{"id":1898,"date":"2026-01-31T12:11:56","date_gmt":"2026-01-31T11:11:56","guid":{"rendered":"https:\/\/hellofinance24.be\/?page_id=1898"},"modified":"2026-02-10T18:03:12","modified_gmt":"2026-02-10T17:03:12","slug":"autofinanciering","status":"publish","type":"page","link":"https:\/\/hellofinance24.be\/nl\/autofinanciering\/","title":{"rendered":"Autofinanciering"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1898\" class=\"elementor elementor-1898\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6efd4cb e-flex e-con-boxed e-con e-parent\" data-id=\"6efd4cb\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-4e72f88 e-con-full e-flex e-con e-child\" data-id=\"4e72f88\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0413193 elementor-widget elementor-widget-text-editor\" data-id=\"0413193\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"rep-example-block\">\n  <h3>Representatief voorbeeld<\/h3>\n\n  <p>Onderstaand voorbeeld illustreert hoe de maandlast en de totale terugbetaling worden berekend op basis van een voorbeeldkrediet.<\/p>\n\n  <p><strong>Nieuwe wagens:<\/strong> kredietbedrag <strong>\u20ac35.000,00<\/strong> \u2013 looptijd <strong>60 maanden<\/strong> \u2013 <strong>JKP 4,45%<\/strong> \u2013 maandelijkse aflossing <strong>\u20ac652,29<\/strong> \u2013 totaal terug te betalen <strong>\u20ac39.137,40<\/strong> \u2013 totale kosten (rente) <strong>\u20ac4.137,40<\/strong>.<\/p>\n\n  <p style=\"font-size: 0.9em; opacity: 0.85;\">\n    Dit is een representatief voorbeeld. 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106;--gf-color-in-ctrl-dark-darker: #112337;--gf-color-in-ctrl-dark-lighter: rgba(17, 35, 55, 0.65);--gf-radius: 3px;--gf-font-size-secondary: 14px;--gf-font-size-tertiary: 13px;--gf-icon-ctrl-number: url(\"data:image\/svg+xml,%3Csvg width='8' height='14' viewBox='0 0 8 14' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M4 0C4.26522 5.96046e-08 4.51957 0.105357 4.70711 0.292893L7.70711 3.29289C8.09763 3.68342 8.09763 4.31658 7.70711 4.70711C7.31658 5.09763 6.68342 5.09763 6.29289 4.70711L4 2.41421L1.70711 4.70711C1.31658 5.09763 0.683417 5.09763 0.292893 4.70711C-0.0976311 4.31658 -0.097631 3.68342 0.292893 3.29289L3.29289 0.292893C3.48043 0.105357 3.73478 0 4 0ZM0.292893 9.29289C0.683417 8.90237 1.31658 8.90237 1.70711 9.29289L4 11.5858L6.29289 9.29289C6.68342 8.90237 7.31658 8.90237 7.70711 9.29289C8.09763 9.68342 8.09763 10.3166 7.70711 10.7071L4.70711 13.7071C4.31658 14.0976 3.68342 14.0976 3.29289 13.7071L0.292893 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192-192s192 85.961 192 192c0 41.466-13.146 79.863-35.498 111.248l154.125 154.125c12.496 12.496 12.496 32.758 0 45.254s-32.758 12.496-45.254 0L367.248 412.502C335.862 434.854 297.467 448 256 448c-106.039 0-192-85.962-192-192z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-label-space-y-secondary: var(--gf-label-space-y-md-secondary);--gf-ctrl-border-color: #686e77;--gf-ctrl-size: var(--gf-ctrl-size-md);--gf-ctrl-label-color-primary: #112337;--gf-ctrl-label-color-secondary: #112337;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);--gf-ctrl-btn-border-color-secondary: #686e77;--gf-ctrl-btn-bg-color-hover-tertiary: #EBEBEB;--gf-field-img-choice-size: var(--gf-field-img-choice-size-md);--gf-field-img-choice-card-space: var(--gf-field-img-choice-card-space-md);--gf-field-img-choice-check-ind-size: var(--gf-field-img-choice-check-ind-size-md);--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Autofinanciering<\/h2>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; geeft vereiste velden aan<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_49'  action='\/nl\/wp-json\/wp\/v2\/pages\/1898' data-formid='49' novalidate><input id=\"partial_entry_id_49\" class=\"partial_entry_id\" type=hidden name=\"partial_entry_id\" value=\"pending\" data-form_id=\"49\"\/><input type=\"hidden\" value=\"0\" name=\"gpps_page_progression_49\" \/>\n                        <div class='gform-body gform_body'><div id='gform_page_49_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_49' class='gform_fields top_label form_sublabel_above description_above validation_below' data-column-layout='fill'><div id=\"field_49_229\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"758996ce\" data-field-span=\"12\"><div class='ginput_container ginput_container_text'><input name='input_229' id='input_49_229' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_49_288\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"ec6b75bc\" data-field-span=\"12\"><div class='ginput_container ginput_container_text'><input name='input_288' id='input_49_288' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><fieldset id=\"field_49_183\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_2col_vertical gfield--width-five-twelfths field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-columns\" data-group-id=\"c1236779\" data-field-span=\"5\"><legend id='gfield_label_49_183' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Aanspreking<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_49_183'>\n\t\t\t<div class='gchoice gchoice_49_183_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_183' type='radio' value='MR'  id='choice_49_183_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_49_183_0 gfield_label_49_183\"   \/>\n\t\t\t\t\t<label for='choice_49_183_0' id='label_49_183_0' class='gform-field-label gform-field-label--type-inline'>Mijnheer<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_49_183_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_183' type='radio' value='MDE'  id='choice_49_183_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_49_183_1' id='label_49_183_1' class='gform-field-label gform-field-label--type-inline'>Mevrouw<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_49_183_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_183' type='radio' value=''  id='choice_49_183_2' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_49_183_2' id='label_49_183_2' class='gform-field-label gform-field-label--type-inline'>Liever niet vermelden<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div data-field-id=\"183\" class=\"spacer gfield\" style=\"grid-column: span 7;\" data-group-id=\"c1236779\"><\/div><fieldset id=\"field_49_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"9b50d6f1\" data-field-span=\"12\"><legend id='gfield_label_49_1' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Uw Naam<\/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_49_1'>\n                            \n                            <span id='input_49_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_49_1_3' value=''   aria-required='true'   placeholder='Voornaam' autocomplete=\"given-name\" aria-labelledby=\"input_49_1_3_label gfield_label_49_1\"\/>\n                                                    <label for='input_49_1_3' id='input_49_1_3_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Voornaam<\/label>\n                                                <\/span>\n                            \n                            <span id='input_49_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_49_1_6' value=''   aria-required='true'   placeholder='Achternaam' autocomplete=\"family-name\" \/>\n                                                    <label for='input_49_1_6' id='input_49_1_6_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Achternaam<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_49_262\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"1434cc55\" data-field-span=\"4\"><label id='gfield_label_49_262' class='gfield_label gform-field-label' for='input_49_262'><span class='gform-field-label__text'>Geboortedatum<\/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_262' id='input_49_262' type='text' value='' class='large'    placeholder='DD\/MM\/JJJ' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"99\/99\/9999\"\/><\/div><\/div><div id=\"field_49_220\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"1434cc55\" data-field-span=\"4\"><label id='gfield_label_49_220' class='gfield_label gform-field-label' for='input_49_220'><span class='gform-field-label__text'>Geboorteplaats<\/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_220' id='input_49_220' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_49_217\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"1434cc55\" data-field-span=\"4\"><label id='gfield_label_49_217' class='gfield_label gform-field-label' for='input_49_217'><span class='gform-field-label__text'>Nationaliteit<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_217' id='input_49_217' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_49_218\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"79753457\" data-field-span=\"4\"><label id='gfield_label_49_218' class='gfield_label gform-field-label' for='input_49_218'><span class='gform-field-label__text'>Rijksregisternummer<\/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_218' id='input_49_218' type='text' value='' class='large'    placeholder='99.99.99-999.99' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"99.99.99-999.99\"\/><\/div><\/div><div id=\"field_49_238\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"79753457\" data-field-span=\"4\"><label id='gfield_label_49_238' class='gfield_label gform-field-label' for='input_49_238'><span class='gform-field-label__text'>IdentiteitskaartNr.<\/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_238' id='input_49_238' type='text' value='' class='large'    placeholder='999-9999999-99' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"999-9999999-99\"\/><\/div><\/div><div id=\"field_49_239\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"79753457\" data-field-span=\"4\"><label id='gfield_label_49_239' class='gfield_label gform-field-label' for='input_49_239'><span class='gform-field-label__text'>Validiteit identiteitskaart<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_239' id='input_49_239' type='text' value='' class='large'    placeholder='9999-99-99'  aria-invalid=\"false\"   data-mask=\"9999-99-99\"\/><\/div><\/div><div id=\"field_49_221\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"4bbb5868\" data-field-span=\"12\"><label id='gfield_label_49_221' class='gfield_label gform-field-label' for='input_49_221'><span class='gform-field-label__text'>Bankrekening<\/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_221' id='input_49_221' type='text' value='' class='small'    placeholder='BE99 9999 9999 9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"BE99 9999 9999 9999\"\/><\/div><\/div><fieldset id=\"field_49_4\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"0dce6d8d\" data-field-span=\"12\"><legend id='gfield_label_49_4' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Uw Adres<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_zip has_country ginput_container_address gform-grid-row' id='input_49_4' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_49_4_1_container' >\n                                        <label for='input_49_4_1' id='input_49_4_1_label' class='gform-field-label gform-field-label--type-sub '>Straat en nummer<\/label>\n                                        <input type='text' name='input_4.1' id='input_49_4_1' value=''   placeholder='Straat en nummer' aria-required='true'    aria-labelledby=\"input_49_4_1_label gfield_label_49_4\"\/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_49_4_2_container' >\n                                        <label for='input_49_4_2' id='input_49_4_2_label' class='gform-field-label gform-field-label--type-sub '>Bus (Optioneel)<\/label>\n                                        <input type='text' name='input_4.2' id='input_49_4_2' value=''   placeholder='Bus'  aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_49_4_3_container' >\n                                    <label for='input_49_4_3' id='input_49_4_3_label' class='gform-field-label gform-field-label--type-sub '>Stad<\/label>\n                                    <input type='text' name='input_4.3' id='input_49_4_3' value=''   placeholder='Stad' aria-required='true'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_4.4' id='input_49_4_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_49_4_5_container' >\n                                    <label for='input_49_4_5' id='input_49_4_5_label' class='gform-field-label gform-field-label--type-sub '>Postcode<\/label>\n                                    <input type='text' name='input_4.5' id='input_49_4_5' value=''   placeholder='Postcode' aria-required='true'    \/>\n                                <\/span><span class='ginput_left address_country ginput_address_country gform-grid-col' id='input_49_4_6_container' >\n                                        <label for='input_49_4_6' id='input_49_4_6_label' class='gform-field-label gform-field-label--type-sub '>Land<\/label>\n                                        <select name='input_4.6' id='input_49_4_6'   aria-required='true'    ><option value='' ><\/option><option value='AF' >Afghanistan<\/option><option value='AX' >Aland-eilanden<\/option><option value='AL' >Albani\u00eb<\/option><option value='DZ' >Algerije<\/option><option value='AS' >Amerikaans Samoa<\/option><option value='VI' >Amerikaanse Maagdeneilanden<\/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 en Barbuda<\/option><option value='SY' >Arabische Republiek Syri\u00eb<\/option><option value='AR' >Argentini\u00eb<\/option><option value='AM' >Armeni\u00eb<\/option><option value='AW' >Aruba<\/option><option value='AU' >Australi\u00eb<\/option><option value='AZ' >Azerbeidzjan<\/option><option value='BS' >Bahama&#039;s<\/option><option value='BH' >Bahrein<\/option><option value='BD' >Bangladesh<\/option><option value='BB' >Barbados<\/option><option value='BE' selected='selected'>Belgi\u00eb<\/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 en Saba<\/option><option value='BA' >Bosni\u00eb en Herzegovina<\/option><option value='BW' >Botswana<\/option><option value='BV' >Bouvet eiland<\/option><option value='BR' >Brazili\u00eb<\/option><option value='IO' >Brits-Indisch oceaan gebied<\/option><option value='VG' >Britse Maagdeneilanden<\/option><option value='BN' >Brunei Darussalam<\/option><option value='BG' >Bulgarije<\/option><option value='BF' >Burkina Faso<\/option><option value='BI' >Burundi<\/option><option value='KH' >Cambodja<\/option><option value='CA' >Canada<\/option><option value='CF' >Centraal-Afrikaanse Republiek<\/option><option value='CL' >Chili<\/option><option value='CN' >China<\/option><option value='CC' >Cocoseilanden<\/option><option value='CO' >Colombia<\/option><option value='KM' >Comoren<\/option><option value='CG' >Congo<\/option><option value='CD' >Congo, Democratische Republiek<\/option><option value='CK' >Cook eilanden<\/option><option value='CR' >Costa Rica<\/option><option value='CU' >Cuba<\/option><option value='CW' >Cura\u00e7ao<\/option><option value='CY' >Cyprus<\/option><option value='DK' >Denemarken<\/option><option value='DJ' >Djibouti<\/option><option value='DM' >Dominica<\/option><option value='DO' >Dominicaanse Republiek<\/option><option value='DE' >Duitsland<\/option><option value='EC' >Ecuador<\/option><option value='EG' >Egypte<\/option><option value='SV' >El Salvador<\/option><option value='GQ' >Equatoriaal-Guinea<\/option><option value='ER' >Eritrea<\/option><option value='EE' >Estland<\/option><option value='SZ' >Eswatini<\/option><option value='ET' >Ethiopi\u00eb<\/option><option value='FO' >Faer\u00f6er<\/option><option value='FK' >Falkland eilanden<\/option><option value='FJ' >Fiji<\/option><option value='PH' >Filipijnen<\/option><option value='FI' >Finland<\/option><option value='FR' >Frankrijk<\/option><option value='GF' >Frans Guyana<\/option><option value='PF' >Frans-Polynesi\u00eb<\/option><option value='TF' >Franse zuidelijke gebieden<\/option><option value='GA' >Gabon<\/option><option value='GM' >Gambia<\/option><option value='GE' >Georgi\u00eb<\/option><option value='GH' >Ghana<\/option><option value='GI' >Gibraltar<\/option><option value='GD' >Grenada<\/option><option value='GR' >Griekenland<\/option><option value='GL' >Groenland<\/option><option value='GP' >Guadeloupe<\/option><option value='GU' >Guam<\/option><option value='GT' >Guatemala<\/option><option value='GG' >Guernsey<\/option><option value='GN' >Guinee<\/option><option value='GW' >Guinee-Bissau<\/option><option value='GY' >Guyana<\/option><option value='HT' >Ha\u00efti<\/option><option value='HM' >Heard Eiland en McDonald Eilanden<\/option><option value='HN' >Honduras<\/option><option value='HK' >Hong Kong<\/option><option value='HU' >Hongarije<\/option><option value='IE' >Ierland<\/option><option value='IS' >IJsland<\/option><option value='IN' >India<\/option><option value='ID' >Indonesi\u00eb<\/option><option value='IQ' >Irak<\/option><option value='IR' >Iran<\/option><option value='IL' >Isra\u00ebl<\/option><option value='IT' >Itali\u00eb<\/option><option value='CI' >Ivoorkust<\/option><option value='JM' >Jamaica<\/option><option value='JP' >Japan<\/option><option value='JE' >Jersey<\/option><option value='GS' >Ji\u017en\u00ed Georgie a Ji\u017en\u00ed Sandwichovy ostrovy<\/option><option value='JO' >Jordani\u00eb<\/option><option value='KY' >Kaaimaneilanden<\/option><option value='CV' >Kaapverdi\u00eb<\/option><option value='CM' >Kameroen<\/option><option value='KZ' >Kazachstan<\/option><option value='KE' >Kenia<\/option><option value='CX' >Kersteiland<\/option><option value='KG' >Kirgizi\u00eb<\/option><option value='KI' >Kiribati<\/option><option value='UM' >Kleine eilanden van de Verenigde Staten<\/option><option value='KW' >Koeweit<\/option><option value='KP' >Korea, Democratische Volksrepubliek<\/option><option value='KR' >Korea, Republiek van<\/option><option value='HR' >Kroati\u00eb<\/option><option value='LA' >Lao Democratische Volksrepubliek<\/option><option value='LS' >Lesotho<\/option><option value='LV' >Letland<\/option><option value='LB' >Libanon<\/option><option value='LR' >Liberia<\/option><option value='LY' >Libi\u00eb<\/option><option value='LI' >Liechtenstein<\/option><option value='LT' >Litouwen<\/option><option value='LU' >Luxemburg<\/option><option value='MO' >Macau<\/option><option value='MG' >Madagaskar<\/option><option value='MW' >Malawi<\/option><option value='MV' >Maldiven<\/option><option value='MY' >Maleisi\u00eb<\/option><option value='ML' >Mali<\/option><option value='MT' >Malta<\/option><option value='IM' >Man<\/option><option value='MA' >Marokko<\/option><option value='MH' >Marshalleilanden<\/option><option value='MQ' >Martinique<\/option><option value='MR' >Mauritani\u00eb<\/option><option value='MU' >Mauritius<\/option><option value='YT' >Mayotte<\/option><option value='MX' >Mexico<\/option><option value='FM' >Micronesia<\/option><option value='MD' >Moldavi\u00eb<\/option><option value='MC' >Monaco<\/option><option value='MN' >Mongoli\u00eb<\/option><option value='ME' >Montenegro<\/option><option value='MS' >Montserrat<\/option><option value='MZ' >Mozambique<\/option><option value='MM' >Myanmar<\/option><option value='NA' >Namibi\u00eb<\/option><option value='NR' >Nauru<\/option><option value='NL' >Nederland<\/option><option value='NP' >Nepal<\/option><option value='NI' >Nicaragua<\/option><option value='NC' >Nieuw-Caledoni\u00eb<\/option><option value='NZ' >Nieuw-Zeeland<\/option><option value='NE' >Niger<\/option><option value='NG' >Nigeria<\/option><option value='NU' >Niue<\/option><option value='MK' >Noord-Macedoni\u00eb<\/option><option value='MP' >Noordelijke Marianen<\/option><option value='NO' >Noorwegen<\/option><option value='NF' >Norfolk eiland<\/option><option value='UG' >Oeganda<\/option><option value='UA' >Oekra\u00efne<\/option><option value='UZ' >Oezbekistan<\/option><option value='OM' >Oman<\/option><option value='AT' >Oostenrijk<\/option><option value='PK' >Pakistan<\/option><option value='PW' >Palau<\/option><option value='PS' >Palestina, Staat<\/option><option value='PA' >Panama<\/option><option value='PG' >Papoea-Nieuw-Guinea<\/option><option value='PY' >Paraguay<\/option><option value='PE' >Peru<\/option><option value='PN' >Pitcairn<\/option><option value='PL' >Polen<\/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' >Roemeni\u00eb<\/option><option value='RU' >Russische Federatie<\/option><option value='RW' >Rwanda<\/option><option value='BL' >Saint Barth\u00e9lemy<\/option><option value='KN' >Saint Kitts en Nevis<\/option><option value='LC' >Saint Lucia<\/option><option value='PM' >Saint Pierre en Miquelon<\/option><option value='VC' >Saint Vincent en de Grenadines<\/option><option value='SB' >Salomonseilanden<\/option><option value='WS' >Samoa<\/option><option value='SM' >San Marino<\/option><option value='ST' >Sao Tom\u00e9 en Principe<\/option><option value='SA' >Saoedi-Arabi\u00eb<\/option><option value='SN' >Senegal<\/option><option value='RS' >Servi\u00eb<\/option><option value='SC' >Seychellen<\/option><option value='SL' >Sierra Leone<\/option><option value='SG' >Singapore<\/option><option value='SX' >Sint Maarten<\/option><option value='MF' >Sint Maarten<\/option><option value='SH' >Sint-Helena, Hemelvaart en Tristan da Cunha<\/option><option value='SI' >Sloveni\u00eb<\/option><option value='SK' >Slowakije<\/option><option value='SD' >Soedan<\/option><option value='SO' >Somali\u00eb<\/option><option value='ES' >Spanje<\/option><option value='SJ' >Spitsbergen en Jan Mayen<\/option><option value='LK' >Sri Lanka<\/option><option value='SR' >Suriname<\/option><option value='TJ' >Tadzjikistan<\/option><option value='TW' >Taiwan<\/option><option value='TZ' >Tanzania, de Verenigde Republiek van<\/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 en Tobago<\/option><option value='TD' >Tsjaad<\/option><option value='CZ' >Tsjechi\u00eb<\/option><option value='TN' >Tunesi\u00eb<\/option><option value='TR' >Turkije<\/option><option value='TM' >Turkmenistan<\/option><option value='TC' >Turks- en Caicoseilanden<\/option><option value='TV' >Tuvalu<\/option><option value='UY' >Uruguay<\/option><option value='VU' >Vanuatu<\/option><option value='VA' >Vaticaanstad<\/option><option value='VE' >Venezuela<\/option><option value='GB' >Verenigd Koninkrijk<\/option><option value='AE' >Verenigde Arabische Emiraten<\/option><option value='US' >Verenigde Staten<\/option><option value='VN' >Vietnam<\/option><option value='WF' >Wallis en Futuna<\/option><option value='EH' >Westelijke Sahara<\/option><option value='BY' >Wit-Rusland<\/option><option value='YE' >Yemen<\/option><option value='ZM' >Zambia<\/option><option value='ZW' >Zimbabwe<\/option><option value='SS' >Zuid Soedan<\/option><option value='ZA' >Zuid-Afrika<\/option><option value='SE' >Zweden<\/option><option value='CH' >Zwitserland<\/option> <\/select>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><input type=\"hidden\" name=\"gpaa_place_4\" class=\"gform_hidden\" value=\"\"><\/fieldset><div id=\"field_49_198\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"e5bc667b\" data-field-span=\"12\"><label id='gfield_label_49_198' class='gfield_label gform-field-label' for='input_49_198'><span class='gform-field-label__text'>Adres sinds<\/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_198' id='input_49_198' type='text' value='' class='medium'    placeholder='DD\/MM\/JJJ' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"99\/99\/9999\"\/><\/div><\/div><div id=\"field_49_10\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"2d3b3f3c\" data-field-span=\"12\"><h3 class=\"gsection_title\">Hoe kunnen wij u bereiken?<\/h3><\/div><div id=\"field_49_2\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gpev-field\" data-field-class=\"gpev-field\" data-group-id=\"92a6673b\" data-field-span=\"6\"><label id='gfield_label_49_2' class='gfield_label gform-field-label' for='input_49_2'><span class='gform-field-label__text'>Email Adres<\/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_49_2' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_49_5\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-international gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"92a6673b\" data-field-span=\"6\"><label id='gfield_label_49_5' class='gfield_label gform-field-label' for='input_49_5'><span class='gform-field-label__text'>Uw gsm-nummer<\/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_5' id='input_49_5' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"tel\"  \/><\/div><\/div><fieldset id=\"field_49_197\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_above gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"418335a7\" data-field-span=\"12\"><legend id='gfield_label_49_197' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Verzekering<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_49_197'><div class='gchoice gchoice_49_197_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_197.1' type='checkbox'  value='Ik wens een offerte te ontvangen voor een schuldsaldoverzekering'  id='choice_49_197_1'    aria-labelledby=\"label_49_197_1 gfield_label_49_197\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_49_197_1' id='label_49_197_1' class='gform-field-label gform-field-label--type-inline'>Ik wens een offerte te ontvangen voor een schuldsaldoverzekering<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_49_11' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_49_2' class='gform_page' data-js='page-field-id-11' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_49_2' class='gform_fields top_label form_sublabel_above description_above validation_below' data-column-layout='fill'><fieldset id=\"field_49_125\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_2col gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-columns\" data-group-id=\"e0002d82\" data-field-span=\"3\"><legend id='gfield_label_49_125' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Garage\/Particulier<\/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_49_125'>\n\t\t\t<div class='gchoice gchoice_49_125_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_125' type='radio' value='Garage'  id='choice_49_125_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_49_125_0 gfield_label_49_125\"   \/>\n\t\t\t\t\t<label for='choice_49_125_0' id='label_49_125_0' class='gform-field-label gform-field-label--type-inline'>Garage<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_49_125_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_125' type='radio' value='Particulier'  id='choice_49_125_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_49_125_1' id='label_49_125_1' class='gform-field-label gform-field-label--type-inline'>Particulier<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div data-field-id=\"125\" class=\"spacer gfield\" style=\"grid-column: span 9;\" data-group-id=\"e0002d82\"><\/div><div id=\"field_49_270\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"8266aadf\" data-field-span=\"12\"><label id='gfield_label_49_270' class='gfield_label gform-field-label' for='input_49_270'><span class='gform-field-label__text'>Naam verkopen<\/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_270' id='input_49_270' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_49_126\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"fc192601\" data-field-span=\"12\"><legend id='gfield_label_49_126' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Brandstoftype<\/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_49_126'>\n\t\t\t<div class='gchoice gchoice_49_126_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_126' type='radio' value='Diesel\/Benzine'  id='choice_49_126_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_49_126_0 gfield_label_49_126\"   \/>\n\t\t\t\t\t<label for='choice_49_126_0' id='label_49_126_0' class='gform-field-label gform-field-label--type-inline'>Diesel\/Benzine<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_49_126_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_126' type='radio' value='Elektrisch\/Hybride'  id='choice_49_126_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_49_126_1' id='label_49_126_1' class='gform-field-label gform-field-label--type-inline'>Elektrisch\/Hybride<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_49_28\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"4685929d\" data-field-span=\"12\"><legend id='gfield_label_49_28' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Heeft u een offerte of factuur?<\/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_49_28'>\n\t\t\t<div class='gchoice gchoice_49_28_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='Ja'  id='choice_49_28_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_49_28_0 gfield_label_49_28\"   \/>\n\t\t\t\t\t<label for='choice_49_28_0' id='label_49_28_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_49_28_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='Nee'  id='choice_49_28_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_49_28_1' id='label_49_28_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_49_163\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"aea21dbe\" data-field-span=\"12\"><label id='gfield_label_49_163' class='gfield_label gform-field-label' for='input_49_163'><span class='gform-field-label__text'>Voeg deze hier toe<\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='268435456' \/><input name='input_163' id='input_49_163' type='file' class='large' aria-describedby=\"gfield_upload_rules_49_163\" onchange='javascript:gformValidateFileSize( this, 268435456 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_49_163'>Max. bestandsgrootte: 256 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_49_163'><\/div> <\/div><\/div><div id=\"field_49_30\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"59a598b7\" data-field-span=\"6\"><label id='gfield_label_49_30' class='gfield_label gform-field-label' for='input_49_30'><span class='gform-field-label__text'>Wat is het merk en model?<\/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_30' id='input_49_30' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_49_162\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"59a598b7\" data-field-span=\"6\"><label id='gfield_label_49_162' class='gfield_label gform-field-label' for='input_49_162'><span class='gform-field-label__text'>Eerste inschrijving (MM\/JJJJ)<\/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_162' id='input_49_162' type='text' value='' class='large'    placeholder='99\/9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"99\/9999\"\/><\/div><\/div><div id=\"field_49_252\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"7f6ee40a\" data-field-span=\"12\"><div class='ginput_container ginput_container_text'><input name='input_252' id='input_49_252' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_49_29\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"5d1223d8\" data-field-span=\"4\" data-currency-format='1'><label id='gfield_label_49_29' class='gfield_label gform-field-label' for='input_49_29'><span class='gform-field-label__text'>Wat is de aankoop prijs?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_29' id='input_49_29' type='text' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div data-field-id=\"29\" class=\"spacer gfield\" style=\"grid-column: span 8;\" data-group-id=\"5d1223d8\"><\/div><div id=\"field_49_33\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"6a1f2e78\" data-field-span=\"12\"><h3 class=\"gsection_title\">Financieringsdetails<\/h3><\/div><div id=\"field_49_34\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"2fea020f\" data-field-span=\"12\" data-currency-format='1'><label id='gfield_label_49_34' class='gfield_label gform-field-label' for='input_49_34'><span class='gform-field-label__text'>Gewenst leenbedrag<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_34' id='input_49_34' type='text' step='any'   value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_49_245\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_calculation field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\" data-group-id=\"f3e4dd3f\" data-field-span=\"12\"><label id='gfield_label_49_245' class='gfield_label gform-field-label' for='input_49_245'><span class='gform-field-label__text'>Gewenst leenbedrag (Raw)<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_245' id='input_49_245' type='text' step='any'   value='' class='medium gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_49_253\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"cac1c04e\" data-field-span=\"12\"><div class='ginput_container ginput_container_text'><input name='input_253' id='input_49_253' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_49_254\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"ae07b000\" data-field-span=\"12\"><div class='ginput_container ginput_container_text'><input name='input_254' id='input_49_254' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_49_255\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"a60c6a2f\" data-field-span=\"12\"><div class='ginput_container ginput_container_text'><input name='input_255' id='input_49_255' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_49_256\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"0c30345c\" data-field-span=\"12\"><div class='ginput_container ginput_container_text'><input name='input_256' id='input_49_256' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_49_257\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"0a577e37\" data-field-span=\"12\"><div class='ginput_container ginput_container_text'><input name='input_257' id='input_49_257' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_49_258\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"f9432707\" data-field-span=\"12\"><div class='ginput_container ginput_container_text'><input name='input_258' id='input_49_258' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_49_35\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"207018b2\" data-field-span=\"6\"><label id='gfield_label_49_35' class='gfield_label gform-field-label' for='input_49_35'><span class='gform-field-label__text'>Gewenste looptijd (in maanden)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_35' id='input_49_35' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='24' >24 maanden<\/option><option value='30' >30 maanden<\/option><option value='36' >36 maanden<\/option><option value='42' >42 maanden<\/option><option value='48' >48 maanden<\/option><option value='60' >60 maanden<\/option><option value='72' >72 maanden<\/option><option value='84' >84 maanden<\/option><option value='96' >96 maanden<\/option><option value='108' >108 maanden<\/option><option value='120' >120 maanden<\/option><option value='144' >144 maanden<\/option><\/select><\/div><\/div><div data-field-id=\"35\" class=\"spacer gfield\" style=\"grid-column: span 6;\" data-group-id=\"207018b2\"><\/div><div id=\"field_49_259\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"e960c3dc\" data-field-span=\"12\"><div>\n  <div>JKP: <strong><span id=\"jkp_display\">\u2014<\/span><\/strong><\/div>\n  <div>Maximale looptijd: <strong><span id=\"maxterm_display\">\u2014<\/span><\/strong> maanden<\/div>\n\n  <div style=\"margin-top:10px;\">Maandelijkse aflossing: <strong><span id=\"m_display\">\u2014<\/span><\/strong><\/div>\n  <div>Totaal terug te betalen: <strong><span id=\"t_display\">\u2014<\/span><\/strong><\/div>\n  <div>Totale kosten (rente): <strong><span id=\"k_display\">\u2014<\/span><\/strong><\/div>\n\n  <div style=\"margin-top:10px;\"><span id=\"rep_display\"><\/span><\/div>\n<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_49_39' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='button' id='gform_next_button_49_39' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_49_3' class='gform_page' data-js='page-field-id-39' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_49_3' class='gform_fields top_label form_sublabel_above description_above validation_below' data-column-layout='fill'><fieldset id=\"field_49_40\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"f7029496\" data-field-span=\"12\"><legend id='gfield_label_49_40' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Vraagt u alleen aan of met een partner?<\/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_49_40'>\n\t\t\t<div class='gchoice gchoice_49_40_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='Alleen'  id='choice_49_40_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_49_40_0 gfield_label_49_40\"   \/>\n\t\t\t\t\t<label for='choice_49_40_0' id='label_49_40_0' class='gform-field-label gform-field-label--type-inline'>Alleen<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_49_40_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='Met een partner'  id='choice_49_40_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_49_40_1' id='label_49_40_1' class='gform-field-label gform-field-label--type-inline'>Met een partner<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_49_186\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"2b8c45f5\" data-field-span=\"6\"><label id='gfield_label_49_186' class='gfield_label gform-field-label' for='input_49_186'><span class='gform-field-label__text'>Burgelijke staat<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_186' id='input_49_186' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='010' >Ongehuwd<\/option><option value='090' >Wettelijk samenwonend<\/option><option value='040' >Gescheiden<\/option><option value='020' >Gehuwd<\/option><option value='050' >Scheiding van tafel en bed<\/option><option value='070' >Feitelijk gescheiden<\/option><option value='030' >Weduwnaar \/ Weduwe<\/option><\/select><\/div><\/div><div id=\"field_49_187\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"2b8c45f5\" data-field-span=\"6\"><label id='gfield_label_49_187' class='gfield_label gform-field-label' for='input_49_187'><span class='gform-field-label__text'>Huwelijkscontract<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_187' id='input_49_187' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='001' >Wettelijk stelsel<\/option><option value='003' >Stelsel van gemeenschap van aanwinsten<\/option><option value='002' >Stelsel van scheiding van goederen<\/option><\/select><\/div><\/div><div id=\"field_49_46\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"60e67763\" data-field-span=\"12\"><label id='gfield_label_49_46' class='gfield_label gform-field-label' for='input_49_46'><span class='gform-field-label__text'>Woont u op dit adres als...?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_46' id='input_49_46' class='small gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='O' >Huurder<\/option><option value='N' >Eigenaar<\/option><option value='C' >Inwonend<\/option><\/select><\/div><\/div><div id=\"field_49_47\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"18d4483d\" data-field-span=\"12\" data-currency-format='1'><label id='gfield_label_49_47' class='gfield_label gform-field-label' for='input_49_47'><span class='gform-field-label__text'>Maandelijkse huurprijs<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_47' id='input_49_47' type='text' step='any'   value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_49_49\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"7716f9b9\" data-field-span=\"12\"><h3 class=\"gsection_title\">Professionele Situatie<\/h3><\/div><div id=\"field_49_188\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"8a12637a\" data-field-span=\"6\"><label id='gfield_label_49_188' class='gfield_label gform-field-label' for='input_49_188'><span class='gform-field-label__text'>Beroeps statuut<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_188' id='input_49_188' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='012' >Arbeider<\/option><option value='011' >Bediende<\/option><option value='062' >Gepensioneerde<\/option><option value='022' >Werkloos<\/option><option value='010' >Ambtenaar<\/option><option value='013' >Zelfstandige<\/option><option value='021' >Invalide<\/option><option value='012' >Ziekenkas (Arbeidsongeschikt)<\/option><option value='033' >Bruggepensioneerde<\/option><option value='080' >Huisvrouw \/ Huisman<\/option><\/select><\/div><\/div><div id=\"field_49_50\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"8a12637a\" data-field-span=\"6\"><label id='gfield_label_49_50' class='gfield_label gform-field-label' for='input_49_50'><span class='gform-field-label__text'>Type arbeidscontract<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_50' id='input_49_50' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='004' >Contractueel<\/option><option value='001' >Bepaalde duur<\/option><option value='002' >Onbepaalde duur<\/option><option value='003' >Interim<\/option><option value='005' >Statutair<\/option><option value='Andere' >Andere<\/option><option value='998' >Niet van toepassing<\/option><\/select><\/div><\/div><div id=\"field_49_222\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"6519bb31\" data-field-span=\"12\"><label id='gfield_label_49_222' class='gfield_label gform-field-label' for='input_49_222'><span class='gform-field-label__text'>Ondernemingsnummer<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_222' id='input_49_222' type='text' value='' class='small'    placeholder='9999.999.999'  aria-invalid=\"false\"   data-mask=\"9999.999.999\"\/><\/div><\/div><div id=\"field_49_119\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"d71b2bf7\" data-field-span=\"12\"><label id='gfield_label_49_119' class='gfield_label gform-field-label' for='input_49_119'><span class='gform-field-label__text'>Andere (Type arbeidscontract)<\/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_119' id='input_49_119' type='text' value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_49_189\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"9bd8c50d\" data-field-span=\"6\"><label id='gfield_label_49_189' class='gfield_label gform-field-label' for='input_49_189'><span class='gform-field-label__text'>Sector<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_189' id='input_49_189' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='008' >Landbouw\/Visserij<\/option><option value='007' >Bouw<\/option><option value='005' >Grote ondernemingen (+50 pers)<\/option><option value='002' >Kleine ondernemingen (-50 pers)<\/option><option value='001' >Openbare sector<\/option><option value='003' >Supranationaal<\/option><option value='Andere' >Andere<\/option><\/select><\/div><\/div><div id=\"field_49_190\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"9bd8c50d\" data-field-span=\"6\"><label id='gfield_label_49_190' class='gfield_label gform-field-label' for='input_49_190'><span class='gform-field-label__text'>Type beroep<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_190' id='input_49_190' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='131' >Kaderleden\/Ingenieurs<\/option><option value='114' >Bestuurder\/Chauffeur\/Vrachtwagenchauffeur<\/option><option value='132' >Directielid, Zaakvoerder, Bestuurder<\/option><option value='134' >Kantoorbediende<\/option><option value='138' >Onderwijs<\/option><option value='172' >Ordediensten\/Brandweer<\/option><option value='164' >Bewaker\/Beveiliging<\/option><option value='110' >Handlanger\/Ongeschoolde arbeider<\/option><option value='162' >Officier bij de strijdkrachten<\/option><option value='Andere' >Andere<\/option><\/select><\/div><\/div><div id=\"field_49_191\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"0696c27c\" data-field-span=\"6\"><label id='gfield_label_49_191' class='gfield_label gform-field-label' for='input_49_191'><span class='gform-field-label__text'>Andere (Sector)<\/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_191' id='input_49_191' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_49_192\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"0696c27c\" data-field-span=\"6\"><label id='gfield_label_49_192' class='gfield_label gform-field-label' for='input_49_192'><span class='gform-field-label__text'>Andere (Type beroep)<\/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_192' id='input_49_192' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_49_52\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"a548dd86\" data-field-span=\"12\"><label id='gfield_label_49_52' class='gfield_label gform-field-label' for='input_49_52'><span class='gform-field-label__text'>Naam werkgever<\/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_52' id='input_49_52' type='text' value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_49_247\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"0a0d76bc\" data-field-span=\"12\"><legend id='gfield_label_49_247' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Adres van werkgever (minstens gemeente + postcode)<\/span><\/legend><div class='gfield_description' id='gfield_description_49_247'>Indien u het exacte adres niet kent, volstaat gemeente + postcode. Dit heeft geen impact op uw aanvraag.<\/div>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_zip has_country ginput_container_address gform-grid-row' id='input_49_247' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_49_247_1_container' >\n                                        <label for='input_49_247_1' id='input_49_247_1_label' class='gform-field-label gform-field-label--type-sub '>Straat en nummer<\/label>\n                                        <input type='text' name='input_247.1' id='input_49_247_1' value=''   placeholder='Straat en nummer' aria-required='false'    aria-describedby=\"gfield_description_49_247\" aria-labelledby=\"input_49_247_1_label gfield_label_49_247\"\/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_49_247_2_container' >\n                                        <label for='input_49_247_2' id='input_49_247_2_label' class='gform-field-label gform-field-label--type-sub '>Bus<\/label>\n                                        <input type='text' name='input_247.2' id='input_49_247_2' value=''   placeholder='Bus'  aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_49_247_3_container' >\n                                    <label for='input_49_247_3' id='input_49_247_3_label' class='gform-field-label gform-field-label--type-sub '>Stad<\/label>\n                                    <input type='text' name='input_247.3' id='input_49_247_3' value=''   placeholder='Stad' aria-required='false'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_247.4' id='input_49_247_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_49_247_5_container' >\n                                    <label for='input_49_247_5' id='input_49_247_5_label' class='gform-field-label gform-field-label--type-sub '>Postcode<\/label>\n                                    <input type='text' name='input_247.5' id='input_49_247_5' value=''   placeholder='Postcode' aria-required='false'    \/>\n                                <\/span><span class='ginput_left address_country ginput_address_country gform-grid-col' id='input_49_247_6_container' >\n                                        <label for='input_49_247_6' id='input_49_247_6_label' class='gform-field-label gform-field-label--type-sub '>Land<\/label>\n                                        <select name='input_247.6' id='input_49_247_6'   aria-required='false'    ><option value='' ><\/option><option value='AF' >Afghanistan<\/option><option value='AX' >Aland-eilanden<\/option><option value='AL' >Albani\u00eb<\/option><option value='DZ' >Algerije<\/option><option value='AS' >Amerikaans Samoa<\/option><option value='VI' >Amerikaanse Maagdeneilanden<\/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 en Barbuda<\/option><option value='SY' >Arabische Republiek Syri\u00eb<\/option><option value='AR' >Argentini\u00eb<\/option><option value='AM' >Armeni\u00eb<\/option><option value='AW' >Aruba<\/option><option value='AU' >Australi\u00eb<\/option><option value='AZ' >Azerbeidzjan<\/option><option value='BS' >Bahama&#039;s<\/option><option value='BH' >Bahrein<\/option><option value='BD' >Bangladesh<\/option><option value='BB' >Barbados<\/option><option value='BE' selected='selected'>Belgi\u00eb<\/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 en Saba<\/option><option value='BA' >Bosni\u00eb en Herzegovina<\/option><option value='BW' >Botswana<\/option><option value='BV' >Bouvet eiland<\/option><option value='BR' >Brazili\u00eb<\/option><option value='IO' >Brits-Indisch oceaan gebied<\/option><option value='VG' >Britse Maagdeneilanden<\/option><option value='BN' >Brunei Darussalam<\/option><option value='BG' >Bulgarije<\/option><option value='BF' >Burkina Faso<\/option><option value='BI' >Burundi<\/option><option value='KH' >Cambodja<\/option><option value='CA' >Canada<\/option><option value='CF' >Centraal-Afrikaanse Republiek<\/option><option value='CL' >Chili<\/option><option value='CN' >China<\/option><option value='CC' >Cocoseilanden<\/option><option value='CO' >Colombia<\/option><option value='KM' >Comoren<\/option><option value='CG' >Congo<\/option><option value='CD' >Congo, Democratische Republiek<\/option><option value='CK' >Cook eilanden<\/option><option value='CR' >Costa Rica<\/option><option value='CU' >Cuba<\/option><option value='CW' >Cura\u00e7ao<\/option><option value='CY' >Cyprus<\/option><option value='DK' >Denemarken<\/option><option value='DJ' >Djibouti<\/option><option value='DM' >Dominica<\/option><option value='DO' >Dominicaanse Republiek<\/option><option value='DE' >Duitsland<\/option><option value='EC' >Ecuador<\/option><option value='EG' >Egypte<\/option><option value='SV' >El Salvador<\/option><option value='GQ' >Equatoriaal-Guinea<\/option><option value='ER' >Eritrea<\/option><option value='EE' >Estland<\/option><option value='SZ' >Eswatini<\/option><option value='ET' >Ethiopi\u00eb<\/option><option value='FO' >Faer\u00f6er<\/option><option value='FK' >Falkland eilanden<\/option><option value='FJ' >Fiji<\/option><option value='PH' >Filipijnen<\/option><option value='FI' >Finland<\/option><option value='FR' >Frankrijk<\/option><option value='GF' >Frans Guyana<\/option><option value='PF' >Frans-Polynesi\u00eb<\/option><option value='TF' >Franse zuidelijke gebieden<\/option><option value='GA' >Gabon<\/option><option value='GM' >Gambia<\/option><option value='GE' >Georgi\u00eb<\/option><option value='GH' >Ghana<\/option><option value='GI' >Gibraltar<\/option><option value='GD' >Grenada<\/option><option value='GR' >Griekenland<\/option><option value='GL' >Groenland<\/option><option value='GP' >Guadeloupe<\/option><option value='GU' >Guam<\/option><option value='GT' >Guatemala<\/option><option value='GG' >Guernsey<\/option><option value='GN' >Guinee<\/option><option value='GW' >Guinee-Bissau<\/option><option value='GY' >Guyana<\/option><option value='HT' >Ha\u00efti<\/option><option value='HM' >Heard Eiland en McDonald Eilanden<\/option><option value='HN' >Honduras<\/option><option value='HK' >Hong Kong<\/option><option value='HU' >Hongarije<\/option><option value='IE' >Ierland<\/option><option value='IS' >IJsland<\/option><option value='IN' >India<\/option><option value='ID' >Indonesi\u00eb<\/option><option value='IQ' >Irak<\/option><option value='IR' >Iran<\/option><option value='IL' >Isra\u00ebl<\/option><option value='IT' >Itali\u00eb<\/option><option value='CI' >Ivoorkust<\/option><option value='JM' >Jamaica<\/option><option value='JP' >Japan<\/option><option value='JE' >Jersey<\/option><option value='GS' >Ji\u017en\u00ed Georgie a Ji\u017en\u00ed Sandwichovy ostrovy<\/option><option value='JO' >Jordani\u00eb<\/option><option value='KY' >Kaaimaneilanden<\/option><option value='CV' >Kaapverdi\u00eb<\/option><option value='CM' >Kameroen<\/option><option value='KZ' >Kazachstan<\/option><option value='KE' >Kenia<\/option><option value='CX' >Kersteiland<\/option><option value='KG' >Kirgizi\u00eb<\/option><option value='KI' >Kiribati<\/option><option value='UM' >Kleine eilanden van de Verenigde Staten<\/option><option value='KW' >Koeweit<\/option><option value='KP' >Korea, Democratische Volksrepubliek<\/option><option value='KR' >Korea, Republiek van<\/option><option value='HR' >Kroati\u00eb<\/option><option value='LA' >Lao Democratische Volksrepubliek<\/option><option value='LS' >Lesotho<\/option><option value='LV' >Letland<\/option><option value='LB' >Libanon<\/option><option value='LR' >Liberia<\/option><option value='LY' >Libi\u00eb<\/option><option value='LI' >Liechtenstein<\/option><option value='LT' >Litouwen<\/option><option value='LU' >Luxemburg<\/option><option value='MO' >Macau<\/option><option value='MG' >Madagaskar<\/option><option value='MW' >Malawi<\/option><option value='MV' >Maldiven<\/option><option value='MY' >Maleisi\u00eb<\/option><option value='ML' >Mali<\/option><option value='MT' >Malta<\/option><option value='IM' >Man<\/option><option value='MA' >Marokko<\/option><option value='MH' >Marshalleilanden<\/option><option value='MQ' >Martinique<\/option><option value='MR' >Mauritani\u00eb<\/option><option value='MU' >Mauritius<\/option><option value='YT' >Mayotte<\/option><option value='MX' >Mexico<\/option><option value='FM' >Micronesia<\/option><option value='MD' >Moldavi\u00eb<\/option><option value='MC' >Monaco<\/option><option value='MN' >Mongoli\u00eb<\/option><option value='ME' >Montenegro<\/option><option value='MS' >Montserrat<\/option><option value='MZ' >Mozambique<\/option><option value='MM' >Myanmar<\/option><option value='NA' >Namibi\u00eb<\/option><option value='NR' >Nauru<\/option><option value='NL' >Nederland<\/option><option value='NP' >Nepal<\/option><option value='NI' >Nicaragua<\/option><option value='NC' >Nieuw-Caledoni\u00eb<\/option><option value='NZ' >Nieuw-Zeeland<\/option><option value='NE' >Niger<\/option><option value='NG' >Nigeria<\/option><option value='NU' >Niue<\/option><option value='MK' >Noord-Macedoni\u00eb<\/option><option value='MP' >Noordelijke Marianen<\/option><option value='NO' >Noorwegen<\/option><option value='NF' >Norfolk eiland<\/option><option value='UG' >Oeganda<\/option><option value='UA' >Oekra\u00efne<\/option><option value='UZ' >Oezbekistan<\/option><option value='OM' >Oman<\/option><option value='AT' >Oostenrijk<\/option><option value='PK' >Pakistan<\/option><option value='PW' >Palau<\/option><option value='PS' >Palestina, Staat<\/option><option value='PA' >Panama<\/option><option value='PG' >Papoea-Nieuw-Guinea<\/option><option value='PY' >Paraguay<\/option><option value='PE' >Peru<\/option><option value='PN' >Pitcairn<\/option><option value='PL' >Polen<\/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' >Roemeni\u00eb<\/option><option value='RU' >Russische Federatie<\/option><option value='RW' >Rwanda<\/option><option value='BL' >Saint Barth\u00e9lemy<\/option><option value='KN' >Saint Kitts en Nevis<\/option><option value='LC' >Saint Lucia<\/option><option value='PM' >Saint Pierre en Miquelon<\/option><option value='VC' >Saint Vincent en de Grenadines<\/option><option value='SB' >Salomonseilanden<\/option><option value='WS' >Samoa<\/option><option value='SM' >San Marino<\/option><option value='ST' >Sao Tom\u00e9 en Principe<\/option><option value='SA' >Saoedi-Arabi\u00eb<\/option><option value='SN' >Senegal<\/option><option value='RS' >Servi\u00eb<\/option><option value='SC' >Seychellen<\/option><option value='SL' >Sierra Leone<\/option><option value='SG' >Singapore<\/option><option value='SX' >Sint Maarten<\/option><option value='MF' >Sint Maarten<\/option><option value='SH' >Sint-Helena, Hemelvaart en Tristan da Cunha<\/option><option value='SI' >Sloveni\u00eb<\/option><option value='SK' >Slowakije<\/option><option value='SD' >Soedan<\/option><option value='SO' >Somali\u00eb<\/option><option value='ES' >Spanje<\/option><option value='SJ' >Spitsbergen en Jan Mayen<\/option><option value='LK' >Sri Lanka<\/option><option value='SR' >Suriname<\/option><option value='TJ' >Tadzjikistan<\/option><option value='TW' >Taiwan<\/option><option value='TZ' >Tanzania, de Verenigde Republiek van<\/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 en Tobago<\/option><option value='TD' >Tsjaad<\/option><option value='CZ' >Tsjechi\u00eb<\/option><option value='TN' >Tunesi\u00eb<\/option><option value='TR' >Turkije<\/option><option value='TM' >Turkmenistan<\/option><option value='TC' >Turks- en Caicoseilanden<\/option><option value='TV' >Tuvalu<\/option><option value='UY' >Uruguay<\/option><option value='VU' >Vanuatu<\/option><option value='VA' >Vaticaanstad<\/option><option value='VE' >Venezuela<\/option><option value='GB' >Verenigd Koninkrijk<\/option><option value='AE' >Verenigde Arabische Emiraten<\/option><option value='US' >Verenigde Staten<\/option><option value='VN' >Vietnam<\/option><option value='WF' >Wallis en Futuna<\/option><option value='EH' >Westelijke Sahara<\/option><option value='BY' >Wit-Rusland<\/option><option value='YE' >Yemen<\/option><option value='ZM' >Zambia<\/option><option value='ZW' >Zimbabwe<\/option><option value='SS' >Zuid Soedan<\/option><option value='ZA' >Zuid-Afrika<\/option><option value='SE' >Zweden<\/option><option value='CH' >Zwitserland<\/option> <\/select>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><input type=\"hidden\" name=\"gpaa_place_247\" class=\"gform_hidden\" value=\"\"><\/fieldset><div id=\"field_49_264\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"c8c669f3\" data-field-span=\"12\"><label id='gfield_label_49_264' class='gfield_label gform-field-label' for='input_49_264'><span class='gform-field-label__text'>Sinds<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_264' id='input_49_264' type='text' value='' class='medium'    placeholder='DD\/MM\/JJJ'  aria-invalid=\"false\"   data-mask=\"99\/99\/9999\"\/><\/div><\/div><div id=\"field_49_53\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"7703fa40\" data-field-span=\"12\" data-currency-format='1'><label id='gfield_label_49_53' class='gfield_label gform-field-label' for='input_49_53'><span class='gform-field-label__text'>Netto maandelijks inkomen<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_53' id='input_49_53' type='text' step='any'   value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_49_196\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_above gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"e716f133\" data-field-span=\"12\"><legend id='gfield_label_49_196' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Hello24 info<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_49_196'><div class='gchoice gchoice_49_196_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_196.1' type='checkbox'  value='Ik ontvang graag vrijblijvend informatie van HelloDeevie over financi\u00eble oplossingen die voor mij interessant kunnen zijn.'  id='choice_49_196_1'    aria-labelledby=\"label_49_196_1 gfield_label_49_196\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_49_196_1' id='label_49_196_1' class='gform-field-label gform-field-label--type-inline'>Ik ontvang graag vrijblijvend informatie van HelloDeevie over financi\u00eble oplossingen die voor mij interessant kunnen zijn.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_49_260\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"88145670\" data-field-span=\"12\"><legend id='gfield_label_49_260' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Heeft u kinderen ten laste?<\/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_49_260'>\n\t\t\t<div class='gchoice gchoice_49_260_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_260' type='radio' value='Ja'  id='choice_49_260_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_49_260_0 gfield_label_49_260\"   \/>\n\t\t\t\t\t<label for='choice_49_260_0' id='label_49_260_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_49_260_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_260' type='radio' value='Nee'  id='choice_49_260_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_49_260_1' id='label_49_260_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_49_287\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"8eba9140\" data-field-span=\"12\" data-currency-format='1'><label id='gfield_label_49_287' class='gfield_label gform-field-label' for='input_49_287'><span class='gform-field-label__text'>Maandelijks bedrag kindergeld<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_287' id='input_49_287' type='text' step='any'   value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_49_261\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"bdffa9f5\" data-field-span=\"12\"><legend id='gfield_label_49_261' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Betaalt u alimentatie?<\/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_49_261'>\n\t\t\t<div class='gchoice gchoice_49_261_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_261' type='radio' value='Ja'  id='choice_49_261_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_49_261_0 gfield_label_49_261\"   \/>\n\t\t\t\t\t<label for='choice_49_261_0' id='label_49_261_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_49_261_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_261' type='radio' value='Nee'  id='choice_49_261_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_49_261_1' id='label_49_261_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_49_273\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"74434180\" data-field-span=\"12\" data-currency-format='1'><label id='gfield_label_49_273' class='gfield_label gform-field-label' for='input_49_273'><span class='gform-field-label__text'>Maandelijks bedrag alimentatie<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_273' id='input_49_273' type='text' step='any'   value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_49_283\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"402a1e63\" data-field-span=\"12\"><legend id='gfield_label_49_283' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Heeft u andere bronnen van inkomst?<\/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_49_283'>\n\t\t\t<div class='gchoice gchoice_49_283_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_283' type='radio' value='Ja'  id='choice_49_283_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_49_283_0 gfield_label_49_283\"   \/>\n\t\t\t\t\t<label for='choice_49_283_0' id='label_49_283_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_49_283_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_283' type='radio' value='Nee'  id='choice_49_283_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_49_283_1' id='label_49_283_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_49_272\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"76cb20e5\" data-field-span=\"12\"><h3 class=\"gsection_title\">Andere bronnen van inkomsten<\/h3><\/div><div id=\"field_49_274\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"527de247\" data-field-span=\"4\" data-currency-format='1'><label id='gfield_label_49_274' class='gfield_label gform-field-label' for='input_49_274'><span class='gform-field-label__text'>Alimentatie<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_274' id='input_49_274' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_49_282\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"527de247\" data-field-span=\"4\" data-currency-format='1'><label id='gfield_label_49_282' class='gfield_label gform-field-label' for='input_49_282'><span class='gform-field-label__text'>Invaliditeit<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_282' id='input_49_282' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_49_280\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"527de247\" data-field-span=\"4\" data-currency-format='1'><label id='gfield_label_49_280' class='gfield_label gform-field-label' for='input_49_280'><span class='gform-field-label__text'>Pensioen<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_280' id='input_49_280' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_49_279\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"521e5bcd\" data-field-span=\"4\" data-currency-format='1'><label id='gfield_label_49_279' class='gfield_label gform-field-label' for='input_49_279'><span class='gform-field-label__text'>Ziekefonds<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_279' id='input_49_279' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_49_278\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"521e5bcd\" data-field-span=\"4\" data-currency-format='1'><label id='gfield_label_49_278' class='gfield_label gform-field-label' for='input_49_278'><span class='gform-field-label__text'>Werkloos<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_278' id='input_49_278' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_49_277\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"521e5bcd\" data-field-span=\"4\" data-currency-format='1'><label id='gfield_label_49_277' class='gfield_label gform-field-label' for='input_49_277'><span class='gform-field-label__text'>Handicap<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_277' id='input_49_277' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_49_276\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"36145422\" data-field-span=\"4\" data-currency-format='1'><label id='gfield_label_49_276' class='gfield_label gform-field-label' for='input_49_276'><span class='gform-field-label__text'>Huurinkomst<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_276' id='input_49_276' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_49_275\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"36145422\" data-field-span=\"4\" data-currency-format='1'><label id='gfield_label_49_275' class='gfield_label gform-field-label' for='input_49_275'><span class='gform-field-label__text'>Maaltijdcheques<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_275' id='input_49_275' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_49_284\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"36145422\" data-field-span=\"4\" data-currency-format='1'><label id='gfield_label_49_284' class='gfield_label gform-field-label' for='input_49_284'><span class='gform-field-label__text'>Andere<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_284' id='input_49_284' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_49_57\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"713aea33\" data-field-span=\"12\"><h3 class=\"gsection_title\">Partner<\/h3><\/div><fieldset id=\"field_49_58\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"cf26884f\" data-field-span=\"12\"><legend id='gfield_label_49_58' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Naam<\/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_49_58'>\n                            \n                            <span id='input_49_58_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_58.3' id='input_49_58_3' value=''   aria-required='true'   placeholder='Voornaam'  aria-labelledby=\"input_49_58_3_label gfield_label_49_58\"\/>\n                                                    <label for='input_49_58_3' id='input_49_58_3_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Voornaam<\/label>\n                                                <\/span>\n                            \n                            <span id='input_49_58_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_58.6' id='input_49_58_6' value=''   aria-required='true'   placeholder='Achternaam'  \/>\n                                                    <label for='input_49_58_6' id='input_49_58_6_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Achternaam<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_49_212\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-five-twelfths gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"866be331\" data-field-span=\"5\"><label id='gfield_label_49_212' class='gfield_label gform-field-label' for='input_49_212'><span class='gform-field-label__text'>Geboortedatum<\/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_212' id='input_49_212' type='text' value='' class='large'    placeholder='DD\/MM\/JJJ' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"99\/99\/9999\"\/><\/div><\/div><div data-field-id=\"212\" class=\"spacer gfield\" style=\"grid-column: span 7;\" data-group-id=\"866be331\"><\/div><div id=\"field_49_170\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gpev-field\" data-field-class=\"gpev-field\" data-group-id=\"673c2065\" data-field-span=\"6\"><label id='gfield_label_49_170' class='gfield_label gform-field-label' for='input_49_170'><span class='gform-field-label__text'>Email Adres<\/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_170' id='input_49_170' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_49_171\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-international gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"673c2065\" data-field-span=\"6\"><label id='gfield_label_49_171' class='gfield_label gform-field-label' for='input_49_171'><span class='gform-field-label__text'>Gsm-nummer<\/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_171' id='input_49_171' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"tel\"  \/><\/div><\/div><fieldset id=\"field_49_168\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"67f885c3\" data-field-span=\"12\"><legend id='gfield_label_49_168' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Adres van uw partner<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    <div id='input_49_168_copy_values_option_container' class='copy_values_option_container' >\n                                        <input type='checkbox' id='input_49_168_copy_values_activated' class='copy_values_activated' value='1' data-source_field_id='4' data-source-field-label='Uw Adres' data-destination-field-label='Adres van uw partner' name='input_168_copy_values_activated'  \/>\n                                        <label for='input_49_168_copy_values_activated' id='input_49_168_copy_values_option_label' class='copy_values_option_label inline gform-field-label gform-field-label--type-inline'>Zelfde adres<\/label>\n                                    <\/div>\n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_zip has_country ginput_container_address gform-grid-row' id='input_49_168' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_49_168_1_container' >\n                                        <label for='input_49_168_1' id='input_49_168_1_label' class='gform-field-label gform-field-label--type-sub '>Straat en nummer<\/label>\n                                        <input type='text' name='input_168.1' id='input_49_168_1' value=''   placeholder='Straat en nummer' aria-required='true'    aria-labelledby=\"input_49_168_1_label gfield_label_49_168\"\/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_49_168_2_container' >\n                                        <label for='input_49_168_2' id='input_49_168_2_label' class='gform-field-label gform-field-label--type-sub '>Bus (Optioneel)<\/label>\n                                        <input type='text' name='input_168.2' id='input_49_168_2' value=''   placeholder='Bus'  aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_49_168_3_container' >\n                                    <label for='input_49_168_3' id='input_49_168_3_label' class='gform-field-label gform-field-label--type-sub '>Stad<\/label>\n                                    <input type='text' name='input_168.3' id='input_49_168_3' value=''   placeholder='Stad' aria-required='true'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_168.4' id='input_49_168_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_49_168_5_container' >\n                                    <label for='input_49_168_5' id='input_49_168_5_label' class='gform-field-label gform-field-label--type-sub '>Postcode<\/label>\n                                    <input type='text' name='input_168.5' id='input_49_168_5' value=''   placeholder='Postcode' aria-required='true'    \/>\n                                <\/span><span class='ginput_left address_country ginput_address_country gform-grid-col' id='input_49_168_6_container' >\n                                        <label for='input_49_168_6' id='input_49_168_6_label' class='gform-field-label gform-field-label--type-sub '>Land<\/label>\n                                        <select name='input_168.6' id='input_49_168_6'   aria-required='true'    ><option value='' >Land<\/option><option value='AF' >Afghanistan<\/option><option value='AX' >Aland-eilanden<\/option><option value='AL' >Albani\u00eb<\/option><option value='DZ' >Algerije<\/option><option value='AS' >Amerikaans Samoa<\/option><option value='VI' >Amerikaanse Maagdeneilanden<\/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 en Barbuda<\/option><option value='SY' >Arabische Republiek Syri\u00eb<\/option><option value='AR' >Argentini\u00eb<\/option><option value='AM' >Armeni\u00eb<\/option><option value='AW' >Aruba<\/option><option value='AU' >Australi\u00eb<\/option><option value='AZ' >Azerbeidzjan<\/option><option value='BS' >Bahama&#039;s<\/option><option value='BH' >Bahrein<\/option><option value='BD' >Bangladesh<\/option><option value='BB' >Barbados<\/option><option value='BE' selected='selected'>Belgi\u00eb<\/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 en Saba<\/option><option value='BA' >Bosni\u00eb en Herzegovina<\/option><option value='BW' >Botswana<\/option><option value='BV' >Bouvet eiland<\/option><option value='BR' >Brazili\u00eb<\/option><option value='IO' >Brits-Indisch oceaan gebied<\/option><option value='VG' >Britse Maagdeneilanden<\/option><option value='BN' >Brunei Darussalam<\/option><option value='BG' >Bulgarije<\/option><option value='BF' >Burkina Faso<\/option><option value='BI' >Burundi<\/option><option value='KH' >Cambodja<\/option><option value='CA' >Canada<\/option><option value='CF' >Centraal-Afrikaanse Republiek<\/option><option value='CL' >Chili<\/option><option value='CN' >China<\/option><option value='CC' >Cocoseilanden<\/option><option value='CO' >Colombia<\/option><option value='KM' >Comoren<\/option><option value='CG' >Congo<\/option><option value='CD' >Congo, Democratische Republiek<\/option><option value='CK' >Cook eilanden<\/option><option value='CR' >Costa Rica<\/option><option value='CU' >Cuba<\/option><option value='CW' >Cura\u00e7ao<\/option><option value='CY' >Cyprus<\/option><option value='DK' >Denemarken<\/option><option value='DJ' >Djibouti<\/option><option value='DM' >Dominica<\/option><option value='DO' >Dominicaanse Republiek<\/option><option value='DE' >Duitsland<\/option><option value='EC' >Ecuador<\/option><option value='EG' >Egypte<\/option><option value='SV' >El Salvador<\/option><option value='GQ' >Equatoriaal-Guinea<\/option><option value='ER' >Eritrea<\/option><option value='EE' >Estland<\/option><option value='SZ' >Eswatini<\/option><option value='ET' >Ethiopi\u00eb<\/option><option value='FO' >Faer\u00f6er<\/option><option value='FK' >Falkland eilanden<\/option><option value='FJ' >Fiji<\/option><option value='PH' >Filipijnen<\/option><option value='FI' >Finland<\/option><option value='FR' >Frankrijk<\/option><option value='GF' >Frans Guyana<\/option><option value='PF' >Frans-Polynesi\u00eb<\/option><option value='TF' >Franse zuidelijke gebieden<\/option><option value='GA' >Gabon<\/option><option value='GM' >Gambia<\/option><option value='GE' >Georgi\u00eb<\/option><option value='GH' >Ghana<\/option><option value='GI' >Gibraltar<\/option><option value='GD' >Grenada<\/option><option value='GR' >Griekenland<\/option><option value='GL' >Groenland<\/option><option value='GP' >Guadeloupe<\/option><option value='GU' >Guam<\/option><option value='GT' >Guatemala<\/option><option value='GG' >Guernsey<\/option><option value='GN' >Guinee<\/option><option value='GW' >Guinee-Bissau<\/option><option value='GY' >Guyana<\/option><option value='HT' >Ha\u00efti<\/option><option value='HM' >Heard Eiland en McDonald Eilanden<\/option><option value='HN' >Honduras<\/option><option value='HK' >Hong Kong<\/option><option value='HU' >Hongarije<\/option><option value='IE' >Ierland<\/option><option value='IS' >IJsland<\/option><option value='IN' >India<\/option><option value='ID' >Indonesi\u00eb<\/option><option value='IQ' >Irak<\/option><option value='IR' >Iran<\/option><option value='IL' >Isra\u00ebl<\/option><option value='IT' >Itali\u00eb<\/option><option value='CI' >Ivoorkust<\/option><option value='JM' >Jamaica<\/option><option value='JP' >Japan<\/option><option value='JE' >Jersey<\/option><option value='GS' >Ji\u017en\u00ed Georgie a Ji\u017en\u00ed Sandwichovy ostrovy<\/option><option value='JO' >Jordani\u00eb<\/option><option value='KY' >Kaaimaneilanden<\/option><option value='CV' >Kaapverdi\u00eb<\/option><option value='CM' >Kameroen<\/option><option value='KZ' >Kazachstan<\/option><option value='KE' >Kenia<\/option><option value='CX' >Kersteiland<\/option><option value='KG' >Kirgizi\u00eb<\/option><option value='KI' >Kiribati<\/option><option value='UM' >Kleine eilanden van de Verenigde Staten<\/option><option value='KW' >Koeweit<\/option><option value='KP' >Korea, Democratische Volksrepubliek<\/option><option value='KR' >Korea, Republiek van<\/option><option value='HR' >Kroati\u00eb<\/option><option value='LA' >Lao Democratische Volksrepubliek<\/option><option value='LS' >Lesotho<\/option><option value='LV' >Letland<\/option><option value='LB' >Libanon<\/option><option value='LR' >Liberia<\/option><option value='LY' >Libi\u00eb<\/option><option value='LI' >Liechtenstein<\/option><option value='LT' >Litouwen<\/option><option value='LU' >Luxemburg<\/option><option value='MO' >Macau<\/option><option value='MG' >Madagaskar<\/option><option value='MW' >Malawi<\/option><option value='MV' >Maldiven<\/option><option value='MY' >Maleisi\u00eb<\/option><option value='ML' >Mali<\/option><option value='MT' >Malta<\/option><option value='IM' >Man<\/option><option value='MA' >Marokko<\/option><option value='MH' >Marshalleilanden<\/option><option value='MQ' >Martinique<\/option><option value='MR' >Mauritani\u00eb<\/option><option value='MU' >Mauritius<\/option><option value='YT' >Mayotte<\/option><option value='MX' >Mexico<\/option><option value='FM' >Micronesia<\/option><option value='MD' >Moldavi\u00eb<\/option><option value='MC' >Monaco<\/option><option value='MN' >Mongoli\u00eb<\/option><option value='ME' >Montenegro<\/option><option value='MS' >Montserrat<\/option><option value='MZ' >Mozambique<\/option><option value='MM' >Myanmar<\/option><option value='NA' >Namibi\u00eb<\/option><option value='NR' >Nauru<\/option><option value='NL' >Nederland<\/option><option value='NP' >Nepal<\/option><option value='NI' >Nicaragua<\/option><option value='NC' >Nieuw-Caledoni\u00eb<\/option><option value='NZ' >Nieuw-Zeeland<\/option><option value='NE' >Niger<\/option><option value='NG' >Nigeria<\/option><option value='NU' >Niue<\/option><option value='MK' >Noord-Macedoni\u00eb<\/option><option value='MP' >Noordelijke Marianen<\/option><option value='NO' >Noorwegen<\/option><option value='NF' >Norfolk eiland<\/option><option value='UG' >Oeganda<\/option><option value='UA' >Oekra\u00efne<\/option><option value='UZ' >Oezbekistan<\/option><option value='OM' >Oman<\/option><option value='AT' >Oostenrijk<\/option><option value='PK' >Pakistan<\/option><option value='PW' >Palau<\/option><option value='PS' >Palestina, Staat<\/option><option value='PA' >Panama<\/option><option value='PG' >Papoea-Nieuw-Guinea<\/option><option value='PY' >Paraguay<\/option><option value='PE' >Peru<\/option><option value='PN' >Pitcairn<\/option><option value='PL' >Polen<\/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' >Roemeni\u00eb<\/option><option value='RU' >Russische Federatie<\/option><option value='RW' >Rwanda<\/option><option value='BL' >Saint Barth\u00e9lemy<\/option><option value='KN' >Saint Kitts en Nevis<\/option><option value='LC' >Saint Lucia<\/option><option value='PM' >Saint Pierre en Miquelon<\/option><option value='VC' >Saint Vincent en de Grenadines<\/option><option value='SB' >Salomonseilanden<\/option><option value='WS' >Samoa<\/option><option value='SM' >San Marino<\/option><option value='ST' >Sao Tom\u00e9 en Principe<\/option><option value='SA' >Saoedi-Arabi\u00eb<\/option><option value='SN' >Senegal<\/option><option value='RS' >Servi\u00eb<\/option><option value='SC' >Seychellen<\/option><option value='SL' >Sierra Leone<\/option><option value='SG' >Singapore<\/option><option value='SX' >Sint Maarten<\/option><option value='MF' >Sint Maarten<\/option><option value='SH' >Sint-Helena, Hemelvaart en Tristan da Cunha<\/option><option value='SI' >Sloveni\u00eb<\/option><option value='SK' >Slowakije<\/option><option value='SD' >Soedan<\/option><option value='SO' >Somali\u00eb<\/option><option value='ES' >Spanje<\/option><option value='SJ' >Spitsbergen en Jan Mayen<\/option><option value='LK' >Sri Lanka<\/option><option value='SR' >Suriname<\/option><option value='TJ' >Tadzjikistan<\/option><option value='TW' >Taiwan<\/option><option value='TZ' >Tanzania, de Verenigde Republiek van<\/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 en Tobago<\/option><option value='TD' >Tsjaad<\/option><option value='CZ' >Tsjechi\u00eb<\/option><option value='TN' >Tunesi\u00eb<\/option><option value='TR' >Turkije<\/option><option value='TM' >Turkmenistan<\/option><option value='TC' >Turks- en Caicoseilanden<\/option><option value='TV' >Tuvalu<\/option><option value='UY' >Uruguay<\/option><option value='VU' >Vanuatu<\/option><option value='VA' >Vaticaanstad<\/option><option value='VE' >Venezuela<\/option><option value='GB' >Verenigd Koninkrijk<\/option><option value='AE' >Verenigde Arabische Emiraten<\/option><option value='US' >Verenigde Staten<\/option><option value='VN' >Vietnam<\/option><option value='WF' >Wallis en Futuna<\/option><option value='EH' >Westelijke Sahara<\/option><option value='BY' >Wit-Rusland<\/option><option value='YE' >Yemen<\/option><option value='ZM' >Zambia<\/option><option value='ZW' >Zimbabwe<\/option><option value='SS' >Zuid Soedan<\/option><option value='ZA' >Zuid-Afrika<\/option><option value='SE' >Zweden<\/option><option value='CH' >Zwitserland<\/option> <\/select>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><input type=\"hidden\" name=\"gpaa_place_168\" class=\"gform_hidden\" value=\"\"><\/fieldset><div id=\"field_49_199\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"e9262396\" data-field-span=\"6\"><label id='gfield_label_49_199' class='gfield_label gform-field-label' for='input_49_199'><span class='gform-field-label__text'>Beroeps statuut<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_199' id='input_49_199' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='011' >Bediende<\/option><option value='062' >Gepensioneerde<\/option><option value='022' >Werkloos<\/option><option value='010' >Ambtenaar<\/option><option value='013' >Zelfstandige<\/option><option value='021' >Invalide<\/option><option value='012' >Ziekenkas (Arbeidsongeschikt)<\/option><option value='033' >Bruggepensioneerde<\/option><option value='080' >Huisvrouw \/ Huisman<\/option><\/select><\/div><\/div><div id=\"field_49_200\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"e9262396\" data-field-span=\"6\"><label id='gfield_label_49_200' class='gfield_label gform-field-label' for='input_49_200'><span class='gform-field-label__text'>Type arbeidscontract<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_200' id='input_49_200' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='004' >Contractueel<\/option><option value='001' >Bepaalde duur<\/option><option value='002' >Onbepaalde duur<\/option><option value='003' >Interim<\/option><option value='005' >Statutair<\/option><option value='Andere' >Andere<\/option><option value='998' >Niet van toepassing<\/option><\/select><\/div><\/div><div id=\"field_49_201\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"ee6c3385\" data-field-span=\"12\"><label id='gfield_label_49_201' class='gfield_label gform-field-label' for='input_49_201'><span class='gform-field-label__text'>Andere (Type arbeidscontract)<\/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_201' id='input_49_201' type='text' value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_49_202\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"790d4476\" data-field-span=\"6\"><label id='gfield_label_49_202' class='gfield_label gform-field-label' for='input_49_202'><span class='gform-field-label__text'>Sector<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_202' id='input_49_202' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='008' >Landbouw\/Visserij<\/option><option value='007' >Bouw<\/option><option value='005' >Grote ondernemingen (+50 pers)<\/option><option value='002' >Kleine ondernemingen (-50 pers)<\/option><option value='001' >Openbare sector<\/option><option value='003' >Supranationaal<\/option><option value='Andere' >Andere<\/option><\/select><\/div><\/div><div id=\"field_49_203\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"790d4476\" data-field-span=\"6\"><label id='gfield_label_49_203' class='gfield_label gform-field-label' for='input_49_203'><span class='gform-field-label__text'>Type beroep<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_203' id='input_49_203' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='131' >Kaderleden\/Ingenieurs<\/option><option value='114' >Bestuurder\/Chauffeur\/Vrachtwagenchauffeur<\/option><option value='132' >Directielid, Zaakvoerder, Bestuurder<\/option><option value='134' >Kantoorbediende<\/option><option value='138' >Onderwijs<\/option><option value='172' >Ordediensten\/Brandweer<\/option><option value='164' >Bewaker\/Beveiliging<\/option><option value='110' >Handlanger\/Ongeschoolde arbeider<\/option><option value='162' >Officier bij de strijdkrachten<\/option><option value='Andere' >Andere<\/option><\/select><\/div><\/div><div id=\"field_49_204\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"20b4e97b\" data-field-span=\"6\"><label id='gfield_label_49_204' class='gfield_label gform-field-label' for='input_49_204'><span class='gform-field-label__text'>Andere (Sector)<\/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_204' id='input_49_204' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_49_205\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"20b4e97b\" data-field-span=\"6\"><label id='gfield_label_49_205' class='gfield_label gform-field-label' for='input_49_205'><span class='gform-field-label__text'>Andere (Type beroep)<\/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_205' id='input_49_205' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_49_132\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"862e20f4\" data-field-span=\"12\"><label id='gfield_label_49_132' class='gfield_label gform-field-label' for='input_49_132'><span class='gform-field-label__text'>Naam werkgever<\/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_132' id='input_49_132' type='text' value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_49_250\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"dad82fe2\" data-field-span=\"12\"><legend id='gfield_label_49_250' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Adres van werkgever (minstens gemeente + postcode)<\/span><\/legend><div class='gfield_description' id='gfield_description_49_250'>Indien u het exacte adres niet kent, volstaat gemeente + postcode. Dit heeft geen impact op uw aanvraag.<\/div>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_zip has_country ginput_container_address gform-grid-row' id='input_49_250' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_49_250_1_container' >\n                                        <label for='input_49_250_1' id='input_49_250_1_label' class='gform-field-label gform-field-label--type-sub '>Straat en nummer<\/label>\n                                        <input type='text' name='input_250.1' id='input_49_250_1' value=''   placeholder='Straat en nummer' aria-required='false'    aria-describedby=\"gfield_description_49_250\" aria-labelledby=\"input_49_250_1_label gfield_label_49_250\"\/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_49_250_2_container' >\n                                        <label for='input_49_250_2' id='input_49_250_2_label' class='gform-field-label gform-field-label--type-sub '>Bus<\/label>\n                                        <input type='text' name='input_250.2' id='input_49_250_2' value=''   placeholder='Bus'  aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_49_250_3_container' >\n                                    <label for='input_49_250_3' id='input_49_250_3_label' class='gform-field-label gform-field-label--type-sub '>Stad<\/label>\n                                    <input type='text' name='input_250.3' id='input_49_250_3' value=''   placeholder='Stad' aria-required='false'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_250.4' id='input_49_250_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_49_250_5_container' >\n                                    <label for='input_49_250_5' id='input_49_250_5_label' class='gform-field-label gform-field-label--type-sub '>Postcode<\/label>\n                                    <input type='text' name='input_250.5' id='input_49_250_5' value=''   placeholder='Postcode' aria-required='false'    \/>\n                                <\/span><span class='ginput_left address_country ginput_address_country gform-grid-col' id='input_49_250_6_container' >\n                                        <label for='input_49_250_6' id='input_49_250_6_label' class='gform-field-label gform-field-label--type-sub '>Land<\/label>\n                                        <select name='input_250.6' id='input_49_250_6'   aria-required='false'    ><option value='' ><\/option><option value='AF' >Afghanistan<\/option><option value='AX' >Aland-eilanden<\/option><option value='AL' >Albani\u00eb<\/option><option value='DZ' >Algerije<\/option><option value='AS' >Amerikaans Samoa<\/option><option value='VI' >Amerikaanse Maagdeneilanden<\/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 en Barbuda<\/option><option value='SY' >Arabische Republiek Syri\u00eb<\/option><option value='AR' >Argentini\u00eb<\/option><option value='AM' >Armeni\u00eb<\/option><option value='AW' >Aruba<\/option><option value='AU' >Australi\u00eb<\/option><option value='AZ' >Azerbeidzjan<\/option><option value='BS' >Bahama&#039;s<\/option><option value='BH' >Bahrein<\/option><option value='BD' >Bangladesh<\/option><option value='BB' >Barbados<\/option><option value='BE' selected='selected'>Belgi\u00eb<\/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 en Saba<\/option><option value='BA' >Bosni\u00eb en Herzegovina<\/option><option value='BW' >Botswana<\/option><option value='BV' >Bouvet eiland<\/option><option value='BR' >Brazili\u00eb<\/option><option value='IO' >Brits-Indisch oceaan gebied<\/option><option value='VG' >Britse Maagdeneilanden<\/option><option value='BN' >Brunei Darussalam<\/option><option value='BG' >Bulgarije<\/option><option value='BF' >Burkina Faso<\/option><option value='BI' >Burundi<\/option><option value='KH' >Cambodja<\/option><option value='CA' >Canada<\/option><option value='CF' >Centraal-Afrikaanse Republiek<\/option><option value='CL' >Chili<\/option><option value='CN' >China<\/option><option value='CC' >Cocoseilanden<\/option><option value='CO' >Colombia<\/option><option value='KM' >Comoren<\/option><option value='CG' >Congo<\/option><option value='CD' >Congo, Democratische Republiek<\/option><option value='CK' >Cook eilanden<\/option><option value='CR' >Costa Rica<\/option><option value='CU' >Cuba<\/option><option value='CW' >Cura\u00e7ao<\/option><option value='CY' >Cyprus<\/option><option value='DK' >Denemarken<\/option><option value='DJ' >Djibouti<\/option><option value='DM' >Dominica<\/option><option value='DO' >Dominicaanse Republiek<\/option><option value='DE' >Duitsland<\/option><option value='EC' >Ecuador<\/option><option value='EG' >Egypte<\/option><option value='SV' >El Salvador<\/option><option value='GQ' >Equatoriaal-Guinea<\/option><option value='ER' >Eritrea<\/option><option value='EE' >Estland<\/option><option value='SZ' >Eswatini<\/option><option value='ET' >Ethiopi\u00eb<\/option><option value='FO' >Faer\u00f6er<\/option><option value='FK' >Falkland eilanden<\/option><option value='FJ' >Fiji<\/option><option value='PH' >Filipijnen<\/option><option value='FI' >Finland<\/option><option value='FR' >Frankrijk<\/option><option value='GF' >Frans Guyana<\/option><option value='PF' >Frans-Polynesi\u00eb<\/option><option value='TF' >Franse zuidelijke gebieden<\/option><option value='GA' >Gabon<\/option><option value='GM' >Gambia<\/option><option value='GE' >Georgi\u00eb<\/option><option value='GH' >Ghana<\/option><option value='GI' >Gibraltar<\/option><option value='GD' >Grenada<\/option><option value='GR' >Griekenland<\/option><option value='GL' >Groenland<\/option><option value='GP' >Guadeloupe<\/option><option value='GU' >Guam<\/option><option value='GT' >Guatemala<\/option><option value='GG' >Guernsey<\/option><option value='GN' >Guinee<\/option><option value='GW' >Guinee-Bissau<\/option><option value='GY' >Guyana<\/option><option value='HT' >Ha\u00efti<\/option><option value='HM' >Heard Eiland en McDonald Eilanden<\/option><option value='HN' >Honduras<\/option><option value='HK' >Hong Kong<\/option><option value='HU' >Hongarije<\/option><option value='IE' >Ierland<\/option><option value='IS' >IJsland<\/option><option value='IN' >India<\/option><option value='ID' >Indonesi\u00eb<\/option><option value='IQ' >Irak<\/option><option value='IR' >Iran<\/option><option value='IL' >Isra\u00ebl<\/option><option value='IT' >Itali\u00eb<\/option><option value='CI' >Ivoorkust<\/option><option value='JM' >Jamaica<\/option><option value='JP' >Japan<\/option><option value='JE' >Jersey<\/option><option value='GS' >Ji\u017en\u00ed Georgie a Ji\u017en\u00ed Sandwichovy ostrovy<\/option><option value='JO' >Jordani\u00eb<\/option><option value='KY' >Kaaimaneilanden<\/option><option value='CV' >Kaapverdi\u00eb<\/option><option value='CM' >Kameroen<\/option><option value='KZ' >Kazachstan<\/option><option value='KE' >Kenia<\/option><option value='CX' >Kersteiland<\/option><option value='KG' >Kirgizi\u00eb<\/option><option value='KI' >Kiribati<\/option><option value='UM' >Kleine eilanden van de Verenigde Staten<\/option><option value='KW' >Koeweit<\/option><option value='KP' >Korea, Democratische Volksrepubliek<\/option><option value='KR' >Korea, Republiek van<\/option><option value='HR' >Kroati\u00eb<\/option><option value='LA' >Lao Democratische Volksrepubliek<\/option><option value='LS' >Lesotho<\/option><option value='LV' >Letland<\/option><option value='LB' >Libanon<\/option><option value='LR' >Liberia<\/option><option value='LY' >Libi\u00eb<\/option><option value='LI' >Liechtenstein<\/option><option value='LT' >Litouwen<\/option><option value='LU' >Luxemburg<\/option><option value='MO' >Macau<\/option><option value='MG' >Madagaskar<\/option><option value='MW' >Malawi<\/option><option value='MV' >Maldiven<\/option><option value='MY' >Maleisi\u00eb<\/option><option value='ML' >Mali<\/option><option value='MT' >Malta<\/option><option value='IM' >Man<\/option><option value='MA' >Marokko<\/option><option value='MH' >Marshalleilanden<\/option><option value='MQ' >Martinique<\/option><option value='MR' >Mauritani\u00eb<\/option><option value='MU' >Mauritius<\/option><option value='YT' >Mayotte<\/option><option value='MX' >Mexico<\/option><option value='FM' >Micronesia<\/option><option value='MD' >Moldavi\u00eb<\/option><option value='MC' >Monaco<\/option><option value='MN' >Mongoli\u00eb<\/option><option value='ME' >Montenegro<\/option><option value='MS' >Montserrat<\/option><option value='MZ' >Mozambique<\/option><option value='MM' >Myanmar<\/option><option value='NA' >Namibi\u00eb<\/option><option value='NR' >Nauru<\/option><option value='NL' >Nederland<\/option><option value='NP' >Nepal<\/option><option value='NI' >Nicaragua<\/option><option value='NC' >Nieuw-Caledoni\u00eb<\/option><option value='NZ' >Nieuw-Zeeland<\/option><option value='NE' >Niger<\/option><option value='NG' >Nigeria<\/option><option value='NU' >Niue<\/option><option value='MK' >Noord-Macedoni\u00eb<\/option><option value='MP' >Noordelijke Marianen<\/option><option value='NO' >Noorwegen<\/option><option value='NF' >Norfolk eiland<\/option><option value='UG' >Oeganda<\/option><option value='UA' >Oekra\u00efne<\/option><option value='UZ' >Oezbekistan<\/option><option value='OM' >Oman<\/option><option value='AT' >Oostenrijk<\/option><option value='PK' >Pakistan<\/option><option value='PW' >Palau<\/option><option value='PS' >Palestina, Staat<\/option><option value='PA' >Panama<\/option><option value='PG' >Papoea-Nieuw-Guinea<\/option><option value='PY' >Paraguay<\/option><option value='PE' >Peru<\/option><option value='PN' >Pitcairn<\/option><option value='PL' >Polen<\/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' >Roemeni\u00eb<\/option><option value='RU' >Russische Federatie<\/option><option value='RW' >Rwanda<\/option><option value='BL' >Saint Barth\u00e9lemy<\/option><option value='KN' >Saint Kitts en Nevis<\/option><option value='LC' >Saint Lucia<\/option><option value='PM' >Saint Pierre en Miquelon<\/option><option value='VC' >Saint Vincent en de Grenadines<\/option><option value='SB' >Salomonseilanden<\/option><option value='WS' >Samoa<\/option><option value='SM' >San Marino<\/option><option value='ST' >Sao Tom\u00e9 en Principe<\/option><option value='SA' >Saoedi-Arabi\u00eb<\/option><option value='SN' >Senegal<\/option><option value='RS' >Servi\u00eb<\/option><option value='SC' >Seychellen<\/option><option value='SL' >Sierra Leone<\/option><option value='SG' >Singapore<\/option><option value='SX' >Sint Maarten<\/option><option value='MF' >Sint Maarten<\/option><option value='SH' >Sint-Helena, Hemelvaart en Tristan da Cunha<\/option><option value='SI' >Sloveni\u00eb<\/option><option value='SK' >Slowakije<\/option><option value='SD' >Soedan<\/option><option value='SO' >Somali\u00eb<\/option><option value='ES' >Spanje<\/option><option value='SJ' >Spitsbergen en Jan Mayen<\/option><option value='LK' >Sri Lanka<\/option><option value='SR' >Suriname<\/option><option value='TJ' >Tadzjikistan<\/option><option value='TW' >Taiwan<\/option><option value='TZ' >Tanzania, de Verenigde Republiek van<\/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 en Tobago<\/option><option value='TD' >Tsjaad<\/option><option value='CZ' >Tsjechi\u00eb<\/option><option value='TN' >Tunesi\u00eb<\/option><option value='TR' >Turkije<\/option><option value='TM' >Turkmenistan<\/option><option value='TC' >Turks- en Caicoseilanden<\/option><option value='TV' >Tuvalu<\/option><option value='UY' >Uruguay<\/option><option value='VU' >Vanuatu<\/option><option value='VA' >Vaticaanstad<\/option><option value='VE' >Venezuela<\/option><option value='GB' >Verenigd Koninkrijk<\/option><option value='AE' >Verenigde Arabische Emiraten<\/option><option value='US' >Verenigde Staten<\/option><option value='VN' >Vietnam<\/option><option value='WF' >Wallis en Futuna<\/option><option value='EH' >Westelijke Sahara<\/option><option value='BY' >Wit-Rusland<\/option><option value='YE' >Yemen<\/option><option value='ZM' >Zambia<\/option><option value='ZW' >Zimbabwe<\/option><option value='SS' >Zuid Soedan<\/option><option value='ZA' >Zuid-Afrika<\/option><option value='SE' >Zweden<\/option><option value='CH' >Zwitserland<\/option> <\/select>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><input type=\"hidden\" name=\"gpaa_place_250\" class=\"gform_hidden\" value=\"\"><\/fieldset><div id=\"field_49_134\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"0ff2068e\" data-field-span=\"12\" data-currency-format='1'><label id='gfield_label_49_134' class='gfield_label gform-field-label' for='input_49_134'><span class='gform-field-label__text'>Netto maandelijks inkomen<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_134' id='input_49_134' type='text' step='any'   value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_49_251\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"bf28cfdc\" data-field-span=\"12\"><legend id='gfield_label_49_251' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Andere bronnen van inkomsten<\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\" id=\"gfield_list_49_251_header_1\">Bron<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\" id=\"gfield_list_49_251_header_2\">Maandelijks Bedrag ( Per maand)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_251_cell1 gform-grid-col' data-label='Bron'><select title='Bron'name='input_251[]'   aria-invalid='false'   aria-labelledby=\"gfield_list_49_251_header_1 gfield_label_49_251\" data-aria-label-template='Bron, Rij {0}'><option value='Kindergeld ( Per Kind)' >Kindergeld ( Per Kind)<\/option><option value='Alimentatie' >Alimentatie<\/option><option value='Maaltijd checks' >Maaltijd checks<\/option><option value='Werkloosheid' >Werkloosheid<\/option><option value='Inkomsten uit een tweede baan' >Inkomsten uit een tweede baan<\/option><option value='Ziekenfonds' >Ziekenfonds<\/option><option value='Huurinkomst' >Huurinkomst<\/option><option value='Handicap' >Handicap<\/option><option value='Invaliditeit' >Invaliditeit<\/option><option value='Andere' >Andere<\/option><\/select><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_251_cell2 gform-grid-col' data-label='Maandelijks Bedrag ( Per maand)'><input aria-invalid='false'   aria-label='Maandelijks Bedrag ( Per maand), Rij 1' data-aria-label-template='Maandelijks Bedrag ( Per maand), Rij {0}' type='text' name='input_251[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Nog een rij toevoegen' onclick='gformAddListItem(this, 0)'>Toevoegen<\/button>   <button type='button'  class='delete_list_item' aria-label='Verwijder rij 1' data-aria-label-template='Verwijder rij {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Verwijder<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_49_66' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='button' id='gform_next_button_49_66' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_49_4' class='gform_page' data-js='page-field-id-66' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_49_4' class='gform_fields top_label form_sublabel_above description_above validation_below' data-column-layout='fill'><div id=\"field_49_144\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"657267a9\" data-field-span=\"12\"><h3 class=\"gsection_title\">Lopende Leningen<\/h3><\/div><fieldset id=\"field_49_143\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"ee5e350c\" data-field-span=\"12\"><legend id='gfield_label_49_143' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Lopende leningen<\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\" id=\"gfield_list_49_143_header_1\">Type lening<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\" id=\"gfield_list_49_143_header_2\">Maandelijkse betaling<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\" id=\"gfield_list_49_143_header_3\">Bank \/ kredietverstrekker<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\" id=\"gfield_list_49_143_header_4\">Ontleend bedrag (zonder interest)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\" id=\"gfield_list_49_143_header_5\">Datum eerste betaling<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\" id=\"gfield_list_49_143_header_6\">Aantal Maanden<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_143_cell1 gform-grid-col' data-label='Type lening'><select title='Type lening'name='input_143[]'   aria-invalid='false'   aria-labelledby=\"gfield_list_49_143_header_1 gfield_label_49_143\" data-aria-label-template='Type lening, Rij {0}'><option value='' ><\/option><option value='Auto' >Auto<\/option><option value='Persoonlijke lening' >Persoonlijke lening<\/option><option value='Hypotheek' >Hypotheek<\/option><option value='Kredietkaarten' >Kredietkaarten<\/option><\/select><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_143_cell2 gform-grid-col' data-label='Maandelijkse betaling'><input aria-invalid='false'   aria-label='Maandelijkse betaling, Rij 1' data-aria-label-template='Maandelijkse betaling, Rij {0}' type='text' name='input_143[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_143_cell3 gform-grid-col' data-label='Bank \/ kredietverstrekker'><input aria-invalid='false'   aria-label='Bank \/ kredietverstrekker, Rij 1' data-aria-label-template='Bank \/ kredietverstrekker, Rij {0}' type='text' name='input_143[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_143_cell4 gform-grid-col' data-label='Ontleend bedrag (zonder interest)'><input aria-invalid='false'   aria-label='Ontleend bedrag (zonder interest), Rij 1' data-aria-label-template='Ontleend bedrag (zonder interest), Rij {0}' type='text' name='input_143[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_143_cell5 gform-grid-col' data-label='Datum eerste betaling'><input  data-inputmask-mask=\"99\/99\/9999\" data-inputmask-placeholder=\"DD\/MM\/JJJJ\" aria-invalid='false'   aria-label='Datum eerste betaling, Rij 1' data-aria-label-template='Datum eerste betaling, Rij {0}' type='text' name='input_143[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_143_cell6 gform-grid-col' data-label='Aantal Maanden'><input aria-invalid='false'   aria-label='Aantal Maanden, Rij 1' data-aria-label-template='Aantal Maanden, Rij {0}' type='text' name='input_143[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Nog een rij toevoegen' onclick='gformAddListItem(this, 0)'>Toevoegen<\/button>   <button type='button'  class='delete_list_item' aria-label='Verwijder rij 1' data-aria-label-template='Verwijder rij {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Verwijder<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_49_173\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"3c553101\" data-field-span=\"12\"><legend id='gfield_label_49_173' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Lopende leningen checkBox<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_49_173'><div class='gchoice gchoice_49_173_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_173.1' type='checkbox'  value='Indien van toepassing, heb ik alle lopende leningen opgegeven.'  id='choice_49_173_1'    aria-labelledby=\"label_49_173_1 gfield_label_49_173\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_49_173_1' id='label_49_173_1' class='gform-field-label gform-field-label--type-inline'>Indien van toepassing, heb ik alle lopende leningen opgegeven.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_49_152\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"8a65edf8\" data-field-span=\"12\"><h3 class=\"gsection_title\">Lopende leningen (Partner)<\/h3><\/div><fieldset id=\"field_49_174\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"1fbade69\" data-field-span=\"12\"><legend id='gfield_label_49_174' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Lopende leningen (Partner)<\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\" id=\"gfield_list_49_174_header_1\">Type lening<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\" id=\"gfield_list_49_174_header_2\">Maandelijkse betaling<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\" id=\"gfield_list_49_174_header_3\">Bank \/ kredietverstrekker<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\" id=\"gfield_list_49_174_header_4\">Ontleend bedrag (zonder interest)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\" id=\"gfield_list_49_174_header_5\">Datum eerste betaling<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\" id=\"gfield_list_49_174_header_6\">Aantal Maanden<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_174_cell1 gform-grid-col' data-label='Type lening'><select title='Type lening'name='input_174[]'   aria-invalid='false'   aria-labelledby=\"gfield_list_49_174_header_1 gfield_label_49_174\" data-aria-label-template='Type lening, Rij {0}'><option value='' ><\/option><option value='Auto' >Auto<\/option><option value='Persoonlijke lening' >Persoonlijke lening<\/option><option value='Hypotheek' >Hypotheek<\/option><option value='Kredietkaarten' >Kredietkaarten<\/option><\/select><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_174_cell2 gform-grid-col' data-label='Maandelijkse betaling'><input aria-invalid='false'   aria-label='Maandelijkse betaling, Rij 1' data-aria-label-template='Maandelijkse betaling, Rij {0}' type='text' name='input_174[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_174_cell3 gform-grid-col' data-label='Bank \/ kredietverstrekker'><input aria-invalid='false'   aria-label='Bank \/ kredietverstrekker, Rij 1' data-aria-label-template='Bank \/ kredietverstrekker, Rij {0}' type='text' name='input_174[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_174_cell4 gform-grid-col' data-label='Ontleend bedrag (zonder interest)'><input aria-invalid='false'   aria-label='Ontleend bedrag (zonder interest), Rij 1' data-aria-label-template='Ontleend bedrag (zonder interest), Rij {0}' type='text' name='input_174[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_174_cell5 gform-grid-col' data-label='Datum eerste betaling'><input  data-inputmask-mask=\"99\/99\/9999\" data-inputmask-placeholder=\"DD\/MM\/JJJJ\" aria-invalid='false'   aria-label='Datum eerste betaling, Rij 1' data-aria-label-template='Datum eerste betaling, Rij {0}' type='text' name='input_174[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_174_cell6 gform-grid-col' data-label='Aantal Maanden'><input aria-invalid='false'   aria-label='Aantal Maanden, Rij 1' data-aria-label-template='Aantal Maanden, Rij {0}' type='text' name='input_174[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Nog een rij toevoegen' onclick='gformAddListItem(this, 0)'>Toevoegen<\/button>   <button type='button'  class='delete_list_item' aria-label='Verwijder rij 1' data-aria-label-template='Verwijder rij {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Verwijder<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_49_149\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"2e0f12f1\" data-field-span=\"12\"><legend id='gfield_label_49_149' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Lopende leningen checkBox<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_49_149'><div class='gchoice gchoice_49_149_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_149.1' type='checkbox'  value='Indien mijn partner lopende leningen heeft, zijn deze allemaal opgegeven.'  id='choice_49_149_1'    aria-labelledby=\"label_49_149_1 gfield_label_49_149\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_49_149_1' id='label_49_149_1' class='gform-field-label gform-field-label--type-inline'>Indien mijn partner lopende leningen heeft, zijn deze allemaal opgegeven.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_49_71\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"aa6733da\" data-field-span=\"12\"><legend id='gfield_label_49_71' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Heeft u kinderen ten laste?<\/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_49_71'>\n\t\t\t<div class='gchoice gchoice_49_71_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='Ja'  id='choice_49_71_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_49_71_0 gfield_label_49_71\"   \/>\n\t\t\t\t\t<label for='choice_49_71_0' id='label_49_71_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_49_71_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='Nee'  id='choice_49_71_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_49_71_1' id='label_49_71_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_49_72\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"9dbe2de2\" data-field-span=\"12\"><label id='gfield_label_49_72' class='gfield_label gform-field-label' for='input_49_72'><span class='gform-field-label__text'>Aantal kinderen ten laste<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_72' id='input_49_72' type='number' step='any'   value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_49_73\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"6380db74\" data-field-span=\"12\"><legend id='gfield_label_49_73' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Betaalt u alimentatie?<\/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_49_73'>\n\t\t\t<div class='gchoice gchoice_49_73_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_73' type='radio' value='Ja'  id='choice_49_73_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_49_73_0 gfield_label_49_73\"   \/>\n\t\t\t\t\t<label for='choice_49_73_0' id='label_49_73_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_49_73_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_73' type='radio' value='Nee'  id='choice_49_73_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_49_73_1' id='label_49_73_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_49_74\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"4d043892\" data-field-span=\"12\" data-currency-format='1'><label id='gfield_label_49_74' class='gfield_label gform-field-label' for='input_49_74'><span class='gform-field-label__text'>Maandelijks bedrag alimentatie<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_74' id='input_49_74' type='text' step='any'   value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_49_75\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"d0c2276e\" data-field-span=\"12\"><legend id='gfield_label_49_75' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Staat u of uw partner (indien van toepassing) gekend op de zwarte lijst van de Nationale Bank?<\/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_49_75'>\n\t\t\t<div class='gchoice gchoice_49_75_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='Ja'  id='choice_49_75_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_49_75_0 gfield_label_49_75\"   \/>\n\t\t\t\t\t<label for='choice_49_75_0' id='label_49_75_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_49_75_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='Nee'  id='choice_49_75_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_49_75_1' id='label_49_75_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_49_76' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='button' id='gform_next_button_49_76' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_49_5' class='gform_page' data-js='page-field-id-76' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_49_5' class='gform_fields top_label form_sublabel_above description_above validation_below' data-column-layout='fill'><div id=\"field_49_77\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"835f6835\" data-field-span=\"12\"><label id='gfield_label_49_77' class='gfield_label gform-field-label' for='input_49_77'><span class='gform-field-label__text'>Heeft u nog extra informatie of specifieke vragen?<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_77' id='input_49_77' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_49_128\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"3c16c9b6\" data-field-span=\"12\"><table style=\"width: 99%; border: none; background-color: #EAEAEA;\"><tr><td>\n                            <table style=\"width: 100%; border: none; background-color: #FFFFFF;\">\n                            <\/table>\n                        <\/td>\n                   <\/tr>\n               <\/table><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><button type='submit' id='gform_previous_button_49' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='submit' id='gform_submit_button_49' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Indienen<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' 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