{"id":9152,"date":"2025-01-20T17:10:27","date_gmt":"2025-01-20T17:10:27","guid":{"rendered":"https:\/\/assekuransa.com\/?page_id=9152"},"modified":"2025-01-20T17:15:03","modified_gmt":"2025-01-20T17:15:03","slug":"forms-registration-of-clients-latinoamerica","status":"publish","type":"page","link":"https:\/\/viejaweb.assekuransa.com\/web2024\/en\/forms-registration-of-clients-latinoamerica\/","title":{"rendered":"Forms &#8211; Registration of clients Latinoam\u00e9rica"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"9152\" class=\"elementor elementor-9152\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d6b02e8 e-flex e-con-boxed e-con e-child\" data-id=\"d6b02e8\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-2453032 e-con-full e-flex e-con e-child\" data-id=\"2453032\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6124d12 elementor-widget elementor-widget-heading\" data-id=\"6124d12\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Cargo Insurance:<br>\nRegistration of clients from Latin America<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-76ddb06 elementor-widget elementor-widget-text-editor\" data-id=\"76ddb06\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>Please complete the information requested in the form. Your business executive will contact you shortly to guide you in your first steps and indicate your username and password that will allow you to access the system and begin operating with us. Thank you very much for choosing us.<br \/>(*) THE SUBMIT BUTTON WILL BE ENABLED ONCE THE REQUIRED FIELDS ARE COMPLETE.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-f74c58c e-flex e-con-boxed e-con e-child\" data-id=\"f74c58c\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8b25bd3 formulario-sty elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"8b25bd3\" data-element_type=\"widget\" data-settings=\"{&quot;button_width&quot;:&quot;20&quot;,&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"Inicio: Seguro de Transoirte de Mercanc\u00edas: Alta de clientes de Latinoam\u00e9rica\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"9152\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"8b25bd3\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"\" \/>\n\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_c7a1d47 elementor-col-33\">\n\t\t\t\t\t<label for=\"form-field-ejecutivos\" class=\"elementor-field-label\">\nBusiness executive*\t\t\t\t\t\t\t<\/label>\n<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-eicon-caret-down\" viewBox=\"0 0 571.4 571.4\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M571 393Q571 407 561 418L311 668Q300 679 286 679T261 668L11 418Q0 407 0 393T11 368 36 357H536Q550 357 561 368T571 393Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[ejecutivos]\" id=\"form-field-ejecutivos-86df49e\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\" aria-required=\"true\">\n<option value=\"\" disabled selected>Business executive*<\/option>\n    [ejecutivos_select]\n<\/select>\n\t\t<\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_8d96513 elementor-col-100\">\n\t\t\t\t\t<h5 style=\"font-weight:bold;color:#003282;font-size:20px;margin:30px 0 0;\" >Company data\n<\/h5>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-empresa elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-empresa\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCompany*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[empresa]\" id=\"form-field-empresa\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Company*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-taxid elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-taxid\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tTAX-ID*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[taxid]\" id=\"form-field-taxid\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"TAX-ID*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-telefono1 elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-telefono1\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPhone*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[telefono1]\" id=\"form-field-telefono1\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Phone*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-direccion elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-direccion\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAddress*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[direccion]\" id=\"form-field-direccion\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Address*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-cp elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-cp\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPC*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[cp]\" id=\"form-field-cp\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"PC*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-ciudad elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-ciudad\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCity*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[ciudad]\" id=\"form-field-ciudad\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"City*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-provincia elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-provincia\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tProvince*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[provincia]\" id=\"form-field-provincia\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Province*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-pais elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-pais\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCountry*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-eicon-caret-down\" viewBox=\"0 0 571.4 571.4\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M571 393Q571 407 561 418L311 668Q300 679 286 679T261 668L11 418Q0 407 0 393T11 368 36 357H536Q550 357 561 368T571 393Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[pais]\" id=\"form-field-pais\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t<option value=\"Country*\">Country*<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Afganist\u00e1n\">Afganist\u00e1n<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Albania\">Albania<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Alemania\">Alemania<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Andorra\">Andorra<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Angola\">Angola<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Antigua y Barbuda\">Antigua y Barbuda<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Arabia Saudita\">Arabia Saudita<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Argelia\">Argelia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Argentina\">Argentina<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Armenia\">Armenia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Australia\">Australia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Austria\">Austria<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Azerbaiy\u00e1n\">Azerbaiy\u00e1n<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Bahamas\">Bahamas<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Banglad\u00e9s\">Banglad\u00e9s<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Barbados\">Barbados<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Bar\u00e9in\">Bar\u00e9in<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"B\u00e9lgica\">B\u00e9lgica<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Belice\">Belice<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Ben\u00edn\">Ben\u00edn<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Bielorrusia\">Bielorrusia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Birmania\">Birmania<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Bolivia\">Bolivia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Bosnia y Herzegovina\">Bosnia y Herzegovina<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Botsuana\">Botsuana<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Brasil\">Brasil<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Brun\u00e9i\">Brun\u00e9i<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Bulgaria\">Bulgaria<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Burkina Faso\">Burkina Faso<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Burundi\">Burundi<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"But\u00e1n\">But\u00e1n<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Cabo Verde\">Cabo Verde<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Camboya\">Camboya<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Camer\u00fan\">Camer\u00fan<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Canad\u00e1\">Canad\u00e1<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Catar\">Catar<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Chad\">Chad<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Chile\">Chile<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"China\">China<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Chipre\">Chipre<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Ciudad del Vaticano\">Ciudad del Vaticano<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Colombia\">Colombia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Comoras\">Comoras<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Corea del Norte\">Corea del Norte<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Corea del Sur\">Corea del Sur<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Costa de Marfil\">Costa de Marfil<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Costa Rica\">Costa Rica<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Croacia\">Croacia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Cuba\">Cuba<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Dinamarca\">Dinamarca<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Dominica\">Dominica<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Ecuador\">Ecuador<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Egipto\">Egipto<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"El Salvador\">El Salvador<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Emiratos \u00c1rabes Unidos\">Emiratos \u00c1rabes Unidos<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Eritrea\">Eritrea<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Eslovaquia\">Eslovaquia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Eslovenia\">Eslovenia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Espa\u00f1a\">Espa\u00f1a<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Estados Unidos\">Estados Unidos<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Estonia\">Estonia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Etiop\u00eda\">Etiop\u00eda<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Filipinas\">Filipinas<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Finlandia\">Finlandia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Fiyi\">Fiyi<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Francia\">Francia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Gab\u00f3n\">Gab\u00f3n<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Gambia\">Gambia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Georgia\">Georgia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Ghana\">Ghana<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Granada\">Granada<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Grecia\">Grecia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Guatemala\">Guatemala<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Guyana\">Guyana<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Guinea\">Guinea<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Guinea ecuatorial\">Guinea ecuatorial<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Guinea-Bis\u00e1u\">Guinea-Bis\u00e1u<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Hait\u00ed\">Hait\u00ed<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Honduras\">Honduras<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Hungr\u00eda\">Hungr\u00eda<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"India\">India<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Indonesia\">Indonesia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Irak\">Irak<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Ir\u00e1n\">Ir\u00e1n<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Irlanda\">Irlanda<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Islandia\">Islandia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Islas Marshall\">Islas Marshall<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Islas Salom\u00f3n\">Islas Salom\u00f3n<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Israel\">Israel<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Italia\">Italia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Jamaica\">Jamaica<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Jap\u00f3n\">Jap\u00f3n<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Jordania\">Jordania<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Kazajist\u00e1n\">Kazajist\u00e1n<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Kenia\">Kenia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Kirguist\u00e1n\">Kirguist\u00e1n<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Kiribati\">Kiribati<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Kuwait\">Kuwait<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Laos\">Laos<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Lesoto\">Lesoto<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Letonia\">Letonia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"L\u00edbano\">L\u00edbano<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Liberia\">Liberia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Libia\">Libia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Liechtenstein\">Liechtenstein<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Lituania\">Lituania<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Luxemburgo\">Luxemburgo<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Macedonia del Norte\">Macedonia del Norte<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Madagascar\">Madagascar<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Malasia\">Malasia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Malaui\">Malaui<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Maldivas\">Maldivas<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Mal\u00ed\">Mal\u00ed<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Malta\">Malta<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Marruecos\">Marruecos<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Mauricio\">Mauricio<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Mauritania\">Mauritania<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"M\u00e9xico\">M\u00e9xico<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Micronesia\">Micronesia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Moldavia\">Moldavia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"M\u00f3naco\">M\u00f3naco<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Mongolia\">Mongolia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Montenegro\">Montenegro<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Mozambique\">Mozambique<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Namibia\">Namibia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Nauru\">Nauru<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Nepal\">Nepal<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Nicaragua\">Nicaragua<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"N\u00edger\">N\u00edger<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Nigeria\">Nigeria<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Noruega\">Noruega<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Nueva Zelanda\">Nueva Zelanda<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Om\u00e1n\">Om\u00e1n<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Pa\u00edses Bajos\">Pa\u00edses Bajos<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Pakist\u00e1n\">Pakist\u00e1n<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Palaos\">Palaos<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Panam\u00e1\">Panam\u00e1<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Pap\u00faa Nueva Guinea\">Pap\u00faa Nueva Guinea<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Paraguay\">Paraguay<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Per\u00fa\">Per\u00fa<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Polonia\">Polonia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Portugal\">Portugal<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Reino Unido\">Reino Unido<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Rep\u00fablica Centroafricana\">Rep\u00fablica Centroafricana<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Rep\u00fablica Checa\">Rep\u00fablica Checa<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Rep\u00fablica del Congo\">Rep\u00fablica del Congo<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Rep\u00fablica Democr\u00e1tica del Congo\">Rep\u00fablica Democr\u00e1tica del Congo<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Rep\u00fablica Dominicana\">Rep\u00fablica Dominicana<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Ruanda\">Ruanda<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Ruman\u00eda\">Ruman\u00eda<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Rusia\">Rusia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Samoa\">Samoa<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"San Crist\u00f3bal y Nieves\">San Crist\u00f3bal y Nieves<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"San Marino\">San Marino<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"San Vicente y las Granadinas\">San Vicente y las Granadinas<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Santa Luc\u00eda\">Santa Luc\u00eda<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Santo Tom\u00e9 y Pr\u00edncipe\">Santo Tom\u00e9 y Pr\u00edncipe<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Senegal\">Senegal<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Serbia\">Serbia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Seychelles\">Seychelles<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Sierra Leona\">Sierra Leona<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Singapur\">Singapur<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Siria\">Siria<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Somalia\">Somalia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Sri Lanka\">Sri Lanka<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Suazilandia\">Suazilandia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Sud\u00e1frica\">Sud\u00e1frica<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Sud\u00e1n\">Sud\u00e1n<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Sud\u00e1n del Sur\">Sud\u00e1n del Sur<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Suecia\">Suecia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Suiza\">Suiza<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Surinam\">Surinam<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Tailandia\">Tailandia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Tanzania\">Tanzania<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Tayikist\u00e1n\">Tayikist\u00e1n<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Timor Oriental\">Timor Oriental<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Togo\">Togo<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Tonga\">Tonga<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Trinidad y Tobago\">Trinidad y Tobago<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"T\u00fanez\">T\u00fanez<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Turkmenist\u00e1n\">Turkmenist\u00e1n<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Turqu\u00eda\">Turqu\u00eda<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Tuvalu\">Tuvalu<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Ucrania\">Ucrania<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Uganda\">Uganda<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Uruguay\">Uruguay<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Uzbekist\u00e1n\">Uzbekist\u00e1n<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Vanuatu\">Vanuatu<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Venezuela\">Venezuela<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Vietnam\">Vietnam<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Yemen\">Yemen<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Yibuti\">Yibuti<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Zambia\">Zambia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Zimbabue\">Zimbabue<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_e8e3cdd elementor-col-100\">\n\t\t\t\t\t<h5 style=\"font-weight:bold;color:#003282;font-size:20px;margin:30px 0 0;\" >General or commercial manager\n<\/h5>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-nombre_gerente elementor-col-40 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-nombre_gerente\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName and surname*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[nombre_gerente]\" id=\"form-field-nombre_gerente\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Name and surname*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email_gerente elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email_gerente\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tE-Mail*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email_gerente]\" id=\"form-field-email_gerente\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"E-Mail*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_804546d elementor-col-30\">\n\t\t\t\t\t<p><\/p>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-cargo_gerente elementor-col-40 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-cargo_gerente\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPosition*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[cargo_gerente]\" id=\"form-field-cargo_gerente\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Position*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-telefono_gerente elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-telefono_gerente\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPhone*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[telefono_gerente]\" id=\"form-field-telefono_gerente\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Phone*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-movil_gerente elementor-col-30\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-movil_gerente\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMobile\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[movil_gerente]\" id=\"form-field-movil_gerente\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Mobile\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_d906029 elementor-col-100\">\n\t\t\t\t\t<h5 style=\"font-weight:bold;color:#003282;font-size:20px;margin:30px 0 0;\" >Billing contact\n<\/h5>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-nombre_pagos elementor-col-40 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-nombre_pagos\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName and surname*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[nombre_pagos]\" id=\"form-field-nombre_pagos\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Name and surname*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email_pagos elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email_pagos\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tE-Mail*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email_pagos]\" id=\"form-field-email_pagos\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"E-Mail*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_6a70e41 elementor-col-30\">\n\t\t\t\t\t<p><\/p>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-cargo_pagos elementor-col-40 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-cargo_pagos\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPosition*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[cargo_pagos]\" id=\"form-field-cargo_pagos\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Position*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-telefono_pagos elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-telefono_pagos\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPhone*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[telefono_pagos]\" id=\"form-field-telefono_pagos\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Phone*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-movil_pagos elementor-col-30\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-movil_pagos\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMobile\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[movil_pagos]\" id=\"form-field-movil_pagos\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Mobile\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_5044b7f elementor-col-40\">\n\t\t\t\t\t<h5 style=\"font-weight:bold;color:#003282;font-size:20px;margin:30px 0 0;\" >Users who will enter policy requests into the system\n<\/h5>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_3d01cbd elementor-col-60\">\n\t\t\t\t\t<p><\/p>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-nombre_usuario1 elementor-col-40 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-nombre_usuario1\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName and surname*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[nombre_usuario1]\" id=\"form-field-nombre_usuario1\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Name and surname*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email_usuario1 elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email_usuario1\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tE-Mail*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email_usuario1]\" id=\"form-field-email_usuario1\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"E-Mail*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_2c2473e elementor-col-30\">\n\t\t\t\t\t<p><\/p>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-cargo_usuario1 elementor-col-40 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-cargo_usuario1\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPosition*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[cargo_usuario1]\" id=\"form-field-cargo_usuario1\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Position*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-telefono_usuario1 elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-telefono_usuario1\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPhone*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[telefono_usuario1]\" id=\"form-field-telefono_usuario1\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Phone*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-movil_usuario1 elementor-col-30\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-movil_usuario1\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMobile\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[movil_usuario1]\" id=\"form-field-movil_usuario1\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Mobile\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_9e77c90 elementor-col-100\">\n\t\t\t\t\t<h5 style=\"font-weight:bold;color:#003282;font-size:20px;margin:30px 0 0;\" >User 2\n<\/h5>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-nombre_usuario2 elementor-col-40 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-nombre_usuario2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName and surname*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[nombre_usuario2]\" id=\"form-field-nombre_usuario2\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Name and surname*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email_usuario2 elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email_usuario2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tE-Mail*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email_usuario2]\" id=\"form-field-email_usuario2\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"E-Mail*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_b600c2d elementor-col-30\">\n\t\t\t\t\t<p><\/p>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-cargo_usuario2 elementor-col-40 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-cargo_usuario2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPosition*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[cargo_usuario2]\" id=\"form-field-cargo_usuario2\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Position*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-telefono_usuario2 elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-telefono_usuario2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPhone*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[telefono_usuario2]\" id=\"form-field-telefono_usuario2\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Phone*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-movil_usuario2 elementor-col-30\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-movil_usuario2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMobile\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[movil_usuario2]\" id=\"form-field-movil_usuario2\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Mobile\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_20cfaa8 elementor-col-100\">\n\t\t\t\t\t<h5 style=\"font-weight:bold;color:#003282;font-size:20px;margin:30px 0 0;\" >User 3\n<\/h5>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-nombre_usuario3 elementor-col-40 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-nombre_usuario3\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName and surname*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[nombre_usuario3]\" id=\"form-field-nombre_usuario3\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Name and surname*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email_usuario3 elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email_usuario3\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tE-Mail*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email_usuario3]\" id=\"form-field-email_usuario3\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"E-Mail*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_173472a elementor-col-30\">\n\t\t\t\t\t<p><\/p>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-cargo_usuario3 elementor-col-40 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-cargo_usuario3\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPosition*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[cargo_usuario3]\" id=\"form-field-cargo_usuario3\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Position*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-telefono_usuario3 elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-telefono_usuario3\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPhone*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[telefono_usuario3]\" id=\"form-field-telefono_usuario3\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Phone*\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-movil_usuario3 elementor-col-30\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-movil_usuario3\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMobile\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[movil_usuario3]\" id=\"form-field-movil_usuario3\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Mobile\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-comentarios elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-comentarios\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tComments\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[comentarios]\" id=\"form-field-comentarios\" rows=\"4\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_c903530 elementor-col-50\">\n\t\t\t\t\t<br>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-como_llego elementor-col-25 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-como_llego\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHow you came to Assekuransa*\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-eicon-caret-down\" viewBox=\"0 0 571.4 571.4\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M571 393Q571 407 561 418L311 668Q300 679 286 679T261 668L11 418Q0 407 0 393T11 368 36 357H536Q550 357 561 368T571 393Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[como_llego]\" id=\"form-field-como_llego\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t<option value=\"How you came to Assekuransa*\">How you came to Assekuransa*<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Recommendation\">Recommendation<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Google or another search engine\">Google or another search engine<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Facebook\">Facebook<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Event (presentation\/stand\/etc.)\">Event (presentation\/stand\/etc.)<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Other\">Other<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-como_llego_otro elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-como_llego_otro\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tOther\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[como_llego_otro]\" id=\"form-field-como_llego_otro\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Other\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_293031f elementor-col-50\">\n\t\t\t\t\t<br>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-recaptcha elementor-field-group elementor-column elementor-field-group-field_42c14b4 elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-field\" id=\"form-field-field_42c14b4\"><div class=\"elementor-g-recaptcha\" data-sitekey=\"6LfG9XgpAAAAAOlSnwpYb5jDJuS7xsuJj_zc76fx\" data-type=\"v2_checkbox\" data-theme=\"light\" data-size=\"normal\"><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-hidden elementor-field-group elementor-column elementor-field-group-dynamic_email_86df49e elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"hidden\" name=\"form_fields[dynamic_email_86df49e]\" id=\"form-field-dynamic_email_86df49e\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-hidden elementor-field-group elementor-column elementor-field-group-dynamic_name_86df49e elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"hidden\" name=\"form_fields[dynamic_name_86df49e]\" id=\"form-field-dynamic_name_86df49e\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-20 e-form__buttons\">\n\t\t\t\t\t<button type=\"submit\" class=\"elementor-button elementor-size-sm\">\n\t\t\t\t\t\t<span >\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\" elementor-button-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">ENVIAR<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Cargo Insurance: Registration of clients from Latin America Please complete the information requested in the form. Your business executive will contact you shortly to guide you in your first steps and indicate your username and password that will allow you to access the system and begin operating with us. Thank you very much for choosing [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-9152","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/viejaweb.assekuransa.com\/web2024\/wp-json\/wp\/v2\/pages\/9152","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/viejaweb.assekuransa.com\/web2024\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/viejaweb.assekuransa.com\/web2024\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/viejaweb.assekuransa.com\/web2024\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/viejaweb.assekuransa.com\/web2024\/wp-json\/wp\/v2\/comments?post=9152"}],"version-history":[{"count":5,"href":"https:\/\/viejaweb.assekuransa.com\/web2024\/wp-json\/wp\/v2\/pages\/9152\/revisions"}],"predecessor-version":[{"id":9161,"href":"https:\/\/viejaweb.assekuransa.com\/web2024\/wp-json\/wp\/v2\/pages\/9152\/revisions\/9161"}],"wp:attachment":[{"href":"https:\/\/viejaweb.assekuransa.com\/web2024\/wp-json\/wp\/v2\/media?parent=9152"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}