e9l\u00e9gu\u00e9 \u00e0 la protection des donn\u00e9es (DPO). Pour cela, vous pouvez contacter avixi vzw (par e-mail : dpo@avixi.be ou par courrier : avixi, DPO, Zeutestraat 2b, 2800 Mechelen). Toute modification des donn\u00e9es fournies par vous doit \u00eatre communiqu\u00e9e \u00e0 avixi vzw dans les 15 jours (article 7 de l'arr\u00eat\u00e9 royal du 19 d\u00e9cembre 1967)<\/li><li id=\"field_146_151\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Ex\u00e9cutions des formalit\u00e9s l\u00e9gales par avixi<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_146_151'>\n\t\t\t<li class='gchoice gchoice_146_151_0'>\n\t\t\t\t<input name='input_151' type='radio' value='Je suis conscient qu&#039;avixi effectuera toutes les formalit\u00e9s l\u00e9gales pour 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top_label'> <button type='submit' id='gform_submit_button_146' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Envoyer la demande<\/button> <input type='hidden' name='gform_ajax' value='form_id=146&amp;title=&amp;description=&amp;tabindex=0&amp;theme=legacy&amp;styles=[]&amp;hash=57372b81a449c32b2e00de987fcad3aa' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_146' value='iframe' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_146' id='gform_theme_146' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_146' id='gform_style_settings_146' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_146' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' 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value='' \/>\n            <input type='hidden' name='gform_uploaded_files' id='gform_uploaded_files_146' value='' \/>\n        <\/div>\n                        <\/form>\n                        <\/div>\n\t\t                <iframe style='display:none;width:0px;height:0px;' src='about:blank' name='gform_ajax_frame_146' id='gform_ajax_frame_146' title='Cette iframe contient la logique n\u00e9cessaire pour manipuler Gravity Forms avec Ajax.'><\/iframe>\n\t\t                <script>\ngform.initializeOnLoaded( function() {jQuery('#gform_ajax_frame_146').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_146');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_146').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect 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[146]);window['gf_submitting_146'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_146').text());}else{jQuery('#gform_146').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"146\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_146\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_146\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_146\" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            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fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_4 1_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:25%;--awb-margin-top-large:0px;--awb-spacing-right-large:7.68%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:7.68%;--awb-width-medium:25%;--awb-order-medium:0;--awb-spacing-right-medium:7.68%;--awb-spacing-left-medium:7.68%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single\" style=\"--awb-height:20px;--awb-amount:20px;border-color:#def0f4;border-top-width:2px;\"><\/div><\/div><div class=\"fusion-text fusion-text-2\"><h3>Document int\u00e9ressants<\/h3>\n<ul>\n<li><a href=\"https:\/\/staging.avixi.be\/wp-content\/uploads\/2023\/02\/procuration-comptable.pdf\" target=\"_blank\" rel=\"noopener\">Procuration comptable<\/a><\/li>\n<li><a href=\"https:\/\/staging.avixi.be\/wp-content\/uploads\/2021\/03\/Aidant-avixi-1.pdf\" target=\"_blank\" rel=\"noopener\">D\u00e9claration sur l\u2019honneur aidant<\/a><\/li>\n<li><a href=\"https:\/\/staging.avixi.be\/wp-content\/uploads\/2021\/03\/declaration-sur-lhonneur-associe-actif.pdf\" target=\"_blank\" rel=\"noopener\">D\u00e9claration sur l\u2019honneur associ\u00e9 actif<\/a><\/li>\n<\/ul>\n<\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single\" style=\"--awb-height:20px;--awb-amount:20px;border-color:#def0f4;border-top-width:2px;\"><\/div><\/div><div class=\"fusion-reading-box-container reading-box-container-1\" style=\"--awb-title-color:#002f47;--awb-margin-top:0px;--awb-margin-bottom:20px;\"><div class=\"reading-box\" style=\"background-color:#def2f2;border-width:0px;border-color:#f6f6f6;border-right-width:3px;border-right-color:var(--primary_color);border-style:solid;\"><div class=\"fusion-reading-box-flex\"><h2>Des questions?<\/h2><a class=\"button fusion-button button-default fusion-button-default-size button-default-size button-flat fusion-desktop-button fusion-tagline-button continue continue-right\" style=\"-webkit-box-shadow:none;-moz-box-shadow:none;box-shadow:none;border-radius:50px 50px 50px 50px\" href=\"https:\/\/staging.avixi.be\/fr\/contact\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span>Contact<\/span><\/a><\/div><a class=\"button fusion-button button-default fusion-button-default-size button-default-size button-flat fusion-mobile-button continue-right\" style=\"-webkit-box-shadow:none;-moz-box-shadow:none;box-shadow:none;border-radius:50px 50px 50px 50px\" href=\"https:\/\/staging.avixi.be\/fr\/contact\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span>Contact<\/span><\/a><\/div><\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":5,"featured_media":0,"parent":3323,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-9141","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/staging.avixi.be\/fr\/wp-json\/wp\/v2\/pages\/9141","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/staging.avixi.be\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/staging.avixi.be\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/staging.avixi.be\/fr\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/staging.avixi.be\/fr\/wp-json\/wp\/v2\/comments?post=9141"}],"version-history":[{"count":5,"href":"https:\/\/staging.avixi.be\/fr\/wp-json\/wp\/v2\/pages\/9141\/revisions"}],"predecessor-version":[{"id":9147,"href":"https:\/\/staging.avixi.be\/fr\/wp-json\/wp\/v2\/pages\/9141\/revisions\/9147"}],"up":[{"embeddable":true,"href":"https:\/\/staging.avixi.be\/fr\/wp-json\/wp\/v2\/pages\/3323"}],"wp:attachment":[{"href":"https:\/\/staging.avixi.be\/fr\/wp-json\/wp\/v2\/media?parent=9141"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}