{"id":273,"date":"2025-08-12T16:34:40","date_gmt":"2025-08-12T16:34:40","guid":{"rendered":"https:\/\/docugo.ca\/?page_id=273"},"modified":"2025-08-14T12:31:06","modified_gmt":"2025-08-14T12:31:06","slug":"request-for-will-search-full","status":"publish","type":"page","link":"https:\/\/docugo.ca\/en\/request-for-will-search-full\/","title":{"rendered":"Request for will search"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"273\" class=\"elementor elementor-273\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-002ba07 e-flex e-con-boxed e-con e-parent\" data-id=\"002ba07\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-5311d30 e-flex e-con-boxed e-con e-child\" data-id=\"5311d30\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-bb525e4 elementor-widget__width-initial elementor-widget elementor-widget-heading\" data-id=\"bb525e4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Power of attorney<br>Request for will search<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-cf207aa e-flex e-con-boxed e-con e-parent\" data-id=\"cf207aa\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-fdbd63f elementor-widget__width-initial elementor-widget elementor-widget-wpforms\" data-id=\"fdbd63f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wpforms.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<style id=\"wpforms-css-vars-elementor-widget-fdbd63f\">\n\t\t\t\t.elementor-widget-wpforms.elementor-element-fdbd63f {\n\t\t\t\t--wpforms-field-border-radius: 10px;\n--wpforms-field-text-color: #000000;\n--wpforms-button-border-radius: 10px;\n--wpforms-button-background-color: #DA3425;\n--wpforms-page-break-color: #DA3425;\n--wpforms-field-border-color: #D98C47;\n--wpforms-field-border-color-spare: #D98C47;\n--wpforms-field-size-input-height: 50px;\n--wpforms-field-size-input-spacing: 20px;\n--wpforms-field-size-font-size: 18px;\n--wpforms-field-size-line-height: 21px;\n--wpforms-field-size-padding-h: 14px;\n--wpforms-field-size-checkbox-size: 18px;\n--wpforms-field-size-sublabel-spacing: 10px;\n--wpforms-field-size-icon-size: 1.25;\n--wpforms-label-size-font-size: 18px;\n--wpforms-label-size-line-height: 21px;\n--wpforms-label-size-sublabel-font-size: 16px;\n--wpforms-label-size-sublabel-line-height: 19px;\n--wpforms-button-size-font-size: 20px;\n--wpforms-button-size-height: 48px;\n--wpforms-button-size-padding-h: 20px;\n--wpforms-button-size-margin-top: 15px;\n\t\t\t}\n\t\t\t<\/style><div class=\"wpforms-container wpforms-container-full wpforms-container-save-resume wpforms-render-modern\" id=\"wpforms-265\"><form id=\"wpforms-form-265\" class=\"wpforms-validate wpforms-form\" data-formid=\"265\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/en\/wp-json\/wp\/v2\/pages\/273?wpforms_form_id=265\" data-token=\"49375b8bfe1260195578eec077995ee2\" data-token-time=\"1792842459\"><div class=\"wpforms-head-container\"><div class=\"wpforms-description\">If you do not know the information, enter \"Unknown.\"<\/div><\/div><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Please enable JavaScript in your browser to complete this form.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-265-field_40-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"40\"><h3 id=\"wpforms-265-field_40\" aria-errormessage=\"wpforms-265-field_40-error\" aria-describedby=\"wpforms-265-field_40-description\">INFORMATION ABOUT THE PERSON WHO HAS APPOINTED US<\/h3><div id=\"wpforms-265-field_40-description\" class=\"wpforms-field-description\">(Also referred to as the \u201c Applicant \u201d)<\/div><\/div><div id=\"wpforms-265-field_42-container\" class=\"wpforms-field wpforms-field-name\" data-field-type=\"name\" data-field-id=\"42\"><fieldset><legend class=\"wpforms-field-label\">Applicant&#039;s Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-265-field_42\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][42][first]\" placeholder=\"First name\" aria-errormessage=\"wpforms-265-field_42-error\" required><label for=\"wpforms-265-field_42\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">First Name<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-265-field_42-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][42][last]\" placeholder=\"Last name\" aria-errormessage=\"wpforms-265-field_42-last-error\" required><label for=\"wpforms-265-field_42-last\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Name<\/label><\/div><\/div><\/fieldset><\/div><div id=\"wpforms-265-field_2-container\" class=\"wpforms-field wpforms-field-email\" data-field-type=\"email\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_2\">Applicant&#039;s Email Address <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-265-field_2\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][2]\" spellcheck=\"false\" aria-errormessage=\"wpforms-265-field_2-error\" required><\/div><div id=\"wpforms-265-field_4-container\" class=\"wpforms-field wpforms-field-phone\" data-field-type=\"phone\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_4\">Applicant&#039;s Phone Number <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-265-field_4\" class=\"wpforms-field-large wpforms-field-required wpforms-masked-input\" data-inputmask=\"&#039;mask&#039;: &#039;(999) 999-9999&#039;\" data-rule-us-phone-field=\"true\" data-inputmask-inputmode=\"tel\" name=\"wpforms[fields][4]\" aria-label=\"Applicant&#039;s Phone Number\" aria-errormessage=\"wpforms-265-field_4-error\" required><\/div><div id=\"wpforms-265-field_41-container\" class=\"wpforms-field wpforms-field-address\" data-field-type=\"address\" data-field-id=\"41\"><fieldset><legend class=\"wpforms-field-label\">Certificate Mailing Address <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-265-field_41\" class=\"wpforms-field-address-address1 wpforms-field-required\" name=\"wpforms[fields][41][address1]\" placeholder=\"Address\" aria-errormessage=\"wpforms-265-field_41-error\" required><label for=\"wpforms-265-field_41\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-265-field_41-city\" class=\"wpforms-field-address-city wpforms-field-required\" name=\"wpforms[fields][41][city]\" placeholder=\"City\" aria-errormessage=\"wpforms-265-field_41-city-error\" required><label for=\"wpforms-265-field_41-city\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-265-field_41-state\" class=\"wpforms-field-address-state wpforms-field-required\" name=\"wpforms[fields][41][state]\" placeholder=\"Province\" aria-errormessage=\"wpforms-265-field_41-state-error\" required><label for=\"wpforms-265-field_41-state\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">State \/ Province \/ Region<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-265-field_41-postal\" class=\"wpforms-field-address-postal wpforms-field-required\" name=\"wpforms[fields][41][postal]\" placeholder=\"Postal code\" aria-errormessage=\"wpforms-265-field_41-postal-error\" required><label for=\"wpforms-265-field_41-postal\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Postal Code<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-265-field_41-country\" class=\"wpforms-field-address-country wpforms-field-required\" name=\"wpforms[fields][41][country]\" aria-errormessage=\"wpforms-265-field_41-country-error\" required><option class=\"placeholder\" value=\"\" selected disabled>country<\/option><option value=\"AF\" >Afghanistan<\/option><option value=\"AL\" >Albania<\/option><option value=\"DZ\" >Algeria<\/option><option value=\"AS\" >American Samoa<\/option><option value=\"AD\" >Andorra<\/option><option value=\"AO\" >Angola<\/option><option value=\"AI\" >Anguilla<\/option><option value=\"AQ\" >Antarctica<\/option><option value=\"AG\" >Antigua and Barbuda<\/option><option value=\"AR\" >Argentina<\/option><option value=\"AM\" >Armenia<\/option><option value=\"AW\" >Aruba<\/option><option value=\"AU\" >Australia<\/option><option value=\"AT\" >Austria<\/option><option value=\"AZ\" >Azerbaijan<\/option><option value=\"BS\" >Bahamas<\/option><option value=\"BH\" >Bahrain<\/option><option value=\"BD\" >Bangladesh<\/option><option value=\"BB\" >Barbados<\/option><option value=\"BY\" >Belarus<\/option><option value=\"BE\" >Belgium<\/option><option value=\"BZ\" >Belize<\/option><option value=\"BJ\" >Benin<\/option><option value=\"BM\" >Bermuda<\/option><option value=\"BT\" >Bhutan<\/option><option value=\"BO\" >Bolivia (Plurinational State of)<\/option><option value=\"BQ\" >Bonaire, Saint Eustatius and Saba<\/option><option value=\"BA\" >Bosnia and Herzegovina<\/option><option value=\"BW\" >Botswana<\/option><option value=\"BV\" >Bouvet Island<\/option><option value=\"BR\" >Brazil<\/option><option value=\"IO\" >British Indian Ocean Territory<\/option><option value=\"BN\" >Brunei Darussalam<\/option><option value=\"BG\" >Bulgaria<\/option><option value=\"BF\" >Burkina Faso<\/option><option value=\"BI\" >Burundi<\/option><option value=\"CV\" >Cabo Verde<\/option><option value=\"KH\" >Cambodia<\/option><option value=\"CM\" >Cameroon<\/option><option value=\"CA\" >Canada<\/option><option value=\"KY\" >Cayman Islands<\/option><option value=\"CF\" >Central African Republic<\/option><option value=\"TD\" >Chad<\/option><option value=\"CL\" >Chile<\/option><option value=\"CN\" >China<\/option><option value=\"CX\" >Christmas Island<\/option><option value=\"CC\" >Cocos (Keeling) Islands<\/option><option value=\"CO\" >Colombia<\/option><option value=\"KM\" >Comoros<\/option><option value=\"CG\" >Congo<\/option><option value=\"CD\" >Congo (Democratic Republic of the)<\/option><option value=\"CK\" >Cook Islands<\/option><option value=\"CR\" >Costa Rica<\/option><option value=\"HR\" >Croatia<\/option><option value=\"CU\" >Cuba<\/option><option value=\"CW\" >Cura\u00e7ao<\/option><option value=\"CY\" >Cyprus<\/option><option value=\"CZ\" >Czech Republic<\/option><option value=\"CI\" >C\u00f4te d&#039;Ivoire<\/option><option value=\"DK\" >Denmark<\/option><option value=\"DJ\" >Djibouti<\/option><option value=\"DM\" >Dominica<\/option><option value=\"DO\" >Dominican Republic<\/option><option value=\"EC\" >Ecuador<\/option><option value=\"EG\" >Egypt<\/option><option value=\"SV\" >El Salvador<\/option><option value=\"GQ\" >Equatorial Guinea<\/option><option value=\"ER\" >Eritrea<\/option><option value=\"EE\" >Estonia<\/option><option value=\"SZ\" >Eswatini (Kingdom of)<\/option><option value=\"ET\" >Ethiopia<\/option><option value=\"FK\" >Falkland Islands (Malvinas)<\/option><option value=\"FO\" >Faroe Islands<\/option><option value=\"FJ\" >Fiji<\/option><option value=\"FI\" >Finland<\/option><option value=\"FR\" >France<\/option><option value=\"GF\" >French Guiana<\/option><option value=\"PF\" >French Polynesia<\/option><option value=\"TF\" >French Southern Territories<\/option><option value=\"GA\" >Gabon<\/option><option value=\"GM\" >Gambia<\/option><option value=\"GE\" >Georgia<\/option><option value=\"DE\" >Germany<\/option><option value=\"GH\" >Ghana<\/option><option value=\"GI\" >Gibraltar<\/option><option value=\"GR\" >Greece<\/option><option value=\"GL\" >Greenland<\/option><option value=\"GD\" >Grenada<\/option><option value=\"GP\" >Guadeloupe<\/option><option value=\"GU\" >Guam<\/option><option value=\"GT\" >Guatemala<\/option><option value=\"GG\" >Guernsey<\/option><option value=\"GN\" >Guinea<\/option><option value=\"GW\" >Guinea-Bissau<\/option><option value=\"GY\" >Guyana<\/option><option value=\"HT\" >Haiti<\/option><option value=\"HM\" >Heard Island and McDonald Islands<\/option><option value=\"HN\" >Honduras<\/option><option value=\"HK\" >Hong Kong<\/option><option value=\"HU\" >Hungary<\/option><option value=\"IS\" >Iceland<\/option><option value=\"IN\" >India<\/option><option value=\"ID\" >Indonesia<\/option><option value=\"IR\" >Iran (Islamic Republic of)<\/option><option value=\"IQ\" >Iraq<\/option><option value=\"IE\" >Ireland (Republic of)<\/option><option value=\"IM\" >Isle of Man<\/option><option value=\"IL\" >Israel<\/option><option value=\"IT\" >Italy<\/option><option value=\"JM\" >Jamaica<\/option><option value=\"JP\" >Japan<\/option><option value=\"JE\" >Jersey<\/option><option value=\"JO\" >Jordan<\/option><option value=\"KZ\" >Kazakhstan<\/option><option value=\"KE\" >Kenya<\/option><option value=\"KI\" >Kiribati<\/option><option value=\"KP\" >Korea (Democratic People&#039;s Republic of)<\/option><option value=\"KR\" >Korea (Republic of)<\/option><option value=\"XK\" >Kosovo<\/option><option value=\"KW\" >Kuwait<\/option><option value=\"KG\" >Kyrgyzstan<\/option><option value=\"LA\" >Lao People&#039;s Democratic Republic<\/option><option value=\"LV\" >Latvia<\/option><option value=\"LB\" >Lebanon<\/option><option value=\"LS\" >Lesotho<\/option><option value=\"LR\" >Liberia<\/option><option value=\"LY\" >Libya<\/option><option value=\"LI\" >Liechtenstein<\/option><option value=\"LT\" >Lithuania<\/option><option value=\"LU\" >Luxembourg<\/option><option value=\"MO\" >Macao<\/option><option value=\"MG\" >Madagascar<\/option><option value=\"MW\" >Malawi<\/option><option value=\"MY\" >Malaysia<\/option><option value=\"MV\" >Maldives<\/option><option value=\"ML\" >Mali<\/option><option value=\"MT\" >Malta<\/option><option value=\"MH\" >Marshall Islands<\/option><option value=\"MQ\" >Martinique<\/option><option value=\"MR\" >Mauritania<\/option><option value=\"MU\" >Mauritius<\/option><option value=\"YT\" >Mayotte<\/option><option value=\"MX\" >Mexico<\/option><option value=\"FM\" >Micronesia (Federated States of)<\/option><option value=\"MD\" >Moldova (Republic of)<\/option><option value=\"MC\" >Monaco<\/option><option value=\"MN\" >Mongolia<\/option><option value=\"ME\" >Montenegro<\/option><option value=\"MS\" >Montserrat<\/option><option value=\"MA\" >Morocco<\/option><option value=\"MZ\" >Mozambique<\/option><option value=\"MM\" >Myanmar<\/option><option value=\"NA\" >Namibia<\/option><option value=\"NR\" >Nauru<\/option><option value=\"NP\" >Nepal<\/option><option value=\"NL\" >Netherlands<\/option><option value=\"NC\" >New Caledonia<\/option><option value=\"NZ\" >New Zealand<\/option><option value=\"NI\" >Nicaragua<\/option><option value=\"NE\" >Niger<\/option><option value=\"NG\" >Nigeria<\/option><option value=\"NU\" >Niue<\/option><option value=\"NF\" >Norfolk Island<\/option><option value=\"MK\" >North Macedonia (Republic of)<\/option><option value=\"MP\" >Northern Mariana Islands<\/option><option value=\"NO\" >Norway<\/option><option value=\"OM\" >Oman<\/option><option value=\"PK\" >Pakistan<\/option><option value=\"PW\" >Palau<\/option><option value=\"PS\" >Palestine (State of)<\/option><option value=\"PA\" >Panama<\/option><option value=\"PG\" >Papua New Guinea<\/option><option value=\"PY\" >Paraguay<\/option><option value=\"PE\" >Peru<\/option><option value=\"PH\" >Philippines<\/option><option value=\"PN\" >Pitcairn<\/option><option value=\"PL\" >Poland<\/option><option value=\"PT\" >Portugal<\/option><option value=\"PR\" >Puerto Rico<\/option><option value=\"QA\" >Qatar<\/option><option value=\"RO\" >Romania<\/option><option value=\"RU\" >Russian Federation<\/option><option value=\"RW\" >Rwanda<\/option><option value=\"RE\" >R\u00e9union<\/option><option value=\"BL\" >Saint Barth\u00e9lemy<\/option><option value=\"SH\" >Saint Helena, Ascension and Tristan da Cunha<\/option><option value=\"KN\" >Saint Kitts and Nevis<\/option><option value=\"LC\" >Saint Lucia<\/option><option value=\"MF\" >Saint Martin (French part)<\/option><option value=\"PM\" >Saint Pierre and Miquelon<\/option><option value=\"VC\" >Saint Vincent and the Grenadines<\/option><option value=\"WS\" >Samoa<\/option><option value=\"SM\" >San Marino<\/option><option value=\"ST\" >Sao Tome and Principe<\/option><option value=\"SA\" >Saudi Arabia<\/option><option value=\"SN\" >Senegal<\/option><option value=\"RS\" >Serbia<\/option><option value=\"SC\" >Seychelles<\/option><option value=\"SL\" >Sierra Leone<\/option><option value=\"SG\" >Singapore<\/option><option value=\"SX\" >Sint Maarten (Dutch part)<\/option><option value=\"SK\" >Slovakia<\/option><option value=\"SI\" >Slovenia<\/option><option value=\"SB\" >Solomon Islands<\/option><option value=\"SO\" >Somalia<\/option><option value=\"ZA\" >South Africa<\/option><option value=\"GS\" >South Georgia and the South Sandwich Islands<\/option><option value=\"SS\" >South Sudan<\/option><option value=\"ES\" >Spain<\/option><option value=\"LK\" >Sri Lanka<\/option><option value=\"SD\" >Sudan<\/option><option value=\"SR\" >Suriname<\/option><option value=\"SJ\" >Svalbard and Jan Mayen<\/option><option value=\"SE\" >Sweden<\/option><option value=\"CH\" >Switzerland<\/option><option value=\"SY\" >Syrian Arab Republic<\/option><option value=\"TW\" >Taiwan, Republic of China<\/option><option value=\"TJ\" >Tajikistan<\/option><option value=\"TZ\" >Tanzania (United Republic of)<\/option><option value=\"TH\" >Thailand<\/option><option value=\"TL\" >Timor-Leste<\/option><option value=\"TG\" >Togo<\/option><option value=\"TK\" >Tokelau<\/option><option value=\"TO\" >Tonga<\/option><option value=\"TT\" >Trinidad and Tobago<\/option><option value=\"TN\" >Tunisia<\/option><option value=\"TM\" >Turkmenistan<\/option><option value=\"TC\" >Turks and Caicos Islands<\/option><option value=\"TV\" >Tuvalu<\/option><option value=\"TR\" >T\u00fcrkiye<\/option><option value=\"UG\" >Uganda<\/option><option value=\"UA\" >Ukraine<\/option><option value=\"AE\" >United Arab Emirates<\/option><option value=\"GB\" >United Kingdom of Great Britain and Northern Ireland<\/option><option value=\"UM\" >United States Minor Outlying Islands<\/option><option value=\"US\" >United States of America<\/option><option value=\"UY\" >Uruguay<\/option><option value=\"UZ\" >Uzbekistan<\/option><option value=\"VU\" >Vanuatu<\/option><option value=\"VA\" >Vatican City State<\/option><option value=\"VE\" >Venezuela (Bolivarian Republic of)<\/option><option value=\"VN\" >Vietnam<\/option><option value=\"VG\" >Virgin Islands (British)<\/option><option value=\"VI\" >Virgin Islands (U.S.)<\/option><option value=\"WF\" >Wallis and Futuna<\/option><option value=\"EH\" >Western Sahara<\/option><option value=\"YE\" >Yemen<\/option><option value=\"ZM\" >Zambia<\/option><option value=\"ZW\" >Zimbabwe<\/option><option value=\"AX\" >\u00c5land Islands<\/option><\/select><label for=\"wpforms-265-field_41-country\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Country<\/label><\/div><\/div><\/fieldset><\/div><div id=\"wpforms-265-field_74-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"74\"><div id=\"wpforms-265-field_74-description\" class=\"wpforms-field-description\"><div class=\"wpforms-testament-notice\">\n  <div class=\"wpforms-testament-notice-title\">\n  \u26a0\ufe0f IMPORTANT \u2013 Shipping Address\n  <\/div>\n  <p>\n  It is your responsibility to verify the accuracy of the shipping address provided before submitting this form. Docugo cannot be held responsible for any delay, delivery error or non-receipt of your documents due to an incorrect or outdated address. \n  <\/p>\n  <p>\n  If you plan to move or be outside the country within <strong>4 months<\/strong> of your request, you must notify us <strong>in advance<\/strong> by email at <strong>info@docugo.ca<\/strong>. <strong>Reshipment fees<\/strong> will apply in the event of a return or redelivery of documents.\n  <\/p>\n  <p>\n  All shipments are sent by courier with <strong>mandatory signature upon delivery<\/strong>. In case of absence, it is your responsibility to retrieve your documents at the carrier's drop-off point within the timeframe indicated on the notice left at your address. \n  <\/p>\n<\/div><\/div><\/div><div id=\"wpforms-265-field_89-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"89\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_89\">Special Instructions \u2013 Delivery<\/label><input type=\"text\" id=\"wpforms-265-field_89\" class=\"wpforms-field-large\" name=\"wpforms[fields][89]\" aria-errormessage=\"wpforms-265-field_89-error\" ><\/div><div id=\"wpforms-265-field_90-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-type=\"checkbox\" data-field-id=\"90\"><fieldset><legend class=\"wpforms-field-label\"> <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-265-field_90\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-265-field_90_1\" name=\"wpforms[fields][90][]\" value=\"I have read and agree to the shipping terms of DOCUGO\" aria-errormessage=\"wpforms-265-field_90_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-265-field_90_1\">I have read and agree to the shipping terms of DOCUGO<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-265-field_43-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"43\"><h3 id=\"wpforms-265-field_43\" aria-errormessage=\"wpforms-265-field_43-error\">INFORMATION ABOUT THE DECEASED<\/h3><\/div>\t\t<div id=\"wpforms-265-field_1-container\"\n\t\t\tclass=\"wpforms-field wpforms-field-text\"\n\t\t\tdata-field-type=\"text\"\n\t\t\tdata-field-id=\"1\"\n\t\t\t>\n\t\t\t<label class=\"wpforms-field-label\" for=\"wpforms-265-field_1\" >and notarized Was<\/label>\n\t\t\t<input type=\"text\" id=\"wpforms-265-field_1\" class=\"wpforms-field-medium\" name=\"wpforms[fields][1]\" >\n\t\t<\/div>\n\t\t<div id=\"wpforms-265-field_44-container\" class=\"wpforms-field wpforms-field-name\" data-field-type=\"name\" data-field-id=\"44\"><fieldset><legend class=\"wpforms-field-label\">Deceased&#039;s Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-265-field_44\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][44][first]\" placeholder=\"First name\" aria-errormessage=\"wpforms-265-field_44-error\" required><label for=\"wpforms-265-field_44\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">First Name<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-265-field_44-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][44][last]\" placeholder=\"Last name\" aria-errormessage=\"wpforms-265-field_44-last-error\" required><label for=\"wpforms-265-field_44-last\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Name<\/label><\/div><\/div><\/fieldset><\/div><div id=\"wpforms-265-field_75-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"75\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_75\">Deceased&#039;s Social Security Number<\/label><input type=\"text\" id=\"wpforms-265-field_75\" class=\"wpforms-field-medium\" name=\"wpforms[fields][75]\" aria-errormessage=\"wpforms-265-field_75-error\" aria-describedby=\"wpforms-265-field_75-description\" ><div id=\"wpforms-265-field_75-description\" class=\"wpforms-field-description\">For security reasons, if you prefer, you may provide your social insurance number by phone at 1-844-760-3434<\/div><\/div><div id=\"wpforms-265-field_9-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_9\">Former Occupation (before retirement) <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-265-field_9\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][9]\" aria-errormessage=\"wpforms-265-field_9-error\" required><\/div><div id=\"wpforms-265-field_94-container\" class=\"wpforms-field wpforms-field-layout\" data-field-type=\"layout\" data-field-id=\"94\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-67\"><div id=\"wpforms-265-field_47-container\" class=\"wpforms-field wpforms-field-address\" data-field-type=\"address\" data-field-id=\"47\"><fieldset><legend class=\"wpforms-field-label\">Deceased&#039;s Recent Address <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-265-field_47\" class=\"wpforms-field-address-address1 wpforms-field-required\" name=\"wpforms[fields][47][address1]\" placeholder=\"Address\" aria-errormessage=\"wpforms-265-field_47-error\" required><label for=\"wpforms-265-field_47\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-265-field_47-city\" class=\"wpforms-field-address-city wpforms-field-required\" name=\"wpforms[fields][47][city]\" placeholder=\"City\" aria-errormessage=\"wpforms-265-field_47-city-error\" required><label for=\"wpforms-265-field_47-city\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-265-field_47-state\" class=\"wpforms-field-address-state wpforms-field-required\" name=\"wpforms[fields][47][state]\" placeholder=\"Province\" aria-errormessage=\"wpforms-265-field_47-state-error\" required><label for=\"wpforms-265-field_47-state\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">State \/ Province \/ Region<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-265-field_47-postal\" class=\"wpforms-field-address-postal wpforms-field-required\" name=\"wpforms[fields][47][postal]\" placeholder=\"Postal code\" aria-errormessage=\"wpforms-265-field_47-postal-error\" required><label for=\"wpforms-265-field_47-postal\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Postal Code<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-265-field_47-country\" class=\"wpforms-field-address-country wpforms-field-required\" name=\"wpforms[fields][47][country]\" aria-errormessage=\"wpforms-265-field_47-country-error\" required><option class=\"placeholder\" value=\"\" selected disabled>Country<\/option><option value=\"AF\" >Afghanistan<\/option><option value=\"AL\" >Albania<\/option><option value=\"DZ\" >Algeria<\/option><option value=\"AS\" >American Samoa<\/option><option value=\"AD\" >Andorra<\/option><option value=\"AO\" >Angola<\/option><option value=\"AI\" >Anguilla<\/option><option value=\"AQ\" >Antarctica<\/option><option value=\"AG\" >Antigua and Barbuda<\/option><option value=\"AR\" >Argentina<\/option><option value=\"AM\" >Armenia<\/option><option value=\"AW\" >Aruba<\/option><option value=\"AU\" >Australia<\/option><option value=\"AT\" >Austria<\/option><option value=\"AZ\" >Azerbaijan<\/option><option value=\"BS\" >Bahamas<\/option><option value=\"BH\" >Bahrain<\/option><option value=\"BD\" >Bangladesh<\/option><option value=\"BB\" >Barbados<\/option><option value=\"BY\" >Belarus<\/option><option value=\"BE\" >Belgium<\/option><option value=\"BZ\" >Belize<\/option><option value=\"BJ\" >Benin<\/option><option value=\"BM\" >Bermuda<\/option><option value=\"BT\" >Bhutan<\/option><option value=\"BO\" >Bolivia (Plurinational State of)<\/option><option value=\"BQ\" >Bonaire, Saint Eustatius and Saba<\/option><option value=\"BA\" >Bosnia and Herzegovina<\/option><option value=\"BW\" >Botswana<\/option><option value=\"BV\" >Bouvet Island<\/option><option value=\"BR\" >Brazil<\/option><option value=\"IO\" >British Indian Ocean Territory<\/option><option value=\"BN\" >Brunei Darussalam<\/option><option value=\"BG\" >Bulgaria<\/option><option value=\"BF\" >Burkina Faso<\/option><option value=\"BI\" >Burundi<\/option><option value=\"CV\" >Cabo Verde<\/option><option value=\"KH\" >Cambodia<\/option><option value=\"CM\" >Cameroon<\/option><option value=\"CA\" >Canada<\/option><option value=\"KY\" >Cayman Islands<\/option><option value=\"CF\" >Central African Republic<\/option><option value=\"TD\" >Chad<\/option><option value=\"CL\" >Chile<\/option><option value=\"CN\" >China<\/option><option value=\"CX\" >Christmas Island<\/option><option value=\"CC\" >Cocos (Keeling) Islands<\/option><option value=\"CO\" >Colombia<\/option><option value=\"KM\" >Comoros<\/option><option value=\"CG\" >Congo<\/option><option value=\"CD\" >Congo (Democratic Republic of the)<\/option><option value=\"CK\" >Cook Islands<\/option><option value=\"CR\" >Costa Rica<\/option><option value=\"HR\" >Croatia<\/option><option value=\"CU\" >Cuba<\/option><option value=\"CW\" >Cura\u00e7ao<\/option><option value=\"CY\" >Cyprus<\/option><option value=\"CZ\" >Czech Republic<\/option><option value=\"CI\" >C\u00f4te d&#039;Ivoire<\/option><option value=\"DK\" >Denmark<\/option><option value=\"DJ\" >Djibouti<\/option><option value=\"DM\" >Dominica<\/option><option value=\"DO\" >Dominican Republic<\/option><option value=\"EC\" >Ecuador<\/option><option value=\"EG\" >Egypt<\/option><option value=\"SV\" >El Salvador<\/option><option value=\"GQ\" >Equatorial Guinea<\/option><option value=\"ER\" >Eritrea<\/option><option value=\"EE\" >Estonia<\/option><option value=\"SZ\" >Eswatini (Kingdom of)<\/option><option value=\"ET\" >Ethiopia<\/option><option value=\"FK\" >Falkland Islands (Malvinas)<\/option><option value=\"FO\" >Faroe Islands<\/option><option value=\"FJ\" >Fiji<\/option><option value=\"FI\" >Finland<\/option><option value=\"FR\" >France<\/option><option value=\"GF\" >French Guiana<\/option><option value=\"PF\" >French Polynesia<\/option><option value=\"TF\" >French Southern Territories<\/option><option value=\"GA\" >Gabon<\/option><option value=\"GM\" >Gambia<\/option><option value=\"GE\" >Georgia<\/option><option value=\"DE\" >Germany<\/option><option value=\"GH\" >Ghana<\/option><option value=\"GI\" >Gibraltar<\/option><option value=\"GR\" >Greece<\/option><option value=\"GL\" >Greenland<\/option><option value=\"GD\" >Grenada<\/option><option value=\"GP\" >Guadeloupe<\/option><option value=\"GU\" >Guam<\/option><option value=\"GT\" >Guatemala<\/option><option value=\"GG\" >Guernsey<\/option><option value=\"GN\" >Guinea<\/option><option value=\"GW\" >Guinea-Bissau<\/option><option value=\"GY\" >Guyana<\/option><option value=\"HT\" >Haiti<\/option><option value=\"HM\" >Heard Island and McDonald Islands<\/option><option value=\"HN\" >Honduras<\/option><option value=\"HK\" >Hong Kong<\/option><option value=\"HU\" >Hungary<\/option><option value=\"IS\" >Iceland<\/option><option value=\"IN\" >India<\/option><option value=\"ID\" >Indonesia<\/option><option value=\"IR\" >Iran (Islamic Republic of)<\/option><option value=\"IQ\" >Iraq<\/option><option value=\"IE\" >Ireland (Republic of)<\/option><option value=\"IM\" >Isle of Man<\/option><option value=\"IL\" >Israel<\/option><option value=\"IT\" >Italy<\/option><option value=\"JM\" >Jamaica<\/option><option value=\"JP\" >Japan<\/option><option value=\"JE\" >Jersey<\/option><option value=\"JO\" >Jordan<\/option><option value=\"KZ\" >Kazakhstan<\/option><option value=\"KE\" >Kenya<\/option><option value=\"KI\" >Kiribati<\/option><option value=\"KP\" >Korea (Democratic People&#039;s Republic of)<\/option><option value=\"KR\" >Korea (Republic of)<\/option><option value=\"XK\" >Kosovo<\/option><option value=\"KW\" >Kuwait<\/option><option value=\"KG\" >Kyrgyzstan<\/option><option value=\"LA\" >Lao People&#039;s Democratic Republic<\/option><option value=\"LV\" >Latvia<\/option><option value=\"LB\" >Lebanon<\/option><option value=\"LS\" >Lesotho<\/option><option value=\"LR\" >Liberia<\/option><option value=\"LY\" >Libya<\/option><option value=\"LI\" >Liechtenstein<\/option><option value=\"LT\" >Lithuania<\/option><option value=\"LU\" >Luxembourg<\/option><option value=\"MO\" >Macao<\/option><option value=\"MG\" >Madagascar<\/option><option value=\"MW\" >Malawi<\/option><option value=\"MY\" >Malaysia<\/option><option value=\"MV\" >Maldives<\/option><option value=\"ML\" >Mali<\/option><option value=\"MT\" >Malta<\/option><option value=\"MH\" >Marshall Islands<\/option><option value=\"MQ\" >Martinique<\/option><option value=\"MR\" >Mauritania<\/option><option value=\"MU\" >Mauritius<\/option><option value=\"YT\" >Mayotte<\/option><option value=\"MX\" >Mexico<\/option><option value=\"FM\" >Micronesia (Federated States of)<\/option><option value=\"MD\" >Moldova (Republic of)<\/option><option value=\"MC\" >Monaco<\/option><option value=\"MN\" >Mongolia<\/option><option value=\"ME\" >Montenegro<\/option><option value=\"MS\" >Montserrat<\/option><option value=\"MA\" >Morocco<\/option><option value=\"MZ\" >Mozambique<\/option><option value=\"MM\" >Myanmar<\/option><option value=\"NA\" >Namibia<\/option><option value=\"NR\" >Nauru<\/option><option value=\"NP\" >Nepal<\/option><option value=\"NL\" >Netherlands<\/option><option value=\"NC\" >New Caledonia<\/option><option value=\"NZ\" >New Zealand<\/option><option value=\"NI\" >Nicaragua<\/option><option value=\"NE\" >Niger<\/option><option value=\"NG\" >Nigeria<\/option><option value=\"NU\" >Niue<\/option><option value=\"NF\" >Norfolk Island<\/option><option value=\"MK\" >North Macedonia (Republic of)<\/option><option value=\"MP\" >Northern Mariana Islands<\/option><option value=\"NO\" >Norway<\/option><option value=\"OM\" >Oman<\/option><option value=\"PK\" >Pakistan<\/option><option value=\"PW\" >Palau<\/option><option value=\"PS\" >Palestine (State of)<\/option><option value=\"PA\" >Panama<\/option><option value=\"PG\" >Papua New Guinea<\/option><option value=\"PY\" >Paraguay<\/option><option value=\"PE\" >Peru<\/option><option value=\"PH\" >Philippines<\/option><option value=\"PN\" >Pitcairn<\/option><option value=\"PL\" >Poland<\/option><option value=\"PT\" >Portugal<\/option><option value=\"PR\" >Puerto Rico<\/option><option value=\"QA\" >Qatar<\/option><option value=\"RO\" >Romania<\/option><option value=\"RU\" >Russian Federation<\/option><option value=\"RW\" >Rwanda<\/option><option value=\"RE\" >R\u00e9union<\/option><option value=\"BL\" >Saint Barth\u00e9lemy<\/option><option value=\"SH\" >Saint Helena, Ascension and Tristan da Cunha<\/option><option value=\"KN\" >Saint Kitts and Nevis<\/option><option value=\"LC\" >Saint Lucia<\/option><option value=\"MF\" >Saint Martin (French part)<\/option><option value=\"PM\" >Saint Pierre and Miquelon<\/option><option value=\"VC\" >Saint Vincent and the Grenadines<\/option><option value=\"WS\" >Samoa<\/option><option value=\"SM\" >San Marino<\/option><option value=\"ST\" >Sao Tome and Principe<\/option><option value=\"SA\" >Saudi Arabia<\/option><option value=\"SN\" >Senegal<\/option><option value=\"RS\" >Serbia<\/option><option value=\"SC\" >Seychelles<\/option><option value=\"SL\" >Sierra Leone<\/option><option value=\"SG\" >Singapore<\/option><option value=\"SX\" >Sint Maarten (Dutch part)<\/option><option value=\"SK\" >Slovakia<\/option><option value=\"SI\" >Slovenia<\/option><option value=\"SB\" >Solomon Islands<\/option><option value=\"SO\" >Somalia<\/option><option value=\"ZA\" >South Africa<\/option><option value=\"GS\" >South Georgia and the South Sandwich Islands<\/option><option value=\"SS\" >South Sudan<\/option><option value=\"ES\" >Spain<\/option><option value=\"LK\" >Sri Lanka<\/option><option value=\"SD\" >Sudan<\/option><option value=\"SR\" >Suriname<\/option><option value=\"SJ\" >Svalbard and Jan Mayen<\/option><option value=\"SE\" >Sweden<\/option><option value=\"CH\" >Switzerland<\/option><option value=\"SY\" >Syrian Arab Republic<\/option><option value=\"TW\" >Taiwan, Republic of China<\/option><option value=\"TJ\" >Tajikistan<\/option><option value=\"TZ\" >Tanzania (United Republic of)<\/option><option value=\"TH\" >Thailand<\/option><option value=\"TL\" >Timor-Leste<\/option><option value=\"TG\" >Togo<\/option><option value=\"TK\" >Tokelau<\/option><option value=\"TO\" >Tonga<\/option><option value=\"TT\" >Trinidad and Tobago<\/option><option value=\"TN\" >Tunisia<\/option><option value=\"TM\" >Turkmenistan<\/option><option value=\"TC\" >Turks and Caicos Islands<\/option><option value=\"TV\" >Tuvalu<\/option><option value=\"TR\" >T\u00fcrkiye<\/option><option value=\"UG\" >Uganda<\/option><option value=\"UA\" >Ukraine<\/option><option value=\"AE\" >United Arab Emirates<\/option><option value=\"GB\" >United Kingdom of Great Britain and Northern Ireland<\/option><option value=\"UM\" >United States Minor Outlying Islands<\/option><option value=\"US\" >United States of America<\/option><option value=\"UY\" >Uruguay<\/option><option value=\"UZ\" >Uzbekistan<\/option><option value=\"VU\" >Vanuatu<\/option><option value=\"VA\" >Vatican City State<\/option><option value=\"VE\" >Venezuela (Bolivarian Republic of)<\/option><option value=\"VN\" >Vietnam<\/option><option value=\"VG\" >Virgin Islands (British)<\/option><option value=\"VI\" >Virgin Islands (U.S.)<\/option><option value=\"WF\" >Wallis and Futuna<\/option><option value=\"EH\" >Western Sahara<\/option><option value=\"YE\" >Yemen<\/option><option value=\"ZM\" >Zambia<\/option><option value=\"ZW\" >Zimbabwe<\/option><option value=\"AX\" >\u00c5land Islands<\/option><\/select><label for=\"wpforms-265-field_47-country\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Country<\/label><\/div><\/div><\/fieldset><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-265-field_95-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"95\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_95\">Approximately between which years? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-265-field_95\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][95]\" aria-errormessage=\"wpforms-265-field_95-error\" required><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-265-field_77-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline wpforms-conditional-trigger\" data-field-type=\"radio\" data-field-id=\"77\"><fieldset><legend class=\"wpforms-field-label\">Was the deceased born before 1963? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-265-field_77\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-265-field_77_1\" name=\"wpforms[fields][77]\" value=\"YES\" aria-errormessage=\"wpforms-265-field_77_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-265-field_77_1\">YES<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-265-field_77_2\" name=\"wpforms[fields][77]\" value=\"NO\" aria-errormessage=\"wpforms-265-field_77_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-265-field_77_2\">NO<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-265-field_76-container\" class=\"wpforms-field wpforms-field-repeater wpforms-conditional-field wpforms-conditional-show wpforms-field-repeater-display-rows\" data-rows-min=\"1\" data-rows-max=\"10\" data-clone-num=\"2\" data-field-type=\"repeater\" data-field-id=\"76\" style=\"display:none;\"><h3 class=\"wpforms-field-label\">\n\t\t\t\tAdd all previous known addresses (the most significant ones)\n\t\t\t<\/h3><div id=\"wpforms-265-field_76-description\" class=\"wpforms-field-description\">Records from this period are not always indexed by date of birth or social security number.\nThe search may therefore require additional information such as residential addresses, occupation, or spouse's name in order to allow for proper identification.<\/div><input type=\"hidden\" class=\"wpforms-field-repeater-clone-list\" name=\"wpforms[fields][76][clone_list]\" value=\"[]\"><script type=\"text\/html\" class=\"tmpl-wpforms-field-repeater-template-76-265\"><div id=\"wpforms-265-repeater-field_76-clone_{CLONE}\" class=\"wpforms-field-repeater-clone-wrap\" data-clone=\"{CLONE}\">\n\t\t\t\t<div class=\"wpforms-field-layout-rows wpforms-field-medium wpforms-field-repeater-display-rows wpforms-field-repeater-preset-67-33\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-67\"><div id=\"wpforms-265-field_78_{CLONE}-container\" class=\"wpforms-field wpforms-field-address\" data-field-type=\"address\" data-field-id=\"78_{CLONE}\"><fieldset><legend class=\"wpforms-field-label\">Address <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-265-field_78_{CLONE}\" class=\"wpforms-field-address-address1 wpforms-field-required\" name=\"wpforms[fields][78_{CLONE}][address1]\" aria-errormessage=\"wpforms-265-field_78_{CLONE}-error\" required><label for=\"wpforms-265-field_78_{CLONE}\" class=\"wpforms-field-sublabel after\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-265-field_78_{CLONE}-city\" class=\"wpforms-field-address-city wpforms-field-required\" name=\"wpforms[fields][78_{CLONE}][city]\" aria-errormessage=\"wpforms-265-field_78_{CLONE}-city-error\" required><label for=\"wpforms-265-field_78_{CLONE}-city\" class=\"wpforms-field-sublabel after\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-265-field_78_{CLONE}-state\" class=\"wpforms-field-address-state wpforms-field-required\" name=\"wpforms[fields][78_{CLONE}][state]\" aria-errormessage=\"wpforms-265-field_78_{CLONE}-state-error\" required><label for=\"wpforms-265-field_78_{CLONE}-state\" class=\"wpforms-field-sublabel after\">State \/ Province \/ Region<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-265-field_78_{CLONE}-postal\" class=\"wpforms-field-address-postal wpforms-field-required\" name=\"wpforms[fields][78_{CLONE}][postal]\" aria-errormessage=\"wpforms-265-field_78_{CLONE}-postal-error\" required><label for=\"wpforms-265-field_78_{CLONE}-postal\" class=\"wpforms-field-sublabel after\">Postal Code<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-265-field_78_{CLONE}-country\" class=\"wpforms-field-address-country wpforms-field-required\" name=\"wpforms[fields][78_{CLONE}][country]\" aria-errormessage=\"wpforms-265-field_78_{CLONE}-country-error\" required><option class=\"placeholder\" value=\"\" selected disabled>--- Select country ---<\/option><option value=\"AF\" >Afghanistan<\/option><option value=\"AL\" >Albania<\/option><option value=\"DZ\" >Algeria<\/option><option value=\"AS\" >American Samoa<\/option><option value=\"AD\" >Andorra<\/option><option value=\"AO\" >Angola<\/option><option value=\"AI\" >Anguilla<\/option><option value=\"AQ\" >Antarctica<\/option><option value=\"AG\" >Antigua and Barbuda<\/option><option value=\"AR\" >Argentina<\/option><option value=\"AM\" >Armenia<\/option><option value=\"AW\" >Aruba<\/option><option value=\"AU\" >Australia<\/option><option value=\"AT\" >Austria<\/option><option value=\"AZ\" >Azerbaijan<\/option><option value=\"BS\" >Bahamas<\/option><option value=\"BH\" >Bahrain<\/option><option value=\"BD\" >Bangladesh<\/option><option value=\"BB\" >Barbados<\/option><option value=\"BY\" >Belarus<\/option><option value=\"BE\" >Belgium<\/option><option value=\"BZ\" >Belize<\/option><option value=\"BJ\" >Benin<\/option><option value=\"BM\" >Bermuda<\/option><option value=\"BT\" >Bhutan<\/option><option value=\"BO\" >Bolivia (Plurinational State of)<\/option><option value=\"BQ\" >Bonaire, Saint Eustatius and Saba<\/option><option value=\"BA\" >Bosnia and Herzegovina<\/option><option value=\"BW\" >Botswana<\/option><option value=\"BV\" >Bouvet Island<\/option><option value=\"BR\" >Brazil<\/option><option value=\"IO\" >British Indian Ocean Territory<\/option><option value=\"BN\" >Brunei Darussalam<\/option><option value=\"BG\" >Bulgaria<\/option><option value=\"BF\" >Burkina Faso<\/option><option value=\"BI\" >Burundi<\/option><option value=\"CV\" >Cabo Verde<\/option><option value=\"KH\" >Cambodia<\/option><option value=\"CM\" >Cameroon<\/option><option value=\"CA\" >Canada<\/option><option value=\"KY\" >Cayman Islands<\/option><option value=\"CF\" >Central African Republic<\/option><option value=\"TD\" >Chad<\/option><option value=\"CL\" >Chile<\/option><option value=\"CN\" >China<\/option><option value=\"CX\" >Christmas Island<\/option><option value=\"CC\" >Cocos (Keeling) Islands<\/option><option value=\"CO\" >Colombia<\/option><option value=\"KM\" >Comoros<\/option><option value=\"CG\" >Congo<\/option><option value=\"CD\" >Congo (Democratic Republic of the)<\/option><option value=\"CK\" >Cook Islands<\/option><option value=\"CR\" >Costa Rica<\/option><option value=\"HR\" >Croatia<\/option><option value=\"CU\" >Cuba<\/option><option value=\"CW\" >Cura\u00e7ao<\/option><option value=\"CY\" >Cyprus<\/option><option value=\"CZ\" >Czech Republic<\/option><option value=\"CI\" >C\u00f4te d&#039;Ivoire<\/option><option value=\"DK\" >Denmark<\/option><option value=\"DJ\" >Djibouti<\/option><option value=\"DM\" >Dominica<\/option><option value=\"DO\" >Dominican Republic<\/option><option value=\"EC\" >Ecuador<\/option><option value=\"EG\" >Egypt<\/option><option value=\"SV\" >El Salvador<\/option><option value=\"GQ\" >Equatorial Guinea<\/option><option value=\"ER\" >Eritrea<\/option><option value=\"EE\" >Estonia<\/option><option value=\"SZ\" >Eswatini (Kingdom of)<\/option><option value=\"ET\" >Ethiopia<\/option><option value=\"FK\" >Falkland Islands (Malvinas)<\/option><option value=\"FO\" >Faroe Islands<\/option><option value=\"FJ\" >Fiji<\/option><option value=\"FI\" >Finland<\/option><option value=\"FR\" >France<\/option><option value=\"GF\" >French Guiana<\/option><option value=\"PF\" >French Polynesia<\/option><option value=\"TF\" >French Southern Territories<\/option><option value=\"GA\" >Gabon<\/option><option value=\"GM\" >Gambia<\/option><option value=\"GE\" >Georgia<\/option><option value=\"DE\" >Germany<\/option><option value=\"GH\" >Ghana<\/option><option value=\"GI\" >Gibraltar<\/option><option value=\"GR\" >Greece<\/option><option value=\"GL\" >Greenland<\/option><option value=\"GD\" >Grenada<\/option><option value=\"GP\" >Guadeloupe<\/option><option value=\"GU\" >Guam<\/option><option value=\"GT\" >Guatemala<\/option><option value=\"GG\" >Guernsey<\/option><option value=\"GN\" >Guinea<\/option><option value=\"GW\" >Guinea-Bissau<\/option><option value=\"GY\" >Guyana<\/option><option value=\"HT\" >Haiti<\/option><option value=\"HM\" >Heard Island and McDonald Islands<\/option><option value=\"HN\" >Honduras<\/option><option value=\"HK\" >Hong Kong<\/option><option value=\"HU\" >Hungary<\/option><option value=\"IS\" >Iceland<\/option><option value=\"IN\" >India<\/option><option value=\"ID\" >Indonesia<\/option><option value=\"IR\" >Iran (Islamic Republic of)<\/option><option value=\"IQ\" >Iraq<\/option><option value=\"IE\" >Ireland (Republic of)<\/option><option value=\"IM\" >Isle of Man<\/option><option value=\"IL\" >Israel<\/option><option value=\"IT\" >Italy<\/option><option value=\"JM\" >Jamaica<\/option><option value=\"JP\" >Japan<\/option><option value=\"JE\" >Jersey<\/option><option value=\"JO\" >Jordan<\/option><option value=\"KZ\" >Kazakhstan<\/option><option value=\"KE\" >Kenya<\/option><option value=\"KI\" >Kiribati<\/option><option value=\"KP\" >Korea (Democratic People&#039;s Republic of)<\/option><option value=\"KR\" >Korea (Republic of)<\/option><option value=\"XK\" >Kosovo<\/option><option value=\"KW\" >Kuwait<\/option><option value=\"KG\" >Kyrgyzstan<\/option><option value=\"LA\" >Lao People&#039;s Democratic Republic<\/option><option value=\"LV\" >Latvia<\/option><option value=\"LB\" >Lebanon<\/option><option value=\"LS\" >Lesotho<\/option><option value=\"LR\" >Liberia<\/option><option value=\"LY\" >Libya<\/option><option value=\"LI\" >Liechtenstein<\/option><option value=\"LT\" >Lithuania<\/option><option value=\"LU\" >Luxembourg<\/option><option value=\"MO\" >Macao<\/option><option value=\"MG\" >Madagascar<\/option><option value=\"MW\" >Malawi<\/option><option value=\"MY\" >Malaysia<\/option><option value=\"MV\" >Maldives<\/option><option value=\"ML\" >Mali<\/option><option value=\"MT\" >Malta<\/option><option value=\"MH\" >Marshall Islands<\/option><option value=\"MQ\" >Martinique<\/option><option value=\"MR\" >Mauritania<\/option><option value=\"MU\" >Mauritius<\/option><option value=\"YT\" >Mayotte<\/option><option value=\"MX\" >Mexico<\/option><option value=\"FM\" >Micronesia (Federated States of)<\/option><option value=\"MD\" >Moldova (Republic of)<\/option><option value=\"MC\" >Monaco<\/option><option value=\"MN\" >Mongolia<\/option><option value=\"ME\" >Montenegro<\/option><option value=\"MS\" >Montserrat<\/option><option value=\"MA\" >Morocco<\/option><option value=\"MZ\" >Mozambique<\/option><option value=\"MM\" >Myanmar<\/option><option value=\"NA\" >Namibia<\/option><option value=\"NR\" >Nauru<\/option><option value=\"NP\" >Nepal<\/option><option value=\"NL\" >Netherlands<\/option><option value=\"NC\" >New Caledonia<\/option><option value=\"NZ\" >New Zealand<\/option><option value=\"NI\" >Nicaragua<\/option><option value=\"NE\" >Niger<\/option><option value=\"NG\" >Nigeria<\/option><option value=\"NU\" >Niue<\/option><option value=\"NF\" >Norfolk Island<\/option><option value=\"MK\" >North Macedonia (Republic of)<\/option><option value=\"MP\" >Northern Mariana Islands<\/option><option value=\"NO\" >Norway<\/option><option value=\"OM\" >Oman<\/option><option value=\"PK\" >Pakistan<\/option><option value=\"PW\" >Palau<\/option><option value=\"PS\" >Palestine (State of)<\/option><option value=\"PA\" >Panama<\/option><option value=\"PG\" >Papua New Guinea<\/option><option value=\"PY\" >Paraguay<\/option><option value=\"PE\" >Peru<\/option><option value=\"PH\" >Philippines<\/option><option value=\"PN\" >Pitcairn<\/option><option value=\"PL\" >Poland<\/option><option value=\"PT\" >Portugal<\/option><option value=\"PR\" >Puerto Rico<\/option><option value=\"QA\" >Qatar<\/option><option value=\"RO\" >Romania<\/option><option value=\"RU\" >Russian Federation<\/option><option value=\"RW\" >Rwanda<\/option><option value=\"RE\" >R\u00e9union<\/option><option value=\"BL\" >Saint Barth\u00e9lemy<\/option><option value=\"SH\" >Saint Helena, Ascension and Tristan da Cunha<\/option><option value=\"KN\" >Saint Kitts and Nevis<\/option><option value=\"LC\" >Saint Lucia<\/option><option value=\"MF\" >Saint Martin (French part)<\/option><option value=\"PM\" >Saint Pierre and Miquelon<\/option><option value=\"VC\" >Saint Vincent and the Grenadines<\/option><option value=\"WS\" >Samoa<\/option><option value=\"SM\" >San Marino<\/option><option value=\"ST\" >Sao Tome and Principe<\/option><option value=\"SA\" >Saudi Arabia<\/option><option value=\"SN\" >Senegal<\/option><option value=\"RS\" >Serbia<\/option><option value=\"SC\" >Seychelles<\/option><option value=\"SL\" >Sierra Leone<\/option><option value=\"SG\" >Singapore<\/option><option value=\"SX\" >Sint Maarten (Dutch part)<\/option><option value=\"SK\" >Slovakia<\/option><option value=\"SI\" >Slovenia<\/option><option value=\"SB\" >Solomon Islands<\/option><option value=\"SO\" >Somalia<\/option><option value=\"ZA\" >South Africa<\/option><option value=\"GS\" >South Georgia and the South Sandwich Islands<\/option><option value=\"SS\" >South Sudan<\/option><option value=\"ES\" >Spain<\/option><option value=\"LK\" >Sri Lanka<\/option><option value=\"SD\" >Sudan<\/option><option value=\"SR\" >Suriname<\/option><option value=\"SJ\" >Svalbard and Jan Mayen<\/option><option value=\"SE\" >Sweden<\/option><option value=\"CH\" >Switzerland<\/option><option value=\"SY\" >Syrian Arab Republic<\/option><option value=\"TW\" >Taiwan, Republic of China<\/option><option value=\"TJ\" >Tajikistan<\/option><option value=\"TZ\" >Tanzania (United Republic of)<\/option><option value=\"TH\" >Thailand<\/option><option value=\"TL\" >Timor-Leste<\/option><option value=\"TG\" >Togo<\/option><option value=\"TK\" >Tokelau<\/option><option value=\"TO\" >Tonga<\/option><option value=\"TT\" >Trinidad and Tobago<\/option><option value=\"TN\" >Tunisia<\/option><option value=\"TM\" >Turkmenistan<\/option><option value=\"TC\" >Turks and Caicos Islands<\/option><option value=\"TV\" >Tuvalu<\/option><option value=\"TR\" >T\u00fcrkiye<\/option><option value=\"UG\" >Uganda<\/option><option value=\"UA\" >Ukraine<\/option><option value=\"AE\" >United Arab Emirates<\/option><option value=\"GB\" >United Kingdom of Great Britain and Northern Ireland<\/option><option value=\"UM\" >United States Minor Outlying Islands<\/option><option value=\"US\" >United States of America<\/option><option value=\"UY\" >Uruguay<\/option><option value=\"UZ\" >Uzbekistan<\/option><option value=\"VU\" >Vanuatu<\/option><option value=\"VA\" >Vatican City State<\/option><option value=\"VE\" >Venezuela (Bolivarian Republic of)<\/option><option value=\"VN\" >Vietnam<\/option><option value=\"VG\" >Virgin Islands (British)<\/option><option value=\"VI\" >Virgin Islands (U.S.)<\/option><option value=\"WF\" >Wallis and Futuna<\/option><option value=\"EH\" >Western Sahara<\/option><option value=\"YE\" >Yemen<\/option><option value=\"ZM\" >Zambia<\/option><option value=\"ZW\" >Zimbabwe<\/option><option value=\"AX\" >\u00c5land Islands<\/option><\/select><label for=\"wpforms-265-field_78_{CLONE}-country\" class=\"wpforms-field-sublabel after\">Country<\/label><\/div><\/div><\/fieldset><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-265-field_79_{CLONE}-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"79_{CLONE}\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_79_{CLONE}\">Between what year and what year <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-265-field_79_{CLONE}\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][79_{CLONE}]\" aria-errormessage=\"wpforms-265-field_79_{CLONE}-error\" required><\/div><\/div><div class=\"wpforms-field-repeater-display-rows-buttons\">\n\t\t\t\t<button type=\"button\" class=\"wpforms-field-repeater-button-add\" title=\"Ajouter\">\n\t\t\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M12.129 7.984v1.032a.392.392 0 0 1-.387.387H8.903v2.839a.392.392 0 0 1-.387.387H7.484a.373.373 0 0 1-.387-.387V9.403H4.258a.373.373 0 0 1-.387-.387V7.984c0-.194.161-.387.387-.387h2.839V4.758c0-.193.161-.387.387-.387h1.032c.194 0 .387.194.387.387v2.839h2.839c.193 0 .387.193.387.387ZM16 8.5c0 4.42-3.58 8-8 8s-8-3.58-8-8 3.58-8 8-8 8 3.58 8 8Zm-1.548 0c0-3.548-2.904-6.452-6.452-6.452A6.45 6.45 0 0 0 1.548 8.5 6.43 6.43 0 0 0 8 14.952 6.45 6.45 0 0 0 14.452 8.5Z\" fill=\"currentColor\"\/><\/svg>\n\t\t\t\t<\/button>\n\t\t\t\t<button type=\"button\" class=\"wpforms-field-repeater-button-remove wpforms-disabled\" title=\"Retirer\">\n\t\t\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M4.258 9.403a.373.373 0 0 1-.387-.387V7.984c0-.194.161-.387.387-.387h7.484c.193 0 .387.193.387.387v1.032a.392.392 0 0 1-.387.387H4.258ZM16 8.5c0 4.42-3.58 8-8 8s-8-3.58-8-8 3.58-8 8-8 8 3.58 8 8Zm-1.548 0c0-3.548-2.904-6.452-6.452-6.452A6.45 6.45 0 0 0 1.548 8.5 6.43 6.43 0 0 0 8 14.952 6.45 6.45 0 0 0 14.452 8.5Z\" fill=\"currentColor\"\/><\/svg>\n\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><\/div>\n\t\t\t<\/div><\/script><div class=\"wpforms-field-layout-rows wpforms-field-medium wpforms-field-repeater-display-rows wpforms-field-repeater-preset-67-33\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-67\"><div id=\"wpforms-265-field_78-container\" class=\"wpforms-field wpforms-field-address\" data-field-type=\"address\" data-field-id=\"78\"><fieldset><legend class=\"wpforms-field-label\">Address <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-265-field_78\" class=\"wpforms-field-address-address1 wpforms-field-required\" name=\"wpforms[fields][78][address1]\" aria-errormessage=\"wpforms-265-field_78-error\" required><label for=\"wpforms-265-field_78\" class=\"wpforms-field-sublabel after\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-265-field_78-city\" class=\"wpforms-field-address-city wpforms-field-required\" name=\"wpforms[fields][78][city]\" aria-errormessage=\"wpforms-265-field_78-city-error\" required><label for=\"wpforms-265-field_78-city\" class=\"wpforms-field-sublabel after\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-265-field_78-state\" class=\"wpforms-field-address-state wpforms-field-required\" name=\"wpforms[fields][78][state]\" aria-errormessage=\"wpforms-265-field_78-state-error\" required><label for=\"wpforms-265-field_78-state\" class=\"wpforms-field-sublabel after\">State \/ Province \/ Region<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-265-field_78-postal\" class=\"wpforms-field-address-postal wpforms-field-required\" name=\"wpforms[fields][78][postal]\" aria-errormessage=\"wpforms-265-field_78-postal-error\" required><label for=\"wpforms-265-field_78-postal\" class=\"wpforms-field-sublabel after\">Postal Code<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-265-field_78-country\" class=\"wpforms-field-address-country wpforms-field-required\" name=\"wpforms[fields][78][country]\" aria-errormessage=\"wpforms-265-field_78-country-error\" required><option class=\"placeholder\" value=\"\" selected disabled>--- Select country ---<\/option><option value=\"AF\" >Afghanistan<\/option><option value=\"AL\" >Albania<\/option><option value=\"DZ\" >Algeria<\/option><option value=\"AS\" >American Samoa<\/option><option value=\"AD\" >Andorra<\/option><option value=\"AO\" >Angola<\/option><option value=\"AI\" >Anguilla<\/option><option value=\"AQ\" >Antarctica<\/option><option value=\"AG\" >Antigua and Barbuda<\/option><option value=\"AR\" >Argentina<\/option><option value=\"AM\" >Armenia<\/option><option value=\"AW\" >Aruba<\/option><option value=\"AU\" >Australia<\/option><option value=\"AT\" >Austria<\/option><option value=\"AZ\" >Azerbaijan<\/option><option value=\"BS\" >Bahamas<\/option><option value=\"BH\" >Bahrain<\/option><option value=\"BD\" >Bangladesh<\/option><option value=\"BB\" >Barbados<\/option><option value=\"BY\" >Belarus<\/option><option value=\"BE\" >Belgium<\/option><option value=\"BZ\" >Belize<\/option><option value=\"BJ\" >Benin<\/option><option value=\"BM\" >Bermuda<\/option><option value=\"BT\" >Bhutan<\/option><option value=\"BO\" >Bolivia (Plurinational State of)<\/option><option value=\"BQ\" >Bonaire, Saint Eustatius and Saba<\/option><option value=\"BA\" >Bosnia and Herzegovina<\/option><option value=\"BW\" >Botswana<\/option><option value=\"BV\" >Bouvet Island<\/option><option value=\"BR\" >Brazil<\/option><option value=\"IO\" >British Indian Ocean Territory<\/option><option value=\"BN\" >Brunei Darussalam<\/option><option value=\"BG\" >Bulgaria<\/option><option value=\"BF\" >Burkina Faso<\/option><option value=\"BI\" >Burundi<\/option><option value=\"CV\" >Cabo Verde<\/option><option value=\"KH\" >Cambodia<\/option><option value=\"CM\" >Cameroon<\/option><option value=\"CA\" >Canada<\/option><option value=\"KY\" >Cayman Islands<\/option><option value=\"CF\" >Central African Republic<\/option><option value=\"TD\" >Chad<\/option><option value=\"CL\" >Chile<\/option><option value=\"CN\" >China<\/option><option value=\"CX\" >Christmas Island<\/option><option value=\"CC\" >Cocos (Keeling) Islands<\/option><option value=\"CO\" >Colombia<\/option><option value=\"KM\" >Comoros<\/option><option value=\"CG\" >Congo<\/option><option value=\"CD\" >Congo (Democratic Republic of the)<\/option><option value=\"CK\" >Cook Islands<\/option><option value=\"CR\" >Costa Rica<\/option><option value=\"HR\" >Croatia<\/option><option value=\"CU\" >Cuba<\/option><option value=\"CW\" >Cura\u00e7ao<\/option><option value=\"CY\" >Cyprus<\/option><option value=\"CZ\" >Czech Republic<\/option><option value=\"CI\" >C\u00f4te d&#039;Ivoire<\/option><option value=\"DK\" >Denmark<\/option><option value=\"DJ\" >Djibouti<\/option><option value=\"DM\" >Dominica<\/option><option value=\"DO\" >Dominican Republic<\/option><option value=\"EC\" >Ecuador<\/option><option value=\"EG\" >Egypt<\/option><option value=\"SV\" >El Salvador<\/option><option value=\"GQ\" >Equatorial Guinea<\/option><option value=\"ER\" >Eritrea<\/option><option value=\"EE\" >Estonia<\/option><option value=\"SZ\" >Eswatini (Kingdom of)<\/option><option value=\"ET\" >Ethiopia<\/option><option value=\"FK\" >Falkland Islands (Malvinas)<\/option><option value=\"FO\" >Faroe Islands<\/option><option value=\"FJ\" >Fiji<\/option><option value=\"FI\" >Finland<\/option><option value=\"FR\" >France<\/option><option value=\"GF\" >French Guiana<\/option><option value=\"PF\" >French Polynesia<\/option><option value=\"TF\" >French Southern Territories<\/option><option value=\"GA\" >Gabon<\/option><option value=\"GM\" >Gambia<\/option><option value=\"GE\" >Georgia<\/option><option value=\"DE\" >Germany<\/option><option value=\"GH\" >Ghana<\/option><option value=\"GI\" >Gibraltar<\/option><option value=\"GR\" >Greece<\/option><option value=\"GL\" >Greenland<\/option><option value=\"GD\" >Grenada<\/option><option value=\"GP\" >Guadeloupe<\/option><option value=\"GU\" >Guam<\/option><option value=\"GT\" >Guatemala<\/option><option value=\"GG\" >Guernsey<\/option><option value=\"GN\" >Guinea<\/option><option value=\"GW\" >Guinea-Bissau<\/option><option value=\"GY\" >Guyana<\/option><option value=\"HT\" >Haiti<\/option><option value=\"HM\" >Heard Island and McDonald Islands<\/option><option value=\"HN\" >Honduras<\/option><option value=\"HK\" >Hong Kong<\/option><option value=\"HU\" >Hungary<\/option><option value=\"IS\" >Iceland<\/option><option value=\"IN\" >India<\/option><option value=\"ID\" >Indonesia<\/option><option value=\"IR\" >Iran (Islamic Republic of)<\/option><option value=\"IQ\" >Iraq<\/option><option value=\"IE\" >Ireland (Republic of)<\/option><option value=\"IM\" >Isle of Man<\/option><option value=\"IL\" >Israel<\/option><option value=\"IT\" >Italy<\/option><option value=\"JM\" >Jamaica<\/option><option value=\"JP\" >Japan<\/option><option value=\"JE\" >Jersey<\/option><option value=\"JO\" >Jordan<\/option><option value=\"KZ\" >Kazakhstan<\/option><option value=\"KE\" >Kenya<\/option><option value=\"KI\" >Kiribati<\/option><option value=\"KP\" >Korea (Democratic People&#039;s Republic of)<\/option><option value=\"KR\" >Korea (Republic of)<\/option><option value=\"XK\" >Kosovo<\/option><option value=\"KW\" >Kuwait<\/option><option value=\"KG\" >Kyrgyzstan<\/option><option value=\"LA\" >Lao People&#039;s Democratic Republic<\/option><option value=\"LV\" >Latvia<\/option><option value=\"LB\" >Lebanon<\/option><option value=\"LS\" >Lesotho<\/option><option value=\"LR\" >Liberia<\/option><option value=\"LY\" >Libya<\/option><option value=\"LI\" >Liechtenstein<\/option><option value=\"LT\" >Lithuania<\/option><option value=\"LU\" >Luxembourg<\/option><option value=\"MO\" >Macao<\/option><option value=\"MG\" >Madagascar<\/option><option value=\"MW\" >Malawi<\/option><option value=\"MY\" >Malaysia<\/option><option value=\"MV\" >Maldives<\/option><option value=\"ML\" >Mali<\/option><option value=\"MT\" >Malta<\/option><option value=\"MH\" >Marshall Islands<\/option><option value=\"MQ\" >Martinique<\/option><option value=\"MR\" >Mauritania<\/option><option value=\"MU\" >Mauritius<\/option><option value=\"YT\" >Mayotte<\/option><option value=\"MX\" >Mexico<\/option><option value=\"FM\" >Micronesia (Federated States of)<\/option><option value=\"MD\" >Moldova (Republic of)<\/option><option value=\"MC\" >Monaco<\/option><option value=\"MN\" >Mongolia<\/option><option value=\"ME\" >Montenegro<\/option><option value=\"MS\" >Montserrat<\/option><option value=\"MA\" >Morocco<\/option><option value=\"MZ\" >Mozambique<\/option><option value=\"MM\" >Myanmar<\/option><option value=\"NA\" >Namibia<\/option><option value=\"NR\" >Nauru<\/option><option value=\"NP\" >Nepal<\/option><option value=\"NL\" >Netherlands<\/option><option value=\"NC\" >New Caledonia<\/option><option value=\"NZ\" >New Zealand<\/option><option value=\"NI\" >Nicaragua<\/option><option value=\"NE\" >Niger<\/option><option value=\"NG\" >Nigeria<\/option><option value=\"NU\" >Niue<\/option><option value=\"NF\" >Norfolk Island<\/option><option value=\"MK\" >North Macedonia (Republic of)<\/option><option value=\"MP\" >Northern Mariana Islands<\/option><option value=\"NO\" >Norway<\/option><option value=\"OM\" >Oman<\/option><option value=\"PK\" >Pakistan<\/option><option value=\"PW\" >Palau<\/option><option value=\"PS\" >Palestine (State of)<\/option><option value=\"PA\" >Panama<\/option><option value=\"PG\" >Papua New Guinea<\/option><option value=\"PY\" >Paraguay<\/option><option value=\"PE\" >Peru<\/option><option value=\"PH\" >Philippines<\/option><option value=\"PN\" >Pitcairn<\/option><option value=\"PL\" >Poland<\/option><option value=\"PT\" >Portugal<\/option><option value=\"PR\" >Puerto Rico<\/option><option value=\"QA\" >Qatar<\/option><option value=\"RO\" >Romania<\/option><option value=\"RU\" >Russian Federation<\/option><option value=\"RW\" >Rwanda<\/option><option value=\"RE\" >R\u00e9union<\/option><option value=\"BL\" >Saint Barth\u00e9lemy<\/option><option value=\"SH\" >Saint Helena, Ascension and Tristan da Cunha<\/option><option value=\"KN\" >Saint Kitts and Nevis<\/option><option value=\"LC\" >Saint Lucia<\/option><option value=\"MF\" >Saint Martin (French part)<\/option><option value=\"PM\" >Saint Pierre and Miquelon<\/option><option value=\"VC\" >Saint Vincent and the Grenadines<\/option><option value=\"WS\" >Samoa<\/option><option value=\"SM\" >San Marino<\/option><option value=\"ST\" >Sao Tome and Principe<\/option><option value=\"SA\" >Saudi Arabia<\/option><option value=\"SN\" >Senegal<\/option><option value=\"RS\" >Serbia<\/option><option value=\"SC\" >Seychelles<\/option><option value=\"SL\" >Sierra Leone<\/option><option value=\"SG\" >Singapore<\/option><option value=\"SX\" >Sint Maarten (Dutch part)<\/option><option value=\"SK\" >Slovakia<\/option><option value=\"SI\" >Slovenia<\/option><option value=\"SB\" >Solomon Islands<\/option><option value=\"SO\" >Somalia<\/option><option value=\"ZA\" >South Africa<\/option><option value=\"GS\" >South Georgia and the South Sandwich Islands<\/option><option value=\"SS\" >South Sudan<\/option><option value=\"ES\" >Spain<\/option><option value=\"LK\" >Sri Lanka<\/option><option value=\"SD\" >Sudan<\/option><option value=\"SR\" >Suriname<\/option><option value=\"SJ\" >Svalbard and Jan Mayen<\/option><option value=\"SE\" >Sweden<\/option><option value=\"CH\" >Switzerland<\/option><option value=\"SY\" >Syrian Arab Republic<\/option><option value=\"TW\" >Taiwan, Republic of China<\/option><option value=\"TJ\" >Tajikistan<\/option><option value=\"TZ\" >Tanzania (United Republic of)<\/option><option value=\"TH\" >Thailand<\/option><option value=\"TL\" >Timor-Leste<\/option><option value=\"TG\" >Togo<\/option><option value=\"TK\" >Tokelau<\/option><option value=\"TO\" >Tonga<\/option><option value=\"TT\" >Trinidad and Tobago<\/option><option value=\"TN\" >Tunisia<\/option><option value=\"TM\" >Turkmenistan<\/option><option value=\"TC\" >Turks and Caicos Islands<\/option><option value=\"TV\" >Tuvalu<\/option><option value=\"TR\" >T\u00fcrkiye<\/option><option value=\"UG\" >Uganda<\/option><option value=\"UA\" >Ukraine<\/option><option value=\"AE\" >United Arab Emirates<\/option><option value=\"GB\" >United Kingdom of Great Britain and Northern Ireland<\/option><option value=\"UM\" >United States Minor Outlying Islands<\/option><option value=\"US\" >United States of America<\/option><option value=\"UY\" >Uruguay<\/option><option value=\"UZ\" >Uzbekistan<\/option><option value=\"VU\" >Vanuatu<\/option><option value=\"VA\" >Vatican City State<\/option><option value=\"VE\" >Venezuela (Bolivarian Republic of)<\/option><option value=\"VN\" >Vietnam<\/option><option value=\"VG\" >Virgin Islands (British)<\/option><option value=\"VI\" >Virgin Islands (U.S.)<\/option><option value=\"WF\" >Wallis and Futuna<\/option><option value=\"EH\" >Western Sahara<\/option><option value=\"YE\" >Yemen<\/option><option value=\"ZM\" >Zambia<\/option><option value=\"ZW\" >Zimbabwe<\/option><option value=\"AX\" >\u00c5land Islands<\/option><\/select><label for=\"wpforms-265-field_78-country\" class=\"wpforms-field-sublabel after\">Country<\/label><\/div><\/div><\/fieldset><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-265-field_79-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"79\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_79\">Between what year and what year <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-265-field_79\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][79]\" aria-errormessage=\"wpforms-265-field_79-error\" required><\/div><\/div><div class=\"wpforms-field-repeater-display-rows-buttons\">\n\t\t\t\t<button type=\"button\" class=\"wpforms-field-repeater-button-add\" title=\"Ajouter\">\n\t\t\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M12.129 7.984v1.032a.392.392 0 0 1-.387.387H8.903v2.839a.392.392 0 0 1-.387.387H7.484a.373.373 0 0 1-.387-.387V9.403H4.258a.373.373 0 0 1-.387-.387V7.984c0-.194.161-.387.387-.387h2.839V4.758c0-.193.161-.387.387-.387h1.032c.194 0 .387.194.387.387v2.839h2.839c.193 0 .387.193.387.387ZM16 8.5c0 4.42-3.58 8-8 8s-8-3.58-8-8 3.58-8 8-8 8 3.58 8 8Zm-1.548 0c0-3.548-2.904-6.452-6.452-6.452A6.45 6.45 0 0 0 1.548 8.5 6.43 6.43 0 0 0 8 14.952 6.45 6.45 0 0 0 14.452 8.5Z\" fill=\"currentColor\"\/><\/svg>\n\t\t\t\t<\/button>\n\t\t\t\t<button type=\"button\" class=\"wpforms-field-repeater-button-remove wpforms-disabled\" title=\"Retirer\">\n\t\t\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M4.258 9.403a.373.373 0 0 1-.387-.387V7.984c0-.194.161-.387.387-.387h7.484c.193 0 .387.193.387.387v1.032a.392.392 0 0 1-.387.387H4.258ZM16 8.5c0 4.42-3.58 8-8 8s-8-3.58-8-8 3.58-8 8-8 8 3.58 8 8Zm-1.548 0c0-3.548-2.904-6.452-6.452-6.452A6.45 6.45 0 0 0 1.548 8.5 6.43 6.43 0 0 0 8 14.952 6.45 6.45 0 0 0 14.452 8.5Z\" fill=\"currentColor\"\/><\/svg>\n\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><\/div><\/div><div id=\"wpforms-265-field_80-container\" class=\"wpforms-field wpforms-field-repeater wpforms-conditional-field wpforms-conditional-show wpforms-field-repeater-display-rows\" data-rows-min=\"1\" data-rows-max=\"10\" data-clone-num=\"2\" data-field-type=\"repeater\" data-field-id=\"80\" style=\"display:none;\"><h3 class=\"wpforms-field-label\">\n\t\t\t\tAdd all previous known addresses (3 if possible)\n\t\t\t<\/h3><div id=\"wpforms-265-field_80-description\" class=\"wpforms-field-description\">The transmission of previous residential addresses may be necessary in order to validate the identity of the person sought and to distinguish them from other persons with similar names in the registers. \"This information improves the accuracy of searches carried out in professional registers.\" <\/div><input type=\"hidden\" class=\"wpforms-field-repeater-clone-list\" name=\"wpforms[fields][80][clone_list]\" value=\"[]\"><script type=\"text\/html\" class=\"tmpl-wpforms-field-repeater-template-80-265\"><div id=\"wpforms-265-repeater-field_80-clone_{CLONE}\" class=\"wpforms-field-repeater-clone-wrap\" data-clone=\"{CLONE}\">\n\t\t\t\t<div class=\"wpforms-field-layout-rows wpforms-field-medium wpforms-field-repeater-display-rows wpforms-field-repeater-preset-67-33\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-67\"><div id=\"wpforms-265-field_81_{CLONE}-container\" class=\"wpforms-field wpforms-field-address\" data-field-type=\"address\" data-field-id=\"81_{CLONE}\"><fieldset><legend class=\"wpforms-field-label\">Address<\/legend><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-265-field_81_{CLONE}\" class=\"wpforms-field-address-address1\" name=\"wpforms[fields][81_{CLONE}][address1]\" aria-errormessage=\"wpforms-265-field_81_{CLONE}-error\" ><label for=\"wpforms-265-field_81_{CLONE}\" class=\"wpforms-field-sublabel after\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-265-field_81_{CLONE}-city\" class=\"wpforms-field-address-city\" name=\"wpforms[fields][81_{CLONE}][city]\" aria-errormessage=\"wpforms-265-field_81_{CLONE}-city-error\" ><label for=\"wpforms-265-field_81_{CLONE}-city\" class=\"wpforms-field-sublabel after\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-265-field_81_{CLONE}-state\" class=\"wpforms-field-address-state\" name=\"wpforms[fields][81_{CLONE}][state]\" aria-errormessage=\"wpforms-265-field_81_{CLONE}-state-error\" ><label for=\"wpforms-265-field_81_{CLONE}-state\" class=\"wpforms-field-sublabel after\">State \/ Province \/ Region<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-265-field_81_{CLONE}-postal\" class=\"wpforms-field-address-postal\" name=\"wpforms[fields][81_{CLONE}][postal]\" aria-errormessage=\"wpforms-265-field_81_{CLONE}-postal-error\" ><label for=\"wpforms-265-field_81_{CLONE}-postal\" class=\"wpforms-field-sublabel after\">Postal Code<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-265-field_81_{CLONE}-country\" class=\"wpforms-field-address-country\" name=\"wpforms[fields][81_{CLONE}][country]\" aria-errormessage=\"wpforms-265-field_81_{CLONE}-country-error\" ><option class=\"placeholder\" value=\"\" selected disabled>--- Select country ---<\/option><option value=\"AF\" >Afghanistan<\/option><option value=\"AL\" >Albania<\/option><option value=\"DZ\" >Algeria<\/option><option value=\"AS\" >American Samoa<\/option><option value=\"AD\" >Andorra<\/option><option value=\"AO\" >Angola<\/option><option value=\"AI\" >Anguilla<\/option><option value=\"AQ\" >Antarctica<\/option><option value=\"AG\" >Antigua and Barbuda<\/option><option value=\"AR\" >Argentina<\/option><option value=\"AM\" >Armenia<\/option><option value=\"AW\" >Aruba<\/option><option value=\"AU\" >Australia<\/option><option value=\"AT\" >Austria<\/option><option value=\"AZ\" >Azerbaijan<\/option><option value=\"BS\" >Bahamas<\/option><option value=\"BH\" >Bahrain<\/option><option value=\"BD\" >Bangladesh<\/option><option value=\"BB\" >Barbados<\/option><option value=\"BY\" >Belarus<\/option><option value=\"BE\" >Belgium<\/option><option value=\"BZ\" >Belize<\/option><option value=\"BJ\" >Benin<\/option><option value=\"BM\" >Bermuda<\/option><option value=\"BT\" >Bhutan<\/option><option value=\"BO\" >Bolivia (Plurinational State of)<\/option><option value=\"BQ\" >Bonaire, Saint Eustatius and Saba<\/option><option value=\"BA\" >Bosnia and Herzegovina<\/option><option value=\"BW\" >Botswana<\/option><option value=\"BV\" >Bouvet Island<\/option><option value=\"BR\" >Brazil<\/option><option value=\"IO\" >British Indian Ocean Territory<\/option><option value=\"BN\" >Brunei Darussalam<\/option><option value=\"BG\" >Bulgaria<\/option><option value=\"BF\" >Burkina Faso<\/option><option value=\"BI\" >Burundi<\/option><option value=\"CV\" >Cabo Verde<\/option><option value=\"KH\" >Cambodia<\/option><option value=\"CM\" >Cameroon<\/option><option value=\"CA\" >Canada<\/option><option value=\"KY\" >Cayman Islands<\/option><option value=\"CF\" >Central African Republic<\/option><option value=\"TD\" >Chad<\/option><option value=\"CL\" >Chile<\/option><option value=\"CN\" >China<\/option><option value=\"CX\" >Christmas Island<\/option><option value=\"CC\" >Cocos (Keeling) Islands<\/option><option value=\"CO\" >Colombia<\/option><option value=\"KM\" >Comoros<\/option><option value=\"CG\" >Congo<\/option><option value=\"CD\" >Congo (Democratic Republic of the)<\/option><option value=\"CK\" >Cook Islands<\/option><option value=\"CR\" >Costa Rica<\/option><option value=\"HR\" >Croatia<\/option><option value=\"CU\" >Cuba<\/option><option value=\"CW\" >Cura\u00e7ao<\/option><option value=\"CY\" >Cyprus<\/option><option value=\"CZ\" >Czech Republic<\/option><option value=\"CI\" >C\u00f4te d&#039;Ivoire<\/option><option value=\"DK\" >Denmark<\/option><option value=\"DJ\" >Djibouti<\/option><option value=\"DM\" >Dominica<\/option><option value=\"DO\" >Dominican Republic<\/option><option value=\"EC\" >Ecuador<\/option><option value=\"EG\" >Egypt<\/option><option value=\"SV\" >El Salvador<\/option><option value=\"GQ\" >Equatorial Guinea<\/option><option value=\"ER\" >Eritrea<\/option><option value=\"EE\" >Estonia<\/option><option value=\"SZ\" >Eswatini (Kingdom of)<\/option><option value=\"ET\" >Ethiopia<\/option><option value=\"FK\" >Falkland Islands (Malvinas)<\/option><option value=\"FO\" >Faroe Islands<\/option><option value=\"FJ\" >Fiji<\/option><option value=\"FI\" >Finland<\/option><option value=\"FR\" >France<\/option><option value=\"GF\" >French Guiana<\/option><option value=\"PF\" >French Polynesia<\/option><option value=\"TF\" >French Southern Territories<\/option><option value=\"GA\" >Gabon<\/option><option value=\"GM\" >Gambia<\/option><option value=\"GE\" >Georgia<\/option><option value=\"DE\" >Germany<\/option><option value=\"GH\" >Ghana<\/option><option value=\"GI\" >Gibraltar<\/option><option value=\"GR\" >Greece<\/option><option value=\"GL\" >Greenland<\/option><option value=\"GD\" >Grenada<\/option><option value=\"GP\" >Guadeloupe<\/option><option value=\"GU\" >Guam<\/option><option value=\"GT\" >Guatemala<\/option><option value=\"GG\" >Guernsey<\/option><option value=\"GN\" >Guinea<\/option><option value=\"GW\" >Guinea-Bissau<\/option><option value=\"GY\" >Guyana<\/option><option value=\"HT\" >Haiti<\/option><option value=\"HM\" >Heard Island and McDonald Islands<\/option><option value=\"HN\" >Honduras<\/option><option value=\"HK\" >Hong Kong<\/option><option value=\"HU\" >Hungary<\/option><option value=\"IS\" >Iceland<\/option><option value=\"IN\" >India<\/option><option value=\"ID\" >Indonesia<\/option><option value=\"IR\" >Iran (Islamic Republic of)<\/option><option value=\"IQ\" >Iraq<\/option><option value=\"IE\" >Ireland (Republic of)<\/option><option value=\"IM\" >Isle of Man<\/option><option value=\"IL\" >Israel<\/option><option value=\"IT\" >Italy<\/option><option value=\"JM\" >Jamaica<\/option><option value=\"JP\" >Japan<\/option><option value=\"JE\" >Jersey<\/option><option value=\"JO\" >Jordan<\/option><option value=\"KZ\" >Kazakhstan<\/option><option value=\"KE\" >Kenya<\/option><option value=\"KI\" >Kiribati<\/option><option value=\"KP\" >Korea (Democratic People&#039;s Republic of)<\/option><option value=\"KR\" >Korea (Republic of)<\/option><option value=\"XK\" >Kosovo<\/option><option value=\"KW\" >Kuwait<\/option><option value=\"KG\" >Kyrgyzstan<\/option><option value=\"LA\" >Lao People&#039;s Democratic Republic<\/option><option value=\"LV\" >Latvia<\/option><option value=\"LB\" >Lebanon<\/option><option value=\"LS\" >Lesotho<\/option><option value=\"LR\" >Liberia<\/option><option value=\"LY\" >Libya<\/option><option value=\"LI\" >Liechtenstein<\/option><option value=\"LT\" >Lithuania<\/option><option value=\"LU\" >Luxembourg<\/option><option value=\"MO\" >Macao<\/option><option value=\"MG\" >Madagascar<\/option><option value=\"MW\" >Malawi<\/option><option value=\"MY\" >Malaysia<\/option><option value=\"MV\" >Maldives<\/option><option value=\"ML\" >Mali<\/option><option value=\"MT\" >Malta<\/option><option value=\"MH\" >Marshall Islands<\/option><option value=\"MQ\" >Martinique<\/option><option value=\"MR\" >Mauritania<\/option><option value=\"MU\" >Mauritius<\/option><option value=\"YT\" >Mayotte<\/option><option value=\"MX\" >Mexico<\/option><option value=\"FM\" >Micronesia (Federated States of)<\/option><option value=\"MD\" >Moldova (Republic of)<\/option><option value=\"MC\" >Monaco<\/option><option value=\"MN\" >Mongolia<\/option><option value=\"ME\" >Montenegro<\/option><option value=\"MS\" >Montserrat<\/option><option value=\"MA\" >Morocco<\/option><option value=\"MZ\" >Mozambique<\/option><option value=\"MM\" >Myanmar<\/option><option value=\"NA\" >Namibia<\/option><option value=\"NR\" >Nauru<\/option><option value=\"NP\" >Nepal<\/option><option value=\"NL\" >Netherlands<\/option><option value=\"NC\" >New Caledonia<\/option><option value=\"NZ\" >New Zealand<\/option><option value=\"NI\" >Nicaragua<\/option><option value=\"NE\" >Niger<\/option><option value=\"NG\" >Nigeria<\/option><option value=\"NU\" >Niue<\/option><option value=\"NF\" >Norfolk Island<\/option><option value=\"MK\" >North Macedonia (Republic of)<\/option><option value=\"MP\" >Northern Mariana Islands<\/option><option value=\"NO\" >Norway<\/option><option value=\"OM\" >Oman<\/option><option value=\"PK\" >Pakistan<\/option><option value=\"PW\" >Palau<\/option><option value=\"PS\" >Palestine (State of)<\/option><option value=\"PA\" >Panama<\/option><option value=\"PG\" >Papua New Guinea<\/option><option value=\"PY\" >Paraguay<\/option><option value=\"PE\" >Peru<\/option><option value=\"PH\" >Philippines<\/option><option value=\"PN\" >Pitcairn<\/option><option value=\"PL\" >Poland<\/option><option value=\"PT\" >Portugal<\/option><option value=\"PR\" >Puerto Rico<\/option><option value=\"QA\" >Qatar<\/option><option value=\"RO\" >Romania<\/option><option value=\"RU\" >Russian Federation<\/option><option value=\"RW\" >Rwanda<\/option><option value=\"RE\" >R\u00e9union<\/option><option value=\"BL\" >Saint Barth\u00e9lemy<\/option><option value=\"SH\" >Saint Helena, Ascension and Tristan da Cunha<\/option><option value=\"KN\" >Saint Kitts and Nevis<\/option><option value=\"LC\" >Saint Lucia<\/option><option value=\"MF\" >Saint Martin (French part)<\/option><option value=\"PM\" >Saint Pierre and Miquelon<\/option><option value=\"VC\" >Saint Vincent and the Grenadines<\/option><option value=\"WS\" >Samoa<\/option><option value=\"SM\" >San Marino<\/option><option value=\"ST\" >Sao Tome and Principe<\/option><option value=\"SA\" >Saudi Arabia<\/option><option value=\"SN\" >Senegal<\/option><option value=\"RS\" >Serbia<\/option><option value=\"SC\" >Seychelles<\/option><option value=\"SL\" >Sierra Leone<\/option><option value=\"SG\" >Singapore<\/option><option value=\"SX\" >Sint Maarten (Dutch part)<\/option><option value=\"SK\" >Slovakia<\/option><option value=\"SI\" >Slovenia<\/option><option value=\"SB\" >Solomon Islands<\/option><option value=\"SO\" >Somalia<\/option><option value=\"ZA\" >South Africa<\/option><option value=\"GS\" >South Georgia and the South Sandwich Islands<\/option><option value=\"SS\" >South Sudan<\/option><option value=\"ES\" >Spain<\/option><option value=\"LK\" >Sri Lanka<\/option><option value=\"SD\" >Sudan<\/option><option value=\"SR\" >Suriname<\/option><option value=\"SJ\" >Svalbard and Jan Mayen<\/option><option value=\"SE\" >Sweden<\/option><option value=\"CH\" >Switzerland<\/option><option value=\"SY\" >Syrian Arab Republic<\/option><option value=\"TW\" >Taiwan, Republic of China<\/option><option value=\"TJ\" >Tajikistan<\/option><option value=\"TZ\" >Tanzania (United Republic of)<\/option><option value=\"TH\" >Thailand<\/option><option value=\"TL\" >Timor-Leste<\/option><option value=\"TG\" >Togo<\/option><option value=\"TK\" >Tokelau<\/option><option value=\"TO\" >Tonga<\/option><option value=\"TT\" >Trinidad and Tobago<\/option><option value=\"TN\" >Tunisia<\/option><option value=\"TM\" >Turkmenistan<\/option><option value=\"TC\" >Turks and Caicos Islands<\/option><option value=\"TV\" >Tuvalu<\/option><option value=\"TR\" >T\u00fcrkiye<\/option><option value=\"UG\" >Uganda<\/option><option value=\"UA\" >Ukraine<\/option><option value=\"AE\" >United Arab Emirates<\/option><option value=\"GB\" >United Kingdom of Great Britain and Northern Ireland<\/option><option value=\"UM\" >United States Minor Outlying Islands<\/option><option value=\"US\" >United States of America<\/option><option value=\"UY\" >Uruguay<\/option><option value=\"UZ\" >Uzbekistan<\/option><option value=\"VU\" >Vanuatu<\/option><option value=\"VA\" >Vatican City State<\/option><option value=\"VE\" >Venezuela (Bolivarian Republic of)<\/option><option value=\"VN\" >Vietnam<\/option><option value=\"VG\" >Virgin Islands (British)<\/option><option value=\"VI\" >Virgin Islands (U.S.)<\/option><option value=\"WF\" >Wallis and Futuna<\/option><option value=\"EH\" >Western Sahara<\/option><option value=\"YE\" >Yemen<\/option><option value=\"ZM\" >Zambia<\/option><option value=\"ZW\" >Zimbabwe<\/option><option value=\"AX\" >\u00c5land Islands<\/option><\/select><label for=\"wpforms-265-field_81_{CLONE}-country\" class=\"wpforms-field-sublabel after\">Country<\/label><\/div><\/div><\/fieldset><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-265-field_82_{CLONE}-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"82_{CLONE}\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_82_{CLONE}\">Between what year and what year<\/label><input type=\"text\" id=\"wpforms-265-field_82_{CLONE}\" class=\"wpforms-field-medium\" name=\"wpforms[fields][82_{CLONE}]\" aria-errormessage=\"wpforms-265-field_82_{CLONE}-error\" ><\/div><\/div><div class=\"wpforms-field-repeater-display-rows-buttons\">\n\t\t\t\t<button type=\"button\" class=\"wpforms-field-repeater-button-add\" title=\"Ajouter\">\n\t\t\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M12.129 7.984v1.032a.392.392 0 0 1-.387.387H8.903v2.839a.392.392 0 0 1-.387.387H7.484a.373.373 0 0 1-.387-.387V9.403H4.258a.373.373 0 0 1-.387-.387V7.984c0-.194.161-.387.387-.387h2.839V4.758c0-.193.161-.387.387-.387h1.032c.194 0 .387.194.387.387v2.839h2.839c.193 0 .387.193.387.387ZM16 8.5c0 4.42-3.58 8-8 8s-8-3.58-8-8 3.58-8 8-8 8 3.58 8 8Zm-1.548 0c0-3.548-2.904-6.452-6.452-6.452A6.45 6.45 0 0 0 1.548 8.5 6.43 6.43 0 0 0 8 14.952 6.45 6.45 0 0 0 14.452 8.5Z\" fill=\"currentColor\"\/><\/svg>\n\t\t\t\t<\/button>\n\t\t\t\t<button type=\"button\" class=\"wpforms-field-repeater-button-remove wpforms-disabled\" title=\"Retirer\">\n\t\t\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M4.258 9.403a.373.373 0 0 1-.387-.387V7.984c0-.194.161-.387.387-.387h7.484c.193 0 .387.193.387.387v1.032a.392.392 0 0 1-.387.387H4.258ZM16 8.5c0 4.42-3.58 8-8 8s-8-3.58-8-8 3.58-8 8-8 8 3.58 8 8Zm-1.548 0c0-3.548-2.904-6.452-6.452-6.452A6.45 6.45 0 0 0 1.548 8.5 6.43 6.43 0 0 0 8 14.952 6.45 6.45 0 0 0 14.452 8.5Z\" fill=\"currentColor\"\/><\/svg>\n\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><\/div>\n\t\t\t<\/div><\/script><div class=\"wpforms-field-layout-rows wpforms-field-medium wpforms-field-repeater-display-rows wpforms-field-repeater-preset-67-33\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-67\"><div id=\"wpforms-265-field_81-container\" class=\"wpforms-field wpforms-field-address\" data-field-type=\"address\" data-field-id=\"81\"><fieldset><legend class=\"wpforms-field-label\">Address<\/legend><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-265-field_81\" class=\"wpforms-field-address-address1\" name=\"wpforms[fields][81][address1]\" aria-errormessage=\"wpforms-265-field_81-error\" ><label for=\"wpforms-265-field_81\" class=\"wpforms-field-sublabel after\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-265-field_81-city\" class=\"wpforms-field-address-city\" name=\"wpforms[fields][81][city]\" aria-errormessage=\"wpforms-265-field_81-city-error\" ><label for=\"wpforms-265-field_81-city\" class=\"wpforms-field-sublabel after\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-265-field_81-state\" class=\"wpforms-field-address-state\" name=\"wpforms[fields][81][state]\" aria-errormessage=\"wpforms-265-field_81-state-error\" ><label for=\"wpforms-265-field_81-state\" class=\"wpforms-field-sublabel after\">State \/ Province \/ Region<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-265-field_81-postal\" class=\"wpforms-field-address-postal\" name=\"wpforms[fields][81][postal]\" aria-errormessage=\"wpforms-265-field_81-postal-error\" ><label for=\"wpforms-265-field_81-postal\" class=\"wpforms-field-sublabel after\">Postal Code<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-265-field_81-country\" class=\"wpforms-field-address-country\" name=\"wpforms[fields][81][country]\" aria-errormessage=\"wpforms-265-field_81-country-error\" ><option class=\"placeholder\" value=\"\" selected disabled>--- Select country ---<\/option><option value=\"AF\" >Afghanistan<\/option><option value=\"AL\" >Albania<\/option><option value=\"DZ\" >Algeria<\/option><option value=\"AS\" >American Samoa<\/option><option value=\"AD\" >Andorra<\/option><option value=\"AO\" >Angola<\/option><option value=\"AI\" >Anguilla<\/option><option value=\"AQ\" >Antarctica<\/option><option value=\"AG\" >Antigua and Barbuda<\/option><option value=\"AR\" >Argentina<\/option><option value=\"AM\" >Armenia<\/option><option value=\"AW\" >Aruba<\/option><option value=\"AU\" >Australia<\/option><option value=\"AT\" >Austria<\/option><option value=\"AZ\" >Azerbaijan<\/option><option value=\"BS\" >Bahamas<\/option><option value=\"BH\" >Bahrain<\/option><option value=\"BD\" >Bangladesh<\/option><option value=\"BB\" >Barbados<\/option><option value=\"BY\" >Belarus<\/option><option value=\"BE\" >Belgium<\/option><option value=\"BZ\" >Belize<\/option><option value=\"BJ\" >Benin<\/option><option value=\"BM\" >Bermuda<\/option><option value=\"BT\" >Bhutan<\/option><option value=\"BO\" >Bolivia (Plurinational State of)<\/option><option value=\"BQ\" >Bonaire, Saint Eustatius and Saba<\/option><option value=\"BA\" >Bosnia and Herzegovina<\/option><option value=\"BW\" >Botswana<\/option><option value=\"BV\" >Bouvet Island<\/option><option value=\"BR\" >Brazil<\/option><option value=\"IO\" >British Indian Ocean Territory<\/option><option value=\"BN\" >Brunei Darussalam<\/option><option value=\"BG\" >Bulgaria<\/option><option value=\"BF\" >Burkina Faso<\/option><option value=\"BI\" >Burundi<\/option><option value=\"CV\" >Cabo Verde<\/option><option value=\"KH\" >Cambodia<\/option><option value=\"CM\" >Cameroon<\/option><option value=\"CA\" >Canada<\/option><option value=\"KY\" >Cayman Islands<\/option><option value=\"CF\" >Central African Republic<\/option><option value=\"TD\" >Chad<\/option><option value=\"CL\" >Chile<\/option><option value=\"CN\" >China<\/option><option value=\"CX\" >Christmas Island<\/option><option value=\"CC\" >Cocos (Keeling) Islands<\/option><option value=\"CO\" >Colombia<\/option><option value=\"KM\" >Comoros<\/option><option value=\"CG\" >Congo<\/option><option value=\"CD\" >Congo (Democratic Republic of the)<\/option><option value=\"CK\" >Cook Islands<\/option><option value=\"CR\" >Costa Rica<\/option><option value=\"HR\" >Croatia<\/option><option value=\"CU\" >Cuba<\/option><option value=\"CW\" >Cura\u00e7ao<\/option><option value=\"CY\" >Cyprus<\/option><option value=\"CZ\" >Czech Republic<\/option><option value=\"CI\" >C\u00f4te d&#039;Ivoire<\/option><option value=\"DK\" >Denmark<\/option><option value=\"DJ\" >Djibouti<\/option><option value=\"DM\" >Dominica<\/option><option value=\"DO\" >Dominican Republic<\/option><option value=\"EC\" >Ecuador<\/option><option value=\"EG\" >Egypt<\/option><option value=\"SV\" >El Salvador<\/option><option value=\"GQ\" >Equatorial Guinea<\/option><option value=\"ER\" >Eritrea<\/option><option value=\"EE\" >Estonia<\/option><option value=\"SZ\" >Eswatini (Kingdom of)<\/option><option value=\"ET\" >Ethiopia<\/option><option value=\"FK\" >Falkland Islands (Malvinas)<\/option><option value=\"FO\" >Faroe Islands<\/option><option value=\"FJ\" >Fiji<\/option><option value=\"FI\" >Finland<\/option><option value=\"FR\" >France<\/option><option value=\"GF\" >French Guiana<\/option><option value=\"PF\" >French Polynesia<\/option><option value=\"TF\" >French Southern Territories<\/option><option value=\"GA\" >Gabon<\/option><option value=\"GM\" >Gambia<\/option><option value=\"GE\" >Georgia<\/option><option value=\"DE\" >Germany<\/option><option value=\"GH\" >Ghana<\/option><option value=\"GI\" >Gibraltar<\/option><option value=\"GR\" >Greece<\/option><option value=\"GL\" >Greenland<\/option><option value=\"GD\" >Grenada<\/option><option value=\"GP\" >Guadeloupe<\/option><option value=\"GU\" >Guam<\/option><option value=\"GT\" >Guatemala<\/option><option value=\"GG\" >Guernsey<\/option><option value=\"GN\" >Guinea<\/option><option value=\"GW\" >Guinea-Bissau<\/option><option value=\"GY\" >Guyana<\/option><option value=\"HT\" >Haiti<\/option><option value=\"HM\" >Heard Island and McDonald Islands<\/option><option value=\"HN\" >Honduras<\/option><option value=\"HK\" >Hong Kong<\/option><option value=\"HU\" >Hungary<\/option><option value=\"IS\" >Iceland<\/option><option value=\"IN\" >India<\/option><option value=\"ID\" >Indonesia<\/option><option value=\"IR\" >Iran (Islamic Republic of)<\/option><option value=\"IQ\" >Iraq<\/option><option value=\"IE\" >Ireland (Republic of)<\/option><option value=\"IM\" >Isle of Man<\/option><option value=\"IL\" >Israel<\/option><option value=\"IT\" >Italy<\/option><option value=\"JM\" >Jamaica<\/option><option value=\"JP\" >Japan<\/option><option value=\"JE\" >Jersey<\/option><option value=\"JO\" >Jordan<\/option><option value=\"KZ\" >Kazakhstan<\/option><option value=\"KE\" >Kenya<\/option><option value=\"KI\" >Kiribati<\/option><option value=\"KP\" >Korea (Democratic People&#039;s Republic of)<\/option><option value=\"KR\" >Korea (Republic of)<\/option><option value=\"XK\" >Kosovo<\/option><option value=\"KW\" >Kuwait<\/option><option value=\"KG\" >Kyrgyzstan<\/option><option value=\"LA\" >Lao People&#039;s Democratic Republic<\/option><option value=\"LV\" >Latvia<\/option><option value=\"LB\" >Lebanon<\/option><option value=\"LS\" >Lesotho<\/option><option value=\"LR\" >Liberia<\/option><option value=\"LY\" >Libya<\/option><option value=\"LI\" >Liechtenstein<\/option><option value=\"LT\" >Lithuania<\/option><option value=\"LU\" >Luxembourg<\/option><option value=\"MO\" >Macao<\/option><option value=\"MG\" >Madagascar<\/option><option value=\"MW\" >Malawi<\/option><option value=\"MY\" >Malaysia<\/option><option value=\"MV\" >Maldives<\/option><option value=\"ML\" >Mali<\/option><option value=\"MT\" >Malta<\/option><option value=\"MH\" >Marshall Islands<\/option><option value=\"MQ\" >Martinique<\/option><option value=\"MR\" >Mauritania<\/option><option value=\"MU\" >Mauritius<\/option><option value=\"YT\" >Mayotte<\/option><option value=\"MX\" >Mexico<\/option><option value=\"FM\" >Micronesia (Federated States of)<\/option><option value=\"MD\" >Moldova (Republic of)<\/option><option value=\"MC\" >Monaco<\/option><option value=\"MN\" >Mongolia<\/option><option value=\"ME\" >Montenegro<\/option><option value=\"MS\" >Montserrat<\/option><option value=\"MA\" >Morocco<\/option><option value=\"MZ\" >Mozambique<\/option><option value=\"MM\" >Myanmar<\/option><option value=\"NA\" >Namibia<\/option><option value=\"NR\" >Nauru<\/option><option value=\"NP\" >Nepal<\/option><option value=\"NL\" >Netherlands<\/option><option value=\"NC\" >New Caledonia<\/option><option value=\"NZ\" >New Zealand<\/option><option value=\"NI\" >Nicaragua<\/option><option value=\"NE\" >Niger<\/option><option value=\"NG\" >Nigeria<\/option><option value=\"NU\" >Niue<\/option><option value=\"NF\" >Norfolk Island<\/option><option value=\"MK\" >North Macedonia (Republic of)<\/option><option value=\"MP\" >Northern Mariana Islands<\/option><option value=\"NO\" >Norway<\/option><option value=\"OM\" >Oman<\/option><option value=\"PK\" >Pakistan<\/option><option value=\"PW\" >Palau<\/option><option value=\"PS\" >Palestine (State of)<\/option><option value=\"PA\" >Panama<\/option><option value=\"PG\" >Papua New Guinea<\/option><option value=\"PY\" >Paraguay<\/option><option value=\"PE\" >Peru<\/option><option value=\"PH\" >Philippines<\/option><option value=\"PN\" >Pitcairn<\/option><option value=\"PL\" >Poland<\/option><option value=\"PT\" >Portugal<\/option><option value=\"PR\" >Puerto Rico<\/option><option value=\"QA\" >Qatar<\/option><option value=\"RO\" >Romania<\/option><option value=\"RU\" >Russian Federation<\/option><option value=\"RW\" >Rwanda<\/option><option value=\"RE\" >R\u00e9union<\/option><option value=\"BL\" >Saint Barth\u00e9lemy<\/option><option value=\"SH\" >Saint Helena, Ascension and Tristan da Cunha<\/option><option value=\"KN\" >Saint Kitts and Nevis<\/option><option value=\"LC\" >Saint Lucia<\/option><option value=\"MF\" >Saint Martin (French part)<\/option><option value=\"PM\" >Saint Pierre and Miquelon<\/option><option value=\"VC\" >Saint Vincent and the Grenadines<\/option><option value=\"WS\" >Samoa<\/option><option value=\"SM\" >San Marino<\/option><option value=\"ST\" >Sao Tome and Principe<\/option><option value=\"SA\" >Saudi Arabia<\/option><option value=\"SN\" >Senegal<\/option><option value=\"RS\" >Serbia<\/option><option value=\"SC\" >Seychelles<\/option><option value=\"SL\" >Sierra Leone<\/option><option value=\"SG\" >Singapore<\/option><option value=\"SX\" >Sint Maarten (Dutch part)<\/option><option value=\"SK\" >Slovakia<\/option><option value=\"SI\" >Slovenia<\/option><option value=\"SB\" >Solomon Islands<\/option><option value=\"SO\" >Somalia<\/option><option value=\"ZA\" >South Africa<\/option><option value=\"GS\" >South Georgia and the South Sandwich Islands<\/option><option value=\"SS\" >South Sudan<\/option><option value=\"ES\" >Spain<\/option><option value=\"LK\" >Sri Lanka<\/option><option value=\"SD\" >Sudan<\/option><option value=\"SR\" >Suriname<\/option><option value=\"SJ\" >Svalbard and Jan Mayen<\/option><option value=\"SE\" >Sweden<\/option><option value=\"CH\" >Switzerland<\/option><option value=\"SY\" >Syrian Arab Republic<\/option><option value=\"TW\" >Taiwan, Republic of China<\/option><option value=\"TJ\" >Tajikistan<\/option><option value=\"TZ\" >Tanzania (United Republic of)<\/option><option value=\"TH\" >Thailand<\/option><option value=\"TL\" >Timor-Leste<\/option><option value=\"TG\" >Togo<\/option><option value=\"TK\" >Tokelau<\/option><option value=\"TO\" >Tonga<\/option><option value=\"TT\" >Trinidad and Tobago<\/option><option value=\"TN\" >Tunisia<\/option><option value=\"TM\" >Turkmenistan<\/option><option value=\"TC\" >Turks and Caicos Islands<\/option><option value=\"TV\" >Tuvalu<\/option><option value=\"TR\" >T\u00fcrkiye<\/option><option value=\"UG\" >Uganda<\/option><option value=\"UA\" >Ukraine<\/option><option value=\"AE\" >United Arab Emirates<\/option><option value=\"GB\" >United Kingdom of Great Britain and Northern Ireland<\/option><option value=\"UM\" >United States Minor Outlying Islands<\/option><option value=\"US\" >United States of America<\/option><option value=\"UY\" >Uruguay<\/option><option value=\"UZ\" >Uzbekistan<\/option><option value=\"VU\" >Vanuatu<\/option><option value=\"VA\" >Vatican City State<\/option><option value=\"VE\" >Venezuela (Bolivarian Republic of)<\/option><option value=\"VN\" >Vietnam<\/option><option value=\"VG\" >Virgin Islands (British)<\/option><option value=\"VI\" >Virgin Islands (U.S.)<\/option><option value=\"WF\" >Wallis and Futuna<\/option><option value=\"EH\" >Western Sahara<\/option><option value=\"YE\" >Yemen<\/option><option value=\"ZM\" >Zambia<\/option><option value=\"ZW\" >Zimbabwe<\/option><option value=\"AX\" >\u00c5land Islands<\/option><\/select><label for=\"wpforms-265-field_81-country\" class=\"wpforms-field-sublabel after\">Country<\/label><\/div><\/div><\/fieldset><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-265-field_82-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"82\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_82\">Between what year and what year<\/label><input type=\"text\" id=\"wpforms-265-field_82\" class=\"wpforms-field-medium\" name=\"wpforms[fields][82]\" aria-errormessage=\"wpforms-265-field_82-error\" ><\/div><\/div><div class=\"wpforms-field-repeater-display-rows-buttons\">\n\t\t\t\t<button type=\"button\" class=\"wpforms-field-repeater-button-add\" title=\"Ajouter\">\n\t\t\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M12.129 7.984v1.032a.392.392 0 0 1-.387.387H8.903v2.839a.392.392 0 0 1-.387.387H7.484a.373.373 0 0 1-.387-.387V9.403H4.258a.373.373 0 0 1-.387-.387V7.984c0-.194.161-.387.387-.387h2.839V4.758c0-.193.161-.387.387-.387h1.032c.194 0 .387.194.387.387v2.839h2.839c.193 0 .387.193.387.387ZM16 8.5c0 4.42-3.58 8-8 8s-8-3.58-8-8 3.58-8 8-8 8 3.58 8 8Zm-1.548 0c0-3.548-2.904-6.452-6.452-6.452A6.45 6.45 0 0 0 1.548 8.5 6.43 6.43 0 0 0 8 14.952 6.45 6.45 0 0 0 14.452 8.5Z\" fill=\"currentColor\"\/><\/svg>\n\t\t\t\t<\/button>\n\t\t\t\t<button type=\"button\" class=\"wpforms-field-repeater-button-remove wpforms-disabled\" title=\"Retirer\">\n\t\t\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M4.258 9.403a.373.373 0 0 1-.387-.387V7.984c0-.194.161-.387.387-.387h7.484c.193 0 .387.193.387.387v1.032a.392.392 0 0 1-.387.387H4.258ZM16 8.5c0 4.42-3.58 8-8 8s-8-3.58-8-8 3.58-8 8-8 8 3.58 8 8Zm-1.548 0c0-3.548-2.904-6.452-6.452-6.452A6.45 6.45 0 0 0 1.548 8.5 6.43 6.43 0 0 0 8 14.952 6.45 6.45 0 0 0 14.452 8.5Z\" fill=\"currentColor\"\/><\/svg>\n\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><\/div><\/div><div id=\"wpforms-265-field_48-container\" class=\"wpforms-field wpforms-field-date-time\" data-field-type=\"date-time\" data-field-id=\"48\"><fieldset><legend class=\"wpforms-field-label\">Date of Birth <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-date-dropdown-wrap wpforms-field-large\"><select name=\"wpforms[fields][48][date][d]\" id=\"wpforms-265-field_48-day\" class=\"wpforms-field-date-time-date-day wpforms-field-required\" aria-label=\"Day\"  required><option value=\"\" class=\"placeholder\" selected disabled>DD<\/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><select name=\"wpforms[fields][48][date][m]\" id=\"wpforms-265-field_48-month\" class=\"wpforms-field-date-time-date-month wpforms-field-required\" aria-label=\"Month\"  required><option value=\"\" class=\"placeholder\" selected disabled>MM<\/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><select name=\"wpforms[fields][48][date][y]\" id=\"wpforms-265-field_48-year\" class=\"wpforms-field-date-time-date-year wpforms-field-required\" aria-label=\"Year\"  required><option value=\"\" class=\"placeholder\" selected disabled>YYYY<\/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><\/fieldset><\/div><div id=\"wpforms-265-field_49-container\" class=\"wpforms-field wpforms-field-date-time\" data-field-type=\"date-time\" data-field-id=\"49\"><fieldset><legend class=\"wpforms-field-label\">Date of Death <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-date-dropdown-wrap wpforms-field-large\"><select name=\"wpforms[fields][49][date][d]\" id=\"wpforms-265-field_49-day\" class=\"wpforms-field-date-time-date-day wpforms-field-required\" aria-label=\"Day\"  required><option value=\"\" class=\"placeholder\" selected disabled>DD<\/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><select name=\"wpforms[fields][49][date][m]\" id=\"wpforms-265-field_49-month\" class=\"wpforms-field-date-time-date-month wpforms-field-required\" aria-label=\"Month\"  required><option value=\"\" class=\"placeholder\" selected disabled>MM<\/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><select name=\"wpforms[fields][49][date][y]\" id=\"wpforms-265-field_49-year\" class=\"wpforms-field-date-time-date-year wpforms-field-required\" aria-label=\"Year\"  required><option value=\"\" class=\"placeholder\" selected disabled>YYYY<\/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><\/fieldset><\/div><div id=\"wpforms-265-field_54-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"54\"><h3 id=\"wpforms-265-field_54\" aria-errormessage=\"wpforms-265-field_54-error\">Deceased&#039;s Civil Status<\/h3><\/div><div id=\"wpforms-265-field_72-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-3-columns wpforms-conditional-trigger\" data-field-type=\"radio\" data-field-id=\"72\"><fieldset><legend class=\"wpforms-field-label\">Marital Status at the Time of Death <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-265-field_72\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-265-field_72_1\" name=\"wpforms[fields][72]\" value=\"Single\" aria-errormessage=\"wpforms-265-field_72_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-265-field_72_1\">Single<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-265-field_72_2\" name=\"wpforms[fields][72]\" value=\"Divorced\" aria-errormessage=\"wpforms-265-field_72_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-265-field_72_2\">Divorced<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-265-field_72_3\" name=\"wpforms[fields][72]\" value=\"Widower \/ Widow\" aria-errormessage=\"wpforms-265-field_72_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-265-field_72_3\">Widower \/ Widow<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"radio\" id=\"wpforms-265-field_72_6\" name=\"wpforms[fields][72]\" value=\"Common-law spouse\" aria-errormessage=\"wpforms-265-field_72_6-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-265-field_72_6\">Common-law spouse<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-265-field_72_5\" name=\"wpforms[fields][72]\" value=\"Married\" aria-errormessage=\"wpforms-265-field_72_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-265-field_72_5\">Married<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-265-field_72_4\" name=\"wpforms[fields][72]\" value=\"Civil union\" aria-errormessage=\"wpforms-265-field_72_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-265-field_72_4\">Civil union<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-265-field_60-container\" class=\"wpforms-field wpforms-field-repeater wpforms-conditional-field wpforms-conditional-hide wpforms-field-repeater-display-rows\" data-rows-min=\"1\" data-rows-max=\"5\" data-clone-num=\"2\" data-field-type=\"repeater\" data-field-id=\"60\"><h3 class=\"wpforms-field-label\">\n\t\t\t\tFormer Partner(s)&#039; Name\n\t\t\t<\/h3><input type=\"hidden\" class=\"wpforms-field-repeater-clone-list\" name=\"wpforms[fields][60][clone_list]\" value=\"[]\"><script type=\"text\/html\" class=\"tmpl-wpforms-field-repeater-template-60-265\"><div id=\"wpforms-265-repeater-field_60-clone_{CLONE}\" class=\"wpforms-field-repeater-clone-wrap\" data-clone=\"{CLONE}\">\n\t\t\t\t<div class=\"wpforms-field-layout-rows wpforms-field-large wpforms-field-repeater-display-rows wpforms-field-repeater-preset-50-25-25\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-265-field_96_{CLONE}-container\" class=\"wpforms-field wpforms-field-name\" data-field-type=\"name\" data-field-id=\"96_{CLONE}\"><fieldset><legend class=\"wpforms-field-label\">Former Partner(s)&#039; Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-265-field_96_{CLONE}\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][96_{CLONE}][first]\" placeholder=\"First name\" aria-errormessage=\"wpforms-265-field_96_{CLONE}-error\" required><label for=\"wpforms-265-field_96_{CLONE}\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">First Name<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-265-field_96_{CLONE}-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][96_{CLONE}][last]\" placeholder=\"Last name\" aria-errormessage=\"wpforms-265-field_96_{CLONE}-last-error\" required><label for=\"wpforms-265-field_96_{CLONE}-last\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Name<\/label><\/div><\/div><\/fieldset><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-265-field_83_{CLONE}-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"83_{CLONE}\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_83_{CLONE}\">Year of Union Commencement <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-265-field_83_{CLONE}\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][83_{CLONE}]\" aria-errormessage=\"wpforms-265-field_83_{CLONE}-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-265-field_84_{CLONE}-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"84_{CLONE}\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_84_{CLONE}\">Year of the End of the Union <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-265-field_84_{CLONE}\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][84_{CLONE}]\" aria-errormessage=\"wpforms-265-field_84_{CLONE}-error\" required><\/div><\/div><div class=\"wpforms-field-repeater-display-rows-buttons\">\n\t\t\t\t<button type=\"button\" class=\"wpforms-field-repeater-button-add\" title=\"Ajouter\">\n\t\t\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M12.129 7.984v1.032a.392.392 0 0 1-.387.387H8.903v2.839a.392.392 0 0 1-.387.387H7.484a.373.373 0 0 1-.387-.387V9.403H4.258a.373.373 0 0 1-.387-.387V7.984c0-.194.161-.387.387-.387h2.839V4.758c0-.193.161-.387.387-.387h1.032c.194 0 .387.194.387.387v2.839h2.839c.193 0 .387.193.387.387ZM16 8.5c0 4.42-3.58 8-8 8s-8-3.58-8-8 3.58-8 8-8 8 3.58 8 8Zm-1.548 0c0-3.548-2.904-6.452-6.452-6.452A6.45 6.45 0 0 0 1.548 8.5 6.43 6.43 0 0 0 8 14.952 6.45 6.45 0 0 0 14.452 8.5Z\" fill=\"currentColor\"\/><\/svg>\n\t\t\t\t<\/button>\n\t\t\t\t<button type=\"button\" class=\"wpforms-field-repeater-button-remove wpforms-disabled\" title=\"Retirer\">\n\t\t\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M4.258 9.403a.373.373 0 0 1-.387-.387V7.984c0-.194.161-.387.387-.387h7.484c.193 0 .387.193.387.387v1.032a.392.392 0 0 1-.387.387H4.258ZM16 8.5c0 4.42-3.58 8-8 8s-8-3.58-8-8 3.58-8 8-8 8 3.58 8 8Zm-1.548 0c0-3.548-2.904-6.452-6.452-6.452A6.45 6.45 0 0 0 1.548 8.5 6.43 6.43 0 0 0 8 14.952 6.45 6.45 0 0 0 14.452 8.5Z\" fill=\"currentColor\"\/><\/svg>\n\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><\/div>\n\t\t\t<\/div><\/script><div class=\"wpforms-field-layout-rows wpforms-field-large wpforms-field-repeater-display-rows wpforms-field-repeater-preset-50-25-25\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-265-field_96-container\" class=\"wpforms-field wpforms-field-name\" data-field-type=\"name\" data-field-id=\"96\"><fieldset><legend class=\"wpforms-field-label\">Former Partner(s)&#039; Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-265-field_96\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][96][first]\" placeholder=\"First name\" aria-errormessage=\"wpforms-265-field_96-error\" required><label for=\"wpforms-265-field_96\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">First Name<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-265-field_96-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][96][last]\" placeholder=\"Last name\" aria-errormessage=\"wpforms-265-field_96-last-error\" required><label for=\"wpforms-265-field_96-last\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Name<\/label><\/div><\/div><\/fieldset><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-265-field_83-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"83\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_83\">Year of Union Commencement <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-265-field_83\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][83]\" aria-errormessage=\"wpforms-265-field_83-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-265-field_84-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"84\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_84\">Year of the End of the Union <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-265-field_84\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][84]\" aria-errormessage=\"wpforms-265-field_84-error\" required><\/div><\/div><div class=\"wpforms-field-repeater-display-rows-buttons\">\n\t\t\t\t<button type=\"button\" class=\"wpforms-field-repeater-button-add\" title=\"Ajouter\">\n\t\t\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M12.129 7.984v1.032a.392.392 0 0 1-.387.387H8.903v2.839a.392.392 0 0 1-.387.387H7.484a.373.373 0 0 1-.387-.387V9.403H4.258a.373.373 0 0 1-.387-.387V7.984c0-.194.161-.387.387-.387h2.839V4.758c0-.193.161-.387.387-.387h1.032c.194 0 .387.194.387.387v2.839h2.839c.193 0 .387.193.387.387ZM16 8.5c0 4.42-3.58 8-8 8s-8-3.58-8-8 3.58-8 8-8 8 3.58 8 8Zm-1.548 0c0-3.548-2.904-6.452-6.452-6.452A6.45 6.45 0 0 0 1.548 8.5 6.43 6.43 0 0 0 8 14.952 6.45 6.45 0 0 0 14.452 8.5Z\" fill=\"currentColor\"\/><\/svg>\n\t\t\t\t<\/button>\n\t\t\t\t<button type=\"button\" class=\"wpforms-field-repeater-button-remove wpforms-disabled\" title=\"Retirer\">\n\t\t\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M4.258 9.403a.373.373 0 0 1-.387-.387V7.984c0-.194.161-.387.387-.387h7.484c.193 0 .387.193.387.387v1.032a.392.392 0 0 1-.387.387H4.258ZM16 8.5c0 4.42-3.58 8-8 8s-8-3.58-8-8 3.58-8 8-8 8 3.58 8 8Zm-1.548 0c0-3.548-2.904-6.452-6.452-6.452A6.45 6.45 0 0 0 1.548 8.5 6.43 6.43 0 0 0 8 14.952 6.45 6.45 0 0 0 14.452 8.5Z\" fill=\"currentColor\"\/><\/svg>\n\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><\/div><\/div><div id=\"wpforms-265-field_57-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"57\"><h3 id=\"wpforms-265-field_57\" aria-errormessage=\"wpforms-265-field_57-error\">Previous Wills<\/h3><\/div><div id=\"wpforms-265-field_58-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline wpforms-conditional-trigger\" data-field-type=\"radio\" data-field-id=\"58\"><fieldset><legend class=\"wpforms-field-label\">To your knowledge, did the deceased have a notarized will? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-265-field_58\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-265-field_58_1\" name=\"wpforms[fields][58]\" value=\"Yes\" aria-errormessage=\"wpforms-265-field_58_1-error\" aria-describedby=\"wpforms-265-field_58-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-265-field_58_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-265-field_58_2\" name=\"wpforms[fields][58]\" value=\"No\" aria-errormessage=\"wpforms-265-field_58_2-error\" aria-describedby=\"wpforms-265-field_58-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-265-field_58_2\">No<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-265-field_58_3\" name=\"wpforms[fields][58]\" value=\"Unknown\" aria-errormessage=\"wpforms-265-field_58_3-error\" aria-describedby=\"wpforms-265-field_58-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-265-field_58_3\">Unknown<\/label><\/li><\/ul><div id=\"wpforms-265-field_58-description\" class=\"wpforms-field-description\"><div class=\"wpforms-testament-notice\">\n  <div class=\"wpforms-testament-notice-title\">\n  \u26a0\ufe0f IMPORTANT\n  <\/div>\n  <p>\n  Please submit only information or documents related to a\n    <strong>notarial will<\/strong> or a\n    <strong>probated holographic will<\/strong>.\n  <\/p>\n  <p>\n  Do not submit any documents or information regarding a\n    <strong>protection mandate<\/strong>, a\n    <strong>power of attorney<\/strong>, an\n    <strong>enduring power of attorney<\/strong> or an\n    <strong>unprobated will<\/strong>.\n  <\/p>\n<\/div><\/div><\/fieldset><\/div><div id=\"wpforms-265-field_26-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"text\" data-field-id=\"26\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_26\">Notary&#039;s Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-265-field_26\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][26]\" aria-errormessage=\"wpforms-265-field_26-error\" required><\/div><div id=\"wpforms-265-field_88-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"text\" data-field-id=\"88\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_88\">Notary&#039;s Name<\/label><input type=\"text\" id=\"wpforms-265-field_88\" class=\"wpforms-field-large\" name=\"wpforms[fields][88]\" aria-errormessage=\"wpforms-265-field_88-error\" ><\/div><div id=\"wpforms-265-field_59-container\" class=\"wpforms-field wpforms-field-date-time wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"date-time\" data-field-id=\"59\" style=\"display:none;\"><fieldset><legend class=\"wpforms-field-label\">Date of Last Known Will <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-date-dropdown-wrap wpforms-field-large\"><select name=\"wpforms[fields][59][date][d]\" id=\"wpforms-265-field_59-day\" class=\"wpforms-field-date-time-date-day wpforms-field-required\" aria-label=\"Day\"  required><option value=\"\" class=\"placeholder\" selected disabled>DD<\/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><select name=\"wpforms[fields][59][date][m]\" id=\"wpforms-265-field_59-month\" class=\"wpforms-field-date-time-date-month wpforms-field-required\" aria-label=\"Month\"  required><option value=\"\" class=\"placeholder\" selected disabled>MM<\/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><select name=\"wpforms[fields][59][date][y]\" id=\"wpforms-265-field_59-year\" class=\"wpforms-field-date-time-date-year wpforms-field-required\" aria-label=\"Year\"  required><option value=\"\" class=\"placeholder\" selected disabled>YYYY<\/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><\/fieldset><\/div><div id=\"wpforms-265-field_87-container\" class=\"wpforms-field wpforms-field-date-time wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"date-time\" data-field-id=\"87\" style=\"display:none;\"><fieldset><legend class=\"wpforms-field-label\">Date of Last Known Will<\/legend><div class=\"wpforms-field-date-dropdown-wrap wpforms-field-large\"><select name=\"wpforms[fields][87][date][d]\" id=\"wpforms-265-field_87-day\" class=\"wpforms-field-date-time-date-day\" aria-label=\"Day\" ><option value=\"\" class=\"placeholder\" selected disabled>DD<\/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><select name=\"wpforms[fields][87][date][m]\" id=\"wpforms-265-field_87-month\" class=\"wpforms-field-date-time-date-month\" aria-label=\"Month\" ><option value=\"\" class=\"placeholder\" selected disabled>MM<\/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><select name=\"wpforms[fields][87][date][y]\" id=\"wpforms-265-field_87-year\" class=\"wpforms-field-date-time-date-year\" aria-label=\"Year\" ><option value=\"\" class=\"placeholder\" selected disabled>YYYY<\/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><\/fieldset><\/div><div id=\"wpforms-265-field_85-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"text\" data-field-id=\"85\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_85\">Minute Number (notarial act) <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-265-field_85\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][85]\" aria-errormessage=\"wpforms-265-field_85-error\" required><\/div><div id=\"wpforms-265-field_86-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"text\" data-field-id=\"86\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_86\">Minute Number (notarial act)<\/label><input type=\"text\" id=\"wpforms-265-field_86\" class=\"wpforms-field-medium\" name=\"wpforms[fields][86]\" aria-errormessage=\"wpforms-265-field_86-error\" ><\/div><div id=\"wpforms-265-field_66-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"66\"><h3 id=\"wpforms-265-field_66\" aria-errormessage=\"wpforms-265-field_66-error\">DEATH CERTIFICATE<\/h3><\/div><div id=\"wpforms-265-field_97-container\" class=\"wpforms-field wpforms-field-html\" data-field-type=\"html\" data-field-id=\"97\"><div id=\"wpforms-265-field_97\" aria-errormessage=\"wpforms-265-field_97-error\"><div style=\"font-family:inherit; color:#303b4d; font-size:15px; font-weight:400; line-height:1.6;\">\r\n\r\n  <!-- INTRODUCTION -->\r\n  <p style=\"font-size:17px; font-weight:400; margin:0 0 24px;\">\r\n To process your will search request, we require a death certificate or a copy of the act of death issued by the Directeur de l'\u00e9tat civil du Qu\u00e9bec.\r\n  <\/p>\r\n\r\n  <!-- DOCUMENTS AND INSTRUCTIONS -->\r\n  <div style=\"display:flex; flex-wrap:wrap; gap:20px; align-items:stretch;\">\r\n\r\n    <!-- ACCEPTED DOCUMENTS -->\r\n    <div style=\"flex:1 1 480px; min-width:0; background:#faf9f7; border:1px solid #eeeae5; border-radius:14px; padding:22px; box-sizing:border-box;\">\r\n\r\n      <div style=\"display:flex; align-items:center; gap:12px; margin-bottom:8px;\">\r\n        <span style=\"display:inline-flex; align-items:center; justify-content:center; flex-shrink:0; width:34px; height:34px; border-radius:50%; background:#348446; color:#fff; font-size:22px; font-weight:bold;\">\u2713<\/span>\r\n        <strong style=\"font-size:19px; font-weight:600; color:#303b4d;\">Accepted documents<\/strong>\r\n      <\/div>\r\n\r\n      <p style=\"margin:0 0 18px 46px; font-size:14px; font-weight:400; color:#747d8d;\">\r\n Issued by the Directeur de l'\u00e9tat civil du Qu\u00e9bec\r\n      <\/p>\r\n\r\n      <img decoding=\"async\" src=\"https:\/\/docugo.ca\/wp-content\/uploads\/2026\/09\/certificats.png\" alt=\"Examples of accepted documents: Quebec death certificate and copy of the act of death\" style=\"display:block; width:100%; max-width:100%; height:auto; border-radius:8px; background:#fff;\"\/>\r\n\r\n    <\/div>\r\n\r\n    <!-- IMPORTANT INSTRUCTIONS -->\r\n    <div style=\"flex:1 1 280px; min-width:0; background:#fff8f2; border:1px solid #f4e4d7; border-radius:14px; padding:22px; box-sizing:border-box;\">\r\n\r\n      <div style=\"display:flex; align-items:center; gap:12px; margin-bottom:18px;\">\r\n        <span style=\"display:inline-flex; align-items:center; justify-content:center; flex-shrink:0; width:34px; height:34px; border-radius:50%; background:#d8653a; color:#fff; font-size:23px; font-weight:bold;\">!<\/span>\r\n        <strong style=\"font-size:19px; font-weight:600; color:#d8653a;\">Important<\/strong>\r\n      <\/div>\r\n\r\n      <p style=\"font-weight:400; margin:0 0 18px; font-size:15px;\">\r\n Death attestations issued by funeral homes are not accepted.\r\n      <\/p>\r\n\r\n      <div style=\"border-top:1px solid #eadfd5; padding-top:17px;\">\r\n\r\n        <strong style=\"display:block; font-size:15px; font-weight:600; margin-bottom:16px;\">\r\n Scanning or Photo Guidelines\r\n        <\/strong>\r\n\r\n        <!-- REQUIREMENT 1 -->\r\n        <div style=\"display:flex; align-items:flex-start; gap:12px; margin-bottom:17px;\">\r\n          <span style=\"display:inline-flex; align-items:center; justify-content:center; flex-shrink:0; width:23px; height:23px; background:#e4f3e7; border-radius:50%; color:#348446; font-size:15px; font-weight:bold;\">\u2713<\/span>\r\n          <span style=\"font-weight:400;\">The document must be complete, clear and legible.<\/span>\r\n        <\/div>\r\n\r\n        <!-- REQUIREMENT 2 -->\r\n        <div style=\"display:flex; align-items:flex-start; gap:12px; margin-bottom:17px;\">\r\n          <span style=\"display:inline-flex; align-items:center; justify-content:center; flex-shrink:0; width:23px; height:23px; background:#e4f3e7; border-radius:50%; color:#348446; font-size:15px; font-weight:bold;\">\u2713<\/span>\r\n          <span style=\"font-weight:400;\">All four corners of the document must be visible.<\/span>\r\n        <\/div>\r\n\r\n        <!-- REQUIREMENT 3 -->\r\n        <div style=\"display:flex; align-items:flex-start; gap:12px; margin-bottom:17px;\">\r\n          <span style=\"display:inline-flex; align-items:center; justify-content:center; flex-shrink:0; width:23px; height:23px; background:#e4f3e7; border-radius:50%; color:#348446; font-size:15px; font-weight:bold;\">\u2713<\/span>\r\n          <span style=\"font-weight:400;\">The \"NUL\" watermark must not be visible.<\/span>\r\n        <\/div>\r\n\r\n        <!-- REQUIREMENT 4 -->\r\n        <div style=\"display:flex; align-items:flex-start; gap:12px;\">\r\n          <span style=\"display:inline-flex; align-items:center; justify-content:center; flex-shrink:0; width:23px; height:23px; background:#e4f3e7; border-radius:50%; color:#348446; font-size:15px; font-weight:bold;\">\u2713<\/span>\r\n          <span style=\"font-weight:400;\">All information on the document must be clearly legible.<\/span>\r\n        <\/div>\r\n\r\n      <\/div>\r\n    <\/div>\r\n\r\n  <\/div>\r\n\r\n  <!-- DOCUMENT NOT YET RECEIVED -->\r\n  <div style=\"margin-top:18px; padding:16px 20px; background:#f3f6fa; border-radius:10px; font-size:14px; font-weight:400;\">\r\n    <strong style=\"font-weight:600;\">Haven't received your document yet?<\/strong><br \/> You may continue your request and submit the document once you receive it. Processing of your will search will begin once we have received the required document. \r\n  <\/div>\r\n\r\n<\/div>\r\n<\/div><\/div><div id=\"wpforms-265-field_27-container\" class=\"wpforms-field wpforms-field-file-upload docugo-deces-upload\" data-field-type=\"file-upload\" data-field-id=\"27\"><label class=\"wpforms-field-label\" for=\"wpforms-265-field_27\">Upload Your Document<\/label><div\n\t\tclass=\"wpforms-uploader \"\n\t\tdata-field-id=\"27\"\n\t\tdata-form-id=\"265\"\n\t\tdata-input-name=\"wpforms_265_27\"\n\t\tdata-extensions=\"pdf,jpg,jpeg,png\"\n\t\tdata-max-size=\"134217728\"\n\t\tdata-max-file-number=\"1\"\n\t\tdata-post-max-size=\"134217728\"\n\t\tdata-max-parallel-uploads=\"4\"\n\t\tdata-parallel-uploads=\"true\"\n\t\tdata-file-chunk-size=\"2097152\">\n\t<div class=\"dz-message\">\n\t\t<svg  viewBox=\"0 0 640 640\" focusable=\"false\" data-icon=\"inbox\" width=\"50px\" height=\"50px\" fill=\"currentColor\" aria-hidden=\"true\">\n\t\t\t<path d=\"M352 173.3L352 384C352 401.7 337.7 416 320 416C302.3 416 288 401.7 288 384L288 173.3L246.6 214.7C234.1 227.2 213.8 227.2 201.3 214.7C188.8 202.2 188.8 181.9 201.3 169.4L297.3 73.4C309.8 60.9 330.1 60.9 342.6 73.4L438.6 169.4C451.1 181.9 451.1 202.2 438.6 214.7C426.1 227.2 405.8 227.2 393.3 214.7L352 173.3zM320 464C364.2 464 400 428.2 400 384L480 384C515.3 384 544 412.7 544 448L544 480C544 515.3 515.3 544 480 544L160 544C124.7 544 96 515.3 96 480L96 448C96 412.7 124.7 384 160 384L240 384C240 428.2 275.8 464 320 464zM464 488C477.3 488 488 477.3 488 464C488 450.7 477.3 440 464 440C450.7 440 440 450.7 440 464C440 477.3 450.7 488 464 488z\"\/>\n\t\t<\/svg>\n\n\t\t<span class=\"modern-title\">\n\t\t\t\t\t\t\tDrag &amp; Drop Files, \t\t\t\t<span>Choose Files to Upload<\/span>, or\t\t\t\t<span class=\"wpforms-camera\">Capture With Your Camera<\/span>\n\t\t\t\t\t<\/span>\n\n\t\t\t<\/div>\n<\/div>\n\n<div id=\"wpforms-camera-modal-265-27\" class=\"wpforms-camera-modal-overlay wpforms-camera-format-photo\"  style=\"display: none;\" data-field-id=\"27\"  data-form-id=\"265\">\n\t<div class=\"wpforms-camera-modal\">\n\t\t<div class=\"wpforms-camera-modal-header\">\n\t\t\t<div class=\"wpforms-camera-modal-title\">Camera Preview<\/div>\n\t\t\t<div class=\"wpforms-camera-modal-close\">\n\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"11\" fill=\"none\">\n\t\t\t\t\t<path d=\"M10.688 2.219 7.405 5.5l3.282 3.313a.964.964 0 0 1 0 1.406.964.964 0 0 1-1.407 0L6 6.938l-3.313 3.28a.964.964 0 0 1-1.406 0 .964.964 0 0 1 0-1.405L4.563 5.5 1.28 2.219a.964.964 0 0 1 0-1.406.964.964 0 0 1 1.407 0L6 4.092 9.281.814a.964.964 0 0 1 1.406 0 .964.964 0 0 1 0 1.406Z\"\/>\n\t\t\t\t<\/svg>\n\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<div class=\"wpforms-camera-modal-content\">\n\t\t\t<div class=\"wpforms-camera-preview\">\n\t\t\t\t<video id=\"wpforms-camera-video-265-27\" autoplay playsinline muted disablepictureinpicture><\/video>\n\t\t\t<\/div>\n\t\t\t<div class=\"wpforms-camera-error\"><\/div>\n\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wpforms-camera-modal-footer\">\n\t\t\t\t<div class=\"wpforms-camera-modal-actions\">\n\t\t\t\t\t<button class=\"wpforms-camera-capture\" title=\"Capture Photo\" disabled>\n\t\t\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"22\" fill=\"none\">\n\t\t\t\t\t\t\t\t<path fill=\"#fff\" d=\"M6.984 2.047C7.313 1.109 8.156.5 9.141.5h5.718c.985 0 1.829.61 2.157 1.547l.468 1.453H21c1.64 0 3 1.36 3 3v12c0 1.64-1.36 3-3 3H3c-1.64 0-3-1.36-3-3v-12c0-1.64 1.36-3 3-3h3.516l.468-1.453ZM12 8a4.501 4.501 0 0 0 0 9 4.501 4.501 0 0 0 0-9Z\"\/>\n\t\t\t\t\t\t\t<\/svg>\n\t\t\t\t\t<\/button>\n\t\t\t\t\t<button class=\"wpforms-camera-stop\" style=\"display:none;\">O<\/button>\n\t\t\t\t\t<div class=\"wpforms-camera-countdown\" style=\"display: none;\">\n\t\t\t\t\t\t<svg>\n\t\t\t\t\t\t\t<circle class=\"bg\" r=\"22\"><\/circle>\n\t\t\t\t\t\t\t<circle class=\"progress\" r=\"22\"><\/circle>\n\t\t\t\t\t\t<\/svg>\n\t\t\t\t\t\t<span>3<\/span>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"wpforms-camera-flip\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"wpforms-camera-modal-buttons\" style=\"display: none;\">\n\t\t\t\t\t<button class=\"wpforms-camera-cancel\" title=\"Retake Photo\"><\/button>\n\t\t\t\t\t<button class=\"wpforms-camera-accept\">Use Photo<\/button>\n\t\t\t\t\t<button class=\"wpforms-camera-accept-crop\" style=\"display: none;\">Apply Crop<\/button>\n\t\t\t\t\t<button class=\"wpforms-camera-crop\" title=\"Crop Photo\"><\/button>\n\t\t\t\t\t<button class=\"wpforms-camera-crop-cancel\" title=\"Cancel Crop\" style=\"display: none;\"><\/button>\n\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\n\t\t<canvas id=\"wpforms-camera-canvas-265-27\" style=\"display:none;\"><\/canvas>\n\t<\/div>\n<\/div>\n<input\n\t\ttype=\"text\"\n\t\tautocomplete=\"off\"\n\t\treadonly\n\t\tclass=\"dropzone-input\"\n\t\tstyle=\"position:absolute!important;clip:rect(0,0,0,0)!important;height:1px!important;width:1px!important;border:0!important;overflow:hidden!important;padding:0!important;margin:0!important;\"\n\t\tid=\"wpforms-265-field_27\"\n\t\tname=\"wpforms_265_27\" \t\tvalue=\"\">\n<div id=\"wpforms-265-field_27-description\" class=\"wpforms-field-description\">Take a photo of your document or select a file from your device. Accepted formats: PDF or JPEG. <\/div><\/div><div id=\"wpforms-265-field_98-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"98\"><h3 id=\"wpforms-265-field_98\" aria-errormessage=\"wpforms-265-field_98-error\">PROCESSING TIMES<\/h3><\/div><div id=\"wpforms-265-field_91-container\" class=\"wpforms-field wpforms-field-radio docugo-delai wpforms-list-inline wpforms-conditional-trigger\" data-field-type=\"radio\" data-field-id=\"91\"><fieldset><legend class=\"wpforms-field-label\">Which processing option would you prefer? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-265-field_91\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-265-field_91_1\" name=\"wpforms[fields][91]\" value=\"Regular&lt;br\/&gt;&lt;br\/&gt;$155 + taxes&lt;br\/&gt;&lt;br\/&gt;20 business days\" aria-errormessage=\"wpforms-265-field_91_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-265-field_91_1\">Regular<br \/><br \/>$155 + taxes<br \/><br \/>20 business days<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-265-field_91_2\" name=\"wpforms[fields][91]\" value=\"Expedited&lt;br\/&gt;&lt;br\/&gt;$245 + taxes&lt;br\/&gt;&lt;br\/&gt;3 to 5 business days\" aria-errormessage=\"wpforms-265-field_91_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-265-field_91_2\">Expedited<br \/><br \/>$245 + taxes<br \/><br \/>3 to 5 business days<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-265-field_92-container\" class=\"wpforms-field wpforms-field-html\" data-field-type=\"html\" data-field-id=\"92\"><div id=\"wpforms-265-field_92\" aria-errormessage=\"wpforms-265-field_92-error\"><div style=\"      background:#f5f7f8;     border-radius:12px;     padding:18px 20px;     margin:16px 0;     color:#344054;     font-size:14px !important;     line-height:1.6 !important;     font-weight:400 !important;  \">\r\n\r\n    <div style=\"          font-size:15px !important;         font-weight:700 !important;         line-height:1.4 !important;         margin-bottom:8px;      \">\r\n Good to know\r\n    <\/div>\r\n\r\n    <div style=\"          font-size:14px !important;         line-height:1.6 !important;         font-weight:400 !important;         margin-bottom:10px;      \">\r\n Both options include official will searches\r\n through the Chambre des notaires du Qu\u00e9bec\r\n and the Barreau du Qu\u00e9bec.\r\n    <\/div>\r\n\r\n    <div style=\"          font-size:14px !important;         line-height:1.6 !important;         font-weight:400 !important;         margin-bottom:10px;      \">\r\n Processing times begin once your application\r\n is complete and all required documents\r\n have been received.\r\n    <\/div>\r\n\r\n    <div style=\"          font-size:13px !important;         line-height:1.6 !important;         font-weight:400 !important;         color:#667085;      \">\r\n        <strong style=\"font-size:13px !important;\">\r\n * Expedited processing:\r\n        <\/strong>\r\n\r\n  Priority processing is initiated within\r\n 3 business days. This timeframe does not\r\n guarantee that both certificates will be\r\n received within that period. \r\n    <\/div>\r\n\r\n<\/div><\/div><\/div><div id=\"wpforms-265-field_93-container\" class=\"wpforms-field wpforms-field-checkbox docugo-signature wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"checkbox\" data-field-id=\"93\" style=\"display:none;\"><fieldset><legend class=\"wpforms-field-label\">Signature Requirement Upon Delivery<\/legend><ul id=\"wpforms-265-field_93\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-265-field_93_1\" name=\"wpforms[fields][93][]\" value=\"Signature upon delivery&lt;br\/&gt;$7.50\" aria-errormessage=\"wpforms-265-field_93_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-265-field_93_1\">Signature upon delivery<br \/>$7.50<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-265-field_69-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"69\"><\/div><div id=\"wpforms-265-field_73-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-type=\"radio\" data-field-id=\"73\"><fieldset><legend class=\"wpforms-field-label\">I would like a member of the DOCUGO team to contact me to follow up on my request. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-265-field_73\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-265-field_73_1\" name=\"wpforms[fields][73]\" value=\"YES\" aria-errormessage=\"wpforms-265-field_73_1-error\" aria-describedby=\"wpforms-265-field_73-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-265-field_73_1\">YES<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-265-field_73_2\" name=\"wpforms[fields][73]\" value=\"NO\" aria-errormessage=\"wpforms-265-field_73_2-error\" aria-describedby=\"wpforms-265-field_73-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-265-field_73_2\">NO<\/label><\/li><\/ul><div id=\"wpforms-265-field_73-description\" class=\"wpforms-field-description\"><b>Please note that DOCUGO does not provide any legal information or legal advice.<\/b><\/div><\/fieldset><\/div><script>\n\t\t\t\t( function() {\n\t\t\t\t\tconst style = document.createElement( 'style' );\n\t\t\t\t\tstyle.appendChild( document.createTextNode( '#wpforms-265-field_1-container { position: absolute !important; overflow: hidden !important; display: inline !important; height: 1px !important; width: 1px !important; z-index: -1000 !important; padding: 0 !important; } #wpforms-265-field_1-container input { visibility: hidden; } #wpforms-conversational-form-page #wpforms-265-field_1-container label { counter-increment: none; }' ) );\n\t\t\t\t\tdocument.head.appendChild( style );\n\t\t\t\t\tdocument.currentScript?.remove();\n\t\t\t\t} )();\n\t\t\t<\/script><\/div><!-- .wpforms-field-container --><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"265\"><input type=\"hidden\" name=\"wpforms[time_token]\" value=\"1792842459.16a13faf88164e8dd25d0f387bf1ae593b17bd943715e6fc88c89b14bea81926\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/docugo.ca\/en\/wp-json\/wp\/v2\/pages\/273\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-265\" class=\"wpforms-submit\" data-alt-text=\"Sending in progress...\" data-submit-text=\"Submit the application\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit the application<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Power of attorneyRequest for will search If you do not know the information, enter \u201cUnknown.\u201dVeuillez activer JavaScript dans votre navigateur 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