{"id":7312,"date":"2026-06-25T11:43:14","date_gmt":"2026-06-25T11:43:14","guid":{"rendered":"https:\/\/grupoxandra.eu\/?page_id=7312"},"modified":"2026-06-25T11:47:32","modified_gmt":"2026-06-25T11:47:32","slug":"autoverzekeringsformulier","status":"publish","type":"page","link":"https:\/\/grupoxandra.eu\/en\/autoverzekeringsformulier\/","title":{"rendered":"car insurance form"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"7312\" class=\"elementor elementor-7312\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-add4a18 e-flex e-con-boxed e-con e-parent\" data-id=\"add4a18\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-53d38e9 elementor-widget elementor-widget-heading\" data-id=\"53d38e9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Receive a unique proposal<br> for your custom car insurance.<\/h2>\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-b53704c e-flex e-con-boxed e-con e-parent\" data-id=\"b53704c\" 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-f4609c0 elementor-widget elementor-widget-shortcode\" data-id=\"f4609c0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><div class=\"forminator-ui forminator-custom-form forminator-custom-form-7195 forminator-design--default  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-7195\" data-uid=\"6a3d5520c97c5\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-7195\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-7195 forminator-design--default  forminator_ajax\"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"7195\"\n\t\t\t\t data-color-option=\"theme\" data-design=\"default\" data-grid=\"open\" style=\"display: none;\"\n\t\t\t\tdata-uid=\"6a3d5520c97c5\" action=\"\"\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-pagination-progress\" aria-hidden=\"true\"><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-7195--page-0\"\n\t\t\t\tclass=\"forminator-pagination forminator-pagination-start\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-7195--page-0-label\"\n\t\t\t\tdata-step=\"0\"\n\t\t\t\tdata-label=\"Finish\"\n\t\t\t\tdata-actual-label=\"Page 1\"\n\t\t\t\tdata-name=\"page-break-1\"\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"section-6\" class=\"forminator-field-section forminator-col forminator-col-12\"><div class=\"forminator-field\"><h2 class=\"forminator-title\">Your Personal Data<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-12\"><div class=\"forminator-row forminator-no-margin\" data-multiple=\"true\"><div class=\"forminator-col forminator-col-md-6\"><div class=\"forminator-field\"><label for=\"forminator-field-first-name-1_6a3d5520c97c5\" id=\"forminator-field-first-name-1_6a3d5520c97c5-label\" class=\"forminator-label\">First name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-1-first-name\" placeholder=\"First name\" id=\"forminator-field-first-name-1_6a3d5520c97c5\" class=\"forminator-input\" aria-required=\"true\" data-multi=\"1\" autocomplete=\"given-name\" value=\"\" \/><\/div><\/div><div class=\"forminator-col forminator-col-md-6\"><div class=\"forminator-field\"><label for=\"forminator-field-last-name-1_6a3d5520c97c5\" id=\"forminator-field-last-name-1_6a3d5520c97c5-label\" class=\"forminator-label\">Last name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-1-last-name\" placeholder=\"Last name\" id=\"forminator-field-last-name-1_6a3d5520c97c5\" class=\"forminator-input\" aria-required=\"true\" data-multi=\"1\" autocomplete=\"family-name\" value=\"\" \/><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_6a3d5520c97c5\" id=\"forminator-field-phone-1_6a3d5520c97c5-label\" class=\"forminator-label\">Your phone number where we can best reach you <span class=\"forminator-required\">*<\/span><\/label><span id=\"forminator-field-phone-1_6a3d5520c97c5-description\" class=\"forminator-description\">With country code<\/span><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-1_6a3d5520c97c5\" class=\"forminator-input forminator-field--phone\" data-required=\"1\" aria-required=\"true\" autocomplete=\"off\" inputmode=\"numeric\" aria-describedby=\"forminator-field-phone-1_6a3d5520c97c5-description\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_6a3d5520c97c5\" id=\"forminator-field-email-1_6a3d5520c97c5-label\" class=\"forminator-label\">Your email address where we can best reach you <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"Email\" id=\"forminator-field-email-1_6a3d5520c97c5\" class=\"forminator-input forminator-email--field\" data-required=\"1\" aria-required=\"true\" autocomplete=\"email\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-1\" class=\"forminator-field-select forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-form-7195__field--select-1_6a3d5520c97c5\" id=\"forminator-form-7195__field--select-1_6a3d5520c97c5-label\" class=\"forminator-label\">Are you already a customer with us? <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-7195__field--select-1_6a3d5520c97c5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-1\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Kies \u00e9\u00e9n optie\" data-search=\"false\" data-search-placeholder=\"Kies \u00e9\u00e9n optie\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-7195__field--select-1_6a3d5520c97c5-label\"><option value=\"\"  >Choose one option<\/option><option value=\"Ja\"  data-calculation=\"0\">Yes<\/option><option value=\"Nee\"  data-calculation=\"0\">No<\/option><\/select><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-7195--page-1\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-7195--page-1-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"1\"\n\t\t\t\tdata-label=\"Page  1\"\n\t\t\t\tdata-actual-label=\"Page 2\"\n\t\t\t\tdata-name=\"page-break-2\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"section-7\" class=\"forminator-field-section forminator-col forminator-col-12\"><div class=\"forminator-field\"><h2 class=\"forminator-title\">Your Personal Data<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-2\" class=\"forminator-field-select forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-form-7195__field--select-2_6a3d5520c97c5\" id=\"forminator-form-7195__field--select-2_6a3d5520c97c5-label\" class=\"forminator-label\">How did you find us? <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-7195__field--select-2_6a3d5520c97c5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-2\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Kies \u00e9\u00e9n optie\" data-search=\"false\" data-search-placeholder=\"Kies \u00e9\u00e9n optie\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-7195__field--select-2_6a3d5520c97c5-label\"><option value=\"\"  >Choose one option<\/option><option value=\"Google\"  data-calculation=\"0\">Google<\/option><option value=\"Sociale media\"  data-calculation=\"0\">Social media<\/option><option value=\"Via makelaar of gestor\u00eda of andere professionals\"  data-calculation=\"0\">Through a real estate agent, a management company, or other professionals<\/option><option value=\"Via kennissen \/ vrienden\"  data-calculation=\"0\">Through acquaintances \/ friends<\/option><option value=\"custom_option\"  data-calculation=\"0\">Miscellaneous<\/option><\/select><div class=\"forminator-field forminator-custom-input\"><input id=\"custom-forminator-form-7195__field--select-2_6a3d5520c97c5\" name=\"custom-select-2\" class=\"forminator-input\" placeholder=\"Via\" aria-label=\"Miscellaneous\" value=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-1\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-1_6a3d5520c97c5\" id=\"forminator-field-text-1_6a3d5520c97c5-label\" class=\"forminator-label\">Can you provide the name? <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-1\" value=\"\" placeholder=\"Name\" id=\"forminator-field-text-1_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-3\" class=\"forminator-field-select forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-form-7195__field--select-3_6a3d5520c97c5\" id=\"forminator-form-7195__field--select-3_6a3d5520c97c5-label\" class=\"forminator-label\">Your Spanish tax identification number (NIE) <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-7195__field--select-3_6a3d5520c97c5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-3\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Kies \u00e9\u00e9n optie\" data-search=\"false\" data-search-placeholder=\"Kies \u00e9\u00e9n optie\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-7195__field--select-3_6a3d5520c97c5-label\"><option value=\"\"  >Choose one option<\/option><option value=\"Ik heb een NIE nummer\"  data-calculation=\"0\">I have an NIE number<\/option><option value=\"Ik heb nog geen NIE nummer\"  data-calculation=\"0\">I don't have an NIE number yet<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-2\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-2_6a3d5520c97c5\" id=\"forminator-field-text-2_6a3d5520c97c5-label\" class=\"forminator-label\">NIE <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-2\" value=\"\" placeholder=\"Noon\" id=\"forminator-field-text-2_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-4\" class=\"forminator-field-select forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-form-7195__field--select-4_6a3d5520c97c5\" id=\"forminator-form-7195__field--select-4_6a3d5520c97c5-label\" class=\"forminator-label\">Your gender <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-7195__field--select-4_6a3d5520c97c5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-4\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Kies \u00e9\u00e9n optie\" data-search=\"false\" data-search-placeholder=\"Kies \u00e9\u00e9n optie\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-7195__field--select-4_6a3d5520c97c5-label\"><option value=\"\"  >Choose one option<\/option><option value=\"Man\"  data-calculation=\"0\">Man<\/option><option value=\"Vrouw\"  data-calculation=\"0\">Woman<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-1\" class=\"forminator-field-date forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-date-1-picker_6a3d5520c97c5\" id=\"forminator-field-date-1-picker_6a3d5520c97c5-label\" class=\"forminator-label\">Your date of birth <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-1\" value=\"\" placeholder=\"\" id=\"forminator-field-date-1-picker_6a3d5520c97c5\" class=\"forminator-input forminator-datepicker\" data-required=\"1\" data-format=\"dd\/mm\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-3\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-3_6a3d5520c97c5\" id=\"forminator-field-text-3_6a3d5520c97c5-label\" class=\"forminator-label\">Your nationality <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-3\" value=\"\" placeholder=\"Your nationality\" id=\"forminator-field-text-3_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-7195--page-2\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-7195--page-2-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"2\"\n\t\t\t\tdata-label=\"Page  2\"\n\t\t\t\tdata-actual-label=\"Uw verblijfsadres in Spanje\"\n\t\t\t\tdata-name=\"page-break-4\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"section-8\" class=\"forminator-field-section forminator-col forminator-col-12\"><div class=\"forminator-field\"><h2 class=\"forminator-title\">Your Spanish residential address<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-17\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-17_6a3d5520c97c5\" id=\"forminator-field-text-17_6a3d5520c97c5-label\" class=\"forminator-label\">Postcode <span class=\"forminator-required\">*<\/span><\/label><span id=\"forminator-field-text-17_6a3d5520c97c5-description\" class=\"forminator-description\"><span data-limit=\"10\" data-type=\"characters\">0 \/ 10<\/span><\/span><input type=\"text\" name=\"text-17\" value=\"\" placeholder=\"\" id=\"forminator-field-text-17_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" maxlength=\"10\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-4\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-4_6a3d5520c97c5\" id=\"forminator-field-text-4_6a3d5520c97c5-label\" class=\"forminator-label\">Municipality <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-4\" value=\"\" placeholder=\"\" id=\"forminator-field-text-4_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-5\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-5_6a3d5520c97c5\" id=\"forminator-field-text-5_6a3d5520c97c5-label\" class=\"forminator-label\">Street <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-5\" value=\"\" placeholder=\"\" id=\"forminator-field-text-5_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-6\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-6_6a3d5520c97c5\" id=\"forminator-field-text-6_6a3d5520c97c5-label\" class=\"forminator-label\">Number <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-6\" value=\"\" placeholder=\"\" id=\"forminator-field-text-6_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-7195--page-3\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-7195--page-3-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"3\"\n\t\t\t\tdata-label=\"Uw verblijfsadres in Spanje\"\n\t\t\t\tdata-actual-label=\"Page 4\"\n\t\t\t\tdata-name=\"page-break-5\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"section-9\" class=\"forminator-field-section forminator-col forminator-col-12\"><div class=\"forminator-field\"><h2 class=\"forminator-title\">Your Personal Data<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-5\" class=\"forminator-field-select forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-form-7195__field--select-5_6a3d5520c97c5\" id=\"forminator-form-7195__field--select-5_6a3d5520c97c5-label\" class=\"forminator-label\">Is the policyholder a company? <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-7195__field--select-5_6a3d5520c97c5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-5\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Kies \u00e9\u00e9n optie\" data-search=\"false\" data-search-placeholder=\"Kies \u00e9\u00e9n optie\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-7195__field--select-5_6a3d5520c97c5-label\"><option value=\"\"  >Choose one option<\/option><option value=\"Nee\"  data-calculation=\"0\">No<\/option><option value=\"Ja\"  data-calculation=\"0\">Yes<\/option><\/select><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-7195--page-4\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-7195--page-4-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"4\"\n\t\t\t\tdata-label=\"Page  4\"\n\t\t\t\tdata-actual-label=\"Page 5\"\n\t\t\t\tdata-name=\"page-break-6\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"section-10\" class=\"forminator-field-section forminator-col forminator-col-12\"><div class=\"forminator-field\"><h2 class=\"forminator-title\">Your Personal Data<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-7\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-7_6a3d5520c97c5\" id=\"forminator-field-text-7_6a3d5520c97c5-label\" class=\"forminator-label\">What is the name of the company? <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-7\" value=\"\" placeholder=\"\" id=\"forminator-field-text-7_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-8\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-8_6a3d5520c97c5\" id=\"forminator-field-text-8_6a3d5520c97c5-label\" class=\"forminator-label\">What is the company's tax number? <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-8\" value=\"\" placeholder=\"\" id=\"forminator-field-text-8_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-1\" class=\"forminator-field-section forminator-col forminator-col-12\"><div class=\"forminator-field\"><h2 class=\"forminator-title\">What is the company's fiscal address?<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-9\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-9_6a3d5520c97c5\" id=\"forminator-field-text-9_6a3d5520c97c5-label\" class=\"forminator-label\">Land <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-9\" value=\"\" placeholder=\"\" id=\"forminator-field-text-9_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-10\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-10_6a3d5520c97c5\" id=\"forminator-field-text-10_6a3d5520c97c5-label\" class=\"forminator-label\">Postcode <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-10\" value=\"\" placeholder=\"\" id=\"forminator-field-text-10_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-11\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-11_6a3d5520c97c5\" id=\"forminator-field-text-11_6a3d5520c97c5-label\" class=\"forminator-label\">Municipality <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-11\" value=\"\" placeholder=\"\" id=\"forminator-field-text-11_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-12\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-12_6a3d5520c97c5\" id=\"forminator-field-text-12_6a3d5520c97c5-label\" class=\"forminator-label\">Street <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-12\" value=\"\" placeholder=\"\" id=\"forminator-field-text-12_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-13\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-13_6a3d5520c97c5\" id=\"forminator-field-text-13_6a3d5520c97c5-label\" class=\"forminator-label\">House number <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-13\" value=\"\" placeholder=\"\" id=\"forminator-field-text-13_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-7195--page-5\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-7195--page-5-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"5\"\n\t\t\t\tdata-label=\"Page  5\"\n\t\t\t\tdata-actual-label=\"Page 6\"\n\t\t\t\tdata-name=\"page-break-7\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"section-2\" class=\"forminator-field-section forminator-col forminator-col-12\"><div class=\"forminator-field\"><h2 class=\"forminator-title\">SPECIFIC<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-6\" class=\"forminator-field-select forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-form-7195__field--select-6_6a3d5520c97c5\" id=\"forminator-form-7195__field--select-6_6a3d5520c97c5-label\" class=\"forminator-label\">In which language would you like to receive the quote? <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-7195__field--select-6_6a3d5520c97c5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-6\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Kies \u00e9\u00e9n optie\" data-search=\"false\" data-search-placeholder=\"Kies \u00e9\u00e9n optie\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-7195__field--select-6_6a3d5520c97c5-label\"><option value=\"\"  >Choose one option<\/option><option value=\"Spaans\"  data-calculation=\"0\">Spanish<\/option><option value=\"Engels\"  data-calculation=\"0\">English<\/option><option value=\"Frans\"  data-calculation=\"0\">French<\/option><option value=\"Duits\"  data-calculation=\"0\">German<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-2\" class=\"forminator-field-date forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-date-2-picker_6a3d5520c97c5\" id=\"forminator-field-date-2-picker_6a3d5520c97c5-label\" class=\"forminator-label\">When would you like the insurance to start? <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-2\" value=\"\" placeholder=\"\" id=\"forminator-field-date-2-picker_6a3d5520c97c5\" class=\"forminator-input forminator-datepicker\" data-required=\"1\" data-format=\"dd\/mm\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-18\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-18_6a3d5520c97c5\" id=\"forminator-field-text-18_6a3d5520c97c5-label\" class=\"forminator-label\">Name of the person who is the policyholder and will usually drive the vehicle? <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-18\" value=\"\" placeholder=\"\" id=\"forminator-field-text-18_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-19\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-19_6a3d5520c97c5\" id=\"forminator-field-text-19_6a3d5520c97c5-label\" class=\"forminator-label\">Spanish fiscal number or NIE number of this person? <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-19\" value=\"\" placeholder=\"\" id=\"forminator-field-text-19_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-3\" class=\"forminator-field-date forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-date-3-picker_6a3d5520c97c5\" id=\"forminator-field-date-3-picker_6a3d5520c97c5-label\" class=\"forminator-label\">What is the birth date of this person? <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-3\" value=\"\" placeholder=\"\" id=\"forminator-field-date-3-picker_6a3d5520c97c5\" class=\"forminator-input forminator-datepicker\" data-required=\"1\" data-format=\"dd\/mm\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-4\" class=\"forminator-field-date forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-date-4-picker_6a3d5520c97c5\" id=\"forminator-field-date-4-picker_6a3d5520c97c5-label\" class=\"forminator-label\">Since when has this person had a driver's license? <span class=\"forminator-required\">*<\/span><\/label><span id=\"forminator-field-date-4-picker_6a3d5520c97c5-description\" class=\"forminator-description\">regardless of the country where this driving license was issued) Provide the original date of first issuance.<\/span><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-4\" value=\"\" placeholder=\"\" id=\"forminator-field-date-4-picker_6a3d5520c97c5\" class=\"forminator-input forminator-datepicker\" data-required=\"1\" data-format=\"mm\/dd\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" aria-describedby=\"forminator-field-date-4-picker_6a3d5520c97c5-description\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-20\" class=\"forminator-field-select forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-form-7195__field--select-20_6a3d5520c97c5\" id=\"forminator-form-7195__field--select-20_6a3d5520c97c5-label\" class=\"forminator-label\">Would you like to list a second driver on the policy? <span class=\"forminator-required\">*<\/span><\/label><span id=\"forminator-form-7195__field--select-20_6a3d5520c97c5-description\" class=\"forminator-description\">This is only necessary if someone else regularly drives the car) By default, every driver aged 26 or older with a license that is at least 2 years old is covered.<\/span><select  id=\"forminator-form-7195__field--select-20_6a3d5520c97c5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-20\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Kies \u00e9\u00e9n optie\" data-search=\"false\" data-search-placeholder=\"Kies \u00e9\u00e9n optie\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-7195__field--select-20_6a3d5520c97c5-label\" aria-describedby=\"forminator-form-7195__field--select-20_6a3d5520c97c5-description\"><option value=\"\"  >Choose one option<\/option><option value=\"Ja\"  data-calculation=\"0\">Yes<\/option><option value=\"Nee\"  data-calculation=\"0\">No<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-20\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-20_6a3d5520c97c5\" id=\"forminator-field-text-20_6a3d5520c97c5-label\" class=\"forminator-label\">What is the first and last name of the second driver? <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-20\" value=\"\" placeholder=\"\" id=\"forminator-field-text-20_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-21\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-21_6a3d5520c97c5\" id=\"forminator-field-text-21_6a3d5520c97c5-label\" class=\"forminator-label\">What is the Spanish tax number or NIE number of the second driver? <span class=\"forminator-required\">*<\/span><\/label><span id=\"forminator-field-text-21_6a3d5520c97c5-description\" class=\"forminator-description\">Please note, an additional driver can only be added if they possess a NIE number.<\/span><input type=\"text\" name=\"text-21\" value=\"\" placeholder=\"\" id=\"forminator-field-text-21_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" aria-describedby=\"forminator-field-text-21_6a3d5520c97c5-description\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-5\" class=\"forminator-field-date forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-date-5-picker_6a3d5520c97c5\" id=\"forminator-field-date-5-picker_6a3d5520c97c5-label\" class=\"forminator-label\">What is the birth date of the second driver? <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-5\" value=\"\" placeholder=\"\" id=\"forminator-field-date-5-picker_6a3d5520c97c5\" class=\"forminator-input forminator-datepicker\" data-required=\"1\" data-format=\"mm\/dd\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-6\" class=\"forminator-field-date forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-date-6-picker_6a3d5520c97c5\" id=\"forminator-field-date-6-picker_6a3d5520c97c5-label\" class=\"forminator-label\">What is the date of the second driver's first license issuance? <span class=\"forminator-required\">*<\/span><\/label><span id=\"forminator-field-date-6-picker_6a3d5520c97c5-description\" class=\"forminator-description\">Regardless of the country where this driver's license was issued) Provide the original date of first issuance.<\/span><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-6\" value=\"\" placeholder=\"\" id=\"forminator-field-date-6-picker_6a3d5520c97c5\" class=\"forminator-input forminator-datepicker\" data-required=\"1\" data-format=\"mm\/dd\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" aria-describedby=\"forminator-field-date-6-picker_6a3d5520c97c5-description\" \/><\/div><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-7195--page-6\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-7195--page-6-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"6\"\n\t\t\t\tdata-label=\"Page  6\"\n\t\t\t\tdata-actual-label=\"Page 7\"\n\t\t\t\tdata-name=\"page-break-8\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"section-13\" class=\"forminator-field-section forminator-col forminator-col-12\"><div class=\"forminator-field\"><h2 class=\"forminator-title\">Vehicle Information to Insure<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-22\" class=\"forminator-field-select forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-form-7195__field--select-22_6a3d5520c97c5\" id=\"forminator-form-7195__field--select-22_6a3d5520c97c5-label\" class=\"forminator-label\">Does the car already have a Spanish license plate? <span class=\"forminator-required\">*<\/span><\/label><span id=\"forminator-form-7195__field--select-22_6a3d5520c97c5-description\" class=\"forminator-description\">If you enter the license plate number, we can often automatically check additional vehicle details.<\/span><select  id=\"forminator-form-7195__field--select-22_6a3d5520c97c5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-22\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Kies \u00e9\u00e9n optie\" data-search=\"false\" data-search-placeholder=\"Kies \u00e9\u00e9n optie\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-7195__field--select-22_6a3d5520c97c5-label\" aria-describedby=\"forminator-form-7195__field--select-22_6a3d5520c97c5-description\"><option value=\"\"  >Choose one option<\/option><option value=\"Ja\"  data-calculation=\"0\">Yes<\/option><option value=\"Nee\"  data-calculation=\"0\">No<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-22\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-22_6a3d5520c97c5\" id=\"forminator-field-text-22_6a3d5520c97c5-label\" class=\"forminator-label\">Please provide the license plate number. <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-22\" value=\"\" placeholder=\"\" id=\"forminator-field-text-22_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-23\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-23_6a3d5520c97c5\" id=\"forminator-field-text-23_6a3d5520c97c5-label\" class=\"forminator-label\">What is the make and model of the car? <span class=\"forminator-required\">*<\/span><\/label><span id=\"forminator-field-text-23_6a3d5520c97c5-description\" class=\"forminator-description\">You will find this on your registration certificate (permiso de circulaci\u00f3n) or purchase invoice.<\/span><input type=\"text\" name=\"text-23\" value=\"\" placeholder=\"\" id=\"forminator-field-text-23_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" aria-describedby=\"forminator-field-text-23_6a3d5520c97c5-description\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-24\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-24_6a3d5520c97c5\" id=\"forminator-field-text-24_6a3d5520c97c5-label\" class=\"forminator-label\">Which edition\/version is it? <span class=\"forminator-required\">*<\/span><\/label><span id=\"forminator-field-text-24_6a3d5520c97c5-description\" class=\"forminator-description\">This is important because the same car can have different versions with different values. You can usually find this: on the purchase invoice, in the maintenance documents, or through your garage. Can't find it? Then fill in as much as you know.<\/span><input type=\"text\" name=\"text-24\" value=\"\" placeholder=\"\" id=\"forminator-field-text-24_6a3d5520c97c5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" aria-describedby=\"forminator-field-text-24_6a3d5520c97c5-description\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"number-1\" class=\"forminator-field-number forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-number-1_6a3d5520c97c5\" id=\"forminator-field-number-1_6a3d5520c97c5-label\" class=\"forminator-label\">Year of manufacture of the car. <span class=\"forminator-required\">*<\/span><\/label><span id=\"forminator-field-number-1_6a3d5520c97c5-description\" class=\"forminator-description\">Enter the year the car was produced here. For example: 2021. You can usually find this on the purchase invoice or from your garage.<\/span><input name=\"number-1\" value=\"\" placeholder=\"\" id=\"forminator-field-number-1_6a3d5520c97c5\" class=\"forminator-input forminator-number--field\" inputmode=\"decimal\" data-required=\"1\" data-decimals=\"0\" aria-required=\"true\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" data-hidden-behavior=\"zero\" type=\"number\" step=\"any\" min=\"1\" max=\"9999\" aria-describedby=\"forminator-field-number-1_6a3d5520c97c5-description\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-7\" class=\"forminator-field-date forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-date-7-picker_6a3d5520c97c5\" id=\"forminator-field-date-7-picker_6a3d5520c97c5-label\" class=\"forminator-label\">What is the date of the vehicle's first registration? <span class=\"forminator-required\">*<\/span><\/label><span id=\"forminator-field-date-7-picker_6a3d5520c97c5-description\" class=\"forminator-description\">You can find this on the circulation permit.<\/span><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-7\" value=\"\" placeholder=\"Choose Date\" id=\"forminator-field-date-7-picker_6a3d5520c97c5\" class=\"forminator-input forminator-datepicker\" data-required=\"1\" data-format=\"mm\/dd\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" aria-describedby=\"forminator-field-date-7-picker_6a3d5520c97c5-description\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"number-2\" class=\"forminator-field-number forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-number-2_6a3d5520c97c5\" id=\"forminator-field-number-2_6a3d5520c97c5-label\" class=\"forminator-label\">What is the engine displacement of the car? <span class=\"forminator-required\">*<\/span><\/label><span id=\"forminator-field-number-2_6a3d5520c97c5-description\" class=\"forminator-description\">You will find this on your registration certificate.<\/span><input name=\"number-2\" value=\"\" placeholder=\"\" id=\"forminator-field-number-2_6a3d5520c97c5\" class=\"forminator-input forminator-number--field\" inputmode=\"decimal\" data-required=\"1\" data-decimals=\"0\" aria-required=\"true\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" data-hidden-behavior=\"zero\" type=\"number\" step=\"any\" min=\"1\" aria-describedby=\"forminator-field-number-2_6a3d5520c97c5-description\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"number-3\" class=\"forminator-field-number forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-number-3_6a3d5520c97c5\" id=\"forminator-field-number-3_6a3d5520c97c5-label\" class=\"forminator-label\">What is the performance of the car? <span class=\"forminator-required\">*<\/span><\/label><span id=\"forminator-field-number-3_6a3d5520c97c5-description\" class=\"forminator-description\">You will find this on your registration certificate<\/span><input name=\"number-3\" value=\"\" placeholder=\"\" id=\"forminator-field-number-3_6a3d5520c97c5\" class=\"forminator-input forminator-number--field\" inputmode=\"decimal\" data-required=\"1\" data-decimals=\"0\" aria-required=\"true\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" data-hidden-behavior=\"zero\" type=\"number\" step=\"any\" min=\"1\" aria-describedby=\"forminator-field-number-3_6a3d5520c97c5-description\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"number-4\" class=\"forminator-field-number forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-number-4_6a3d5520c97c5\" id=\"forminator-field-number-4_6a3d5520c97c5-label\" class=\"forminator-label\">How many doors does the car have? <span class=\"forminator-required\">*<\/span><\/label><input name=\"number-4\" value=\"\" placeholder=\"\" id=\"forminator-field-number-4_6a3d5520c97c5\" class=\"forminator-input forminator-number--field\" inputmode=\"decimal\" data-required=\"1\" data-decimals=\"0\" aria-required=\"true\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" data-hidden-behavior=\"zero\" type=\"number\" step=\"any\" min=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-23\" class=\"forminator-field-select forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-form-7195__field--select-23_6a3d5520c97c5\" id=\"forminator-form-7195__field--select-23_6a3d5520c97c5-label\" class=\"forminator-label\">What fuel does the car run on? <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-7195__field--select-23_6a3d5520c97c5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-23\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Kies \u00e9\u00e9n optie\" data-search=\"false\" data-search-placeholder=\"Kies \u00e9\u00e9n optie\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-7195__field--select-23_6a3d5520c97c5-label\"><option value=\"\"  >Choose one option<\/option><option value=\"Diesel\"  data-calculation=\"0\">Diesel<\/option><option value=\"Benzine\"  data-calculation=\"0\">Gasoline<\/option><option value=\"Hybride\"  data-calculation=\"0\">Hybrid<\/option><option value=\"Plug-in-Hybride\"  data-calculation=\"0\">Plug-in Hybrid<\/option><option value=\"Elektrisch\"  data-calculation=\"0\">Electric<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-24\" class=\"forminator-field-select forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-form-7195__field--select-24_6a3d5520c97c5\" id=\"forminator-form-7195__field--select-24_6a3d5520c97c5-label\" class=\"forminator-label\">Is the car manual or automatic? <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-7195__field--select-24_6a3d5520c97c5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-24\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Kies \u00e9\u00e9n optie\" data-search=\"false\" data-search-placeholder=\"Kies \u00e9\u00e9n optie\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-7195__field--select-24_6a3d5520c97c5-label\"><option value=\"\"  >Choose one option<\/option><option value=\"Handgeschakeld\"  data-calculation=\"0\">Manual transmission<\/option><option value=\"Automatisch\"  data-calculation=\"0\">Automatic<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-25\" class=\"forminator-field-select forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-form-7195__field--select-25_6a3d5520c97c5\" id=\"forminator-form-7195__field--select-25_6a3d5520c97c5-label\" class=\"forminator-label\">Does the car have a trailer hitch? <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-7195__field--select-25_6a3d5520c97c5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-25\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Kies \u00e9\u00e9n optie\" data-search=\"false\" data-search-placeholder=\"Kies \u00e9\u00e9n optie\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-7195__field--select-25_6a3d5520c97c5-label\"><option value=\"\"  >Choose one option<\/option><option value=\"Ja\"  data-calculation=\"0\">Yes<\/option><option value=\"Nee\"  data-calculation=\"0\">No<\/option><\/select><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-7195--page-7\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-7195--page-7-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"7\"\n\t\t\t\tdata-label=\"Page  7\"\n\t\t\t\tdata-actual-label=\"Page 8\"\n\t\t\t\tdata-name=\"page-break-9\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"section-12\" class=\"forminator-field-section forminator-col forminator-col-12\"><div class=\"forminator-field\"><h2 class=\"forminator-title\">COVERAGE<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-21\" class=\"forminator-field-select forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-form-7195__field--select-21_6a3d5520c97c5\" id=\"forminator-form-7195__field--select-21_6a3d5520c97c5-label\" class=\"forminator-label\">Would you like a more comprehensive breakdown assistance option with a replacement vehicle in case of breakdown?<\/label><span id=\"forminator-form-7195__field--select-21_6a3d5520c97c5-description\" class=\"forminator-description\">As standard, a replacement car is included in case of an accident, provided certain conditions are met. With this extension, you are also covered in case of breakdown.<\/span><select  id=\"forminator-form-7195__field--select-21_6a3d5520c97c5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"\" name=\"select-21\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"\" data-search=\"false\" data-search-placeholder=\"\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-7195__field--select-21_6a3d5520c97c5-label\" aria-describedby=\"forminator-form-7195__field--select-21_6a3d5520c97c5-description\"><option value=\"Ja, ik wens ook dekking bij pech\"  data-calculation=\"0\">Yes, I would also like breakdown cover.<\/option><option value=\"Nee, enkel dekking bij ongeval (standaard inbegrepen)\"  data-calculation=\"0\">No, accident cover only (included as standard)<\/option><\/select><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-7195--page-8\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-7195--page-8-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"8\"\n\t\t\t\tdata-label=\"Page  8\"\n\t\t\t\tdata-actual-label=\"Page 9\"\n\t\t\t\tdata-name=\"\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"section-4\" class=\"forminator-field-section forminator-col forminator-col-12\"><div class=\"forminator-field\"><h2 class=\"forminator-title\">FINAL CHECK<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-1\" class=\"forminator-field-html forminator-col forminator-col-12\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-1\"><p>Perfect, we\u2019ve received all the information. Would you like to carefully review it one last time before clicking \u2018send\u2019? This way, we can process your request correctly right away.<\/p>\n<p>Upon confirmation, we will immediately begin preparing your personalized quote. If any information is missing or further clarification is needed, we will contact you personally.<\/p><\/div><\/div><\/div><\/div><button class=\"forminator-button forminator-pagination-submit\" style=\"display: none;\" disabled>Shipping and requesting a quote<\/button><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"59195110d2\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/en\/wp-json\/wp\/v2\/pages\/7312\" \/><input type=\"hidden\" name=\"form_id\" value=\"7195\"><input type=\"hidden\" name=\"page_id\" value=\"7312\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/grupoxandra.eu\/en\/autoverzekeringsformulier\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><label for=\"input_48\" class=\"forminator-hidden\" aria-hidden=\"true\">Please do not fill in this field. <input id=\"input_48\" type=\"text\" name=\"input_48\" value=\"\" autocomplete=\"off\"><\/label><input type=\"hidden\" name=\"trp-form-language\" value=\"en\"\/><\/form><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Receive a unique, tailor-made car insurance quote.<\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-7312","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/grupoxandra.eu\/en\/wp-json\/wp\/v2\/pages\/7312","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/grupoxandra.eu\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/grupoxandra.eu\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/grupoxandra.eu\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/grupoxandra.eu\/en\/wp-json\/wp\/v2\/comments?post=7312"}],"version-history":[{"count":7,"href":"https:\/\/grupoxandra.eu\/en\/wp-json\/wp\/v2\/pages\/7312\/revisions"}],"predecessor-version":[{"id":7322,"href":"https:\/\/grupoxandra.eu\/en\/wp-json\/wp\/v2\/pages\/7312\/revisions\/7322"}],"wp:attachment":[{"href":"https:\/\/grupoxandra.eu\/en\/wp-json\/wp\/v2\/media?parent=7312"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}