{"id":5586,"date":"2024-03-11T11:58:45","date_gmt":"2024-03-11T10:58:45","guid":{"rendered":"https:\/\/certa.nl\/?page_id=5586"},"modified":"2024-06-18T08:59:30","modified_gmt":"2024-06-18T06:59:30","slug":"file-a-claim","status":"publish","type":"page","link":"https:\/\/certa.nl\/en\/file-a-claim\/","title":{"rendered":"File a claim"},"content":{"rendered":"<div id=\"pl-5586\"  class=\"panel-layout\" ><div id=\"pg-5586-0\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-5586-0\" ><div id=\"pgc-5586-0-0\"  class=\"panel-grid-cell panel-grid-cell-empty\" ><\/div><div id=\"pgc-5586-0-1\"  class=\"panel-grid-cell panel-grid-cell-mobile-last\" ><div id=\"panel-5586-0-1-0\" class=\"so-panel widget widget_so-premium-mirror-widget panel-first-child\" data-index=\"0\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-so-premium-mirror-widget so-widget-so-premium-mirror-widget-default-d75171398898-5586\"\n\t\t\t\n\t\t><div id=\"pl-w6a87c34d8dc9b\"  class=\"panel-layout\" ><div id=\"pg-w6a87c34d8dc9b-0\"  class=\"panel-grid panel-has-style\" ><div class=\"mirror-layout panel-row-style panel-row-style-for-w6a87c34d8dc9b-0\" ><div id=\"pgc-w6a87c34d8dc9b-0-0\"  class=\"panel-grid-cell\" ><div id=\"panel-w6a87c34d8dc9b-0-0-0\" class=\"widget_text so-panel widget widget_custom_html panel-first-child panel-last-child\" data-index=\"0\" ><div class=\"textwidget custom-html-widget\"><div class=\"top-line\">\n\t<div class=\"line\">\n\t\n<\/div>\n<\/div>\n<div style=\"margin-bottom:130px;\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div id=\"panel-5586-0-1-1\" class=\"so-panel widget widget_sow-headline\" data-index=\"1\" ><div class=\"animate-6a87c34d8e3df782516040 panels-animation-hide panel-widget-style panel-widget-style-for-5586-0-1-1\" data-so-animation=\"{&quot;selector&quot;:&quot;.animate-6a87c34d8e3df782516040&quot;,&quot;animation&quot;:&quot;fadeIn&quot;,&quot;breakpoint&quot;:&quot;768px&quot;,&quot;duration&quot;:1,&quot;repeat&quot;:0,&quot;hide&quot;:1,&quot;disableAnimationMobile&quot;:0,&quot;finalState&quot;:&quot;visible&quot;,&quot;delay&quot;:0,&quot;debounce&quot;:0.1,&quot;event&quot;:&quot;enter&quot;,&quot;offset&quot;:0}\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-headline so-widget-sow-headline-default-0b5c2a9a8893-5586 so-widget-fittext-wrapper\"\n\t\t\t data-fit-text-compressor=\"0.85\"\n\t\t><div class=\"sow-headline-container \">\n\t\t\t\t\t\t\t<p class=\"sow-sub-headline\">\n\t\t\t\t\t\tCERTA because you want to move on\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t<h2 class=\"sow-headline\">\n\t\t\t\t\t\tFile a claim:\t\t\t\t\t\t<\/h2>\n\t\t\t\t\t\t<\/div>\n<\/div><\/div><\/div><div id=\"panel-5586-0-1-2\" class=\"so-panel widget widget_sow-editor panel-last-child\" data-index=\"2\" ><div class=\"animate-6a87c34d8e6b4349471141 panels-animation-hide panel-widget-style panel-widget-style-for-5586-0-1-2\" data-so-animation=\"{&quot;selector&quot;:&quot;.animate-6a87c34d8e6b4349471141&quot;,&quot;animation&quot;:&quot;fadeIn&quot;,&quot;breakpoint&quot;:&quot;768px&quot;,&quot;duration&quot;:1,&quot;repeat&quot;:0,&quot;hide&quot;:1,&quot;disableAnimationMobile&quot;:0,&quot;finalState&quot;:&quot;visible&quot;,&quot;delay&quot;:0,&quot;debounce&quot;:0.1,&quot;event&quot;:&quot;enter&quot;,&quot;offset&quot;:0}\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<div class=\"fusion-text fusion-text-1 fusion-animated\" data-animationtype=\"fadeInUp\" data-animationduration=\"2.0\" data-animationoffset=\"top-into-view\">\n<p style=\"text-align: center;\">After filing your claim you will receive a confirmation email.<br \/>\nWe will keep you informed about your filed claim.<span class=\"Apple-converted-space\"><br \/>\n<\/span>The handling of your claim may take a while due to the volume of claims.<\/p>\n<\/div>\n<\/div>\n<\/div><\/div><\/div><\/div><div id=\"pgc-5586-0-2\"  class=\"panel-grid-cell panel-grid-cell-empty\" ><\/div><\/div><\/div><div id=\"pg-5586-1\"  class=\"panel-grid panel-no-style\" ><div id=\"pgc-5586-1-0\"  class=\"panel-grid-cell\" ><div id=\"panel-5586-1-0-0\" class=\"so-panel widget widget_sow-editor panel-first-child panel-last-child\" data-index=\"3\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<p style=\"text-align: center;\"><b>Your claim must be substantiated<br \/>\nwith supporting documents<br \/>\n(agreements, invoices, etc).<\/b><\/p>\n<\/div>\n<\/div><\/div><\/div><div id=\"pgc-5586-1-1\"  class=\"panel-grid-cell\" ><div id=\"panel-5586-1-1-0\" class=\"so-panel widget widget_sow-editor panel-first-child panel-last-child\" data-index=\"4\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<p style=\"text-align: center;\"><b>Files can only be uploaded as<br \/>\nPDF, Word- or Excel file.<br \/>\nYou can upload multiple documents at once.<\/b><\/p>\n<\/div>\n<\/div><\/div><\/div><div id=\"pgc-5586-1-2\"  class=\"panel-grid-cell\" ><div id=\"panel-5586-1-2-0\" class=\"so-panel widget widget_sow-editor panel-first-child panel-last-child\" data-index=\"5\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<p style=\"text-align: center;\"><b>Any\u00a0additional comments<br \/>\ncan be added in the comment box<br \/>\nat the end of the form<\/b><\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><div id=\"pg-5586-2\"  class=\"panel-grid panel-has-style\" ><div class=\"siteorigin-panels-stretch panel-row-style panel-row-style-for-5586-2\" data-stretch-type=\"full\" ><div id=\"pgc-5586-2-0\"  class=\"panel-grid-cell\" ><div id=\"panel-5586-2-0-0\" class=\"so-panel widget widget_sow-headline panel-first-child\" data-index=\"6\" ><div class=\"animate-6a87c34d8ebb3055021802 panels-animation-hide panel-widget-style panel-widget-style-for-5586-2-0-0\" data-so-animation=\"{&quot;selector&quot;:&quot;.animate-6a87c34d8ebb3055021802&quot;,&quot;animation&quot;:&quot;fadeIn&quot;,&quot;breakpoint&quot;:&quot;768px&quot;,&quot;duration&quot;:1,&quot;repeat&quot;:0,&quot;hide&quot;:1,&quot;disableAnimationMobile&quot;:0,&quot;finalState&quot;:&quot;visible&quot;,&quot;delay&quot;:0,&quot;debounce&quot;:0.1,&quot;event&quot;:&quot;enter&quot;,&quot;offset&quot;:0}\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-headline so-widget-sow-headline-default-0b5c2a9a8893-5586 so-widget-fittext-wrapper\"\n\t\t\t data-fit-text-compressor=\"0.85\"\n\t\t><div class=\"sow-headline-container \">\n\t\t\t\t\t\t\t<h2 class=\"sow-headline\">\n\t\t\t\t\t\tMY CLAIM\t\t\t\t\t\t<\/h2>\n\t\t\t\t\t\t<\/div>\n<\/div><\/div><\/div><div id=\"panel-5586-2-0-1\" class=\"so-panel widget widget_sow-editor\" data-index=\"7\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<div class=\"fusion-text fusion-text-5\">\n<p style=\"text-align: center;\">Fields marked * are mandatory.<br \/>\nThe TAB button will take you to<span lang=\"en\">\u00a0the next input field.<\/span><\/p>\n<\/div>\n<\/div>\n<\/div><\/div><div id=\"panel-5586-2-0-2\" class=\"so-panel widget widget_gform_widget gform_widget panel-last-child\" data-index=\"8\" ><h3 class=\"widget-title\">MY CLAIM<\/h3><script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_17' >\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_17'  action='\/en\/wp-json\/wp\/v2\/pages\/5586' data-formid='17' novalidate><div class='gf_invisible ginput_recaptchav3'  data-tabindex='0'><input id=\"input_c2c6c65a70b83a7330b6c25ecb7df87d\" class=\"gfield_recaptcha_response\" type=\"hidden\" name=\"input_c2c6c65a70b83a7330b6c25ecb7df87d\" value=\"\"\/><\/div>\n                        <div class='gform-body gform_body'><div id='gform_fields_17' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_17_53\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_53'><span class='gform-field-label__text'>Company<\/span><\/label><div class='ginput_container'><input name='input_53' id='input_17_53' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_17_53'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_17_7\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_7'><span class='gform-field-label__text'>Name bankruptcy\/debtor<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_17_7' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_8\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">YOUR CREDENTIALS<\/h3><\/div><div id=\"field_17_9\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_9'><span class='gform-field-label__text'>Company name<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_17_9' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_5\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_17_5'>\n                            \n                            <span id='input_17_5_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_5.3' id='input_17_5_3' value=''   aria-required='true'   placeholder='First name* *'  \/>\n                                                    <label for='input_17_5_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_17_5_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_5.6' id='input_17_5_6' value=''   aria-required='true'   placeholder='Last name*'  \/>\n                                                    <label for='input_17_5_6' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_17_10\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Address<\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_city has_zip has_country ginput_container_address gform-grid-row' id='input_17_10' >\n                        <span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_17_10_3_container' >\n                                    <input type='text' name='input_10.3' id='input_17_10_3' value=''    aria-required='false'    \/>\n                                    <label for='input_17_10_3' id='input_17_10_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_10.4' id='input_17_10_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_17_10_5_container' >\n                                    <input type='text' name='input_10.5' id='input_17_10_5' value=''    aria-required='false'    \/>\n                                    <label for='input_17_10_5' id='input_17_10_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><span class='ginput_left address_country ginput_address_country gform-grid-col' id='input_17_10_6_container' >\n                                        <select name='input_10.6' id='input_17_10_6'   aria-required='false'    ><option value='' ><\/option><option value='AF' >Afghanistan<\/option><option value='AX' >\u00c5land Islands<\/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<\/option><option value='BQ' >Bonaire, Sint 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 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='CI' >C\u00f4te d&#039;Ivoire<\/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' >Czechia<\/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<\/option><option value='ET' >Ethiopia<\/option><option value='FK' >Falkland Islands<\/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='VA' >Holy See<\/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<\/option><option value='IQ' >Iraq<\/option><option value='IE' >Ireland<\/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='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<\/option><option value='MD' >Moldova<\/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<\/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='RE' >R\u00e9union<\/option><option value='RO' >Romania<\/option><option value='RU' >Russian Federation<\/option><option value='RW' >Rwanda<\/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<\/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<\/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' >Syria Arab Republic<\/option><option value='TW' >Taiwan<\/option><option value='TJ' >Tajikistan<\/option><option value='TZ' >Tanzania, the 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='TR' >T\u00fcrkiye<\/option><option value='TM' >Turkmenistan<\/option><option value='TC' >Turks and Caicos Islands<\/option><option value='TV' >Tuvalu<\/option><option value='UG' >Uganda<\/option><option value='UA' >Ukraine<\/option><option value='AE' >United Arab Emirates<\/option><option value='GB' >United Kingdom<\/option><option value='US' >United States<\/option><option value='UY' >Uruguay<\/option><option value='UM' >US Minor Outlying Islands<\/option><option value='UZ' >Uzbekistan<\/option><option value='VU' >Vanuatu<\/option><option value='VE' >Venezuela<\/option><option value='VN' >Viet Nam<\/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><\/select>\n                                        <label for='input_17_10_6' id='input_17_10_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_17_11\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-international gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_11'><span class='gform-field-label__text'>Phone number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_11' id='input_17_11' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"    \/><\/div><\/div><div id=\"field_17_2\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_2'><span class='gform-field-label__text'>E-mail address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_2' id='input_17_2' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_17_12\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_12'><span class='gform-field-label__text'>Reference number (if you have one)<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_17_12' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_13\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_13'><span class='gform-field-label__text'>Bank account number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_17_13' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_14\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">AMOUNT OF YOUR CLAIM<\/h3><\/div><div id=\"field_17_15\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_15'><span class='gform-field-label__text'>Amount of claim (without VAT)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_17_15' type='text' value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_16\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_16'><span class='gform-field-label__text'>VAT<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_17_16' type='text' value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_17\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_17'><span class='gform-field-label__text'>Total amount (incl. VAT)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_17_17' type='text' value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_18\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_17_18'><span class='gform-field-label__text'>(Please upload evidence\/files to support your claim)<\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_18' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_18&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_18&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_18&quot;,&quot;filelist&quot;:&quot;gform_preview_17_18&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/certa.nl\\\/en\\\/?gf_page=b66f4890d8c29d8&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/certa.nl\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/certa.nl\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;12884901888b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:18,&quot;_gform_file_upload_nonce_17_18&quot;:&quot;520ea06055&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_17_18&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_18' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_18' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_18\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_18'>Max. file size: 12 GB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_18'><\/ul> <div id='gform_preview_17_18' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_17_19\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">RETENTION OF TITLE<\/h3><\/div><fieldset id=\"field_17_20\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Does your claim involve retention of title?*<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_20'>\n\t\t\t<div class='gchoice gchoice_17_20_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='Yes'  id='choice_17_20_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_20_0' id='label_17_20_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_20_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='No'  id='choice_17_20_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_20_1' id='label_17_20_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_21\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_17_21'><span class='gform-field-label__text'>(Please upload evidence\/files regarding retention of title)<\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_21' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_21&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_21&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_21&quot;,&quot;filelist&quot;:&quot;gform_preview_17_21&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/certa.nl\\\/en\\\/?gf_page=b66f4890d8c29d8&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/certa.nl\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/certa.nl\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;12884901888b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:21,&quot;_gform_file_upload_nonce_17_21&quot;:&quot;95b44377a8&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_17_21&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_21' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_21' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_21\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_21'>Max. file size: 12 GB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_21'><\/ul> <div id='gform_preview_17_21' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_17_3\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_3'><span class='gform-field-label__text'>Comments regarding retention of title:<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_3' id='input_17_3' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_17_22\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">MORTGAGE\/LIEN<\/h3><\/div><fieldset id=\"field_17_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Does your claim involve a mortgage or lien?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_23'>\n\t\t\t<div class='gchoice gchoice_17_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Yes'  id='choice_17_23_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_23_0' id='label_17_23_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='No'  id='choice_17_23_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_23_1' id='label_17_23_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_24\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_17_24'><span class='gform-field-label__text'>(Please upload evidence\/files regarding mortgage\/lien)<\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_24' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_24&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_24&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_24&quot;,&quot;filelist&quot;:&quot;gform_preview_17_24&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/certa.nl\\\/en\\\/?gf_page=b66f4890d8c29d8&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/certa.nl\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/certa.nl\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;12884901888b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:24,&quot;_gform_file_upload_nonce_17_24&quot;:&quot;580d3560c3&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_17_24&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_24' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_24' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_24\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_24'>Max. file size: 12 GB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_24'><\/ul> <div id='gform_preview_17_24' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_17_25\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_25'><span class='gform-field-label__text'>Comments regarding mortgage\/lien:<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_25' id='input_17_25' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_17_26\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">PREFERENTIAL CLAIM<\/h3><\/div><fieldset id=\"field_17_27\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Is your claim a preferential claim? (legal priority)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_27'>\n\t\t\t<div class='gchoice gchoice_17_27_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Yes'  id='choice_17_27_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_27_0' id='label_17_27_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_27_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='No'  id='choice_17_27_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_27_1' id='label_17_27_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_28\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_28'><span class='gform-field-label__text'>Amount preferential claim:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_28' id='input_17_28' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_29\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_17_29'><span class='gform-field-label__text'>(Please upload evidence\/files to support preferential claim)<\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_29' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_29&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_29&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_29&quot;,&quot;filelist&quot;:&quot;gform_preview_17_29&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/certa.nl\\\/en\\\/?gf_page=b66f4890d8c29d8&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/certa.nl\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/certa.nl\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;12884901888b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:29,&quot;_gform_file_upload_nonce_17_29&quot;:&quot;e0d41e0519&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_17_29&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_29' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_29' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_29\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_29'>Max. file size: 12 GB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_29'><\/ul> <div id='gform_preview_17_29' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_17_30\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_30'><span class='gform-field-label__text'>Comments regarding preferential claim<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_30' id='input_17_30' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_17_31\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">CURRENT AGREEMENTS<\/h3><\/div><fieldset id=\"field_17_32\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Are there any current agreements (with debtor)?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_32'>\n\t\t\t<div class='gchoice gchoice_17_32_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Yes'  id='choice_17_32_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_32_0' id='label_17_32_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_32_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='No'  id='choice_17_32_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_32_1' id='label_17_32_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_33\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_17_33'><span class='gform-field-label__text'>(Please upload evidence\/files regarding current agreements)<\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_33' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_33&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_33&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_33&quot;,&quot;filelist&quot;:&quot;gform_preview_17_33&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/certa.nl\\\/en\\\/?gf_page=b66f4890d8c29d8&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/certa.nl\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/certa.nl\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;12884901888b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:33,&quot;_gform_file_upload_nonce_17_33&quot;:&quot;2c4895398d&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_17_33&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_33' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_33' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_33\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_33'>Max. file size: 12 GB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_33'><\/ul> <div id='gform_preview_17_33' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_17_34\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_34'><span class='gform-field-label__text'>Comments regarding current agreements<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_34' id='input_17_34' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_17_35\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">RIGHT TO ADVERTISE<\/h3><\/div><fieldset id=\"field_17_36\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Does your claim involve right to advertise?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_36'>\n\t\t\t<div class='gchoice gchoice_17_36_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Yes'  id='choice_17_36_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_36_0' id='label_17_36_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_36_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='No'  id='choice_17_36_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_36_1' id='label_17_36_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_37\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_17_37'><span class='gform-field-label__text'>(Please upload evidence\/files regarding right to advertise)<\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_37' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_37&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_37&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_37&quot;,&quot;filelist&quot;:&quot;gform_preview_17_37&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/certa.nl\\\/en\\\/?gf_page=b66f4890d8c29d8&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/certa.nl\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/certa.nl\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;12884901888b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:37,&quot;_gform_file_upload_nonce_17_37&quot;:&quot;41c7c8d523&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_17_37&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_37' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_37' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_37\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_37'>Max. file size: 12 GB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_37'><\/ul> <div id='gform_preview_17_37' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_17_38\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_38'><span class='gform-field-label__text'>Comments regarding right to advertise<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_38' id='input_17_38' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_17_39\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">RIGHT OF RETENTION<\/h3><\/div><fieldset id=\"field_17_40\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Does your claim involve right of retention?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_40'>\n\t\t\t<div class='gchoice gchoice_17_40_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='Yes'  id='choice_17_40_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_40_0' id='label_17_40_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_40_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='No'  id='choice_17_40_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_40_1' id='label_17_40_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_45\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_17_45'><span class='gform-field-label__text'>(Please upload evidence\/files regarding right of retention)<\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_45' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_45&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_45&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_45&quot;,&quot;filelist&quot;:&quot;gform_preview_17_45&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/certa.nl\\\/en\\\/?gf_page=b66f4890d8c29d8&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/certa.nl\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/certa.nl\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;12884901888b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:45,&quot;_gform_file_upload_nonce_17_45&quot;:&quot;1432360287&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_17_45&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_45' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_45' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_45\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_45'>Max. file size: 12 GB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_45'><\/ul> <div id='gform_preview_17_45' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_17_46\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_46'><span class='gform-field-label__text'>Comments regarding right of retention<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_46' id='input_17_46' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_17_47\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">ADDITIONAL RIGHTS<\/h3><\/div><fieldset id=\"field_17_49\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Does your claim involve additional rights?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_49'>\n\t\t\t<div class='gchoice gchoice_17_49_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Yes'  id='choice_17_49_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_49_0' id='label_17_49_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_49_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='No'  id='choice_17_49_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_49_1' id='label_17_49_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_50\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_17_50'><span class='gform-field-label__text'>(Please upload evidence\/files regarding additional rights)<\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_50' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_50&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_50&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_50&quot;,&quot;filelist&quot;:&quot;gform_preview_17_50&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/certa.nl\\\/en\\\/?gf_page=b66f4890d8c29d8&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/certa.nl\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/certa.nl\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;12884901888b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:50,&quot;_gform_file_upload_nonce_17_50&quot;:&quot;754a8281e9&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_17_50&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_50' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_50' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_50\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_50'>Max. file size: 12 GB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_50'><\/ul> <div id='gform_preview_17_50' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_17_48\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_48'><span class='gform-field-label__text'>Comments regarding additional rights<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_48' id='input_17_48' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_17_51\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">ADDITIONAL COMMENTS<\/h3><\/div><div id=\"field_17_52\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_52'><span class='gform-field-label__text'>Please add any additional comments regarding your claim<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_52' id='input_17_52' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_17_6\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Privacy policy &amp; anti-SPAM measures<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_6.1' id='input_17_6_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_17_6_1' ><span class='gform-field-label__text'>Ik ga akkoord met het <a href=\"https:\/\/certa.nl\/privacypolicy\" target=\"_blank\">Privacy statement<\/a>.<\/span><\/label><input type='hidden' name='input_6.2' value='Ik ga akkoord met het &lt;a href=&quot;https:\/\/certa.nl\/privacypolicy&quot; target=&quot;_blank&quot;&gt;Privacy statement&lt;\/a&gt;.' class='gform_hidden' \/><input type='hidden' name='input_6.3' value='10' class='gform_hidden' \/><\/div><\/fieldset><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <button type='submit' id='gform_submit_button_17' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Send your cliam<\/button> <input type='hidden' class='gform_hidden' name='gform_submission_speeds' value='{&quot;pages&quot;:[]}' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_17' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_17' id='gform_theme_17' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_17' id='gform_style_settings_17' value='' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_17' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='17' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='EUR' value='moC7kEd3Enwp3RhWy9bWWdjoUghJ2omgG30QfpvFsbyetwHcCmvga0FreRZXz9P89W\/fTnpYbaIBDbxEmI4ZMC3W8dirpFPAeCGCaHynFPZRcYI=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_17' value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_17' id='gform_target_page_number_17' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_17' id='gform_source_page_number_17' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            <input type='hidden' name='gform_uploaded_files' id='gform_uploaded_files_17' value='' \/>\n        <\/div>\n                        <\/form>\n                        <\/div><\/div><\/div><\/div><\/div><div id=\"pg-5586-3\"  class=\"panel-grid panel-has-style\" ><div class=\"siteorigin-panels-stretch panel-row-style panel-row-style-for-5586-3\" data-stretch-type=\"full\" ><div id=\"pgc-5586-3-0\"  class=\"panel-grid-cell panel-grid-cell-empty\" ><\/div><div id=\"pgc-5586-3-1\"  class=\"panel-grid-cell panel-grid-cell-mobile-last\" ><div id=\"panel-5586-3-1-0\" class=\"so-panel widget widget_so-premium-mirror-widget panel-first-child\" data-index=\"9\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-so-premium-mirror-widget so-widget-so-premium-mirror-widget-default-d75171398898-5586\"\n\t\t\t\n\t\t><div id=\"pl-w6a87c34d931dc\"  class=\"panel-layout\" ><div id=\"pg-w6a87c34d931dc-0\"  class=\"panel-grid panel-has-style\" ><div class=\"mirror-layout panel-row-style panel-row-style-for-w6a87c34d931dc-0\" ><div id=\"pgc-w6a87c34d931dc-0-0\"  class=\"panel-grid-cell\" ><div id=\"panel-w6a87c34d931dc-0-0-0\" class=\"widget_text so-panel widget widget_custom_html panel-first-child panel-last-child\" data-index=\"0\" ><div class=\"textwidget custom-html-widget\"><div style=\"margin-top:130px;\"><\/div>\n<div class=\"bottom-line\">\n\t<div class=\"line\">\n\t\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div id=\"panel-5586-3-1-1\" class=\"so-panel widget widget_so-premium-mirror-widget panel-last-child\" data-index=\"10\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-so-premium-mirror-widget so-widget-so-premium-mirror-widget-default-d75171398898-5586\"\n\t\t\t\n\t\t><div id=\"pl-w6a87c34d93429\"  class=\"panel-layout\" ><div id=\"pg-w6a87c34d93429-0\"  class=\"panel-grid panel-has-style\" ><div class=\"mirror-layout panel-row-style panel-row-style-for-w6a87c34d93429-0\" ><div id=\"pgc-w6a87c34d93429-0-0\"  class=\"panel-grid-cell\" ><div id=\"panel-w6a87c34d93429-0-0-0\" class=\"widget_text so-panel widget widget_custom_html panel-first-child panel-last-child\" data-index=\"0\" ><div class=\"textwidget custom-html-widget\"><div style=\"margin-top:130px;\"><\/div>\n<div class=\"bottom-line\">\n\t<div class=\"line\">\n\t\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div id=\"pgc-5586-3-2\"  class=\"panel-grid-cell panel-grid-cell-empty\" ><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>After filing your claim you will receive a confirmation email. We will keep you informed about your filed claim. The handling of your claim may take a while due to the volume of claims. Your claim must be substantiated with supporting documents (agreements, invoices, etc). Files can only be uploaded as PDF, Word- or Excel [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"class_list":["post-5586","page","type-page","status-publish","entry"],"acf":[],"_links":{"self":[{"href":"https:\/\/certa.nl\/en\/wp-json\/wp\/v2\/pages\/5586","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/certa.nl\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/certa.nl\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/certa.nl\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/certa.nl\/en\/wp-json\/wp\/v2\/comments?post=5586"}],"version-history":[{"count":0,"href":"https:\/\/certa.nl\/en\/wp-json\/wp\/v2\/pages\/5586\/revisions"}],"wp:attachment":[{"href":"https:\/\/certa.nl\/en\/wp-json\/wp\/v2\/media?parent=5586"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}