[{"text":"[Prénom et nom]","fontSize":"15","textAlign":"left","bold":true,"underline":false,"marginBottom":"0","active":true,"id":"37e54261-7981-4622-86f2-4c5e95dbb0ba","order":1},{"text":"[Adresse]","fontSize":"15","textAlign":"left","bold":false,"underline":false,"marginBottom":"0","active":true,"id":"68b9595d-1401-4b64-bdbe-4a34a6766243","order":2},{"text":"[Code postal et Ville]","fontSize":"15","textAlign":"left","bold":false,"underline":false,"marginBottom":"30","active":true,"id":"30642226-814c-454a-a240-787292155860","order":3},{"text":"[Ville], le [Date]","fontSize":"15","textAlign":"right-align","bold":false,"underline":false,"marginBottom":"30","active":true,"id":"86fcffae-75a1-41c1-8621-5962eea2e36c","order":4},{"text":"Objet : Procuration donnée à [Prénom et nom]","fontSize":"15","textAlign":"left","bold":true,"underline":false,"marginBottom":"40","active":true,"id":"06a5238f-bc66-475b-867c-c560814fec26","order":5},{"text":"PROCURATION","fontSize":"20","textAlign":"center","bold":true,"underline":true,"marginBottom":"30","active":true,"id":"1854ebec-78cc-4d37-b3a4-7d67eb547df9","order":6},{"text":"Je soussigné [Madame] [Prénom et Nom], né(e) le [Date de naissance] à [Lieu de naissance], donne par la présente pouvoir à :","fontSize":"15","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","active":true,"id":"14fb849e-dbe2-4eb0-bf7e-34e667da8915","order":7},{"text":"

- [Madame] [Prénom et Nom], né(e) le [Date de naissance] à [Lieu de naissance], demeurant [Adresse], [Code postal et Ville] ;

","fontSize":"15","textAlign":"left","bold":false,"underline":false,"marginBottom":"0","active":true,"id":"f3fcf372-8c7d-49b5-ab12-057df2d3d4e3","order":8},{"id":"f23afb81-2635-411a-94e8-3b96e1b463c8","text":"- afin que cette personne puisse effectuer les actions suivantes à ma place et en mon nom :","fontSize":"15","textAlign":"left","bold":false,"cflou":false,"underline":false,"marginBottom":"0","active":false,"order":9,"displayConditions":[{"field":"4c2ccdb3-9ad2-484f-98b6-659e29d601eb","value":"2","type":"add","operator":"=","operatorType":"AND"}]},{"id":"21ac0d09-e75e-4519-84f9-b22622b11dc2","text":"- [Listes des actions à effectuer] ;","fontSize":"15","textAlign":"left","bold":false,"cflou":false,"underline":false,"marginBottom":"0","active":false,"order":10,"displayConditions":[{"field":"4c2ccdb3-9ad2-484f-98b6-659e29d601eb","value":"2","type":"add","operator":"=","operatorType":"AND"}]},{"text":"- afin que cette personne puisse signer en mon nom tout formulaire et document, ainsi que requérir pour moi, tout document nécessaire.
","fontSize":"15","textAlign":"left","bold":false,"underline":false,"marginBottom":"0","active":true,"id":"95955897-5f39-4d65-bf1b-2c531f115a0d","order":11,"displayConditions":[{"field":"4c2ccdb3-9ad2-484f-98b6-659e29d601eb","value":"1","type":"add","operator":"=","operatorType":"AND"},{"field":"30e4eb74-feb0-4457-9d48-b64e2dcce508","value":"1","type":"add","operator":"=","operatorType":"AND"}]},{"id":"3e287d76-8126-481e-89d1-1c2e3a5db00c","text":"

- afin que cette personne puisse signer pour moi et en mon nom les formulaires et documents suivants : [Liste des documents concernés].

","fontSize":"15","textAlign":"left","bold":false,"cflou":false,"underline":false,"marginBottom":"0","active":false,"order":12,"displayConditions":[{"field":"30e4eb74-feb0-4457-9d48-b64e2dcce508","value":"2","type":"add","operator":"=","operatorType":"AND"},{"field":"4c2ccdb3-9ad2-484f-98b6-659e29d601eb","value":"1","type":"add","operator":"=","operatorType":"AND"}]},{"text":"Cette procuration est donnée à [Prénom et Nom] pour une durée indéterminée. Je me réserve la possibilité d'y mettre un terme à tout moment.","fontSize":"15","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","active":false,"id":"8f13dc74-8f8d-45ab-a40b-8d8cfaa4bcaa","order":13,"displayConditions":[{"field":"74bdad68-4b6e-4ebc-a53f-6786b03e2f95","value":"option2","type":"add","operator":"="},{"field":"74bdad68-4b6e-4ebc-a53f-6786b03e2f95","value":"option1","type":"remove","operator":"="}],"cflou":true},{"id":"3b613c2c-e21c-4be2-8164-ad5653271060","text":"Cette procuration est donnée à [Prénom et Nom] pour une durée limitée de [Durée de validité de la procuration] à compter de ce jour.","fontSize":"15","textAlign":"left","bold":false,"cflou":true,"underline":false,"marginBottom":"10","active":true,"order":14,"displayConditions":[{"field":"74bdad68-4b6e-4ebc-a53f-6786b03e2f95","value":"option1","type":"add","operator":"="},{"field":"74bdad68-4b6e-4ebc-a53f-6786b03e2f95","value":"option2","type":"remove","operator":"="}]},{"text":"Je suis conscient que cette déclaration m'engage juridiquement et que toute fausse déclaration pourra entraîner des sanctions pénales.","fontSize":"15","textAlign":"left","bold":false,"underline":false,"marginBottom":"40","active":true,"id":"bd6abfea-dbf7-4abb-a604-b830d4819062","order":15},{"text":"Fait à [Ville], le [Date], en [Nombre d'exemplaires] exemplaires originaux.","fontSize":"15","textAlign":"left","bold":true,"underline":false,"marginBottom":"50","active":true,"id":"794b0856-6118-4379-89f9-ef42cad34ce6","order":16},{"text":"[Prénom et nom]","fontSize":"15","textAlign":"right-align","bold":true,"underline":false,"marginBottom":"0","active":true,"id":"1c0f21be-bfb9-4bc8-a3a6-e3a411c8d069","order":17},{"text":"Signature du mandant","fontSize":"12","textAlign":"right-align","bold":false,"underline":false,"marginBottom":"50","active":true,"id":"b5bd37cb-fe0c-4365-8ebe-af9b55099788","order":18},{"id":"2cc31d78-096f-476e-89d9-5621ec1f1553","text":"[Prénom et nom]","fontSize":"15","textAlign":"right-align","bold":true,"cflou":false,"underline":false,"marginBottom":"0","active":true,"order":19},{"id":"f9e0f2db-018c-49b8-8361-a6104e24ac7f","text":"Signature du mandataire","fontSize":"12","textAlign":"right-align","bold":false,"cflou":false,"underline":false,"marginBottom":"40","active":true,"order":20},{"id":"d30a0be4-077c-4ebf-84d0-e98c8257bfee","text":"Pièces jointes :","fontSize":"15","textAlign":"left","bold":true,"cflou":false,"underline":true,"marginBottom":"0","active":true,"order":21},{"id":"5cd8b270-d8ed-492a-9409-912851a4ad6e","text":"- Copie de la pièce d'identité de [Prénom et Nom] (mandant) ;","fontSize":"12","textAlign":"left","bold":false,"cflou":false,"underline":false,"marginBottom":"0","active":true,"order":22},{"id":"5ba74d18-51da-4715-b67f-c3b5013fd61a","text":"- Copie de la pièce d'identité de [Prénom et Nom] (mandataire) ;","fontSize":"12","textAlign":"left","bold":false,"cflou":false,"underline":false,"marginBottom":"0","active":true,"order":23}]