{"id":12487,"date":"2025-07-15T07:45:25","date_gmt":"2025-07-15T11:45:25","guid":{"rendered":"https:\/\/housing.county-lambton.on.ca\/?page_id=12487"},"modified":"2025-07-15T07:46:16","modified_gmt":"2025-07-15T11:46:16","slug":"lambton-renovates","status":"publish","type":"page","link":"https:\/\/housing.county-lambton.on.ca\/fr\/lambton-renovates\/","title":{"rendered":"Lambton Renovates"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><div class=\"vc_row wpb_row vc_row-fluid\"><style type=\"text\/css\"><\/style>     <script type=\"text\/javascript\">\n        document.addEventListener('DOMContentLoaded', function () {\n            \/\/ Function to delete a specific cookie\n            function deleteCookie(name) {\n                document.cookie = name + '=; Max-Age=-99999999;';\n            }\n\n            \/\/ Function to get all cookies\n            function getCookies() {\n                var cookies = {};\n                document.cookie.split(';').forEach(function 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action='\/fr\/wp-json\/wp\/v2\/pages\/12487#gf_17' data-formid='17' novalidate autocomplete=\"off\" data-trp-original-action=\"\/fr\/wp-json\/wp\/v2\/pages\/12487#gf_17\"><input id=\"gpnf_session_hash_17\" type=\"hidden\" name=\"gpnf_session_hash\" value=\"22d2ecb0468a\" autocomplete=\"off\"> \r\n <input type='hidden' class='gforms-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/>\n        <div id='gf_progressbar_wrapper_17' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>10<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_10' style='width:10%;'><span>10%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_17_1' class='gform_page' data-js='page-field-id-0' >\n                                    <div class='gform_page_fields'><div id='gform_fields_17' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_17_81\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  data-js-reload=\"field_17_81\" ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lors de la visualisation du formulaire\"><\/i><span>Ce champ est masqu\u00e9 lors de la visualisation du formulaire<\/span><\/div><label class='gfield_label gform-field-label' for='input_17_81'>ID unique<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_81' id='input_17_81' type='text' value='{entry_id}' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_82\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  data-js-reload=\"field_17_82\" ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lors de la visualisation du formulaire\"><\/i><span>Ce champ est masqu\u00e9 lors de la visualisation du formulaire<\/span><\/div><label class='gfield_label gform-field-label' for='input_17_82'>Statut<\/label><div class='ginput_container ginput_container_select'><select name='input_82' id='input_17_82' class='large gfield_select'     aria-invalid=\"false\" ><option value='New' >Nouveau<\/option><option value='Incomplete' >Incomplet<\/option><option value='Complete' >Complet<\/option><\/select><\/div><\/div><div id=\"field_17_90\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_90\" ><strong>Please ensure you have the following documents to  help in the application process:<\/strong><\/br><\/br>\n<ul>\n<li>- Proof of Canadian Citizenship (ex. Birth Certificate, Passport, Status Card) for every member of the household.<\/li>\n<li>- Income Verification (Notice of Assessment, Paystubs, Pension Statements)<\/li>\n<li>- Asset Verification Documentation (30 days of bank activity, investment statements, account summaries)<\/li>\n<li>- Recent House Value Assessment (MPAC, property tax notice or appraisal)<\/li>\n<li>- Proof Property Tax Payments are up-to-date (Receipt, Tax Summary or Bank Letter)<\/li>\n<li>- Proof Mortgage Payments are up-to-date and Mortgage Balance (Statement or Bank Letter)<\/li>\n<li>- Certificate or copy of insurance showing coverage is in place for the full value of the home<\/li><\/div><div id=\"field_17_1\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_1\" ><h3 class=\"gsection_title\">Homeowner Information<\/h3><\/div><fieldset id=\"field_17_3\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_3\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Nom officiel<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_17_3'>\n                            \n                            <span id='input_17_3_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input autocomplete=\"off\"  type='text' name='input_3.3' id='input_17_3_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_17_3_3' class='gform-field-label gform-field-label--type-sub'>D&#039;abord<\/label>\n                                                <\/span>\n                            \n                            <span id='input_17_3_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input autocomplete=\"off\"  type='text' name='input_3.6' id='input_17_3_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_17_3_6' class='gform-field-label gform-field-label--type-sub'>Dernier<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_17_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_4\" ><label class='gfield_label gform-field-label' for='input_17_4'>Nom d\u2019usage (facultatif)<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_4' id='input_17_4' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_75\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_75\" ><label class='gfield_label gform-field-label' for='input_17_75'>Date de naissance<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input autocomplete=\"off\"  name='input_75' id='input_17_75' type='text' value='' class='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'   placeholder='dd\/mm\/yyyy' aria-describedby=\"input_17_75_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_17_75_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input autocomplete=\"off\"  type='hidden' id='gforms_calendar_icon_input_17_75' class='gform_hidden' value='https:\/\/housing.county-lambton.on.ca\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_17_7\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_7\" ><label class='gfield_label gform-field-label' for='input_17_7'>Home Number<\/label><div class='ginput_container ginput_container_phone'><input autocomplete=\"off\"  name='input_7' id='input_17_7' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_8\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_8\" ><label class='gfield_label gform-field-label' for='input_17_8'>Cell Number<\/label><div class='ginput_container ginput_container_phone'><input autocomplete=\"off\"  name='input_8' id='input_17_8' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_5\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  data-js-reload=\"field_17_5\" ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lors de la visualisation du formulaire\"><\/i><span>Ce champ est masqu\u00e9 lors de la visualisation du formulaire<\/span><\/div><label class='gfield_label gform-field-label' for='input_17_5'>Sexe<\/label><div class='ginput_container ginput_container_select'><select name='input_5' id='input_17_5' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Veuillez s\u00e9lectionner votre sexe<\/option><option value='Male' >Homme<\/option><option value='Female' >Femme<\/option><option value='Other' >Autre<\/option><option value='Prefer Not to Say' >Je pr\u00e9f\u00e8re ne pas r\u00e9pondre<\/option><\/select><\/div><\/div><div id=\"field_17_74\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_74\" ><label class='gfield_label gform-field-label' for='input_17_74'>E-mail<\/label><div class='ginput_container ginput_container_email'>\n                            <input autocomplete=\"off\"  name='input_74' id='input_17_74' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_17_72\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_72\" ><legend class='gfield_label gform-field-label' >I prefer correspondence to be<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_72'>\n\t\t\t<div class='gchoice gchoice_17_72_0'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_72' type='radio' value='Emailed'  id='choice_17_72_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_72_0' id='label_17_72_0' class='gform-field-label gform-field-label--type-inline'>Emailed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_72_1'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_72' type='radio' value='Mailed'  id='choice_17_72_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_72_1' id='label_17_72_1' class='gform-field-label gform-field-label--type-inline'>Mailed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_91\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_91\" ><label class='gfield_label gform-field-label' for='gform_browse_button_17_91'>Preuve de citoyennet\u00e9 canadienne<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_91' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_91&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_91&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_91&quot;,&quot;filelist&quot;:&quot;gform_preview_17_91&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/?gf_page=6e09d9d2b26667e&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;jpg,jpeg,gif,png,heic,pdf,doc,docx&quot;}],&quot;max_file_size&quot;:&quot;10485760b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:91},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;1&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_17_91&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_91' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_91' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_91 gfield_description_17_91\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_91'>Accepted file types: jpg, jpeg, gif, png, heic, pdf, doc, docx, Max. file size: 10 MB, Max. files: 1.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_91'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_17_91' class='ginput_preview_list'><\/div><div class='gfield_description' id='gfield_description_17_91'>Veuillez t\u00e9l\u00e9charger la preuve du statut\/citoyennet\u00e9 canadien(ne) de ce membre du m\u00e9nage. Exemples : passeport, certificat de naissance, carte de r\u00e9sident permanent.<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_17_109' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this)' value='Suivant'  \/> <button type='button'  id='gform_save_17_2_link' onclick='gform.submission.handleButtonClick(this)' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Enregistrer et continuer plus tard<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_2' class='gform_page' data-js='page-field-id-109' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_17_12\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_12\" ><h3 class=\"gsection_title\">Property Information<\/h3><\/div><fieldset id=\"field_17_9\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_9\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address of Home<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_zip ginput_container_address gform-grid-row' id='input_17_9' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_17_9_1_container' >\n                                        <input autocomplete=\"off\"  type='text' name='input_9.1' id='input_17_9_1' value=''    aria-required='true'    \/>\n                                        <label for='input_17_9_1' id='input_17_9_1_label' class='gform-field-label gform-field-label--type-sub'>Adresse de la rue<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_17_9_2_container' >\n                                        <input autocomplete=\"off\"  type='text' name='input_9.2' id='input_17_9_2' value=''     aria-required='false'   \/>\n                                        <label for='input_17_9_2' id='input_17_9_2_label' class='gform-field-label gform-field-label--type-sub'>Num\u00e9ro d&#039;unit\u00e9<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_17_9_3_container' >\n                                    <input autocomplete=\"off\"  type='text' name='input_9.3' id='input_17_9_3' value=''    aria-required='true'    \/>\n                                    <label for='input_17_9_3' id='input_17_9_3_label' class='gform-field-label gform-field-label--type-sub'>City\/Town<\/label>\n                                 <\/span><input autocomplete=\"off\"  type='hidden' class='gform_hidden' name='input_9.4' id='input_17_9_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_17_9_5_container' >\n                                    <input autocomplete=\"off\"  type='text' name='input_9.5' id='input_17_9_5' value=''    aria-required='true'    \/>\n                                    <label for='input_17_9_5' id='input_17_9_5_label' class='gform-field-label gform-field-label--type-sub'>Code Postal<\/label>\n                                <\/span><input autocomplete=\"off\"  type='hidden' class='gform_hidden' name='input_9.6' id='input_17_9_6' value='Canada' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_17_13\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gf_list_4col gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_13\" ><legend class='gfield_label gform-field-label' >Taper<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_13'>\n\t\t\t<div class='gchoice gchoice_17_13_0'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_13' type='radio' value='Detached'  id='choice_17_13_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_13_0' id='label_17_13_0' class='gform-field-label gform-field-label--type-inline'>Detached<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_13_1'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_13' type='radio' value='Semi-Detached'  id='choice_17_13_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_13_1' id='label_17_13_1' class='gform-field-label gform-field-label--type-inline'>Semi-Detached<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_13_2'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_13' type='radio' value='Townhouse\/Row'  id='choice_17_13_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_13_2' id='label_17_13_2' class='gform-field-label gform-field-label--type-inline'>Townhouse\/Row<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_13_3'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_13' type='radio' value='Other'  id='choice_17_13_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_13_3' id='label_17_13_3' class='gform-field-label gform-field-label--type-inline'>Autre<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_59\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_59\" ><label class='gfield_label gform-field-label' for='input_17_59'>Other Type<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_59' id='input_17_59' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_6\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_6\" ><legend class='gfield_label gform-field-label' >Do you live in the home?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_6'>\n\t\t\t<div class='gchoice gchoice_17_6_0'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_6' type='radio' value='Yes'  id='choice_17_6_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_6_0' id='label_17_6_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_6_1'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_6' type='radio' value='No'  id='choice_17_6_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_6_1' id='label_17_6_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_99\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_99\" ><label class='gfield_label gform-field-label' for='input_17_99'>If No, please explain<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_99' id='input_17_99' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_98\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_98\" ><\/div><div id=\"field_17_14\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half currency_input gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_14\" ><label class='gfield_label gform-field-label' for='input_17_14'>Approximate Value of Home<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_14' id='input_17_14' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_16\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_16\" ><label class='gfield_label gform-field-label' for='input_17_16'>Year Built<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_16' id='input_17_16' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_17\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_17\" ><label class='gfield_label gform-field-label' for='input_17_17'>Number of Bedrooms<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_17' id='input_17_17' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_18\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_18\" ><label class='gfield_label gform-field-label' for='input_17_18'>Home Size (sq. ft.)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_18' id='input_17_18' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_19\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gf_clear gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_19\" ><legend class='gfield_label gform-field-label' >Insurance Payments up to date?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_19'>\n\t\t\t<div class='gchoice gchoice_17_19_0'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_19' type='radio' value='Yes'  id='choice_17_19_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_19_0' id='label_17_19_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_19_1'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_19' type='radio' value='No'  id='choice_17_19_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_19_1' id='label_17_19_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_55\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_55\" ><label class='gfield_label gform-field-label' for='gform_browse_button_17_55'>Proof of up to date Insurance Payments<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_55' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_55&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_55&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_55&quot;,&quot;filelist&quot;:&quot;gform_preview_17_55&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/?gf_page=6e09d9d2b26667e&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;jpg,jpeg,gif,png,heic,pdf,doc,docx&quot;}],&quot;max_file_size&quot;:&quot;10485760b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:55},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;1&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_17_55&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_55' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_55' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_55\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_55'>Accepted file types: jpg, jpeg, gif, png, heic, pdf, doc, docx, Max. file size: 10 MB, Max. files: 1.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_55'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_17_55' class='ginput_preview_list'><\/div><\/div><div id=\"field_17_67\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_67\" ><\/div><fieldset id=\"field_17_21\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gf_clear gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_21\" ><legend class='gfield_label gform-field-label' >Property Taxes up to date?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_21'>\n\t\t\t<div class='gchoice gchoice_17_21_0'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_21' type='radio' value='Yes'  id='choice_17_21_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_21_0' id='label_17_21_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_21_1'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_21' type='radio' value='No'  id='choice_17_21_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_21_1' id='label_17_21_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_56\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_56\" ><label class='gfield_label gform-field-label' for='gform_browse_button_17_56'>Proof of up to date Property Taxes<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_56' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_56&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_56&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_56&quot;,&quot;filelist&quot;:&quot;gform_preview_17_56&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/?gf_page=6e09d9d2b26667e&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;jpg,jpeg,gif,png,heic,pdf,doc,docx&quot;}],&quot;max_file_size&quot;:&quot;10485760b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:56},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;1&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_17_56&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_56' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_56' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_56\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_56'>Accepted file types: jpg, jpeg, gif, png, heic, pdf, doc, docx, Max. file size: 10 MB, Max. files: 1.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_56'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_17_56' class='ginput_preview_list'><\/div><\/div><div id=\"field_17_68\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_68\" ><\/div><fieldset id=\"field_17_20\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gf_clear gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_20\" ><legend class='gfield_label gform-field-label' >Mortgage Payments up to date?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_20'>\n\t\t\t<div class='gchoice gchoice_17_20_0'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_20' type='radio' value='Yes'  id='choice_17_20_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_20_0' id='label_17_20_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_20_1'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_20' type='radio' value='No'  id='choice_17_20_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_20_1' id='label_17_20_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_20_2'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_20' type='radio' value='Mortgage Paid Off'  id='choice_17_20_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_20_2' id='label_17_20_2' class='gform-field-label gform-field-label--type-inline'>Mortgage Paid Off<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_57\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_57\" ><label class='gfield_label gform-field-label' for='gform_browse_button_17_57'>Proof of up to date Mortgage Payments<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_57' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_57&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_57&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_57&quot;,&quot;filelist&quot;:&quot;gform_preview_17_57&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/?gf_page=6e09d9d2b26667e&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;jpg,jpeg,gif,png,heic,pdf,doc,docx&quot;}],&quot;max_file_size&quot;:&quot;10485760b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:57},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;1&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_17_57&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_57' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_57' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_57\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_57'>Accepted file types: jpg, jpeg, gif, png, heic, pdf, doc, docx, Max. file size: 10 MB, Max. files: 1.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_57'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_17_57' class='ginput_preview_list'><\/div><\/div><div id=\"field_17_58\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_58\" ><center><strong><p style=\"color:red\">Please be advised if you have any outstanding payments owing, this may affect your eligibility. <\/p><\/strong><\/center><\/div><div id=\"field_17_22\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_22\" ><label class='gfield_label gform-field-label' for='input_17_22'>Property Roll Number<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_22' id='input_17_22' type='text' value='' class='large'  aria-describedby=\"gfield_description_17_22\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_17_22'>The Property Roll Number can be found on your property assessment notice or your property tax bill.<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_17_110' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this)' value='Previous'  \/> <input type='button' id='gform_next_button_17_110' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this)' value='Suivant'  \/> <button type='button'  id='gform_save_17_3_link' onclick='gform.submission.handleButtonClick(this)' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Enregistrer et continuer plus tard<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_3' class='gform_page' data-js='page-field-id-110' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_17_34\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_34\" ><h3 class=\"gsection_title\">Additional Information<\/h3><\/div><div id=\"field_17_41\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_41\" ><p style=\"font-weight:bold;color:blue;text-align:center\">If there are any co-signers, guarantors or co-owners, they may need to provide additional information or signatures on this application<\/p><\/div><fieldset id=\"field_17_35\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_35\" ><legend class='gfield_label gform-field-label' >Is there anyone that owns the home that does not live in the home and is not named on this application?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_35'>\n\t\t\t<div class='gchoice gchoice_17_35_0'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_35' type='radio' value='Yes'  id='choice_17_35_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_35_0' id='label_17_35_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_35_1'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_35' type='radio' value='No'  id='choice_17_35_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_35_1' id='label_17_35_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_70\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_70\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Additional Owners<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/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\">First Name<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Last Name<\/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_70_cell1 gform-grid-col' data-label='First Name'><input autocomplete=\"off\"  aria-invalid='false' aria-required=\"true\"  aria-label='First Name, Row 1' data-aria-label-template='First Name, Row {0}' type='text' name='input_70[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_70_cell2 gform-grid-col' data-label='Last Name'><input autocomplete=\"off\"  aria-invalid='false' aria-required=\"true\"  aria-label='Last Name, Row 1' data-aria-label-template='Last Name, Row {0}' type='text' name='input_70[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type=\"button\"  class='add_list_item' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type=\"button\"  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_36\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_36\" ><legend class='gfield_label gform-field-label' >Has anyone co-signed or guaranteed the mortgage but does not live in the home and is not named on this application?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_36'>\n\t\t\t<div class='gchoice gchoice_17_36_0'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_36' type='radio' value='Yes'  id='choice_17_36_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_36_0' id='label_17_36_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_36_1'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_36' type='radio' value='No'  id='choice_17_36_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_36_1' id='label_17_36_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_71\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_71\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Additional Signers or Guarantors<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/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\">First Name<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Last Name<\/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_71_cell1 gform-grid-col' data-label='First Name'><input autocomplete=\"off\"  aria-invalid='false' aria-required=\"true\"  aria-label='First Name, Row 1' data-aria-label-template='First Name, Row {0}' type='text' name='input_71[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_71_cell2 gform-grid-col' data-label='Last Name'><input autocomplete=\"off\"  aria-invalid='false' aria-required=\"true\"  aria-label='Last Name, Row 1' data-aria-label-template='Last Name, Row {0}' type='text' name='input_71[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type=\"button\"  class='add_list_item' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type=\"button\"  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_39\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_39\" ><legend class='gfield_label gform-field-label' >Are the individuals listed aware that this application is being submitted?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_39'>\n\t\t\t<div class='gchoice gchoice_17_39_0'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_39' type='radio' value='Yes'  id='choice_17_39_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_39_0' id='label_17_39_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_39_1'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_39' type='radio' value='No'  id='choice_17_39_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_39_1' id='label_17_39_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_17_111' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this)' value='Previous'  \/> <input type='button' id='gform_next_button_17_111' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this)' value='Suivant'  \/> <button type='button'  id='gform_save_17_4_link' onclick='gform.submission.handleButtonClick(this)' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Enregistrer et continuer plus tard<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_4' class='gform_page' data-js='page-field-id-111' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_17_42\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_42\" ><h3 class=\"gsection_title\">Scope of work to be completed<\/h3><\/div><fieldset id=\"field_17_44\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gf_list_4col gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_44\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Check all that apply<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_17_44'><div class='gchoice gchoice_17_44_1'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_44.1' type='checkbox'  value='Accessibility'  id='choice_17_44_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_44_1' id='label_17_44_1' class='gform-field-label gform-field-label--type-inline'>Accessibility<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_44_2'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_44.2' type='checkbox'  value='Foundation'  id='choice_17_44_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_44_2' id='label_17_44_2' class='gform-field-label gform-field-label--type-inline'>Foundation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_44_3'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_44.3' type='checkbox'  value='Septic\/Well Water'  id='choice_17_44_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_44_3' id='label_17_44_3' class='gform-field-label gform-field-label--type-inline'>Septic\/Well Water<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_44_4'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_44.4' type='checkbox'  value='Doors'  id='choice_17_44_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_44_4' id='label_17_44_4' class='gform-field-label gform-field-label--type-inline'>Doors<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_44_5'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_44.5' type='checkbox'  value='Heating\/Furnace'  id='choice_17_44_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_44_5' id='label_17_44_5' class='gform-field-label gform-field-label--type-inline'>Heating\/Furnace<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_44_6'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_44.6' type='checkbox'  value='Structural'  id='choice_17_44_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_44_6' id='label_17_44_6' class='gform-field-label gform-field-label--type-inline'>Structural<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_44_7'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_44.7' type='checkbox'  value='Electrical'  id='choice_17_44_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_44_7' id='label_17_44_7' class='gform-field-label gform-field-label--type-inline'>Electrical<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_44_8'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_44.8' type='checkbox'  value='Plumbing'  id='choice_17_44_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_44_8' id='label_17_44_8' class='gform-field-label gform-field-label--type-inline'>Plumbing<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_44_9'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_44.9' type='checkbox'  value='Windows'  id='choice_17_44_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_44_9' id='label_17_44_9' class='gform-field-label gform-field-label--type-inline'>Windows<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_44_11'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_44.11' type='checkbox'  value='Fire Safety'  id='choice_17_44_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_44_11' id='label_17_44_11' class='gform-field-label gform-field-label--type-inline'>Fire Safety<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_44_12'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_44.12' type='checkbox'  value='Roof'  id='choice_17_44_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_44_12' id='label_17_44_12' class='gform-field-label gform-field-label--type-inline'>Roof<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_44_13'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_44.13' type='checkbox'  value='Other'  id='choice_17_44_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_44_13' id='label_17_44_13' class='gform-field-label gform-field-label--type-inline'>Autre<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_46\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_46\" ><label class='gfield_label gform-field-label' for='input_17_46'>Please Specify Other Work<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea autocomplete=\"off\"  name='input_46' id='input_17_46' class='textarea small'   maxlength='100'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_17_93\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_93\" ><label class='gfield_label gform-field-label' for='input_17_93'>Please Specify Accessibility Work<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea autocomplete=\"off\"  name='input_93' id='input_17_93' class='textarea small'   maxlength='100'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_17_69\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_69\" ><label class='gfield_label gform-field-label' for='gform_browse_button_17_69'>Please upload a medical note<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_69' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_69&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_69&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_69&quot;,&quot;filelist&quot;:&quot;gform_preview_17_69&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/?gf_page=6e09d9d2b26667e&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;jpg,jpeg,gif,png,heic,pdf,doc,docx&quot;}],&quot;max_file_size&quot;:&quot;10485760b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:69},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;1&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_17_69&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_69' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_69' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_69\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_69'>Accepted file types: jpg, jpeg, gif, png, heic, pdf, doc, docx, Max. file size: 10 MB, Max. files: 1.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_69'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_17_69' class='ginput_preview_list'><\/div><\/div><div id=\"field_17_47\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_47\" ><p style=\"font-weight:bold;color:blue;text-align:center\">Please indicate if you have previously received any government funding from the following:<\/p><\/div><fieldset id=\"field_17_48\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_48\" ><legend class='gfield_label gform-field-label' >Lambton Renovates<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_48'>\n\t\t\t<div class='gchoice gchoice_17_48_0'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_48' type='radio' value='Yes'  id='choice_17_48_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_48_0' id='label_17_48_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_48_1'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_48' type='radio' value='No'  id='choice_17_48_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_48_1' id='label_17_48_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_49\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_49\" ><legend class='gfield_label gform-field-label' >Homeownership Down Payment Assistance Program<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_49'>\n\t\t\t<div class='gchoice gchoice_17_49_0'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_49' type='radio' value='Yes'  id='choice_17_49_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_49_0' id='label_17_49_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_49_1'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_49' type='radio' value='No'  id='choice_17_49_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_49_1' id='label_17_49_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_62\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_62\" ><center><strong><p style=\"color:red\">Please be advised if you have received previous funding, this may affect your eligibility. <\/p><\/strong><\/center><\/div><fieldset id=\"field_17_50\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-five-twelfths gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_50\" ><legend class='gfield_label gform-field-label' >RRAP (Residential Rehabilitation Assistance Program)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_50'>\n\t\t\t<div class='gchoice gchoice_17_50_0'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_50' type='radio' value='Yes'  id='choice_17_50_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_50_0' id='label_17_50_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_50_1'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_50' type='radio' value='No'  id='choice_17_50_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_50_1' id='label_17_50_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_51\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_51\" ><label class='gfield_label gform-field-label' for='input_17_51'>Ann\u00e9e<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_51' id='input_17_51' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_52\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_52\" ><label class='gfield_label gform-field-label' for='input_17_52'>CMHC Account Number<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_52' id='input_17_52' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_94\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_94\" ><label class='gfield_label gform-field-label' for='input_17_94'>Please describe the work completed<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea autocomplete=\"off\"  name='input_94' id='input_17_94' class='textarea small'   maxlength='250'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_17_112' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this)' value='Previous'  \/> <input type='button' id='gform_next_button_17_112' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this)' value='Suivant'  \/> <button type='button'  id='gform_save_17_5_link' onclick='gform.submission.handleButtonClick(this)' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Enregistrer et continuer plus tard<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_5' class='gform_page' data-js='page-field-id-112' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_17_11\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_11\" ><h3 class=\"gsection_title\">Informations sur les revenus pour <span data-gppa-live-merge-tag=\"@{Legal Name:3.3:fallback[Applicant]}\">Applicant<\/span> <span data-gppa-live-merge-tag=\"@{Legal Name:3.6}\"><\/span><\/h3><\/div><div id=\"field_17_80\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half currency_input gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_80\" ><label class='gfield_label gform-field-label' for='input_17_80'>Annual Income for <span data-gppa-live-merge-tag=\"@{Legal Name:3.3:fallback[Applicant]}\">Applicant<\/span> <span data-gppa-live-merge-tag=\"@{Legal Name:3.6}\"><\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_80' id='input_17_80' type='text' value='' class='large'  aria-describedby=\"gfield_description_17_80\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_17_80'>Please enter the amount shown on Line 15000 of your Notice of Assessment<\/div><\/div><div id=\"field_17_92\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_92\" ><label class='gfield_label gform-field-label' for='gform_browse_button_17_92'>Notice of Assessment Upload<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_92' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_92&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_92&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_92&quot;,&quot;filelist&quot;:&quot;gform_preview_17_92&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/?gf_page=6e09d9d2b26667e&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;jpg,jpeg,gif,png,heic,pdf,doc,docx&quot;}],&quot;max_file_size&quot;:&quot;10485760b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:92},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;1&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_17_92&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_92' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_92' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_92 gfield_description_17_92\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_92'>Accepted file types: jpg, jpeg, gif, png, heic, pdf, doc, docx, Max. file size: 10 MB, Max. files: 1.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_92'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_17_92' class='ginput_preview_list'><\/div><div class='gfield_description' id='gfield_description_17_92'>Please upload your NOA here<\/div><\/div><div id=\"field_17_27\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_27\" ><p>\u00c9num\u00e9rez tout l\u2019argent que vous recevez chaque mois. <strong>L&#039;\u00e9num\u00e9ration de tous les revenus est obligatoire<\/strong><\/p> \n<b><p>Des documents permettant de v\u00e9rifier votre revenu actuel doivent \u00eatre joints \u00e0 votre demande.<\/p><\/b>\n<p>Vous devrez fournir une copie de votre avis de cotisation le plus r\u00e9cent de l&#039;Agence du revenu du Canada. Si vous n&#039;avez pas de copie de cet avis de cotisation, vous pouvez en demander une en appelant l&#039;Agence du revenu du Canada au 1-800-959-8281.<\/p>\n<p>Cliquez sur le bouton ci-dessous pour ajouter des sources de revenus suppl\u00e9mentaires<\/p><\/div><div id=\"field_17_29\" class=\"gfield gfield--type-form gfield--input-type-form gform-theme__no-reset--children gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_29\" ><label class='gfield_label gform-field-label' for='input_17_29'>Sources de revenus<\/label><div class=\"gpnf-nested-entries-container ginput_container\">\n\n\t<table class=\"gpnf-nested-entries\">\n\n\t\t<thead>\n\t\t<tr>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-7\">\n\t\t\t\t\tType de revenu\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-5\">\n\t\t\t\t\tRevenu mensuel brut ($)\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-6\">\n\t\t\t\t\tPreuve de revenu\t\t\t\t<\/th>\n\t\t\t\t\t\t<th class=\"gpnf-row-actions\"><span class=\"screen-reader-text\">Actes<\/span><\/th>\n\t\t<\/tr>\n\t\t<\/thead>\n\n\t\t<tbody data-bind=\"visible: entries().length, foreach: entries\">\n\t\t<tr data-bind=\"attr: { 'data-entryid': id }\">\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f7.label, attr: { 'data-value': f7.label }\"\n\t\t\t\t\tdata-heading=\"Type of Income\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f5.label, attr: { 'data-value': f5.label }\"\n\t\t\t\t\tdata-heading=\"Gross Monthly Income ($)\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f6.label, attr: { 'data-value': f6.label }\"\n\t\t\t\t\tdata-heading=\"Proof of Income\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t<td class=\"gpnf-row-actions\" style=\"display: none;\" data-bind=\"visible: true\">\n\t\t\t\t<ul>\n\t\t\t\t\t<li class=\"edit\"><button type=\"button\" class=\"edit-button gform-theme-button--secondary\" data-bind=\"click: $parent.editEntry, attr: { 'aria-label': 'Edit Income {0} where Type of Income is {1}.'.gformFormat( $index() + 1, f7.label ) }\">Modifier<\/button><\/li>\n\t\t\t\t\t\t\t\t\t\t<li class=\"delete\"><button type=\"button\" class=\"delete-button gform-theme-button--simple gform-theme-button--size-md\" data-bind=\"click: $parent.deleteEntry, attr: { 'aria-label': 'Delete Income {0} where Type of Income is {1}.'.gformFormat( $index() + 1, f7.label ) }\">Supprimer<\/button><\/li>\n\t\t\t\t<\/ul>\n\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t\t<tbody data-bind=\"visible: entries().length <= 0\">\n\t\t<tr class=\"gpnf-no-entries\" data-bind=\"visible: entries().length <= 0\" style=\"display: none;\">\n\t\t\t<td colspan=\"4\">\n\t\t\t\tIl n&#039;y a pas de <span>Income.<\/span>\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t<\/table>\n\n\t<button type=\"button\" class=\"gpnf-add-entry\"\n\t\t        data-formid=\"17\"\n\t\t        data-nestedformid=\"4\"\n\t\t\t\tdata-bind=\"attr: { disabled: isMaxed }, css: { 'gf-default-disabled': isMaxed }\"\n\t\t\t\t>\n\t\t\t\tAdd Income\n\t\t\t<\/button>\t\n\t\t\t<p class=\"gpnf-add-entry-max\" data-bind=\"visible: isMaxed\" style=\"display: none;\">\n\t\t\t\tMaximum number of income reached.\n\t\t\t<\/p>\n<\/div>\n<input autocomplete=\"off\"  type=\"hidden\"\n                name=\"input_29\"\n                id=\"input_17_29\"\n                data-bind=\"value: entryIds\"\n                value=\"\" \/><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_17_113' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this)' value='Previous'  \/> <input type='button' id='gform_next_button_17_113' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this)' value='Suivant'  \/> <button type='button'  id='gform_save_17_6_link' onclick='gform.submission.handleButtonClick(this)' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Enregistrer et continuer plus tard<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_6' class='gform_page' data-js='page-field-id-113' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_6' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_17_30\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_30\" ><h3 class=\"gsection_title\">Informations sur les actifs pour <span data-gppa-live-merge-tag=\"@{Legal Name:3.3:fallback[Applicant]}\">Applicant<\/span> <span data-gppa-live-merge-tag=\"@{Legal Name:3.6}\"><\/span><\/h3><\/div><div id=\"field_17_53\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_53\" ><p>List all Assets owned by you. <strong>La liste de tous les actifs est obligatoire<\/strong>.<\/p>\n<b>La documentation permettant de v\u00e9rifier l\u2019ensemble de vos actifs doit \u00eatre jointe \u00e0 votre demande. <\/b><\/div><div id=\"field_17_89\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_89\" ><p style=\"font-weight:bold;color:blue;text-align:center\">Reminder: Bank Accounts Are Assets!<\/br>Bank accounts (checking, savings, CDs, etc.) are considered assets. Please ensure you've declared all financial accounts before proceeding.<\/p><p>Click the button below to add additional assets<\/p><\/div><div id=\"field_17_33\" class=\"gfield gfield--type-form gfield--input-type-form gform-theme__no-reset--children gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_33\" ><label class='gfield_label gform-field-label' for='input_17_33'>Actifs<\/label><div class=\"gpnf-nested-entries-container ginput_container\">\n\n\t<table class=\"gpnf-nested-entries\">\n\n\t\t<thead>\n\t\t<tr>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-7\">\n\t\t\t\t\tType d&#039;actif (y compris ceux situ\u00e9s \u00e0 l&#039;\u00e9tranger)\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-4\">\n\t\t\t\t\tD\u00e9tails de l&#039;actif\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-5\">\n\t\t\t\t\tValeur\/Solde du compte ($)\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-6\">\n\t\t\t\t\tPreuve de patrimoine\t\t\t\t<\/th>\n\t\t\t\t\t\t<th class=\"gpnf-row-actions\"><span class=\"screen-reader-text\">Actes<\/span><\/th>\n\t\t<\/tr>\n\t\t<\/thead>\n\n\t\t<tbody data-bind=\"visible: entries().length, foreach: entries\">\n\t\t<tr data-bind=\"attr: { 'data-entryid': id }\">\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f7.label, attr: { 'data-value': f7.label }\"\n\t\t\t\t\tdata-heading=\"Type of Asset (including those in foreign countries)\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f4.label, attr: { 'data-value': f4.label }\"\n\t\t\t\t\tdata-heading=\"Details of Asset\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f5.label, attr: { 'data-value': f5.label }\"\n\t\t\t\t\tdata-heading=\"Value\/Account Balance ($)\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f6.label, attr: { 'data-value': f6.label }\"\n\t\t\t\t\tdata-heading=\"Proof of Assets\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t<td class=\"gpnf-row-actions\" style=\"display: none;\" data-bind=\"visible: true\">\n\t\t\t\t<ul>\n\t\t\t\t\t<li class=\"edit\"><button type=\"button\" class=\"edit-button gform-theme-button--secondary\" data-bind=\"click: $parent.editEntry, attr: { 'aria-label': 'Edit Asset {0} where Type of Asset (including those in foreign countries) is {1}.'.gformFormat( $index() + 1, f7.label ) }\">Modifier<\/button><\/li>\n\t\t\t\t\t\t\t\t\t\t<li class=\"delete\"><button type=\"button\" class=\"delete-button gform-theme-button--simple gform-theme-button--size-md\" data-bind=\"click: $parent.deleteEntry, attr: { 'aria-label': 'Delete Asset {0} where Type of Asset (including those in foreign countries) is {1}.'.gformFormat( $index() + 1, f7.label ) }\">Supprimer<\/button><\/li>\n\t\t\t\t<\/ul>\n\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t\t<tbody data-bind=\"visible: entries().length <= 0\">\n\t\t<tr class=\"gpnf-no-entries\" data-bind=\"visible: entries().length <= 0\" style=\"display: none;\">\n\t\t\t<td colspan=\"5\">\n\t\t\t\tIl n&#039;y a pas de <span>Assets.<\/span>\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t<\/table>\n\n\t<button type=\"button\" class=\"gpnf-add-entry\"\n\t\t        data-formid=\"17\"\n\t\t        data-nestedformid=\"6\"\n\t\t\t\tdata-bind=\"attr: { disabled: isMaxed }, css: { 'gf-default-disabled': isMaxed }\"\n\t\t\t\t>\n\t\t\t\tAdd Asset\n\t\t\t<\/button>\t\n\t\t\t<p class=\"gpnf-add-entry-max\" data-bind=\"visible: isMaxed\" style=\"display: none;\">\n\t\t\t\tMaximum number of assets reached.\n\t\t\t<\/p>\n<\/div>\n<input autocomplete=\"off\"  type=\"hidden\"\n                name=\"input_33\"\n                id=\"input_17_33\"\n                data-bind=\"value: entryIds\"\n                value=\"\" \/><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_17_114' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this)' value='Previous'  \/> <input type='button' id='gform_next_button_17_114' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this)' value='Suivant'  \/> <button type='button'  id='gform_save_17_7_link' onclick='gform.submission.handleButtonClick(this)' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Enregistrer et continuer plus tard<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_7' class='gform_page' data-js='page-field-id-114' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_7' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_17_83\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_83\" ><h3 class=\"gsection_title\">Additional Assets<\/h3><\/div><fieldset id=\"field_17_54\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_54\" ><legend class='gfield_label gform-field-label' >Do you, or any member of your household own any property? (e.g. house, farm, land)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_54'>\n\t\t\t<div class='gchoice gchoice_17_54_0'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_54' type='radio' value='Yes'  id='choice_17_54_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_54_0' id='label_17_54_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_54_1'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_54' type='radio' value='No'  id='choice_17_54_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_54_1' id='label_17_54_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_76\" class=\"gfield gfield--type-form gfield--input-type-form gform-theme__no-reset--children gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_76\" ><label class='gfield_label gform-field-label' for='input_17_76'>Additional Properties<\/label><div class=\"gpnf-nested-entries-container ginput_container\">\n\n\t<table class=\"gpnf-nested-entries\">\n\n\t\t<thead>\n\t\t<tr>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-11\">\n\t\t\t\t\tType de bien\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-5\">\n\t\t\t\t\tLocalisation de la propri\u00e9t\u00e9\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-9\">\n\t\t\t\t\tValeur estim\u00e9e\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-10\">\n\t\t\t\t\tHypoth\u00e8que due\t\t\t\t<\/th>\n\t\t\t\t\t\t<th class=\"gpnf-row-actions\"><span class=\"screen-reader-text\">Actes<\/span><\/th>\n\t\t<\/tr>\n\t\t<\/thead>\n\n\t\t<tbody data-bind=\"visible: entries().length, foreach: entries\">\n\t\t<tr data-bind=\"attr: { 'data-entryid': id }\">\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f11.label, attr: { 'data-value': f11.label }\"\n\t\t\t\t\tdata-heading=\"Type of Property\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f5.label, attr: { 'data-value': f5.label }\"\n\t\t\t\t\tdata-heading=\"Property Location\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f9.label, attr: { 'data-value': f9.label }\"\n\t\t\t\t\tdata-heading=\"Assessed Value\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f10.label, attr: { 'data-value': f10.label }\"\n\t\t\t\t\tdata-heading=\"Mortgage Owing\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t<td class=\"gpnf-row-actions\" style=\"display: none;\" data-bind=\"visible: true\">\n\t\t\t\t<ul>\n\t\t\t\t\t<li class=\"edit\"><button type=\"button\" class=\"edit-button gform-theme-button--secondary\" data-bind=\"click: $parent.editEntry, attr: { 'aria-label': 'Edit Property {0} where Type of Property is {1}.'.gformFormat( $index() + 1, f11.label ) }\">Modifier<\/button><\/li>\n\t\t\t\t\t\t\t\t\t\t<li class=\"delete\"><button type=\"button\" class=\"delete-button gform-theme-button--simple gform-theme-button--size-md\" data-bind=\"click: $parent.deleteEntry, attr: { 'aria-label': 'Delete Property {0} where Type of Property is {1}.'.gformFormat( $index() + 1, f11.label ) }\">Supprimer<\/button><\/li>\n\t\t\t\t<\/ul>\n\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t\t<tbody data-bind=\"visible: entries().length <= 0\">\n\t\t<tr class=\"gpnf-no-entries\" data-bind=\"visible: entries().length <= 0\" style=\"display: none;\">\n\t\t\t<td colspan=\"5\">\n\t\t\t\tIl n&#039;y a pas de <span>Properties.<\/span>\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t<\/table>\n\n\t<button type=\"button\" class=\"gpnf-add-entry\"\n\t\t        data-formid=\"17\"\n\t\t        data-nestedformid=\"21\"\n\t\t\t\tdata-bind=\"attr: { disabled: isMaxed }, css: { 'gf-default-disabled': isMaxed }\"\n\t\t\t\t>\n\t\t\t\tAdd Property\n\t\t\t<\/button>\t\n\t\t\t<p class=\"gpnf-add-entry-max\" data-bind=\"visible: isMaxed\" style=\"display: none;\">\n\t\t\t\tMaximum number of properties reached.\n\t\t\t<\/p>\n<\/div>\n<input autocomplete=\"off\"  type=\"hidden\"\n                name=\"input_76\"\n                id=\"input_17_76\"\n                data-bind=\"value: entryIds\"\n                value=\"\" \/><\/div><fieldset id=\"field_17_77\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_77\" ><legend class='gfield_label gform-field-label' >Do you, or any member of your household have any other assets such as vehicles, trailers, boats, etc.?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_77'>\n\t\t\t<div class='gchoice gchoice_17_77_0'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_77' type='radio' value='Yes'  id='choice_17_77_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_77_0' id='label_17_77_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_77_1'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_77' type='radio' value='No'  id='choice_17_77_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_77_1' id='label_17_77_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_78\" class=\"gfield gfield--type-form gfield--input-type-form gform-theme__no-reset--children gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_78\" ><label class='gfield_label gform-field-label' for='input_17_78'>Additional Assets<\/label><div class=\"gpnf-nested-entries-container ginput_container\">\n\n\t<table class=\"gpnf-nested-entries\">\n\n\t\t<thead>\n\t\t<tr>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-11\">\n\t\t\t\t\tType of Asset\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-9\">\n\t\t\t\t\tModel & Year\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-10\">\n\t\t\t\t\tFair Market Value ($)\t\t\t\t<\/th>\n\t\t\t\t\t\t<th class=\"gpnf-row-actions\"><span class=\"screen-reader-text\">Actes<\/span><\/th>\n\t\t<\/tr>\n\t\t<\/thead>\n\n\t\t<tbody data-bind=\"visible: entries().length, foreach: entries\">\n\t\t<tr data-bind=\"attr: { 'data-entryid': id }\">\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f11.label, attr: { 'data-value': f11.label }\"\n\t\t\t\t\tdata-heading=\"Type of Asset\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f9.label, attr: { 'data-value': f9.label }\"\n\t\t\t\t\tdata-heading=\"Model & Year\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f10.label, attr: { 'data-value': f10.label }\"\n\t\t\t\t\tdata-heading=\"Fair Market Value ($)\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t<td class=\"gpnf-row-actions\" style=\"display: none;\" data-bind=\"visible: true\">\n\t\t\t\t<ul>\n\t\t\t\t\t<li class=\"edit\"><button type=\"button\" class=\"edit-button gform-theme-button--secondary\" data-bind=\"click: $parent.editEntry, attr: { 'aria-label': 'Edit Asset {0} where Type of Asset is {1}.'.gformFormat( $index() + 1, f11.label ) }\">Modifier<\/button><\/li>\n\t\t\t\t\t\t\t\t\t\t<li class=\"delete\"><button type=\"button\" class=\"delete-button gform-theme-button--simple gform-theme-button--size-md\" data-bind=\"click: $parent.deleteEntry, attr: { 'aria-label': 'Delete Asset {0} where Type of Asset is {1}.'.gformFormat( $index() + 1, f11.label ) }\">Supprimer<\/button><\/li>\n\t\t\t\t<\/ul>\n\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t\t<tbody data-bind=\"visible: entries().length <= 0\">\n\t\t<tr class=\"gpnf-no-entries\" data-bind=\"visible: entries().length <= 0\" style=\"display: none;\">\n\t\t\t<td colspan=\"4\">\n\t\t\t\tIl n&#039;y a pas de <span>Assets.<\/span>\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t<\/table>\n\n\t<button type=\"button\" class=\"gpnf-add-entry\"\n\t\t        data-formid=\"17\"\n\t\t        data-nestedformid=\"22\"\n\t\t\t\tdata-bind=\"attr: { disabled: isMaxed }, css: { 'gf-default-disabled': isMaxed }\"\n\t\t\t\t>\n\t\t\t\tAdd Asset\n\t\t\t<\/button>\t\n\t\t\t<p class=\"gpnf-add-entry-max\" data-bind=\"visible: isMaxed\" style=\"display: none;\">\n\t\t\t\tMaximum number of assets reached.\n\t\t\t<\/p>\n<\/div>\n<input autocomplete=\"off\"  type=\"hidden\"\n                name=\"input_78\"\n                id=\"input_17_78\"\n                data-bind=\"value: entryIds\"\n                value=\"\" \/><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_17_107' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this)' value='Previous'  \/> <input type='button' id='gform_next_button_17_107' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this)' value='Suivant'  \/> <button type='button'  id='gform_save_17_8_link' onclick='gform.submission.handleButtonClick(this)' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Enregistrer et continuer plus tard<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_8' class='gform_page' data-js='page-field-id-107' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_8' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_17_25\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_25\" ><h3 class=\"gsection_title\">Membres du m\u00e9nage<\/h3><\/div><fieldset id=\"field_17_87\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_87\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Des membres du m\u00e9nage ?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_17_87'><div class='gchoice gchoice_17_87_1'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_87.1' type='checkbox'  value='I have no additional household members'  id='choice_17_87_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_87_1' id='label_17_87_1' class='gform-field-label gform-field-label--type-inline'>Je n&#039;ai pas de membres suppl\u00e9mentaires dans mon foyer<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_100\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_calculation field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  data-js-reload=\"field_17_100\" ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lors de la visualisation du formulaire\"><\/i><span>Ce champ est masqu\u00e9 lors de la visualisation du formulaire<\/span><\/div><label class='gfield_label gform-field-label' for='input_17_100'>Nombre de membres du m\u00e9nage<\/label><div class='ginput_container ginput_container_number'><input autocomplete=\"off\"  name='input_100' id='input_17_100' type='text' step='any'   value='' class='large'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_17_10\" class=\"gfield gfield--type-form gfield--input-type-form gform-theme__no-reset--children gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_10\" ><label class='gfield_label gform-field-label' for='input_17_10'>Members<\/label><div class=\"gpnf-nested-entries-container ginput_container\">\n\n\t<table class=\"gpnf-nested-entries\">\n\n\t\t<thead>\n\t\t<tr>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-49\">\n\t\t\t\t\tNom officiel\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-5\">\n\t\t\t\t\tDate de naissance\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-8\">\n\t\t\t\t\tRelation\t\t\t\t<\/th>\n\t\t\t\t\t\t<th class=\"gpnf-row-actions\"><span class=\"screen-reader-text\">Actes<\/span><\/th>\n\t\t<\/tr>\n\t\t<\/thead>\n\n\t\t<tbody data-bind=\"visible: entries().length, foreach: entries\">\n\t\t<tr data-bind=\"attr: { 'data-entryid': id }\">\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f49.label, attr: { 'data-value': f49.label }\"\n\t\t\t\t\tdata-heading=\"Legal Name\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f5.label, attr: { 'data-value': f5.label }\"\n\t\t\t\t\tdata-heading=\"Date of Birth\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f8.label, attr: { 'data-value': f8.label }\"\n\t\t\t\t\tdata-heading=\"Relationship\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t<td class=\"gpnf-row-actions\" style=\"display: none;\" data-bind=\"visible: true\">\n\t\t\t\t<ul>\n\t\t\t\t\t<li class=\"edit\"><button type=\"button\" class=\"edit-button gform-theme-button--secondary\" data-bind=\"click: $parent.editEntry, attr: { 'aria-label': 'Edit Member {0} where Legal Name is {1}.'.gformFormat( $index() + 1, f49.label ) }\">Modifier<\/button><\/li>\n\t\t\t\t\t\t\t\t\t\t<li class=\"delete\"><button type=\"button\" class=\"delete-button gform-theme-button--simple gform-theme-button--size-md\" data-bind=\"click: $parent.deleteEntry, attr: { 'aria-label': 'Delete Member {0} where Legal Name is {1}.'.gformFormat( $index() + 1, f49.label ) }\">Supprimer<\/button><\/li>\n\t\t\t\t<\/ul>\n\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t\t<tbody data-bind=\"visible: entries().length <= 0\">\n\t\t<tr class=\"gpnf-no-entries\" data-bind=\"visible: entries().length <= 0\" style=\"display: none;\">\n\t\t\t<td colspan=\"4\">\n\t\t\t\tIl n&#039;y a pas de <span>Members.<\/span>\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t<\/table>\n\n\t<button type=\"button\" class=\"gpnf-add-entry\"\n\t\t        data-formid=\"17\"\n\t\t        data-nestedformid=\"19\"\n\t\t\t\tdata-bind=\"attr: { disabled: isMaxed }, css: { 'gf-default-disabled': isMaxed }\"\n\t\t\t\t>\n\t\t\t\tAdd Member\n\t\t\t<\/button>\t\n\t\t\t<p class=\"gpnf-add-entry-max\" data-bind=\"visible: isMaxed\" style=\"display: none;\">\n\t\t\t\tMaximum number of members reached.\n\t\t\t<\/p>\n<\/div>\n<input autocomplete=\"off\"  type=\"hidden\"\n                name=\"input_10\"\n                id=\"input_17_10\"\n                data-bind=\"value: entryIds\"\n                value=\"\" \/><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_17_97' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this)' value='Previous'  \/> <input type='button' id='gform_next_button_17_97' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this)' value='Suivant'  \/> <button type='button'  id='gform_save_17_9_link' onclick='gform.submission.handleButtonClick(this)' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Enregistrer et continuer plus tard<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_9' class='gform_page' data-js='page-field-id-97' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_9' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_17_84\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_84\" ><h3 class=\"gsection_title\">Commentaires suppl\u00e9mentaires<\/h3><\/div><div id=\"field_17_85\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_85\" ><label class='gfield_label gform-field-label' for='input_17_85'>Y a-t-il d\u2019autres informations que vous souhaiteriez inclure dans cette demande ?<\/label><div class='ginput_container ginput_container_textarea'><textarea autocomplete=\"off\"  name='input_85' id='input_17_85' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_17_108' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this)' value='Previous'  \/> <input type='button' id='gform_next_button_17_108' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this)' value='Suivant'  \/> <button type='button'  id='gform_save_17_10_link' onclick='gform.submission.handleButtonClick(this)' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Enregistrer et continuer plus tard<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_10' class='gform_page' data-js='page-field-id-108' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_10' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_17_96\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_96\" ><h3 class=\"gsection_title\">Notice<\/h3><\/div><div id=\"field_17_95\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_95\" ><p>For the purposes of this application, an owner includes all individuals 18 years of age or older who reside in the household, whether or not their name appears on the property's legal title or deed. All adult household members are required to provide income and asset information for the purpose of determining eligibility for the Lambton Renovates Program.<\/p><\/div><div id=\"field_17_23\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_23\" ><h3 class=\"gsection_title\">Declaration<\/h3><\/div><div id=\"field_17_24\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_24\" ><p>I\/we hereby confirm that I\/we are the owners of the house and property and that no other person is an owner.   <\/p>\n\n<p>I\/we hereby acknowledge that if my\/our funding application is accepted I\/we cannot claim the repairs for any Provincial tax rebate program. <\/p>\n\n<p>I\/ we declare and certify that all information given in this application is correct and complete.  I \/ we understand that falsifying information may result in the cancellation of my application. This application and any requested supporting documents become the property of the Corporation of the County of Lambton, Housing Services Department. <\/p>\n\n<p>Personal information contained on this form or in attachments hereto is collected by the Corporation of the County of Lambton pursuant to the Municipal Freedom of Information and Protection of Privacy Act, (R.S.O. 1990, c.M.56) for the purpose of determining eligibility for Lambton Renovates Funding under the Investment in Affordable Housing Program. Inquiries relating to this collection should be directed to the Corporation of the County of Lambton, Housing Services Department, 162 Lochiel Street \u2013 Suite 100, Sarnia, ON N7T 7W5, 519-344-2062. <\/p>\n\n<p>Pursuant to the Municipal\/Provincial Freedom of Information and Protection of Privacy Act, I give my consent and authorization to the Corporation of the County of Lambton, Housing Services Department, to make enquiries to verify the information given in this application and I authorize any person, corporation or any social agency having knowledge of any such required information to release information to the Corporation of the County of Lambton, Housing Services Department.  I also give my consent and authorization to the Corporation of the County of Lambton, Housing Services Department, to disclose the information given on this form to any person, corporation, social agency and other municipal, provincial and federal department agencies providing assistance to me and persons listed on this application. <\/p>  \n<\/div><div id=\"field_17_61\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_61\" ><label class='gfield_label gform-field-label' for='input_17_61'>Applicant Signature<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_17_61_Container' class='gfield_signature_container ginput_container' style='height:180px; width:450px; ' ><input autocomplete=\"off\"  type='hidden' class='gform_hidden' name='input_17_61_valid' id='input_17_61_valid' \/><canvas id='input_17_61' width='450' height='180'><\/canvas><\/div><\/div><\/div><div id=\"field_17_88\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_88\" ><label class='gfield_label gform-field-label' for='input_17_88'>Additional Emails<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_88' id='input_17_88' type='text' value='' class='large'  aria-describedby=\"gfield_description_17_88\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_17_88'>If you would like to send a confirmation of completed application to any additional emails, please specify them here. You may put multiple emails separated by a semi colon (;)<\/div><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_17' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this)' value='Previous'  \/> <input type='submit' id='gform_submit_button_17' class='gform_button button' onclick='gform.submission.handleButtonClick(this)' value='Soumettre'  \/> <button type='button'  id='gform_save_17_footer_link' onclick='gform.submission.handleButtonClick(this)' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Enregistrer et continuer plus tard<\/button>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_17' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_17' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='17' \/>\n            <input type='hidden' class='gform_hidden' name='gform_save' id='gform_save_17' value='' \/>\n                             <input type='hidden' class='gform_hidden' name='gform_resume_token' id='gform_resume_token_17' value='' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_17' 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