<p style="text-align: left;"><span style="font-size: small;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span><span style="text-decoration: underline;"><span style="font-size: small;">CLOTURE DEMANDE Maarch Mairie - [res_letterbox.type_label] - [res_letterbox.res_id] </span></span></p>
<p style="text-align: center;">&nbsp;</p>
<table style="background-color: #a8c33c; width: 800px; border: #000000 1pt solid;" border="1" cellspacing="1" cellpadding="5">
<tbody>
<tr>
<td style="width: 200px;">CLOTURE&nbsp;DE LA DEMANDE</td>
<td>DATE: [dates]</td>
<td>HEURE: [time]</td>
</tr>
</tbody>
</table>
<table style="width: 800px; border: #000000 1pt solid;" border="1" cellspacing="1" cellpadding="5">
<tbody>
<tr>
<td style="width: 200px; background-color: #a8c33c;">OBJET</td>
<td style="background-color: #e1f787;">&nbsp;[res_letterbox.subject]</td>
</tr>
<tr>
<td style="width: 200px; background-color: #a8c33c;">ACTIONS CONDUITES</td>
<td>&nbsp;</td>
</tr>
<tr>
<td style="width: 200px; background-color: #a8c33c;">DATE DE REMISE EN ETAT / SERVICE</td>
<td style="background-color: #e1f787;">&nbsp;</td>
</tr>
<tr>
<td style="width: 200px; background-color: #a8c33c;">CONSIGNES COMPLEMENTAIRES</td>
<td>&nbsp;</td>
</tr>
<tr>
<td style="width: 200px; background-color: #a8c33c;">AUTRES OBSERVATIONS</td>
<td style="background-color: #e1f787;">&nbsp;</td>
</tr>
<tr>
<td style="width: 200px; background-color: #a8c33c;">&nbsp;</td>
<td>&nbsp;</td>
</tr>
<tr>
<td style="width: 200px; background-color: #a8c33c;">&nbsp;</td>
<td style="background-color: #e1f787;">&nbsp;</td>
</tr>
</tbody>
</table>