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class=\u0022content-container\u0022\u003E\n  \n  \u003Cform class=\u0022webform-submission-form webform-submission-add-form webform-submission-damage-form webform-submission-damage-add-form js-webform-details-toggle webform-details-toggle antibot\u0022 data-drupal-selector=\u0022webform-submission-damage-add-form\u0022 enctype=\u0022multipart\/form-data\u0022 data-action=\u0022\/en\/contact\/next\/damage\u0022 action=\u0022\/antibot\u0022 method=\u0022post\u0022 id=\u0022webform-submission-damage-add-form\u0022 accept-charset=\u0022UTF-8\u0022\u003E\n  \n  \u003Cnoscript\u003E\n  \u003Cdiv class=\u0022antibot-no-js antibot-message antibot-message-warning\u0022\u003EYou must have JavaScript enabled to use this form.\u003C\/div\u003E\n\u003C\/noscript\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-personal-info\u0022 id=\u0022edit-personal-info\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EPersonal data\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv data-drupal-selector=\u0022edit-flexbox\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-firstname js-form-item-firstname\u0022\u003E\n      \u003Clabel for=\u0022edit-firstname\u0022 class=\u0022js-form-required form-required\u0022\u003EFirst name\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-firstname\u0022 type=\u0022text\u0022 id=\u0022edit-firstname\u0022 name=\u0022firstname\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text required\u0022 required=\u0022required\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-lastname js-form-item-lastname\u0022\u003E\n      \u003Clabel for=\u0022edit-lastname\u0022 class=\u0022js-form-required form-required\u0022\u003ELast name\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-lastname\u0022 type=\u0022text\u0022 id=\u0022edit-lastname\u0022 name=\u0022lastname\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text required\u0022 required=\u0022required\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv data-drupal-selector=\u0022edit-flexbox-01\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-01\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--2\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-street js-form-item-street\u0022\u003E\n      \u003Clabel for=\u0022edit-street\u0022 class=\u0022js-form-required form-required\u0022\u003EStreet\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-street\u0022 type=\u0022text\u0022 id=\u0022edit-street\u0022 name=\u0022street\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text required\u0022 required=\u0022required\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-number webform-type-number js-form-item form-item js-form-type-number form-item-number js-form-item-number\u0022\u003E\n      \u003Clabel for=\u0022edit-number\u0022 class=\u0022js-form-required form-required\u0022\u003ENumber\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-number\u0022 type=\u0022number\u0022 id=\u0022edit-number\u0022 name=\u0022number\u0022 value=\u0022\u0022 step=\u0022any\u0022 class=\u0022form-number required\u0022 required=\u0022required\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-bus js-form-item-bus\u0022\u003E\n      \u003Clabel for=\u0022edit-bus\u0022\u003EBus\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-bus\u0022 type=\u0022text\u0022 id=\u0022edit-bus\u0022 name=\u0022bus\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv data-drupal-selector=\u0022edit-flexbox-02\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-02\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-number webform-type-number js-form-item form-item js-form-type-number form-item-postal-code js-form-item-postal-code\u0022\u003E\n      \u003Clabel for=\u0022edit-postal-code\u0022 class=\u0022js-form-required form-required\u0022\u003EZipcode\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-postal-code\u0022 type=\u0022number\u0022 id=\u0022edit-postal-code\u0022 name=\u0022postal_code\u0022 value=\u0022\u0022 step=\u00221\u0022 min=\u00221000\u0022 max=\u00229999\u0022 class=\u0022form-number required\u0022 required=\u0022required\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--2\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-city js-form-item-city\u0022\u003E\n      \u003Clabel for=\u0022edit-city\u0022 class=\u0022js-form-required form-required\u0022\u003EPlace\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-city\u0022 type=\u0022text\u0022 id=\u0022edit-city\u0022 name=\u0022city\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text required\u0022 required=\u0022required\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-date webform-type-date js-form-item form-item js-form-type-date form-item-birthdate js-form-item-birthdate\u0022\u003E\n      \u003Clabel for=\u0022edit-birthdate\u0022\u003EBirth date\u003C\/label\u003E\n        \u003Cinput type=\u0022date\u0022 data-drupal-selector=\u0022edit-birthdate\u0022 id=\u0022edit-birthdate\u0022 name=\u0022birthdate\u0022 value=\u0022\u0022 class=\u0022form-date\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv data-drupal-selector=\u0022edit-flexbox-03\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-03\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv 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data-drupal-selector=\u0022edit-email\u0022 type=\u0022email\u0022 id=\u0022edit-email\u0022 name=\u0022email\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022254\u0022 class=\u0022form-email required\u0022 required=\u0022required\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv data-drupal-selector=\u0022edit-flexbox-04\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-04\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-contract-number js-form-item-contract-number\u0022\u003E\n      \u003Clabel for=\u0022edit-contract-number\u0022\u003EContract number\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-contract-number\u0022 type=\u0022text\u0022 id=\u0022edit-contract-number\u0022 name=\u0022contract_number\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--2\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-insurance-company js-form-item-insurance-company\u0022\u003E\n      \u003Clabel for=\u0022edit-insurance-company\u0022\u003EInsurance company\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-insurance-company\u0022 type=\u0022text\u0022 id=\u0022edit-insurance-company\u0022 name=\u0022insurance_company\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        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form-item-date-damage js-form-item-date-damage\u0022\u003E\n      \u003Clabel class=\u0022js-form-required form-required\u0022\u003EDate of damage\u003C\/label\u003E\n        \u003Cdiv id=\u0022edit-date-damage\u0022 class=\u0022container-inline\u0022\u003E\n  \u003Cdiv class=\u0022js-form-item form-item js-form-type-date form-item-date-damage-date js-form-item-date-damage-date form-no-label\u0022\u003E\n      \u003Clabel for=\u0022edit-date-damage-date\u0022 class=\u0022visually-hidden js-form-required form-required\u0022\u003EDate of damage: Date\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-date-damage-date\u0022 type=\u0022date\u0022 id=\u0022edit-date-damage-date\u0022 name=\u0022date_damage[date]\u0022 value=\u0022\u0022 size=\u002212\u0022 class=\u0022form-date required\u0022 required=\u0022required\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003Cdiv class=\u0022js-form-item form-item js-form-type-webform-time form-item-date-damage-time js-form-item-date-damage-time form-no-label\u0022\u003E\n      \u003Clabel for=\u0022edit-date-damage-time\u0022 class=\u0022visually-hidden js-form-required form-required\u0022\u003EDate of damage: Time\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-date-damage-time\u0022 type=\u0022time\u0022 step=\u002260\u0022 id=\u0022edit-date-damage-time\u0022 name=\u0022date_damage[time]\u0022 value=\u0022\u0022 size=\u002212\u0022 maxlength=\u002212\u0022 class=\u0022form-time webform-time required\u0022 required=\u0022required\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-location-damage js-form-item-location-damage\u0022\u003E\n      \u003Clabel for=\u0022edit-location-damage\u0022 class=\u0022js-form-required form-required\u0022\u003EPlace where the damage occurred\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-location-damage\u0022 type=\u0022text\u0022 id=\u0022edit-location-damage\u0022 name=\u0022location_damage\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text required\u0022 required=\u0022required\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-what-happened js-form-item-what-happened\u0022\u003E\n      \u003Clabel for=\u0022edit-what-happened\u0022 class=\u0022js-form-required form-required\u0022\u003EWhat happened exactly?\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-what-happened\u0022 id=\u0022edit-what-happened\u0022 name=\u0022what_happened\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea required resize-vertical\u0022 required=\u0022required\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-select webform-type-select js-form-item form-item js-form-type-select form-item-which-policy js-form-item-which-policy\u0022\u003E\n      \u003Clabel for=\u0022edit-which-policy\u0022\u003EWhich insurance policy do you want to use?\u003C\/label\u003E\n        \u003Cselect data-drupal-selector=\u0022edit-which-policy\u0022 id=\u0022edit-which-policy\u0022 name=\u0022which_policy\u0022 class=\u0022form-select\u0022\u003E\u003Coption value=\u0022\u0022 selected=\u0022selected\u0022\u003E- Select -\u003C\/option\u003E\u003Coption value=\u0022car\u0022\u003ECar\u003C\/option\u003E\u003Coption value=\u0022fire\u0022\u003EFire\u003C\/option\u003E\u003Coption value=\u0022liability\u0022\u003ELiabilty\u003C\/option\u003E\u003Coption value=\u0022legal_counsal\u0022\u003ELegal aid\u003C\/option\u003E\u003Coption value=\u0022hospitalization\u0022\u003EHospitalization\u003C\/option\u003E\u003Coption value=\u0022personal\u0022\u003EPersonal accident \/ guaranteed income\u003C\/option\u003E\u003Coption value=\u0022other\u0022\u003EOther \/ I don\u0026#039;t know\u003C\/option\u003E\u003C\/select\u003E\n        \u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset class=\u0022js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022 data-drupal-selector=\u0022edit-details-damage\u0022 data-drupal-states=\u0022{\u0026quot;visible\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;filled\u0026quot;:true}}}\u0022 id=\u0022edit-details-damage\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EDetails about the damage\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv class=\u0022js-webform-states-hidden js-form-wrapper form-wrapper\u0022 data-drupal-selector=\u0022edit-car\u0022 data-drupal-states=\u0022{\u0026quot;visible\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022 id=\u0022edit-car\u0022\u003E\u003Cdiv class=\u0022js-webform-type-select webform-type-select js-form-item form-item js-form-type-select form-item-damage-type js-form-item-damage-type\u0022\u003E\n      \u003Clabel for=\u0022edit-damage-type\u0022\u003EDamage type\u003C\/label\u003E\n        \u003Cselect data-drupal-selector=\u0022edit-damage-type\u0022 id=\u0022edit-damage-type\u0022 name=\u0022damage_type\u0022 class=\u0022form-select\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022\u003E\u003Coption value=\u0022\u0022 selected=\u0022selected\u0022\u003E- Select -\u003C\/option\u003E\u003Coption value=\u0022theft\u0022\u003ETheft\u003C\/option\u003E\u003Coption value=\u0022glass_breakage\u0022\u003EGlass breakage\u003C\/option\u003E\u003Coption value=\u0022with_third_parties\u0022\u003EAccident with third party\u003C\/option\u003E\u003Coption value=\u0022without_third_parties\u0022\u003EAccident without third party\u003C\/option\u003E\u003C\/select\u003E\n        \u003C\/div\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-vehicle\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022 id=\u0022edit-vehicle\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EVehicle\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-license-plate js-form-item-license-plate\u0022\u003E\n      \u003Clabel for=\u0022edit-license-plate\u0022\u003ELicense plate number\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-license-plate\u0022 type=\u0022text\u0022 id=\u0022edit-license-plate\u0022 name=\u0022license_plate\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-vehicle-location js-form-item-vehicle-location\u0022\u003E\n      \u003Clabel for=\u0022edit-vehicle-location\u0022\u003EVehicle\u0027s current location\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-vehicle-location\u0022 type=\u0022text\u0022 id=\u0022edit-vehicle-location\u0022 name=\u0022vehicle_location\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-name-address-repairer js-form-item-name-address-repairer\u0022\u003E\n      \u003Clabel for=\u0022edit-name-address-repairer\u0022\u003EName and address of your repairer\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-name-address-repairer\u0022 type=\u0022text\u0022 id=\u0022edit-name-address-repairer\u0022 name=\u0022name_address_repairer\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-driver\u0022 id=\u0022edit-driver\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EDriver of the vehicle on the moment of the accident\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv data-drupal-selector=\u0022edit-flexbox-06\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-06\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-driver-first-name js-form-item-driver-first-name\u0022\u003E\n      \u003Clabel for=\u0022edit-driver-first-name\u0022\u003EFirst name\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-driver-first-name\u0022 type=\u0022text\u0022 id=\u0022edit-driver-first-name\u0022 name=\u0022driver_first_name\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-driver-last-name js-form-item-driver-last-name\u0022\u003E\n      \u003Clabel for=\u0022edit-driver-last-name\u0022\u003ELast name\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-driver-last-name\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022 id=\u0022edit-driver-last-name\u0022 name=\u0022driver_last_name\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-number-drivers-license js-form-item-number-drivers-license\u0022\u003E\n      \u003Clabel for=\u0022edit-number-drivers-license\u0022\u003ELicense number\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-number-drivers-license\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022 id=\u0022edit-number-drivers-license\u0022 name=\u0022number_drivers_license\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-damage\u0022 id=\u0022edit-damage\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EDamage\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv class=\u0022js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-damage-description js-form-item-damage-description\u0022\u003E\n      \u003Clabel for=\u0022edit-damage-description\u0022\u003EDescribe the damage of the vehicle\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-damage-description\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022 id=\u0022edit-damage-description\u0022 name=\u0022damage_description\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-material-damage js-form-item-material-damage\u0022\u003E\n      \u003Clabel for=\u0022edit-material-damage\u0022\u003EDescribe any material damage (damage other then your own vehicle and the vehicle of the counterpart)\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-material-damage\u0022 id=\u0022edit-material-damage\u0022 name=\u0022material_damage\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-counterparty\u0022 id=\u0022edit-counterparty\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003ECounterpart\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cfieldset data-drupal-selector=\u0022edit-counterparty-available\u0022 id=\u0022edit-counterparty-available--wrapper\u0022 class=\u0022radios--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-radios webform-type-radios js-form-item form-item js-form-wrapper form-wrapper\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;\u0026quot;:\u0026quot;\u0026quot;}}}\u0022\u003E\n      \u003Clegend id=\u0022edit-counterparty-available--wrapper-legend\u0022\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EWas there a counterpart involved in the accident?\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv id=\u0022edit-counterparty-available\u0022 class=\u0022js-webform-radios webform-options-display-one-column\u0022\u003E\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-counterparty-available js-form-item-counterparty-available\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-available-yes\u0022 type=\u0022radio\u0022 id=\u0022edit-counterparty-available-yes\u0022 name=\u0022counterparty_available\u0022 value=\u0022yes\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-counterparty-available-yes\u0022 class=\u0022option\u0022\u003EYes\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-counterparty-available js-form-item-counterparty-available\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-available-yes-unknown\u0022 type=\u0022radio\u0022 id=\u0022edit-counterparty-available-yes-unknown\u0022 name=\u0022counterparty_available\u0022 value=\u0022yes_unknown\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-counterparty-available-yes-unknown\u0022 class=\u0022option\u0022\u003EYes, unknown\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-counterparty-available js-form-item-counterparty-available\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-available-no\u0022 type=\u0022radio\u0022 id=\u0022edit-counterparty-available-no\u0022 name=\u0022counterparty_available\u0022 value=\u0022no\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-counterparty-available-no\u0022 class=\u0022option\u0022\u003ENo \/ not applicable\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cdiv class=\u0022js-webform-states-hidden js-form-wrapper form-wrapper\u0022 data-drupal-selector=\u0022edit-counterparty-container\u0022 data-drupal-states=\u0022{\u0026quot;visible\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022counterparty_available\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;yes\u0026quot;}}}\u0022 id=\u0022edit-counterparty-container\u0022\u003E\u003Cdiv data-drupal-selector=\u0022edit-flexbox-07\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-07\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-counterparty-first-name js-form-item-counterparty-first-name\u0022\u003E\n      \u003Clabel for=\u0022edit-counterparty-first-name\u0022\u003EFirst name\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-first-name\u0022 type=\u0022text\u0022 id=\u0022edit-counterparty-first-name\u0022 name=\u0022counterparty_first_name\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-counterparty-last-name js-form-item-counterparty-last-name\u0022\u003E\n      \u003Clabel for=\u0022edit-counterparty-last-name\u0022\u003ELast name\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-last-name\u0022 type=\u0022text\u0022 id=\u0022edit-counterparty-last-name\u0022 name=\u0022counterparty_last_name\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv data-drupal-selector=\u0022edit-flexbox-08\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-08\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--2\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-counterparty-street js-form-item-counterparty-street\u0022\u003E\n      \u003Clabel for=\u0022edit-counterparty-street\u0022\u003EStreet\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-street\u0022 type=\u0022text\u0022 id=\u0022edit-counterparty-street\u0022 name=\u0022counterparty_street\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-number webform-type-number js-form-item form-item js-form-type-number form-item-counterparty-number js-form-item-counterparty-number\u0022\u003E\n      \u003Clabel for=\u0022edit-counterparty-number\u0022\u003ENumber\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-number\u0022 type=\u0022number\u0022 id=\u0022edit-counterparty-number\u0022 name=\u0022counterparty_number\u0022 value=\u0022\u0022 step=\u0022any\u0022 class=\u0022form-number\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-counterparty-bus js-form-item-counterparty-bus\u0022\u003E\n      \u003Clabel for=\u0022edit-counterparty-bus\u0022\u003EBus\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-bus\u0022 type=\u0022text\u0022 id=\u0022edit-counterparty-bus\u0022 name=\u0022counterparty_bus\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv data-drupal-selector=\u0022edit-flexbox-09\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-09\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-number webform-type-number js-form-item form-item js-form-type-number form-item-counterparty-postal-code js-form-item-counterparty-postal-code\u0022\u003E\n      \u003Clabel for=\u0022edit-counterparty-postal-code\u0022\u003EZipcode\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-postal-code\u0022 type=\u0022number\u0022 id=\u0022edit-counterparty-postal-code\u0022 name=\u0022counterparty_postal_code\u0022 value=\u0022\u0022 step=\u0022any\u0022 min=\u00221000\u0022 max=\u00229999\u0022 class=\u0022form-number\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--2\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-counterparty-city js-form-item-counterparty-city\u0022\u003E\n      \u003Clabel for=\u0022edit-counterparty-city\u0022\u003EPlace\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-city\u0022 type=\u0022text\u0022 id=\u0022edit-counterparty-city\u0022 name=\u0022counterparty_city\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv data-drupal-selector=\u0022edit-flexbox-10\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-10\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-tel webform-type-tel js-form-item form-item js-form-type-tel form-item-counterparty-phone js-form-item-counterparty-phone\u0022\u003E\n      \u003Clabel for=\u0022edit-counterparty-phone\u0022\u003EPhone \/ cellphone\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-phone\u0022 type=\u0022tel\u0022 id=\u0022edit-counterparty-phone\u0022 name=\u0022counterparty_phone\u0022 value=\u0022\u0022 size=\u002230\u0022 maxlength=\u0022128\u0022 class=\u0022form-tel\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--2\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-counterparty-insurance-company js-form-item-counterparty-insurance-company\u0022\u003E\n      \u003Clabel for=\u0022edit-counterparty-insurance-company\u0022\u003EInsurance company\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-insurance-company\u0022 type=\u0022text\u0022 id=\u0022edit-counterparty-insurance-company\u0022 name=\u0022counterparty_insurance_company\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cdiv class=\u0022js-webform-type-select webform-type-select js-form-item form-item js-form-type-select form-item-responsible js-form-item-responsible\u0022\u003E\n      \u003Clabel for=\u0022edit-responsible\u0022\u003EAccording to you, who is responsible for the damage?\u003C\/label\u003E\n        \u003Cselect data-drupal-selector=\u0022edit-responsible\u0022 id=\u0022edit-responsible\u0022 name=\u0022responsible\u0022 class=\u0022form-select\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022\u003E\u003Coption value=\u0022\u0022 selected=\u0022selected\u0022\u003E- Select -\u003C\/option\u003E\u003Coption value=\u0022counterparty\u0022\u003EThe counterpart was responsible\u003C\/option\u003E\u003Coption value=\u0022me\u0022\u003EI am responsible\u003C\/option\u003E\u003Coption value=\u0022both\u0022\u003EBoth parties made a wrong manoeuvre\u003C\/option\u003E\u003Coption value=\u0022other\u0022\u003EOther \/ I don\u0026#039;t know\u003C\/option\u003E\u003C\/select\u003E\n        \u003C\/div\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-verbalizing-entity-group\u0022 id=\u0022edit-verbalizing-entity-group\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EVerbalising government\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cfieldset data-drupal-selector=\u0022edit-police-report\u0022 id=\u0022edit-police-report--wrapper\u0022 class=\u0022radios--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-radios webform-type-radios js-form-item form-item js-form-wrapper form-wrapper\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022\u003E\n      \u003Clegend id=\u0022edit-police-report--wrapper-legend\u0022\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EWas a report drawn up?\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv id=\u0022edit-police-report\u0022 class=\u0022js-webform-radios webform-options-display-one-column\u0022\u003E\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-police-report js-form-item-police-report\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-police-report-yes\u0022 type=\u0022radio\u0022 id=\u0022edit-police-report-yes\u0022 name=\u0022police_report\u0022 value=\u0022yes\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-police-report-yes\u0022 class=\u0022option\u0022\u003EYes \u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-police-report js-form-item-police-report\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-police-report-no\u0022 type=\u0022radio\u0022 id=\u0022edit-police-report-no\u0022 name=\u0022police_report\u0022 value=\u0022no\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-police-report-no\u0022 class=\u0022option\u0022\u003ENo\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cdiv class=\u0022js-webform-states-hidden js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-pv-nummer js-form-item-pv-nummer\u0022\u003E\n      \u003Clabel for=\u0022edit-pv-nummer\u0022\u003EReport number (of known)\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-pv-nummer\u0022 type=\u0022text\u0022 id=\u0022edit-pv-nummer\u0022 name=\u0022pv_nummer\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 data-drupal-states=\u0022{\u0026quot;visible\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022police_report\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;yes\u0026quot;}}}\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-alcoholtest\u0022 id=\u0022edit-alcoholtest--wrapper\u0022 class=\u0022radios--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-radios webform-type-radios js-form-item form-item js-form-wrapper form-wrapper\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022\u003E\n      \u003Clegend id=\u0022edit-alcoholtest--wrapper-legend\u0022\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EHas there been a breathing test or a blood test?\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv id=\u0022edit-alcoholtest\u0022 class=\u0022js-webform-radios webform-options-display-one-column\u0022\u003E\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-alcoholtest js-form-item-alcoholtest\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-alcoholtest-no\u0022 type=\u0022radio\u0022 id=\u0022edit-alcoholtest-no\u0022 name=\u0022alcoholtest\u0022 value=\u0022no\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-alcoholtest-no\u0022 class=\u0022option\u0022\u003ENo\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-alcoholtest js-form-item-alcoholtest\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-alcoholtest-yes-negative\u0022 type=\u0022radio\u0022 id=\u0022edit-alcoholtest-yes-negative\u0022 name=\u0022alcoholtest\u0022 value=\u0022yes_negative\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-alcoholtest-yes-negative\u0022 class=\u0022option\u0022\u003EYes, negative result\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-alcoholtest js-form-item-alcoholtest\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-alcoholtest-yes-positive\u0022 type=\u0022radio\u0022 id=\u0022edit-alcoholtest-yes-positive\u0022 name=\u0022alcoholtest\u0022 value=\u0022yes_positive\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-alcoholtest-yes-positive\u0022 class=\u0022option\u0022\u003EYes, positive result\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-alcoholtest js-form-item-alcoholtest\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-alcoholtest-yes-unknown\u0022 type=\u0022radio\u0022 id=\u0022edit-alcoholtest-yes-unknown\u0022 name=\u0022alcoholtest\u0022 value=\u0022yes_unknown\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-alcoholtest-yes-unknown\u0022 class=\u0022option\u0022\u003EYes, I don\u0027t know the result\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-witnesses-group\u0022 id=\u0022edit-witnesses-group\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EWitnesses\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cfieldset data-drupal-selector=\u0022edit-witnesses\u0022 id=\u0022edit-witnesses--wrapper\u0022 class=\u0022radios--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-radios webform-type-radios js-form-item form-item js-form-wrapper form-wrapper\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022\u003E\n      \u003Clegend id=\u0022edit-witnesses--wrapper-legend\u0022\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EWhere there any witnesses of the accident?\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv id=\u0022edit-witnesses\u0022 class=\u0022js-webform-radios webform-options-display-one-column\u0022\u003E\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-witnesses js-form-item-witnesses\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-witnesses-yes\u0022 type=\u0022radio\u0022 id=\u0022edit-witnesses-yes\u0022 name=\u0022witnesses\u0022 value=\u0022yes\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-witnesses-yes\u0022 class=\u0022option\u0022\u003EYes\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-witnesses js-form-item-witnesses\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-witnesses-no\u0022 type=\u0022radio\u0022 id=\u0022edit-witnesses-no\u0022 name=\u0022witnesses\u0022 value=\u0022no\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-witnesses-no\u0022 class=\u0022option\u0022\u003ENon\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cdiv class=\u0022js-webform-states-hidden js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-witnesses-info js-form-item-witnesses-info\u0022\u003E\n      \u003Clabel for=\u0022edit-witnesses-info\u0022\u003EName and contact information of witnesses\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-witnesses-info\u0022 data-drupal-states=\u0022{\u0026quot;visible\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022witnesses\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;yes\u0026quot;}}}\u0022 id=\u0022edit-witnesses-info\u0022 name=\u0022witnesses_info\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-injured-group\u0022 id=\u0022edit-injured-group\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EInjured\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cfieldset data-drupal-selector=\u0022edit-injured\u0022 id=\u0022edit-injured--wrapper\u0022 class=\u0022radios--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-radios webform-type-radios js-form-item form-item js-form-wrapper form-wrapper\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022\u003E\n      \u003Clegend id=\u0022edit-injured--wrapper-legend\u0022\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EAre there any injured in the accident?\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv id=\u0022edit-injured\u0022 class=\u0022js-webform-radios webform-options-display-one-column\u0022\u003E\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-injured js-form-item-injured\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-injured-yes\u0022 type=\u0022radio\u0022 id=\u0022edit-injured-yes\u0022 name=\u0022injured\u0022 value=\u0022yes\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-injured-yes\u0022 class=\u0022option\u0022\u003EYes\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-injured js-form-item-injured\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-injured-no\u0022 type=\u0022radio\u0022 id=\u0022edit-injured-no\u0022 name=\u0022injured\u0022 value=\u0022no\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-injured-no\u0022 class=\u0022option\u0022\u003ENo\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cdiv class=\u0022js-webform-states-hidden js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-injured-info js-form-item-injured-info\u0022\u003E\n      \u003Clabel for=\u0022edit-injured-info\u0022\u003EName, adres en birthdate of the victim\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-injured-info\u0022 data-drupal-states=\u0022{\u0026quot;visible\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022injured\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;yes\u0026quot;}}}\u0022 id=\u0022edit-injured-info\u0022 name=\u0022injured_info\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-states-hidden js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-injured-injuries js-form-item-injured-injuries\u0022\u003E\n      \u003Clabel for=\u0022edit-injured-injuries\u0022\u003EDescribe the injury\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-injured-injuries\u0022 data-drupal-states=\u0022{\u0026quot;visible\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022injured\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;yes\u0026quot;}}}\u0022 id=\u0022edit-injured-injuries\u0022 name=\u0022injured_injuries\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-states-hidden js-form-wrapper form-wrapper\u0022 data-drupal-selector=\u0022edit-fire\u0022 data-drupal-states=\u0022{\u0026quot;visible\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;fire\u0026quot;}}}\u0022 id=\u0022edit-fire\u0022\u003E\u003Cfieldset data-drupal-selector=\u0022edit-fire-address-group\u0022 id=\u0022edit-fire-address-group\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EAddress of the insured risk\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv data-drupal-selector=\u0022edit-flexbox-11\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-11\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--2\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-fire-street js-form-item-fire-street\u0022\u003E\n      \u003Clabel for=\u0022edit-fire-street\u0022\u003EStreet\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-fire-street\u0022 type=\u0022text\u0022 id=\u0022edit-fire-street\u0022 name=\u0022fire_street\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;fire\u0026quot;}}}\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-number webform-type-number js-form-item form-item js-form-type-number form-item-fire-number js-form-item-fire-number\u0022\u003E\n      \u003Clabel for=\u0022edit-fire-number\u0022\u003ENumber\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-fire-number\u0022 type=\u0022number\u0022 id=\u0022edit-fire-number\u0022 name=\u0022fire_number\u0022 value=\u0022\u0022 step=\u0022any\u0022 class=\u0022form-number\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;fire\u0026quot;}}}\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-fire-bus js-form-item-fire-bus\u0022\u003E\n      \u003Clabel for=\u0022edit-fire-bus\u0022\u003EBus\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-fire-bus\u0022 type=\u0022text\u0022 id=\u0022edit-fire-bus\u0022 name=\u0022fire_bus\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv data-drupal-selector=\u0022edit-flexbox-12\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-12\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-number webform-type-number js-form-item form-item js-form-type-number form-item-fire-postal-code js-form-item-fire-postal-code\u0022\u003E\n      \u003Clabel for=\u0022edit-fire-postal-code\u0022\u003EZipcode \u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-fire-postal-code\u0022 type=\u0022number\u0022 id=\u0022edit-fire-postal-code\u0022 name=\u0022fire_postal_code\u0022 value=\u0022\u0022 step=\u0022any\u0022 min=\u00221000\u0022 max=\u00229999\u0022 class=\u0022form-number\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;fire\u0026quot;}}}\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--2\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-fire-city js-form-item-fire-city\u0022\u003E\n      \u003Clabel for=\u0022edit-fire-city\u0022\u003EPlace\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-fire-city\u0022 type=\u0022text\u0022 id=\u0022edit-fire-city\u0022 name=\u0022fire_city\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;fire\u0026quot;}}}\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-fire-damage-type-group\u0022 id=\u0022edit-fire-damage-type-group\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EDamage type\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv class=\u0022js-webform-type-select webform-type-select js-form-item form-item js-form-type-select form-item-fire-damage-type js-form-item-fire-damage-type\u0022\u003E\n      \u003Clabel for=\u0022edit-fire-damage-type\u0022\u003EDamage type\u003C\/label\u003E\n        \u003Cselect data-drupal-selector=\u0022edit-fire-damage-type\u0022 id=\u0022edit-fire-damage-type\u0022 name=\u0022fire_damage_type\u0022 class=\u0022form-select\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;fire\u0026quot;}}}\u0022\u003E\u003Coption value=\u0022\u0022 selected=\u0022selected\u0022\u003E- Select -\u003C\/option\u003E\u003Coption value=\u0022fire_explosion\u0022\u003EFire \/ explosion\u003C\/option\u003E\u003Coption value=\u0022electrical\u0022\u003EElectrical devices\u003C\/option\u003E\u003Coption value=\u0022flood\u0022\u003EFlood\u003C\/option\u003E\u003Coption value=\u0022storm\u0022\u003EStorm and hail damage\u003C\/option\u003E\u003Coption value=\u0022water\u0022\u003EWater damage\u003C\/option\u003E\u003Coption value=\u0022theft\u0022\u003ETheft\u003C\/option\u003E\u003Coption value=\u0022other\u0022\u003EOther \/ I don\u0026#039;t know\u003C\/option\u003E\u003C\/select\u003E\n        \u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-fire-damage-group\u0022 id=\u0022edit-fire-damage-group\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EDamage\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv class=\u0022js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-fire-damage js-form-item-fire-damage\u0022\u003E\n      \u003Clabel for=\u0022edit-fire-damage\u0022\u003EDescription of the damage\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-fire-damage\u0022 aria-describedby=\u0022edit-fire-damage--description\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;fire\u0026quot;}}}\u0022 id=\u0022edit-fire-damage\u0022 name=\u0022fire_damage\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n            \u003Cdiv class=\u0022description\u0022\u003E\n      \u003Cdiv id=\u0022edit-fire-damage--description\u0022 class=\u0022webform-element-description\u0022\u003EPlease provide a statement of the losses or damage caused to the building, the contents and to third parties; a repair estimate of the necessary costs; the contact details of the repair company; a global estimate of the damage; an indication of any injured people, \u2026 Through the field \u2018Attachments and Documents\u2019 you can forward all supporting documents (photographs, purchase invoices, minutes from the police report). Attention: In case you are a tenant, please note that all losses should be notified by the owner to his insurance company!\u003C\/div\u003E\n\n    \u003C\/div\u003E\n  \u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-states-hidden js-form-wrapper form-wrapper\u0022 data-drupal-selector=\u0022edit-other\u0022 data-drupal-states=\u0022{\u0026quot;visible\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:{\u0026quot;pattern\u0026quot;:\u0026quot;^(liability|legal_counsal|hospitalization|personal|other)$\u0026quot;}}}}\u0022 id=\u0022edit-other\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-other-damage-description js-form-item-other-damage-description\u0022\u003E\n      \u003Clabel for=\u0022edit-other-damage-description\u0022\u003EDescription of the damage\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-other-damage-description\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:{\u0026quot;pattern\u0026quot;:\u0026quot;^(liability|legal_counsal|hospitalization|personal|other)$\u0026quot;}}}}\u0022 id=\u0022edit-other-damage-description\u0022 name=\u0022other_damage_description\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-extra-info-group\u0022 id=\u0022edit-extra-info-group\u0022 class=\u0022required js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend js-form-required form-required\u0022\u003ERemarks \/ extra information\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv class=\u0022js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-exta-info js-form-item-exta-info\u0022\u003E\n      \u003Clabel for=\u0022edit-exta-info\u0022\u003ERemarks \/ extra information\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-exta-info\u0022 id=\u0022edit-exta-info\u0022 name=\u0022exta_info\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-documents-group\u0022 id=\u0022edit-documents-group\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EAnnexes and documents\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv id=\u0022ajax-wrapper\u0022\u003E\u003Cdiv class=\u0022js-webform-type-webform-document-file webform-type-webform-document-file js-form-item form-item js-form-type-webform-document-file form-item-documents js-form-item-documents\u0022\u003E\n      \u003Clabel for=\u0022edit-documents-upload\u0022 id=\u0022edit-documents--label\u0022\u003EAnnexes and documents\u003C\/label\u003E\n        \u003Cdiv id=\u0022edit-documents\u0022 class=\u0022js-webform-document-file webform-document-file js-form-managed-file form-managed-file\u0022\u003E\n  \u003Cinput aria-describedby=\u0022edit-documents--description\u0022 data-drupal-selector=\u0022edit-documents-upload\u0022 multiple=\u0022multiple\u0022 type=\u0022file\u0022 id=\u0022edit-documents-upload\u0022 name=\u0022files[documents][]\u0022 size=\u002222\u0022 class=\u0022js-form-file form-file\u0022 \/\u003E\n\u003Cinput class=\u0022js-hide button js-form-submit form-submit\u0022 data-drupal-selector=\u0022edit-documents-upload-button\u0022 formnovalidate=\u0022formnovalidate\u0022 type=\u0022submit\u0022 id=\u0022edit-documents-upload-button\u0022 name=\u0022documents_upload_button\u0022 value=\u0022Upload\u0022 \/\u003E\n\u003Cinput data-drupal-selector=\u0022edit-documents-fids\u0022 type=\u0022hidden\u0022 name=\u0022documents[fids]\u0022 \/\u003E\n\n\u003C\/div\u003E\n\n            \u003Cdiv class=\u0022description\u0022\u003E\n      \u003Cdiv id=\u0022edit-documents--description\u0022 class=\u0022webform-element-description\u0022\u003EYou can upload up to 5 files of type \u0022jpeg\u0022, \u0022jpg\u0022, \u0022png\u0022, \u0022PDF\u0022, \u0022doc\u0022 or \u0022docx\u0022. The total size of all files should not exceed 6 Mb together.\u003Cbr \/\u003E\u003C\/div\u003E\n\n    \u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cdiv data-drupal-selector=\u0022edit-actions\u0022 class=\u0022form-actions webform-actions js-form-wrapper form-wrapper\u0022 id=\u0022edit-actions\u0022\u003E\u003Cinput class=\u0022webform-button--submit button button--primary js-form-submit form-submit\u0022 data-drupal-selector=\u0022edit-actions-submit\u0022 type=\u0022submit\u0022 id=\u0022edit-actions-submit\u0022 name=\u0022op\u0022 value=\u0022Send\u0022 \/\u003E\n\n\u003C\/div\u003E\n\u003Cinput autocomplete=\u0022off\u0022 data-drupal-selector=\u0022form-u6-jw9oaz6smfua8r9363piworwexejrker1am4h-8y\u0022 type=\u0022hidden\u0022 name=\u0022form_build_id\u0022 value=\u0022form-U6-jw9OaZ6SMfUa8R9363PIWoRWExeJRKEr1aM4h_8Y\u0022 \/\u003E\n\u003Cinput data-drupal-selector=\u0022edit-webform-submission-damage-add-form\u0022 type=\u0022hidden\u0022 name=\u0022form_id\u0022 value=\u0022webform_submission_damage_add_form\u0022 \/\u003E\n\u003Cinput data-drupal-selector=\u0022edit-antibot-key\u0022 type=\u0022hidden\u0022 name=\u0022antibot_key\u0022 value=\u0022\u0022 \/\u003E\n\n\n  \n\u003C\/form\u003E\n\n\u003C\/div\u003E\n","settings":null}]