{"id":18938,"date":"2022-02-04T11:28:36","date_gmt":"2022-02-04T21:28:36","guid":{"rendered":"https:\/\/www.service-public.pf\/biosecurite\/?page_id=18938"},"modified":"2022-04-28T15:55:37","modified_gmt":"2022-04-29T01:55:37","slug":"demande-de-permis-dimportation","status":"publish","type":"page","link":"https:\/\/www.service-public.pf\/biosecurite\/formulaires\/demande-de-permis-dimportation\/","title":{"rendered":"Demande de permis d&rsquo;importation phyto"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1144px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_unknown gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_4' style='display:none'>\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Formulaire de demande d'importation PHYTO<\/h3>\n                            <p class='gform_description'>Remplir ce formulaire dans le cadre d'une demande d'importation <\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_4'  action='\/biosecurite\/wp-json\/wp\/v2\/pages\/18938\/' data-formid='4' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_4' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_4_52\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_52\" ><label class='gfield_label gform-field-label' >Indiquez votre statut<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_4_52'>\n\t\t\t<li class='gchoice gchoice_4_52_0'>\n\t\t\t\t<input name='input_52' type='radio' value='Particulier (j&#039;importe \u00e0 mon nom \u00e0 des fins de consommation ou plantation))'  id='choice_4_52_0'    \/>\n\t\t\t\t<label for='choice_4_52_0' id='label_4_52_0' class='gform-field-label gform-field-label--type-inline'>Particulier (j'importe \u00e0 mon nom \u00e0 des fins de consommation ou plantation))<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_4_52_1'>\n\t\t\t\t<input name='input_52' type='radio' value='Professionnel (j&#039;importe au nom de ma soci\u00e9t\u00e9 \u00e0 des fins de plantation ou commercialisation)'  id='choice_4_52_1'    \/>\n\t\t\t\t<label for='choice_4_52_1' id='label_4_52_1' class='gform-field-label gform-field-label--type-inline'>Professionnel (j'importe au nom de ma soci\u00e9t\u00e9 \u00e0 des fins de plantation ou commercialisation)<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_4_3\" class=\"gfield gfield--type-name field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_3\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Nom du demandeur<\/label><div class='ginput_complex ginput_container ginput_container--name has_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_4_3'>\n                            <span id='input_4_3_2_container' class='name_prefix name_prefix_select gform-grid-col gform-grid-col--size-auto' >\n                                                    <select name='input_3.2' id='input_4_3_2'    aria-required='false'   >\n                          <option value=''><\/option><option value='M.' >M.<\/option><option value='Mme' >Mme<\/option>\n                      <\/select>\n                                                    <label for='input_4_3_2' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9fixe<\/label>\n                                                  <\/span>\n                            <span id='input_4_3_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_3.3' id='input_4_3_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_4_3_3' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                <\/span>\n                            \n                            <span id='input_4_3_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_3.6' id='input_4_3_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_4_3_6' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_4_58\" class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_58\" ><label class='gfield_label gform-field-label' for='input_4_58'>Raison sociale<\/label><div class='ginput_container ginput_container_select'><select name='input_58' id='input_4_58' class='medium gfield_select'     aria-invalid=\"false\" ><option value='S\u00e9lectionner' >S\u00e9lectionner<\/option><option value='AB DISTRIBUTION (ex MC DO)' >AB DISTRIBUTION (ex MC DO)<\/option><option value='ABC STORE MOOREA' >ABC STORE MOOREA<\/option><option value='ACE SIN TUNG HING TARAVAO' >ACE SIN TUNG HING TARAVAO<\/option><option value='Adjuvant CABINARD GSBDD\/SSV\/BILT' >Adjuvant CABINARD GSBDD\/SSV\/BILT<\/option><option value='Adjuvant MELHEUST Benoit - RSMA' >Adjuvant MELHEUST Benoit - RSMA<\/option><option value='AF POLYNESIE' >AF POLYNESIE<\/option><option value='AGRICHEM' >AGRICHEM<\/option><option value='AGRILAND (ex ZOOLAND)' >AGRILAND (ex ZOOLAND)<\/option><option value='AGRITECH SARL' >AGRITECH SARL<\/option><option value='AGRO NUTRITION' >AGRO NUTRITION<\/option><option value='AH SING IMPORT' >AH SING IMPORT<\/option><option value='AHE PEARLS (CHENNE Noelline)' >AHE PEARLS (CHENNE Noelline)<\/option><option value='AINU TAUTAI' >AINU TAUTAI<\/option><option value='AIR FRANCE' >AIR FRANCE<\/option><option value='AIR TAHITI NUI' >AIR TAHITI NUI<\/option><option value='ALBATROS' >ALBATROS<\/option><option value='ALINE TAHITI' >ALINE TAHITI<\/option><option value='ALPHA EMPIRE' >ALPHA EMPIRE<\/option><option value='AMERIGO VESPUCCI' >AMERIGO VESPUCCI<\/option><option value='ANIMAL WORLD' >ANIMAL WORLD<\/option><option value='ANI&#039;MALICE' >ANI&#039;MALICE<\/option><option value='ANTOINE KATHY' >ANTOINE KATHY<\/option><option value='APPROTEC' >APPROTEC<\/option><option value='AQUAPAC' >AQUAPAC<\/option><option value='ARAKA IMPORT' >ARAKA IMPORT<\/option><option value='ARAKA-GRENIER DE JOSEPH' >ARAKA-GRENIER DE JOSEPH<\/option><option value='ARMAX' >ARMAX<\/option><option value='Association tubuai fane' >Association tubuai fane<\/option><option value='ASSOSSIATION RIMA HERE' >ASSOSSIATION RIMA HERE<\/option><option value='ATELIER DU DECOR' >ATELIER DU DECOR<\/option><option value='AVICOLE ELEVAGE FAAROA' >AVICOLE ELEVAGE FAAROA<\/option><option value='AVICOOP' >AVICOOP<\/option><option value='BAJA CANTINA' >BAJA CANTINA<\/option><option value='BALMORAL\/SCAT\/TT' >BALMORAL\/SCAT\/TT<\/option><option value='BEARD PAPA' >BEARD PAPA<\/option><option value='BIG CE' >BIG CE<\/option><option value='BLACK WATCH' >BLACK WATCH<\/option><option value='BORA-BORA AQUACULTURE' >BORA-BORA AQUACULTURE<\/option><option value='BORA-BORA NUI RESORT' >BORA-BORA NUI RESORT<\/option><option value='BOURGOIN fr\u00e9d\u00e9ric' >BOURGOIN fr\u00e9d\u00e9ric<\/option><option value='BOUTIQUE IMPORT H&amp;V' >BOUTIQUE IMPORT H&amp;V<\/option><option value='BRAPAC' >BRAPAC<\/option><option value='BRASSERIE DU PACIFIQUE (BRAPAC)' >BRASSERIE DU PACIFIQUE (BRAPAC)<\/option><option value='BRAUN MANAGEMENT CY Ltd' >BRAUN MANAGEMENT CY Ltd<\/option><option value='BREMEN' >BREMEN<\/option><option value='BRICO DECO' >BRICO DECO<\/option><option value='BRICOGITE' >BRICOGITE<\/option><option value='BRUNO MOLINARO' >BRUNO MOLINARO<\/option><option value='BUILLARD Tanoa' >BUILLARD Tanoa<\/option><option value='CABINET URIVET' >CABINET URIVET<\/option><option value='CABINET VET (Huahine)' >CABINET VET (Huahine)<\/option><option value='CABINET VET GOLDER' >CABINET VET GOLDER<\/option><option value='CABINET VET LECOMTE' >CABINET VET LECOMTE<\/option><option value='CANDY STORE' >CANDY STORE<\/option><option value='CAROLE BOUTIQUE' >CAROLE BOUTIQUE<\/option><option value='CAROVOG BATIR' >CAROVOG BATIR<\/option><option value='CARREFOUR ARUE' >CARREFOUR ARUE<\/option><option value='CARREFOUR ARUE \/ CEDIS' >CARREFOUR ARUE \/ CEDIS<\/option><option value='CARREFOUR ARUE \/ PUNAAUIA' >CARREFOUR ARUE \/ PUNAAUIA<\/option><option value='CARREFOUR FAA&#039;A' >CARREFOUR FAA&#039;A<\/option><option value='CARREFOUR PUNAAAUIA \/ ARUE' >CARREFOUR PUNAAAUIA \/ ARUE<\/option><option value='CARREFOUR PUNAAUIA' >CARREFOUR PUNAAUIA<\/option><option value='CARREFOUR PUNAAUIA \/ ARUE \/ CEDIS' >CARREFOUR PUNAAUIA \/ ARUE \/ CEDIS<\/option><option value='CARREFOUR PUNAAUIA \/ CEDIS' >CARREFOUR PUNAAUIA \/ CEDIS<\/option><option value='CARREFOUR TARAVAO' >CARREFOUR TARAVAO<\/option><option value='CASH API (paea)' >CASH API (paea)<\/option><option value='CASH CLUB' >CASH CLUB<\/option><option value='CASTAING' >CASTAING<\/option><option value='CAVIAR &amp; CO' >CAVIAR &amp; CO<\/option><option value='CDP TAHITI' >CDP TAHITI<\/option><option value='CDPP' >CDPP<\/option><option value='CEDIS' >CEDIS<\/option><option value='CEDIS \/ CARREFOUR' >CEDIS \/ CARREFOUR<\/option><option value='CEDIS \/ CARREFOUR ARUE' >CEDIS \/ CARREFOUR ARUE<\/option><option value='CEDIS \/ CARREFOUR PUNAAUIA' >CEDIS \/ CARREFOUR PUNAAUIA<\/option><option value='CEDIS \/ WAN DISTRIBUTION' >CEDIS \/ WAN DISTRIBUTION<\/option><option value='CEDIS C\/O CARREFOUR ARUE' >CEDIS C\/O CARREFOUR ARUE<\/option><option value='CEDIS MIXTE KODRINK' >CEDIS MIXTE KODRINK<\/option><option value='CEDIS MIXTE WAN DISTRIBUTION' >CEDIS MIXTE WAN DISTRIBUTION<\/option><option value='CENTRAL D&#039;ACHATS ET DE GESTION' >CENTRAL D&#039;ACHATS ET DE GESTION<\/option><option value='CERPOL' >CERPOL<\/option><option value='CGPME' >CGPME<\/option><option value='CHAMPION FAAA' >CHAMPION FAAA<\/option><option value='CHAMPION MAHINA' >CHAMPION MAHINA<\/option><option value='CHAMPION - MOOREA' >CHAMPION - MOOREA<\/option><option value='CHAMPION - PAOFAI' >CHAMPION - PAOFAI<\/option><option value='CHAMPION PAOFAI \/ CHAMPION MAHINA' >CHAMPION PAOFAI \/ CHAMPION MAHINA<\/option><option value='CHAMPION - RAIATEA' >CHAMPION - RAIATEA<\/option><option value='CHAMPION - TARAVAO' >CHAMPION - TARAVAO<\/option><option value='CHAMPION - TOA MOOREA' >CHAMPION - TOA MOOREA<\/option><option value='CHANT JIMMY' >CHANT JIMMY<\/option><option value='CHARCUTERIE CHAINE' >CHARCUTERIE CHAINE<\/option><option value='CHARCUTERIE DU PACIFIQUE' >CHARCUTERIE DU PACIFIQUE<\/option><option value='CHIMECAL OVERSEAS' >CHIMECAL OVERSEAS<\/option><option value='CHOCO AND CO' >CHOCO AND CO<\/option><option value='CIE POLYNESIENNE DE LONG LINE' >CIE POLYNESIENNE DE LONG LINE<\/option><option value='CLINIQUE VET DE FAAA (Dr LEBOZEC)' >CLINIQUE VET DE FAAA (Dr LEBOZEC)<\/option><option value='CLINIQUE VETERINAIRE DE PAOFAI' >CLINIQUE VETERINAIRE DE PAOFAI<\/option><option value='CLINIQUE VETERINAIRE Dr TESSIER Ophelie' >CLINIQUE VETERINAIRE Dr TESSIER Ophelie<\/option><option value='CLINIQUE VETERINAIRE Dr VONSY Jean' >CLINIQUE VETERINAIRE Dr VONSY Jean<\/option><option value='CLINIQUE VETERINAIRE DU LOTUS' >CLINIQUE VETERINAIRE DU LOTUS<\/option><option value='CLINIQUE VETERINAIRE - FAARIIPITI' >CLINIQUE VETERINAIRE - FAARIIPITI<\/option><option value='CLINIQUE VETERINAIRE MAEVA' >CLINIQUE VETERINAIRE MAEVA<\/option><option value='COLUMBUS' >COLUMBUS<\/option><option value='COMAT' >COMAT<\/option><option value='COMINPEX' >COMINPEX<\/option><option value='COMMANDANT DE LA GENDARMERIE DE POLYNESIE FRANCAISE' >COMMANDANT DE LA GENDARMERIE DE POLYNESIE FRANCAISE<\/option><option value='COMPTOIR COMMERCIAL CECILE' >COMPTOIR COMMERCIAL CECILE<\/option><option value='COMPTOIR DEL TAHITI' >COMPTOIR DEL TAHITI<\/option><option value='COMTESSE DU BARRY' >COMTESSE DU BARRY<\/option><option value='CONSERVERIE DU PACIFIQUE' >CONSERVERIE DU PACIFIQUE<\/option><option value='COOPERATIVE DES AQUACULTEURS DE PF (CAPF)' >COOPERATIVE DES AQUACULTEURS DE PF (CAPF)<\/option><option value='COOPERATIVE PUAA MAOHI' >COOPERATIVE PUAA MAOHI<\/option><option value='COPA' >COPA<\/option><option value='COPPENRATH BRICE' >COPPENRATH BRICE<\/option><option value='COPPENRATH ERIC' >COPPENRATH ERIC<\/option><option value='COTE MAISON' >COTE MAISON<\/option><option value='COUTIMEX' >COUTIMEX<\/option><option value='CRIOBE PAPETOAI MOOREA' >CRIOBE PAPETOAI MOOREA<\/option><option value='CROWN ODYSSEY' >CROWN ODYSSEY<\/option><option value='CRYSTAL SERENITY C\/O PST' >CRYSTAL SERENITY C\/O PST<\/option><option value='D.HEYER FOODS LTD' >D.HEYER FOODS LTD<\/option><option value='DAWN PRINCESS' >DAWN PRINCESS<\/option><option value='DCM SUB' >DCM SUB<\/option><option value='DELICES DU MONDE' >DELICES DU MONDE<\/option><option value='DELICES DU PERIGORD' >DELICES DU PERIGORD<\/option><option value='DELPHIN RENAISSANCE' >DELPHIN RENAISSANCE<\/option><option value='DEVAPPRO AGRO SARL' >DEVAPPRO AGRO SARL<\/option><option value='DICOM POLYNESIE' >DICOM POLYNESIE<\/option><option value='DIETEX' >DIETEX<\/option><option value='DIRECTION DES COMMISSARIATS DE LA MARINE' >DIRECTION DES COMMISSARIATS DE LA MARINE<\/option><option value='DIRECTION DES RESSOURCES MARINES' >DIRECTION DES RESSOURCES MARINES<\/option><option value='DISFRUIT PACIFIC' >DISFRUIT PACIFIC<\/option><option value='DISTRIPOL' >DISTRIPOL<\/option><option value='DIVERS DESTINATAIRES' >DIVERS DESTINATAIRES<\/option><option value='DIVERS FOURNISSEURS' >DIVERS FOURNISSEURS<\/option><option value='DIVERS MAGASINS U' >DIVERS MAGASINS U<\/option><option value='DOLPHIN QUEST' >DOLPHIN QUEST<\/option><option value='DR BRIZARD' >DR BRIZARD<\/option><option value='Dr LECOMTE' >Dr LECOMTE<\/option><option value='Dr VONSY Jean' >Dr VONSY Jean<\/option><option value='DRAKNI DRISS' >DRAKNI DRISS<\/option><option value='EASY MARKET (prince Hinoi)' >EASY MARKET (prince Hinoi)<\/option><option value='ECONOMAT DES ARMEES' >ECONOMAT DES ARMEES<\/option><option value='EDUCA' >EDUCA<\/option><option value='EFFEMEX' >EFFEMEX<\/option><option value='EGLISE ADVENTISTE' >EGLISE ADVENTISTE<\/option><option value='EICO' >EICO<\/option><option value='ELEVAGE DE FAAROA' >ELEVAGE DE FAAROA<\/option><option value='ELEVAGE LES BOUGAINVILLIERS' >ELEVAGE LES BOUGAINVILLIERS<\/option><option value='ELVIR' >ELVIR<\/option><option value='ENT HAITI Melina' >ENT HAITI Melina<\/option><option value='ENTREPRISE AVICOLE CHOQUET' >ENTREPRISE AVICOLE CHOQUET<\/option><option value='EPICURIEN' >EPICURIEN<\/option><option value='ESPACE SERVICE' >ESPACE SERVICE<\/option><option value='ESSOR IMPORT' >ESSOR IMPORT<\/option><option value='ETS FARNHAM' >ETS FARNHAM<\/option><option value='ETS LEV&#039;ARRIM' >ETS LEV&#039;ARRIM<\/option><option value='ETS LONFAT ET FILS SARL' >ETS LONFAT ET FILS SARL<\/option><option value='ETS OCEANIA' >ETS OCEANIA<\/option><option value='ETS ZOOLAND' >ETS ZOOLAND<\/option><option value='EURL AB DISTRIBUTION' >EURL AB DISTRIBUTION<\/option><option value='EURL MANUTAHI APICULTURE' >EURL MANUTAHI APICULTURE<\/option><option value='EURL P.E.I' >EURL P.E.I<\/option><option value='EURL SOLUTIONS' >EURL SOLUTIONS<\/option><option value='EXPRESS OCEANIE' >EXPRESS OCEANIE<\/option><option value='FAAROA ELEVAGE' >FAAROA ELEVAGE<\/option><option value='FARDIS DISTRIBUTION' >FARDIS DISTRIBUTION<\/option><option value='FARE HUAHINE' >FARE HUAHINE<\/option><option value='FARE PAPEAVA' >FARE PAPEAVA<\/option><option value='FARNHAM DISTRIBUTION' >FARNHAM DISTRIBUTION<\/option><option value='FEDERATION GENERALE DU COMMERCE' >FEDERATION GENERALE DU COMMERCE<\/option><option value='FENUA FISH' >FENUA FISH<\/option><option value='FILET +' >FILET +<\/option><option value='FOODEEZ' >FOODEEZ<\/option><option value='FOUR SEASONS RESORT' >FOUR SEASONS RESORT<\/option><option value='GENDARMERIE NATIONALE' >GENDARMERIE NATIONALE<\/option><option value='GESELLSCHAFT MBH' >GESELLSCHAFT MBH<\/option><option value='GIE RAAU CENTER' >GIE RAAU CENTER<\/option><option value='GIE TE ORA SUCCESS' >GIE TE ORA SUCCESS<\/option><option value='GREEN ZONE' >GREEN ZONE<\/option><option value='GROUPE ALINE' >GROUPE ALINE<\/option><option value='GSBDD\/SERVICE SOUTIEN VIE' >GSBDD\/SERVICE SOUTIEN VIE<\/option><option value='HACHETTE' >HACHETTE<\/option><option value='HAERERAAROA' >HAERERAAROA<\/option><option value='HAPPY MARKET \/ PAEA' >HAPPY MARKET \/ PAEA<\/option><option value='HBT FENUA' >HBT FENUA<\/option><option value='HENRI ALIMENTATION' >HENRI ALIMENTATION<\/option><option value='HERMIER FRANCOIS' >HERMIER FRANCOIS<\/option><option value='HOTEL LE MERIDIEN BORABORA' >HOTEL LE MERIDIEN BORABORA<\/option><option value='HOTEL ST REGIS BORA BORA' >HOTEL ST REGIS BORA BORA<\/option><option value='HOTU MOANA DISTRIBUTION' >HOTU MOANA DISTRIBUTION<\/option><option value='HUANG IMPORT' >HUANG IMPORT<\/option><option value='HUILERIE DE TAHITI' >HUILERIE DE TAHITI<\/option><option value='HYPER BRICO' >HYPER BRICO<\/option><option value='HYPER CHAMPION TARAVAO' >HYPER CHAMPION TARAVAO<\/option><option value='HYPER U' >HYPER U<\/option><option value='HYPER U\/LIBRE SERVICE FAAA' >HYPER U\/LIBRE SERVICE FAAA<\/option><option value='HYPER U\/SUPER FARE NUI\/VENUSTAR\/LS FAAA' >HYPER U\/SUPER FARE NUI\/VENUSTAR\/LS FAAA<\/option><option value='IDEE GOURMANDE' >IDEE GOURMANDE<\/option><option value='IFREMER' >IFREMER<\/option><option value='IMDEX INC' >IMDEX INC<\/option><option value='IMEX IMPORT' >IMEX IMPORT<\/option><option value='IMPEX IMPORT' >IMPEX IMPORT<\/option><option value='IMPORLUX' >IMPORLUX<\/option><option value='IMPORT PAC' >IMPORT PAC<\/option><option value='INSTITUT Louis Malard\u00e9' >INSTITUT Louis Malard\u00e9<\/option><option value='&quot;J&amp;V IMPORT SERVICES' >&quot;J&amp;V IMPORT SERVICES<\/option><option value='J &amp; V IMPORT SERVICES&quot;' >J &amp; V IMPORT SERVICES&quot;<\/option><option value='JA COWAN &amp; FILS' >JA COWAN &amp; FILS<\/option><option value='JC PEST CONTROL' >JC PEST CONTROL<\/option><option value='JLM SYSTEME D' >JLM SYSTEME D<\/option><option value='JOUANNE BENOITAVA NESSA LEGAST' >JOUANNE BENOITAVA NESSA LEGAST<\/option><option value='JOUSSIN Joseph' >JOUSSIN Joseph<\/option><option value='KALANI IMPORT' >KALANI IMPORT<\/option><option value='KEOPS' >KEOPS<\/option><option value='KERR BROTHERS AUSTRALIA' >KERR BROTHERS AUSTRALIA<\/option><option value='KIM FA' >KIM FA<\/option><option value='KOUI WIN' >KOUI WIN<\/option><option value='LA BASE DE DEFENSE' >LA BASE DE DEFENSE<\/option><option value='LA CAVE DE TAHITI' >LA CAVE DE TAHITI<\/option><option value='LA CONSERVERIE' >LA CONSERVERIE<\/option><option value='LA VIE CLAIRE' >LA VIE CLAIRE<\/option><option value='LA VIE EN BIO' >LA VIE EN BIO<\/option><option value='LA VIE PACIFIQUE' >LA VIE PACIFIQUE<\/option><option value='LABORATOIRE DE COSMETOLOGIE' >LABORATOIRE DE COSMETOLOGIE<\/option><option value='LAFILLE' >LAFILLE<\/option><option value='LAITERIE ROCHE' >LAITERIE ROCHE<\/option><option value='LAITERIE SACHET' >LAITERIE SACHET<\/option><option value='LC 689 IMPORT' >LC 689 IMPORT<\/option><option value='LE FARE DES ABEILLES' >LE FARE DES ABEILLES<\/option><option value='LE FARE DES ZANIMOS' >LE FARE DES ZANIMOS<\/option><option value='LE PALAIS DES GLACES' >LE PALAIS DES GLACES<\/option><option value='LE RETRO - JUAN Denis' >LE RETRO - JUAN Denis<\/option><option value='LE TOHIC Philippe' >LE TOHIC Philippe<\/option><option value='LE VAIMA' >LE VAIMA<\/option><option value='LEOU Jean Jacques' >LEOU Jean Jacques<\/option><option value='L&#039;EPICERIE' >L&#039;EPICERIE<\/option><option value='LES DELICES DU MONDE (ex LES DELICES DU PERIGORD)' >LES DELICES DU MONDE (ex LES DELICES DU PERIGORD)<\/option><option value='LES DELICES DU PERIGORD' >LES DELICES DU PERIGORD<\/option><option value='LES OVOS DE LA PRESQU&#039;ILE' >LES OVOS DE LA PRESQU&#039;ILE<\/option><option value='LEVARRIM' >LEVARRIM<\/option><option value='L&#039;EXQUISE' >L&#039;EXQUISE<\/option><option value='LIBRAIRIE VIE ET SANTE' >LIBRAIRIE VIE ET SANTE<\/option><option value='LIBRE SERVICE (Faaa)' >LIBRE SERVICE (Faaa)<\/option><option value='LIBRE SERVICE MARAA API' >LIBRE SERVICE MARAA API<\/option><option value='L&#039;IDEE GOURMANDE' >L&#039;IDEE GOURMANDE<\/option><option value='LINE Paul' >LINE Paul<\/option><option value='LIOU FONG' >LIOU FONG<\/option><option value='LPA D&#039;OPUNOHU' >LPA D&#039;OPUNOHU<\/option><option value='LS FAAA' >LS FAAA<\/option><option value='LS PROXI (Paea)' >LS PROXI (Paea)<\/option><option value='LUINE IMPORT JR' >LUINE IMPORT JR<\/option><option value='M D L C  ALDEGERRE Laurent' >M D L C  ALDEGERRE Laurent<\/option><option value='M.C.M.' >M.C.M.<\/option><option value='MADISSOL' >MADISSOL<\/option><option value='MAG LEOGITE (Raiatea)' >MAG LEOGITE (Raiatea)<\/option><option value='MAGASIN AH-SING' >MAGASIN AH-SING<\/option><option value='MAGASIN TEFANA' >MAGASIN TEFANA<\/option><option value='MAHAIATEA PRODUCTION LOCALE' >MAHAIATEA PRODUCTION LOCALE<\/option><option value='MAJESTIC' >MAJESTIC<\/option><option value='MANATE BORA' >MANATE BORA<\/option><option value='MANU URA POLYNESIE' >MANU URA POLYNESIE<\/option><option value='MANUIA TRADING' >MANUIA TRADING<\/option><option value='MANUTEA TAHITI SA (Moorea)' >MANUTEA TAHITI SA (Moorea)<\/option><option value='MARIE YU' >MARIE YU<\/option><option value='MARIUS SHRM' >MARIUS SHRM<\/option><option value='MARKET LEOGITE' >MARKET LEOGITE<\/option><option value='MARKET RAI (Uturoa)' >MARKET RAI (Uturoa)<\/option><option value='MARS UNISABI Mme PLUVIAUD Bernadette' >MARS UNISABI Mme PLUVIAUD Bernadette<\/option><option value='MAVARA IMPORT ZI TIPAERUI' >MAVARA IMPORT ZI TIPAERUI<\/option><option value='MCGHIE GLEN' >MCGHIE GLEN<\/option><option value='MEDIPAC' >MEDIPAC<\/option><option value='MEIHAO IMPORT' >MEIHAO IMPORT<\/option><option value='MF DISTRIBUTION' >MF DISTRIBUTION<\/option><option value='MF PRODUCTION' >MF PRODUCTION<\/option><option value='MILLESIME' >MILLESIME<\/option><option value='MISSION ADVENTISTE' >MISSION ADVENTISTE<\/option><option value='MISTER SWEET' >MISTER SWEET<\/option><option value='MOANA TAHITI IMPORT' >MOANA TAHITI IMPORT<\/option><option value='MOANA TAHITI PRODUCTS' >MOANA TAHITI PRODUCTS<\/option><option value='MOLINARO Bruno' >MOLINARO Bruno<\/option><option value='MOLINARO YACHT SUPPLIES' >MOLINARO YACHT SUPPLIES<\/option><option value='MOOREA DOLPHIN CENTER' >MOOREA DOLPHIN CENTER<\/option><option value='MOOREA PECHE' >MOOREA PECHE<\/option><option value='MORGAN VERNEX' >MORGAN VERNEX<\/option><option value='MR BRICOLAGE' >MR BRICOLAGE<\/option><option value='MS REGATTA OCEANIA' >MS REGATTA OCEANIA<\/option><option value='MS STAR FLYER' >MS STAR FLYER<\/option><option value='MS STATEENDAM CO PST' >MS STATEENDAM CO PST<\/option><option value='MS WESTERDAM C\/0 P,S,T' >MS WESTERDAM C\/0 P,S,T<\/option><option value='MURA SALVATORE' >MURA SALVATORE<\/option><option value='MUSICALES DE TAHITI' >MUSICALES DE TAHITI<\/option><option value='MV DISCOVERY' >MV DISCOVERY<\/option><option value='MV EMERALD PRINCESS C\/O TSMA' >MV EMERALD PRINCESS C\/O TSMA<\/option><option value='MV HANSEATIC IN TRANSIT C\/O CMA-CGM' >MV HANSEATIC IN TRANSIT C\/O CMA-CGM<\/option><option value='MV IN TRANSIT CELEBRITY SOLSTICE' >MV IN TRANSIT CELEBRITY SOLSTICE<\/option><option value='MV IN TRANSIT RADIANCE OF THE SEAS' >MV IN TRANSIT RADIANCE OF THE SEAS<\/option><option value='MV NAVIGATOR' >MV NAVIGATOR<\/option><option value='MV OCEAN' >MV OCEAN<\/option><option value='MV PAUL GAUGUIN' >MV PAUL GAUGUIN<\/option><option value='MV REGATTA C\/O AMFU' >MV REGATTA C\/O AMFU<\/option><option value='NAHITI D' >NAHITI D<\/option><option value='NATURA NUI (RASSELET Herv\u00e9)' >NATURA NUI (RASSELET Herv\u00e9)<\/option><option value='NATURAL SHOP TAHITI' >NATURAL SHOP TAHITI<\/option><option value='NESTLE POLYNESIE SAS' >NESTLE POLYNESIE SAS<\/option><option value='NEW CDP' >NEW CDP<\/option><option value='NEW TECHNOLOGIE IMPORT' >NEW TECHNOLOGIE IMPORT<\/option><option value='NEWREST SUPPORT POLYNESIE' >NEWREST SUPPORT POLYNESIE<\/option><option value='NIUPOA-AGRI' >NIUPOA-AGRI<\/option><option value='NOVADI&#039;S POLYNESIE C\/O I.CHAUVINEAU' >NOVADI&#039;S POLYNESIE C\/O I.CHAUVINEAU<\/option><option value='OCEAN PRINCESS' >OCEAN PRINCESS<\/option><option value='OCEAN PRODUCTS' >OCEAN PRODUCTS<\/option><option value='OCEAN TRADING' >OCEAN TRADING<\/option><option value='OCEANIA' >OCEANIA<\/option><option value='OCEANIA MARINA' >OCEANIA MARINA<\/option><option value='ODYSSEY-TAHITI JEUNESSE' >ODYSSEY-TAHITI JEUNESSE<\/option><option value='ORION' >ORION<\/option><option value='PACI FRUTTI DISTRIBUTION COMPANY' >PACI FRUTTI DISTRIBUTION COMPANY<\/option><option value='PACIFIC BUSINESS' >PACIFIC BUSINESS<\/option><option value='PACIFIC DAWN C\/O SAS TRANSIT SAT NUI' >PACIFIC DAWN C\/O SAS TRANSIT SAT NUI<\/option><option value='PACIFIC EXPRESS IMPORT(MC DONALD USA)' >PACIFIC EXPRESS IMPORT(MC DONALD USA)<\/option><option value='PACIFIC IMPORTS' >PACIFIC IMPORTS<\/option><option value='PACIFIC MULTITRADE' >PACIFIC MULTITRADE<\/option><option value='PACIFIC PERLES' >PACIFIC PERLES<\/option><option value='PACIFIC PRINCESS' >PACIFIC PRINCESS<\/option><option value='PACIFIC SUN' >PACIFIC SUN<\/option><option value='PACIFIC TUNA' >PACIFIC TUNA<\/option><option value='PACIFIC YO' >PACIFIC YO<\/option><option value='PACIFICANA' >PACIFICANA<\/option><option value='PACIFIQUE AQUACULTURE SERVICES' >PACIFIQUE AQUACULTURE SERVICES<\/option><option value='PACIFIQUE MULTITRADE' >PACIFIQUE MULTITRADE<\/option><option value='PAPEETE SEAIRLAND TRANSPORT' >PAPEETE SEAIRLAND TRANSPORT<\/option><option value='PAPEHUE IMPORT' >PAPEHUE IMPORT<\/option><option value='PAQUEBOT BREMEN' >PAQUEBOT BREMEN<\/option><option value='PAQUEBOT THE WORLD OF RESIDENSEA' >PAQUEBOT THE WORLD OF RESIDENSEA<\/option><option value='PAUL GAUGUIN SHIPPING Ltd' >PAUL GAUGUIN SHIPPING Ltd<\/option><option value='P\u00eache Logistique Service (PLS)' >P\u00eache Logistique Service (PLS)<\/option><option value='PEI (MC DO)' >PEI (MC DO)<\/option><option value='PENSION TE MITI' >PENSION TE MITI<\/option><option value='PET SHOP TARAVAO' >PET SHOP TARAVAO<\/option><option value='PHARMACIE CARDELA' >PHARMACIE CARDELA<\/option><option value='PHARMACIE DE FAA&#039;A' >PHARMACIE DE FAA&#039;A<\/option><option value='PHARMACIE DE FAONE' >PHARMACIE DE FAONE<\/option><option value='PHARMACIE DE HUAHINE' >PHARMACIE DE HUAHINE<\/option><option value='PHARMACIE DE MOOREA' >PHARMACIE DE MOOREA<\/option><option value='PHARMACIE DE PAPARA' >PHARMACIE DE PAPARA<\/option><option value='PHARMACIE DU MARCHE \/ RAAU CENTER' >PHARMACIE DU MARCHE \/ RAAU CENTER<\/option><option value='PHARMACIE DU PORT (Mr Demachy)' >PHARMACIE DU PORT (Mr Demachy)<\/option><option value='PHARMACIE FARIIPITI' >PHARMACIE FARIIPITI<\/option><option value='PHARMACIE MAEVA' >PHARMACIE MAEVA<\/option><option value='PHARMACIE MAHINA' >PHARMACIE MAHINA<\/option><option value='PHARMACIE MOOREA (Afareitu)' >PHARMACIE MOOREA (Afareitu)<\/option><option value='PHARMACIE OROHENA' >PHARMACIE OROHENA<\/option><option value='PHARMACIE OTEANIA' >PHARMACIE OTEANIA<\/option><option value='PHARMACIE PAMATAI' >PHARMACIE PAMATAI<\/option><option value='PHARMACIE PAOFAI (Fichter)' >PHARMACIE PAOFAI (Fichter)<\/option><option value='PHARMACIE PIRAE' >PHARMACIE PIRAE<\/option><option value='PHARMACIE ROYALE' >PHARMACIE ROYALE<\/option><option value='PHARMACIE TAHARUU' >PHARMACIE TAHARUU<\/option><option value='PHARMACIE TAMANU' >PHARMACIE TAMANU<\/option><option value='PHARMACIE TEVAIUTA' >PHARMACIE TEVAIUTA<\/option><option value='PHARMACIE TIAPA (Punaauia)' >PHARMACIE TIAPA (Punaauia)<\/option><option value='PHARMACIE TIAREI' >PHARMACIE TIAREI<\/option><option value='PLAN B' >PLAN B<\/option><option value='PLANETE BONBONS' >PLANETE BONBONS<\/option><option value='POLIMEX' >POLIMEX<\/option><option value='POLMEN' >POLMEN<\/option><option value='POLMEN IMPORT' >POLMEN IMPORT<\/option><option value='POLY IMPORT' >POLY IMPORT<\/option><option value='POLYAGRO' >POLYAGRO<\/option><option value='POLYCULTURES' >POLYCULTURES<\/option><option value='POLYFIX' >POLYFIX<\/option><option value='POLYNESIA DIRECT' >POLYNESIA DIRECT<\/option><option value='POLYNESIA TRADING' >POLYNESIA TRADING<\/option><option value='POLYNESIE IMPORT EXPORT' >POLYNESIE IMPORT EXPORT<\/option><option value='POLYNESIE MARKET' >POLYNESIE MARKET<\/option><option value='POLYNESIENNE DE LONG LINE' >POLYNESIENNE DE LONG LINE<\/option><option value='POPOFF POLLY' >POPOFF POLLY<\/option><option value='PORCISUD' >PORCISUD<\/option><option value='PORK DIS' >PORK DIS<\/option><option value='PRADIGMAC MIRAMBEAU' >PRADIGMAC MIRAMBEAU<\/option><option value='PRESPHARM OTC' >PRESPHARM OTC<\/option><option value='PRINCESS CRUISES' >PRINCESS CRUISES<\/option><option value='PRODISTRIB' >PRODISTRIB<\/option><option value='PROFISH COMPANY' >PROFISH COMPANY<\/option><option value='PROGRESS 002' >PROGRESS 002<\/option><option value='PUSSONNIER LEA' >PUSSONNIER LEA<\/option><option value='QUINCAILLERIE TAVARARO' >QUINCAILLERIE TAVARARO<\/option><option value='RADIANCE C\/O SAS TRANSIT SAT NUI' >RADIANCE C\/O SAS TRANSIT SAT NUI<\/option><option value='RAROMATAI IMPORT EXPORT' >RAROMATAI IMPORT EXPORT<\/option><option value='RAUMANU INDUSTRIE (TIP-TOP)' >RAUMANU INDUSTRIE (TIP-TOP)<\/option><option value='RAVEL BILL' >RAVEL BILL<\/option><option value='RAYNAL &amp; ROQUELAURE' >RAYNAL &amp; ROQUELAURE<\/option><option value='RB DISTRIBUTION' >RB DISTRIBUTION<\/option><option value='RESTAURANT LE VAIMA' >RESTAURANT LE VAIMA<\/option><option value='RHAPSODY OF THE SEAS C\/O SAS TRANSIT SAT NUI' >RHAPSODY OF THE SEAS C\/O SAS TRANSIT SAT NUI<\/option><option value='RIDLEY AGRIPRODUCTS' >RIDLEY AGRIPRODUCTS<\/option><option value='RIMAP' >RIMAP<\/option><option value='ROYAL IMPORT' >ROYAL IMPORT<\/option><option value='RSSC NAVIGATOR' >RSSC NAVIGATOR<\/option><option value='RUDOLPH FOODS' >RUDOLPH FOODS<\/option><option value='SA MANUTEA' >SA MANUTEA<\/option><option value='SA OUTUMAORO' >SA OUTUMAORO<\/option><option value='SACHET' >SACHET<\/option><option value='SACHET (Jean Fran\u00e7ois)' >SACHET (Jean Fran\u00e7ois)<\/option><option value='SALAISONS DE TAHITI' >SALAISONS DE TAHITI<\/option><option value='SALVA STORE' >SALVA STORE<\/option><option value='SANGUES SA' >SANGUES SA<\/option><option value='SANTE NATURE' >SANTE NATURE<\/option><option value='SAOM' >SAOM<\/option><option value='SAPPHIRE PRINCESS' >SAPPHIRE PRINCESS<\/option><option value='SARL APPROTEC' >SARL APPROTEC<\/option><option value='SARL ARMAX POLYNESIE' >SARL ARMAX POLYNESIE<\/option><option value='SARL CAVIAR&amp;CO' >SARL CAVIAR&amp;CO<\/option><option value='Sarl CDP' >Sarl CDP<\/option><option value='SARL ESSOR IMPORT' >SARL ESSOR IMPORT<\/option><option value='SARL GAM' >SARL GAM<\/option><option value='SARL HBT FENUA' >SARL HBT FENUA<\/option><option value='SARL MANATE \/ SUPER TOA AMOK' >SARL MANATE \/ SUPER TOA AMOK<\/option><option value='SARL MANATE \/ SUPER TOA AMOK (Bora Bora)' >SARL MANATE \/ SUPER TOA AMOK (Bora Bora)<\/option><option value='SARL MANATE BORA (MAG AMOK)' >SARL MANATE BORA (MAG AMOK)<\/option><option value='SARL MANATE BORA \/ SUPER TOA AMOK' >SARL MANATE BORA \/ SUPER TOA AMOK<\/option><option value='SARL MANATE\/SUPER TOA AMOK' >SARL MANATE\/SUPER TOA AMOK<\/option><option value='SARL NANIVA' >SARL NANIVA<\/option><option value='SARL OVO DE LA PRESQU&#039;ILE' >SARL OVO DE LA PRESQU&#039;ILE<\/option><option value='SARL PACIFIC MULTITRADE' >SARL PACIFIC MULTITRADE<\/option><option value='SARL POLYNESIE MARKET' >SARL POLYNESIE MARKET<\/option><option value='SARL RAI IMPORT' >SARL RAI IMPORT<\/option><option value='SARL REZO' >SARL REZO<\/option><option value='SARL SDP - LS PROXI (Paea)' >SARL SDP - LS PROXI (Paea)<\/option><option value='SARL SUPER FARE NUI HUAHINE' >SARL SUPER FARE NUI HUAHINE<\/option><option value='SARL SUPERMARCHE ARE' >SARL SUPERMARCHE ARE<\/option><option value='SARL TAHITI FOOD STREET' >SARL TAHITI FOOD STREET<\/option><option value='SARL TAHITI ISLAND SEAFOOD' >SARL TAHITI ISLAND SEAFOOD<\/option><option value='SARL TNB' >SARL TNB<\/option><option value='SARL URIVET' >SARL URIVET<\/option><option value='SARL YO&#039;RANA' >SARL YO&#039;RANA<\/option><option value='SAS AVAI&#039;A COMPANY LTD' >SAS AVAI&#039;A COMPANY LTD<\/option><option value='SAS BORA BORA HONEY' >SAS BORA BORA HONEY<\/option><option value='SAS SOPOLCO' >SAS SOPOLCO<\/option><option value='SAS Ste Com. Taiarapu Taravao' >SAS Ste Com. Taiarapu Taravao<\/option><option value='SAS WING CHONG' >SAS WING CHONG<\/option><option value='SAVOIE Kevin' >SAVOIE Kevin<\/option><option value='SC INTERNATIONAL' >SC INTERNATIONAL<\/option><option value='SC PORCISUD' >SC PORCISUD<\/option><option value='SCA AVICOLE ELEVAGE FAAROA' >SCA AVICOLE ELEVAGE FAAROA<\/option><option value='SCA FAAPUNA' >SCA FAAPUNA<\/option><option value='SCA FAARARO ELEVAGE' >SCA FAARARO ELEVAGE<\/option><option value='SCE DE LA PECHE' >SCE DE LA PECHE<\/option><option value='SCEA POLYCULTURE' >SCEA POLYCULTURE<\/option><option value='SCEAP' >SCEAP<\/option><option value='SCI JOLIE VUE' >SCI JOLIE VUE<\/option><option value='SDA' >SDA<\/option><option value='SDA POLYNESIE' >SDA POLYNESIE<\/option><option value='SDEC HYPER U' >SDEC HYPER U<\/option><option value='SDEM CECILE' >SDEM CECILE<\/option><option value='SDFO-SOCIETE DE DISTRIBUTION DE FILMS DE L&#039;OCEANIE' >SDFO-SOCIETE DE DISTRIBUTION DE FILMS DE L&#039;OCEANIE<\/option><option value='SEABOURN QUEST' >SEABOURN QUEST<\/option><option value='SELAN KALAI' >SELAN KALAI<\/option><option value='SELARL DE VETERINAIRES' >SELARL DE VETERINAIRES<\/option><option value='SELARL URIVET' >SELARL URIVET<\/option><option value='SENECHAL CHRISTINE' >SENECHAL CHRISTINE<\/option><option value='SERDIS SA' >SERDIS SA<\/option><option value='SERVICE DE LA PECHE' >SERVICE DE LA PECHE<\/option><option value='SERVICE DE PECHE c\/o TRANSIT SAT NUI' >SERVICE DE PECHE c\/o TRANSIT SAT NUI<\/option><option value='SERVICE DISTRIBUTION ASSISTANCE' >SERVICE DISTRIBUTION ASSISTANCE<\/option><option value='SERVICE SOUTIEN VIE(ssv)' >SERVICE SOUTIEN VIE(ssv)<\/option><option value='SEVEN SEAS' >SEVEN SEAS<\/option><option value='SHRM' >SHRM<\/option><option value='SHRMP' >SHRMP<\/option><option value='SICOM' >SICOM<\/option><option value='SIG' >SIG<\/option><option value='SILVER SHADOW' >SILVER SHADOW<\/option><option value='SILVER SPIRIT' >SILVER SPIRIT<\/option><option value='SILVER WHISPER' >SILVER WHISPER<\/option><option value='SIMON' >SIMON<\/option><option value='SIN TUNG HING' >SIN TUNG HING<\/option><option value='SIN TUNG HING MARINE' >SIN TUNG HING MARINE<\/option><option value='SIN TUNG HING MATERIAUX' >SIN TUNG HING MATERIAUX<\/option><option value='SIPAC' >SIPAC<\/option><option value='SIPOF(Syndicat des Industriels de Polyn\u00e9sie Fran\u00e7aise)' >SIPOF(Syndicat des Industriels de Polyn\u00e9sie Fran\u00e7aise)<\/option><option value='SM ARE' >SM ARE<\/option><option value='SM CECILE' >SM CECILE<\/option><option value='SM FARE NUI' >SM FARE NUI<\/option><option value='SM IMPORT DISTRIBUTION' >SM IMPORT DISTRIBUTION<\/option><option value='SM MARINA' >SM MARINA<\/option><option value='SM TAIARAPU NUI' >SM TAIARAPU NUI<\/option><option value='SM2D SARL' >SM2D SARL<\/option><option value='SN IMPORT' >SN IMPORT<\/option><option value='SN IMPORT TAIARAPU NUI' >SN IMPORT TAIARAPU NUI<\/option><option value='SNACK LE LAGON BLEU' >SNACK LE LAGON BLEU<\/option><option value='SNC EQUIP MAISON' >SNC EQUIP MAISON<\/option><option value='SNP' >SNP<\/option><option value='SNP \/ Super U' >SNP \/ Super U<\/option><option value='SNP \/ VENUSTAR \/ STE COM TAIARAPU' >SNP \/ VENUSTAR \/ STE COM TAIARAPU<\/option><option value='SNP chez DISFRUIT' >SNP chez DISFRUIT<\/option><option value='SNP chez disfruit1' >SNP chez disfruit1<\/option><option value='SNP chez SERLOTRANS' >SNP chez SERLOTRANS<\/option><option value='SOAP ADDICTION' >SOAP ADDICTION<\/option><option value='SOCIETE AGRICOLE DE TAHITI' >SOCIETE AGRICOLE DE TAHITI<\/option><option value='SOCIETE CIVILE D&#039;EXPLOITATION AGRICOLE' >SOCIETE CIVILE D&#039;EXPLOITATION AGRICOLE<\/option><option value='SOCIETE COMMERCIALE DE AUAE' >SOCIETE COMMERCIALE DE AUAE<\/option><option value='SOCIETE DE NEGOCE DE POLYNESIE (SNP)' >SOCIETE DE NEGOCE DE POLYNESIE (SNP)<\/option><option value='SOCIETE SCA TEVAITAI' >SOCIETE SCA TEVAITAI<\/option><option value='SOCOPU' >SOCOPU<\/option><option value='SOCOPU \/ TAMANU PAPARA' >SOCOPU \/ TAMANU PAPARA<\/option><option value='SODISPO' >SODISPO<\/option><option value='SOFADIF \/ FAAA DIFFUSION' >SOFADIF \/ FAAA DIFFUSION<\/option><option value='SOJEFO POLYNESIE' >SOJEFO POLYNESIE<\/option><option value='SOLUTIONS' >SOLUTIONS<\/option><option value='SOTAMA COTADA' >SOTAMA COTADA<\/option><option value='SOUTH BOUND TRADING' >SOUTH BOUND TRADING<\/option><option value='SPIRIT OF OCEANUS' >SPIRIT OF OCEANUS<\/option><option value='SSRT DU DETACHEMENT AERIEN 190' >SSRT DU DETACHEMENT AERIEN 190<\/option><option value='STAR FLYER' >STAR FLYER<\/option><option value='STAR PHARMA' >STAR PHARMA<\/option><option value='STAR PRINCESS' >STAR PRINCESS<\/option><option value='STATENDAM C\/O PST' >STATENDAM C\/O PST<\/option><option value='STE COM TAIRAPU (TARAVAO)' >STE COM TAIRAPU (TARAVAO)<\/option><option value='STE COM.TAIARAPU \/ SN IMPORT \/ SAS TAIARAPU NUI' >STE COM.TAIARAPU \/ SN IMPORT \/ SAS TAIARAPU NUI<\/option><option value='STE COMMERCIAL TAIARAPU' >STE COMMERCIAL TAIARAPU<\/option><option value='STE COMMERCIALE TAIARAPU \/ SN IMPORT \/ SAS TAIARAPU NUI' >STE COMMERCIALE TAIARAPU \/ SN IMPORT \/ SAS TAIARAPU NUI<\/option><option value='STE EXP CC OUTUMAORO' >STE EXP CC OUTUMAORO<\/option><option value='STE MADA ITI' >STE MADA ITI<\/option><option value='STE POLMEN' >STE POLMEN<\/option><option value='STH MARINE' >STH MARINE<\/option><option value='STH MATERIAUX' >STH MATERIAUX<\/option><option value='SUN PACIFIC INVESTMENT' >SUN PACIFIC INVESTMENT<\/option><option value='SUN PRINCESS' >SUN PRINCESS<\/option><option value='SUNPADIS (Papeete)' >SUNPADIS (Papeete)<\/option><option value='SUNPADIS\/ SUN PACIFIC INVEST' >SUNPADIS\/ SUN PACIFIC INVEST<\/option><option value='SUPER CECILE' >SUPER CECILE<\/option><option value='SUPER CECILE \/ TAMANU PUNAAUIA' >SUPER CECILE \/ TAMANU PUNAAUIA<\/option><option value='SUPER FARE NUI SARL' >SUPER FARE NUI SARL<\/option><option value='SUPER TOA AMOK' >SUPER TOA AMOK<\/option><option value='SUPER U' >SUPER U<\/option><option value='SUPER U - Fare Nui' >SUPER U - Fare Nui<\/option><option value='SUPER U - TAMANU ITI (papara)' >SUPER U - TAMANU ITI (papara)<\/option><option value='SUPER U (Faa&#039;a)' >SUPER U (Faa&#039;a)<\/option><option value='SUPER U (Faa&#039;a) \/ SOCOPU' >SUPER U (Faa&#039;a) \/ SOCOPU<\/option><option value='SUPER U (Punaauia)' >SUPER U (Punaauia)<\/option><option value='SUPER U (Taravao)' >SUPER U (Taravao)<\/option><option value='SUPER U \/ FARE NUI' >SUPER U \/ FARE NUI<\/option><option value='SUPER U CECILE' >SUPER U CECILE<\/option><option value='SUPER U CECILE \/ TAMANU PUNAAUIA' >SUPER U CECILE \/ TAMANU PUNAAUIA<\/option><option value='SUPER U CHEZ DISFRUIT (Faaa)' >SUPER U CHEZ DISFRUIT (Faaa)<\/option><option value='SUPER U chez serlotrans' >SUPER U chez serlotrans<\/option><option value='SUPER U FARE NUI (Huahine)' >SUPER U FARE NUI (Huahine)<\/option><option value='SUPER U LS (Faaa)' >SUPER U LS (Faaa)<\/option><option value='SUPER U TAIARAPU NUI (Taravao)' >SUPER U TAIARAPU NUI (Taravao)<\/option><option value='SUPER U Tamanu (Papara)' >SUPER U Tamanu (Papara)<\/option><option value='SUPER U TAMANU (Punaauia)' >SUPER U TAMANU (Punaauia)<\/option><option value='SUPER U UTUROA' >SUPER U UTUROA<\/option><option value='SUPER U V\u00e9nustar' >SUPER U V\u00e9nustar<\/option><option value='SUPER U V\u00e9nustar Mahina' >SUPER U V\u00e9nustar Mahina<\/option><option value='SUPERETTE HAAMENE TAHAA ISLV' >SUPERETTE HAAMENE TAHAA ISLV<\/option><option value='SUPERMARCHE ARE' >SUPERMARCHE ARE<\/option><option value='SUPERMARCHE CECILE' >SUPERMARCHE CECILE<\/option><option value='SUPERMARCHE FARE-NUI' >SUPERMARCHE FARE-NUI<\/option><option value='SUPERMARCHE HAMUTA' >SUPERMARCHE HAMUTA<\/option><option value='SUPERMARCHE LIAUT' >SUPERMARCHE LIAUT<\/option><option value='SUPERMARCHE PAEA' >SUPERMARCHE PAEA<\/option><option value='SUPERMARCHE TAIARAPU NUI' >SUPERMARCHE TAIARAPU NUI<\/option><option value='SUPERMARCHE TAMANU PAPARA' >SUPERMARCHE TAMANU PAPARA<\/option><option value='SUPERMARCHE TAMANU PUNAAUIA' >SUPERMARCHE TAMANU PUNAAUIA<\/option><option value='SUPERMARCHE TCA' >SUPERMARCHE TCA<\/option><option value='SUPERMARCHE VENUSTAR' >SUPERMARCHE VENUSTAR<\/option><option value='SURF CO' >SURF CO<\/option><option value='SYSTEME U' >SYSTEME U<\/option><option value='TAHITI AQUACULTURE (Mr Mizael FAUCON)' >TAHITI AQUACULTURE (Mr Mizael FAUCON)<\/option><option value='TAHITI CASH API (Heiri)' >TAHITI CASH API (Heiri)<\/option><option value='TAHITI CHIPS FACTORY TIPAERUI' >TAHITI CHIPS FACTORY TIPAERUI<\/option><option value='TAHITI DISTRIBUTION SARL (Titioro)' >TAHITI DISTRIBUTION SARL (Titioro)<\/option><option value='TAHITI FISH AQUACULTURE' >TAHITI FISH AQUACULTURE<\/option><option value='TAHITI FISHING' >TAHITI FISHING<\/option><option value='TAHITI FOOD MART' >TAHITI FOOD MART<\/option><option value='TAHITI FOOD STREET' >TAHITI FOOD STREET<\/option><option value='TAHITI FOODS AND BEVERAGE ex MAEVA DIST' >TAHITI FOODS AND BEVERAGE ex MAEVA DIST<\/option><option value='TAHITI GARDEN CENTER' >TAHITI GARDEN CENTER<\/option><option value='TAHITI HERE VERT' >TAHITI HERE VERT<\/option><option value='TAHITI ISLAND FISH' >TAHITI ISLAND FISH<\/option><option value='TAHITI ISLAND SEAFOOD' >TAHITI ISLAND SEAFOOD<\/option><option value='TAHITI KLM' >TAHITI KLM<\/option><option value='TAHITI MARINE SERVICES' >TAHITI MARINE SERVICES<\/option><option value='TAHITI NUI FISH' >TAHITI NUI FISH<\/option><option value='TAHITI NUI PRODUCTS' >TAHITI NUI PRODUCTS<\/option><option value='TAHITI NUI TRADING' >TAHITI NUI TRADING<\/option><option value='TAHITI OCEAN' >TAHITI OCEAN<\/option><option value='TAHITI PAA PAA PUA' >TAHITI PAA PAA PUA<\/option><option value='TAHITI PHARM' >TAHITI PHARM<\/option><option value='TAHITI REEF PASSION' >TAHITI REEF PASSION<\/option><option value='TAHITI SERVICE MARITIME AGENCY' >TAHITI SERVICE MARITIME AGENCY<\/option><option value='TAHITI SNACK' >TAHITI SNACK<\/option><option value='TAHITI SPORT' >TAHITI SPORT<\/option><option value='TAHITI SUPERYACHT SUPPORT' >TAHITI SUPERYACHT SUPPORT<\/option><option value='TAHITI TRADING' >TAHITI TRADING<\/option><option value='TAHITIAN PRINCESS' >TAHITIAN PRINCESS<\/option><option value='TALLASSA' >TALLASSA<\/option><option value='TAMANU ITI (Papara)' >TAMANU ITI (Papara)<\/option><option value='TAMANU ITI PUNAAUIA U EXPRESS CECILE' >TAMANU ITI PUNAAUIA U EXPRESS CECILE<\/option><option value='TAMANU PAPARA' >TAMANU PAPARA<\/option><option value='TAMANU PUNAAUIA \/ SUPER CECILE' >TAMANU PUNAAUIA \/ SUPER CECILE<\/option><option value='TAMANU PUNAAUIA SAS' >TAMANU PUNAAUIA SAS<\/option><option value='TE MAIRE IMPORT' >TE MAIRE IMPORT<\/option><option value='TEANUANUA IMPORT' >TEANUANUA IMPORT<\/option><option value='TEAVE SARL' >TEAVE SARL<\/option><option value='TEFAIMANU IMPORT' >TEFAIMANU IMPORT<\/option><option value='TEHEURA VAITEATEA' >TEHEURA VAITEATEA<\/option><option value='TEVA IMPORT' >TEVA IMPORT<\/option><option value='TEVIRU FAKARAVA' >TEVIRU FAKARAVA<\/option><option value='TEXTYL' >TEXTYL<\/option><option value='THIERRY CHONGER' >THIERRY CHONGER<\/option><option value='THS TAHITI' >THS TAHITI<\/option><option value='TI PET DISTRIBUTION' >TI PET DISTRIBUTION<\/option><option value='TIE' >TIE<\/option><option value='TNB' >TNB<\/option><option value='TOA DISTRIBUTION \/ HAPPY MARKET' >TOA DISTRIBUTION \/ HAPPY MARKET<\/option><option value='TOA DISTRIBUTION SARL' >TOA DISTRIBUTION SARL<\/option><option value='TOA FAAA' >TOA FAAA<\/option><option value='TOA MOOREA' >TOA MOOREA<\/option><option value='TONOI IMPORT' >TONOI IMPORT<\/option><option value='TRANSAM POLYNESIE' >TRANSAM POLYNESIE<\/option><option value='TROPICAL FISH TAHITI' >TROPICAL FISH TAHITI<\/option><option value='TS Distribution' >TS Distribution<\/option><option value='TUTTI FRUTTI PACIFIC' >TUTTI FRUTTI PACIFIC<\/option><option value='U EXPRESS CECILE' >U EXPRESS CECILE<\/option><option value='VAINONI NATU PRODUCT' >VAINONI NATU PRODUCT<\/option><option value='VENSUTAR \/ PAPARA \/ SOCOPU \/ TAIARAPU' >VENSUTAR \/ PAPARA \/ SOCOPU \/ TAIARAPU<\/option><option value='VENUS STAR' >VENUS STAR<\/option><option value='VENUSTAR' >VENUSTAR<\/option><option value='VENUSTAR \/ ARE \/ PAPARA \/ TAIARAPU' >VENUSTAR \/ ARE \/ PAPARA \/ TAIARAPU<\/option><option value='VENUSTAR \/ SOCOPU' >VENUSTAR \/ SOCOPU<\/option><option value='VERDEEN' >VERDEEN<\/option><option value='VERNAUDON' >VERNAUDON<\/option><option value='VETERINAIRE POAFAI' >VETERINAIRE POAFAI<\/option><option value='VETOMOBILE (DR DeSavigny)' >VETOMOBILE (DR DeSavigny)<\/option><option value='VINI VINI LONG LINE PRODUCTS' >VINI VINI LONG LINE PRODUCTS<\/option><option value='VINIVINI MAREYEUR' >VINIVINI MAREYEUR<\/option><option value='VONSY JEAN' >VONSY JEAN<\/option><option value='VONSY VETERINAIRE' >VONSY VETERINAIRE<\/option><option value='WAN DISTRIBUTION \/ SALAISON DE TAHITI' >WAN DISTRIBUTION \/ SALAISON DE TAHITI<\/option><option value='WAN DISTRIBUTIONS' >WAN DISTRIBUTIONS<\/option><option value='WAN DISTRIBUTIONS \/CEDIS' >WAN DISTRIBUTIONS \/CEDIS<\/option><option value='WAN IMPORT' >WAN IMPORT<\/option><option value='WANDA' >WANDA<\/option><option value='WANDIS' >WANDIS<\/option><option value='WASSMAN' >WASSMAN<\/option><option value='WILD TAHITIAN FISH &amp; SARDINES' >WILD TAHITIAN FISH &amp; SARDINES<\/option><option value='WINDSONG C\u00b0 SEAIRLAND TRANSPORTS' >WINDSONG C\u00b0 SEAIRLAND TRANSPORTS<\/option><option value='WINDSTAR' >WINDSTAR<\/option><option value='WING CHONG' >WING CHONG<\/option><option value='WING CHONG (Fare Ute)' >WING CHONG (Fare Ute)<\/option><option value='WING CHONG (Titioro)' >WING CHONG (Titioro)<\/option><option value='WING KHONG' >WING KHONG<\/option><option value='WONG KUI LONG' >WONG KUI LONG<\/option><option value='Xavier MOTTARD' >Xavier MOTTARD<\/option><option value='YAN IMPORT' >YAN IMPORT<\/option><option value='YEOU CHRISTIAN' >YEOU CHRISTIAN<\/option><option value='YINKET' >YINKET<\/option><option value='YOUN YOUN' >YOUN YOUN<\/option><option value='YUAN IMPORT' >YUAN IMPORT<\/option><option value='ZAKTAD PRZEMYSTU MIESNEGO BIERNACKI' >ZAKTAD PRZEMYSTU MIESNEGO BIERNACKI<\/option><option value='ZEN CAFE' >ZEN CAFE<\/option><option value='ZOOLAND' >ZOOLAND<\/option><\/select><\/div><\/li><li id=\"field_4_59\" class=\"gfield gfield--type-address field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_59\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Adresse<\/label>    <div id='input_4_59_copy_values_option_container' class='copy_values_option_container' >\n                                        <input type='checkbox' id='input_4_59_copy_values_activated' class='copy_values_activated' value='1' data-source_field_id='34' name='input_59_copy_values_activated'  \/>\n                                        <label for='input_4_59_copy_values_activated' id='input_4_59_copy_values_option_label' class='copy_values_option_label inline gform-field-label gform-field-label--type-inline'>Adresse connue par la Direction de la Bios\u00e9curit\u00e9<\/label>\n                                    <\/div>\n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_4_59' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_4_59_1_container' >\n                                        <input type='text' name='input_59.1' id='input_4_59_1' value=''    aria-required='false'    \/>\n                                        <label for='input_4_59_1' id='input_4_59_1_label' class='gform-field-label gform-field-label--type-sub '>Adresse postale<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_4_59_2_container' >\n                                        <input type='text' name='input_59.2' id='input_4_59_2' value=''     aria-required='false'   \/>\n                                        <label for='input_4_59_2' id='input_4_59_2_label' class='gform-field-label gform-field-label--type-sub '>Adresse ligne 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_4_59_3_container' >\n                                    <input type='text' name='input_59.3' id='input_4_59_3' value=''    aria-required='false'    \/>\n                                    <label for='input_4_59_3' id='input_4_59_3_label' class='gform-field-label gform-field-label--type-sub '>Commune\/Ville<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_4_59_4_container' >\n                                        <input type='text' name='input_59.4' id='input_4_59_4' value=''      aria-required='false'    \/>\n                                        <label for='input_4_59_4' id='input_4_59_4_label' class='gform-field-label gform-field-label--type-sub '>Ile\/Etat\/Province\/R\u00e9gion<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_4_59_5_container' >\n                                    <input type='text' name='input_59.5' id='input_4_59_5' value=''    aria-required='false'    \/>\n                                    <label for='input_4_59_5' id='input_4_59_5_label' class='gform-field-label gform-field-label--type-sub '>Code postal<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_4_59_6_container' >\n                                        <select name='input_59.6' id='input_4_59_6'   aria-required='false'    ><option value='' selected='selected'><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Afrique du Sud' >Afrique du Sud<\/option><option value='Albanie' >Albanie<\/option><option value='Alg\u00e9rie' >Alg\u00e9rie<\/option><option value='Allemagne' >Allemagne<\/option><option value='Andorre' >Andorre<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctique' >Antarctique<\/option><option value='Antigua-et-Barbuda' >Antigua-et-Barbuda<\/option><option value='Arabie Saoudite' >Arabie Saoudite<\/option><option value='Argentine' >Argentine<\/option><option value='Arm\u00e9nie' >Arm\u00e9nie<\/option><option value='Aruba' >Aruba<\/option><option value='Australie' >Australie<\/option><option value='Autriche' >Autriche<\/option><option value='Azerba\u00efdjan' >Azerba\u00efdjan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahre\u00efn' >Bahre\u00efn<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Belarus' >Belarus<\/option><option value='Belgique' >Belgique<\/option><option value='Belize' >Belize<\/option><option value='Bermudes' >Bermudes<\/option><option value='Bhoutan' >Bhoutan<\/option><option value='Bolivie' >Bolivie<\/option><option value='Bonaire, Saint-Eustache et Saba ' >Bonaire, Saint-Eustache et Saba <\/option><option value='Bosnie-Herz\u00e9govine' >Bosnie-Herz\u00e9govine<\/option><option value='Botswana' >Botswana<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Br\u00e9sil' >Br\u00e9sil<\/option><option value='Bulgarie' >Bulgarie<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='B\u00e9nin' >B\u00e9nin<\/option><option value='Cambodge' >Cambodge<\/option><option value='Cameroun' >Cameroun<\/option><option value='Canada' >Canada<\/option><option value='Cap-Vert' >Cap-Vert<\/option><option value='Chili' >Chili<\/option><option value='Chine' >Chine<\/option><option value='Chypre' >Chypre<\/option><option value='Colombie' >Colombie<\/option><option value='Comores' >Comores<\/option><option value='Congo' >Congo<\/option><option value='Cor\u00e9e (R\u00e9publique de)' >Cor\u00e9e (R\u00e9publique de)<\/option><option value='Cor\u00e9e (R\u00e9publique populaire d\u00e9mocratique de)' >Cor\u00e9e (R\u00e9publique populaire d\u00e9mocratique de)<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatie' >Croatie<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='C\u00f4te d\u2019Ivoire' >C\u00f4te d\u2019Ivoire<\/option><option value='Danemark' >Danemark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominique' >Dominique<\/option><option value='Espagne' >Espagne<\/option><option value='Estonie' >Estonie<\/option><option value='Eswatini' >Eswatini<\/option><option value='Fidji' >Fidji<\/option><option value='Finlande' >Finlande<\/option><option value='France' >France<\/option><option value='F\u00e9d\u00e9ration Russe' >F\u00e9d\u00e9ration Russe<\/option><option value='Gabon' >Gabon<\/option><option value='Gambie' >Gambie<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Grenade' >Grenade<\/option><option value='Groenland' >Groenland<\/option><option value='Gr\u00e8ce' >Gr\u00e8ce<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guin\u00e9e' >Guin\u00e9e<\/option><option value='Guin\u00e9e \u00e9quatoriale' >Guin\u00e9e \u00e9quatoriale<\/option><option value='Guin\u00e9e-Bissau' >Guin\u00e9e-Bissau<\/option><option value='Guyane' >Guyane<\/option><option value='Guyane' >Guyane<\/option><option value='G\u00e9orgie' >G\u00e9orgie<\/option><option value='G\u00e9orgie du Sud et \u00celes Sandwich du Sud' >G\u00e9orgie du Sud et \u00celes Sandwich du Sud<\/option><option value='Ha\u00efti' >Ha\u00efti<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hongrie' >Hongrie<\/option><option value='Inde' >Inde<\/option><option value='Indon\u00e9sie' >Indon\u00e9sie<\/option><option value='Irak' >Irak<\/option><option value='Iran' >Iran<\/option><option value='Irlande' >Irlande<\/option><option value='Islande' >Islande<\/option><option value='Isra\u00ebl' >Isra\u00ebl<\/option><option value='Italie' >Italie<\/option><option value='Jama\u00efque' >Jama\u00efque<\/option><option value='Japon' >Japon<\/option><option value='Jersey' >Jersey<\/option><option value='Jordanie' >Jordanie<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kirghizistan' >Kirghizistan<\/option><option value='Kiribati' >Kiribati<\/option><option value='Kowe\u00eft' >Kowe\u00eft<\/option><option value='La Barbade' >La Barbade<\/option><option value='La R\u00e9union' >La R\u00e9union<\/option><option value='Lesotho' >Lesotho<\/option><option value='Lettonie' >Lettonie<\/option><option value='Liban' >Liban<\/option><option value='Liberia' >Liberia<\/option><option value='Libye' >Libye<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lituanie' >Lituanie<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Mac\u00e9doine du Nord' >Mac\u00e9doine du Nord<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malaisie' >Malaisie<\/option><option value='Malawi' >Malawi<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malte' >Malte<\/option><option value='Maroc' >Maroc<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritanie' >Mauritanie<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexique' >Mexique<\/option><option value='Micron\u00e9sie' >Micron\u00e9sie<\/option><option value='Moldavie' >Moldavie<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolie' >Mongolie<\/option><option value='Montserrat' >Montserrat<\/option><option value='Mont\u00e9n\u00e9gro' >Mont\u00e9n\u00e9gro<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibie' >Namibie<\/option><option value='Nauru' >Nauru<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nig\u00e9ria' >Nig\u00e9ria<\/option><option value='Niu\u00e9' >Niu\u00e9<\/option><option value='Norv\u00e8ge' >Norv\u00e8ge<\/option><option value='Nouvelle-Cal\u00e9donie' >Nouvelle-Cal\u00e9donie<\/option><option value='Nouvelle-Z\u00e9lande' >Nouvelle-Z\u00e9lande<\/option><option value='N\u00e9pal' >N\u00e9pal<\/option><option value='Oman' >Oman<\/option><option value='Ouganda' >Ouganda<\/option><option value='Ouzb\u00e9kistan' >Ouzb\u00e9kistan<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Panama' >Panama<\/option><option value='Papouasie-Nouvelle-Guin\u00e9e' >Papouasie-Nouvelle-Guin\u00e9e<\/option><option value='Paraguay' >Paraguay<\/option><option value='Pays-Bas' >Pays-Bas<\/option><option value='Philippines' >Philippines<\/option><option value='Pologne' >Pologne<\/option><option value='Polyn\u00e9sie fran\u00e7aise' >Polyn\u00e9sie fran\u00e7aise<\/option><option value='Porto Rico' >Porto Rico<\/option><option value='Portugal' >Portugal<\/option><option value='P\u00e9rou' >P\u00e9rou<\/option><option value='Qatar' >Qatar<\/option><option value='Roumanie' >Roumanie<\/option><option value='Royaume-Uni' >Royaume-Uni<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9publique Dominicaine' >R\u00e9publique Dominicaine<\/option><option value='R\u00e9publique Tch\u00e8que' >R\u00e9publique Tch\u00e8que<\/option><option value='R\u00e9publique arabe syrienne' >R\u00e9publique arabe syrienne<\/option><option value='R\u00e9publique centrafricaine' >R\u00e9publique centrafricaine<\/option><option value='R\u00e9publique d\u00e9mocratique du Congo' >R\u00e9publique d\u00e9mocratique du Congo<\/option><option value='R\u00e9publique d\u00e9mocratique populaire du Laos' >R\u00e9publique d\u00e9mocratique populaire du Laos<\/option><option value='Sahara occidental' >Sahara occidental<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre et Miquelon' >Saint Pierre et Miquelon<\/option><option value='Saint-Christophe-et-Nevis' >Saint-Christophe-et-Nevis<\/option><option value='Saint-Marin' >Saint-Marin<\/option><option value='Saint-Si\u00e8ge' >Saint-Si\u00e8ge<\/option><option value='Saint-Vincent-et-les Grenadines' >Saint-Vincent-et-les Grenadines<\/option><option value='Sainte-H\u00e9l\u00e8ne, Ascension et Tristan da Cunha' >Sainte-H\u00e9l\u00e8ne, Ascension et Tristan da Cunha<\/option><option value='Sainte-Lucie' >Sainte-Lucie<\/option><option value='Salvador' >Salvador<\/option><option value='Samoa' >Samoa<\/option><option value='Samoa am\u00e9ricaines' >Samoa am\u00e9ricaines<\/option><option value='Sao Tom\u00e9 et Principe' >Sao Tom\u00e9 et Principe<\/option><option value='Serbie' >Serbie<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapour' >Singapour<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovaquie' >Slovaquie<\/option><option value='Slov\u00e9nie' >Slov\u00e9nie<\/option><option value='Somalie' >Somalie<\/option><option value='Soudan' >Soudan<\/option><option value='Soudan du Sud' >Soudan du Sud<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Suisse' >Suisse<\/option><option value='Suriname' >Suriname<\/option><option value='Su\u00e8de' >Su\u00e8de<\/option><option value='S\u00e9n\u00e9gal' >S\u00e9n\u00e9gal<\/option><option value='Tadjikistan' >Tadjikistan<\/option><option value='Tanzanie (R\u00e9publique-Unie de)' >Tanzanie (R\u00e9publique-Unie de)<\/option><option value='Ta\u00efwan' >Ta\u00efwan<\/option><option value='Tchad' >Tchad<\/option><option value='Terres Australes Fran\u00e7aises' >Terres Australes Fran\u00e7aises<\/option><option value='Territoire britannique de l\u2019oc\u00e9an Indien' >Territoire britannique de l\u2019oc\u00e9an Indien<\/option><option value='Tha\u00eflande' >Tha\u00eflande<\/option><option value='Timor oriental' >Timor oriental<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinit\u00e9 et Tobago' >Trinit\u00e9 et Tobago<\/option><option value='Tunisie' >Tunisie<\/option><option value='Turkm\u00e9nistan' >Turkm\u00e9nistan<\/option><option value='Turquie' >Turquie<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='Ukraine' >Ukraine<\/option><option value='Uruguay' >Uruguay<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/option><option value='Wallis et Futuna' >Wallis et Futuna<\/option><option value='Y\u00e9men' >Y\u00e9men<\/option><option value='Zambie' >Zambie<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c9gypte' >\u00c9gypte<\/option><option value='\u00c9mirats arabes unis' >\u00c9mirats arabes unis<\/option><option value='\u00c9quateur' >\u00c9quateur<\/option><option value='\u00c9rythr\u00e9e' >\u00c9rythr\u00e9e<\/option><option value='\u00c9tat palestinien' >\u00c9tat palestinien<\/option><option value='\u00c9tats-Unis' >\u00c9tats-Unis<\/option><option value='\u00c9thiopie' >\u00c9thiopie<\/option><option value='\u00cele Bouvet' >\u00cele Bouvet<\/option><option value='\u00cele Christmas' >\u00cele Christmas<\/option><option value='\u00cele Maurice' >\u00cele Maurice<\/option><option value='\u00cele Norfolk' >\u00cele Norfolk<\/option><option value='\u00cele de Man' >\u00cele de Man<\/option><option value='\u00celes Cayman' >\u00celes Cayman<\/option><option value='\u00celes Cocos' >\u00celes Cocos<\/option><option value='\u00celes Cook' >\u00celes Cook<\/option><option value='\u00celes Falkland' >\u00celes Falkland<\/option><option value='\u00celes F\u00e9ro\u00e9' >\u00celes F\u00e9ro\u00e9<\/option><option value='\u00celes Heard et McDonald' >\u00celes Heard et McDonald<\/option><option value='\u00celes Mariannes du Nord' >\u00celes Mariannes du Nord<\/option><option value='\u00celes Marshall' >\u00celes Marshall<\/option><option value='\u00celes Pitcairn' >\u00celes Pitcairn<\/option><option value='\u00celes Salomon' >\u00celes Salomon<\/option><option value='\u00celes Turques et Ca\u00efques' >\u00celes Turques et Ca\u00efques<\/option><option value='\u00celes Vierges am\u00e9ricaines' >\u00celes Vierges am\u00e9ricaines<\/option><option value='\u00celes Vierges britanniques' >\u00celes Vierges britanniques<\/option><option value='\u00celes de Svalbard et Jan Mayen' >\u00celes de Svalbard et Jan Mayen<\/option><option value='\u00celes mineures am\u00e9ricaines' >\u00celes mineures am\u00e9ricaines<\/option><option value='\u00celes \u00c5land' >\u00celes \u00c5land<\/option><\/select>\n                                        <label for='input_4_59_6' id='input_4_59_6_label' class='gform-field-label gform-field-label--type-sub '>Pays<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_4_34\" class=\"gfield gfield--type-address field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_34\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Adresse de r\u00e9sidence<\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_4_34' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_4_34_1_container' >\n                                        <input type='text' name='input_34.1' id='input_4_34_1' value=''    aria-required='false'    \/>\n                                        <label for='input_4_34_1' id='input_4_34_1_label' class='gform-field-label gform-field-label--type-sub '>Adresse<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_4_34_3_container' >\n                                    <input type='text' name='input_34.3' id='input_4_34_3' value=''    aria-required='false'    \/>\n                                    <label for='input_4_34_3' id='input_4_34_3_label' class='gform-field-label gform-field-label--type-sub '>Commune \/ Ville<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_4_34_4_container' >\n                                        <input type='text' name='input_34.4' id='input_4_34_4' value=''      aria-required='false'    \/>\n                                        <label for='input_4_34_4' id='input_4_34_4_label' class='gform-field-label gform-field-label--type-sub '>Ile \/ Etat \/ R\u00e9gion<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_4_34_5_container' >\n                                    <input type='text' name='input_34.5' id='input_4_34_5' value=''    aria-required='false'    \/>\n                                    <label for='input_4_34_5' id='input_4_34_5_label' class='gform-field-label gform-field-label--type-sub '>Code postal<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_4_34_6_container' >\n                                        <select name='input_34.6' id='input_4_34_6'   aria-required='false'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Afrique du Sud' >Afrique du Sud<\/option><option value='Albanie' >Albanie<\/option><option value='Alg\u00e9rie' >Alg\u00e9rie<\/option><option value='Allemagne' >Allemagne<\/option><option value='Andorre' >Andorre<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctique' >Antarctique<\/option><option value='Antigua-et-Barbuda' >Antigua-et-Barbuda<\/option><option value='Arabie Saoudite' >Arabie Saoudite<\/option><option value='Argentine' >Argentine<\/option><option value='Arm\u00e9nie' >Arm\u00e9nie<\/option><option value='Aruba' >Aruba<\/option><option value='Australie' >Australie<\/option><option value='Autriche' >Autriche<\/option><option value='Azerba\u00efdjan' >Azerba\u00efdjan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahre\u00efn' >Bahre\u00efn<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Belarus' >Belarus<\/option><option value='Belgique' >Belgique<\/option><option value='Belize' >Belize<\/option><option value='Bermudes' >Bermudes<\/option><option value='Bhoutan' >Bhoutan<\/option><option value='Bolivie' >Bolivie<\/option><option value='Bonaire, Saint-Eustache et Saba ' >Bonaire, Saint-Eustache et Saba <\/option><option value='Bosnie-Herz\u00e9govine' >Bosnie-Herz\u00e9govine<\/option><option value='Botswana' >Botswana<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Br\u00e9sil' >Br\u00e9sil<\/option><option value='Bulgarie' >Bulgarie<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='B\u00e9nin' >B\u00e9nin<\/option><option value='Cambodge' >Cambodge<\/option><option value='Cameroun' >Cameroun<\/option><option value='Canada' >Canada<\/option><option value='Cap-Vert' >Cap-Vert<\/option><option value='Chili' >Chili<\/option><option value='Chine' >Chine<\/option><option value='Chypre' >Chypre<\/option><option value='Colombie' >Colombie<\/option><option value='Comores' >Comores<\/option><option value='Congo' >Congo<\/option><option value='Cor\u00e9e (R\u00e9publique de)' >Cor\u00e9e (R\u00e9publique de)<\/option><option value='Cor\u00e9e (R\u00e9publique populaire d\u00e9mocratique de)' >Cor\u00e9e (R\u00e9publique populaire d\u00e9mocratique de)<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatie' >Croatie<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='C\u00f4te d\u2019Ivoire' >C\u00f4te d\u2019Ivoire<\/option><option value='Danemark' >Danemark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominique' >Dominique<\/option><option value='Espagne' >Espagne<\/option><option value='Estonie' >Estonie<\/option><option value='Eswatini' >Eswatini<\/option><option value='Fidji' >Fidji<\/option><option value='Finlande' >Finlande<\/option><option value='France' >France<\/option><option value='F\u00e9d\u00e9ration Russe' >F\u00e9d\u00e9ration Russe<\/option><option value='Gabon' >Gabon<\/option><option value='Gambie' >Gambie<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Grenade' >Grenade<\/option><option value='Groenland' >Groenland<\/option><option value='Gr\u00e8ce' >Gr\u00e8ce<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guin\u00e9e' >Guin\u00e9e<\/option><option value='Guin\u00e9e \u00e9quatoriale' >Guin\u00e9e \u00e9quatoriale<\/option><option value='Guin\u00e9e-Bissau' >Guin\u00e9e-Bissau<\/option><option value='Guyane' >Guyane<\/option><option value='Guyane' >Guyane<\/option><option value='G\u00e9orgie' >G\u00e9orgie<\/option><option value='G\u00e9orgie du Sud et \u00celes Sandwich du Sud' >G\u00e9orgie du Sud et \u00celes Sandwich du Sud<\/option><option value='Ha\u00efti' >Ha\u00efti<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hongrie' >Hongrie<\/option><option value='Inde' >Inde<\/option><option value='Indon\u00e9sie' >Indon\u00e9sie<\/option><option value='Irak' >Irak<\/option><option value='Iran' >Iran<\/option><option value='Irlande' >Irlande<\/option><option value='Islande' >Islande<\/option><option value='Isra\u00ebl' >Isra\u00ebl<\/option><option value='Italie' >Italie<\/option><option value='Jama\u00efque' >Jama\u00efque<\/option><option value='Japon' >Japon<\/option><option value='Jersey' >Jersey<\/option><option value='Jordanie' >Jordanie<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kirghizistan' >Kirghizistan<\/option><option value='Kiribati' >Kiribati<\/option><option value='Kowe\u00eft' >Kowe\u00eft<\/option><option value='La Barbade' >La Barbade<\/option><option value='La R\u00e9union' >La R\u00e9union<\/option><option value='Lesotho' >Lesotho<\/option><option value='Lettonie' >Lettonie<\/option><option value='Liban' >Liban<\/option><option value='Liberia' >Liberia<\/option><option value='Libye' >Libye<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lituanie' >Lituanie<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Mac\u00e9doine du Nord' >Mac\u00e9doine du Nord<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malaisie' >Malaisie<\/option><option value='Malawi' >Malawi<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malte' >Malte<\/option><option value='Maroc' >Maroc<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritanie' >Mauritanie<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexique' >Mexique<\/option><option value='Micron\u00e9sie' >Micron\u00e9sie<\/option><option value='Moldavie' >Moldavie<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolie' >Mongolie<\/option><option value='Montserrat' >Montserrat<\/option><option value='Mont\u00e9n\u00e9gro' >Mont\u00e9n\u00e9gro<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibie' >Namibie<\/option><option value='Nauru' >Nauru<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nig\u00e9ria' >Nig\u00e9ria<\/option><option value='Niu\u00e9' >Niu\u00e9<\/option><option value='Norv\u00e8ge' >Norv\u00e8ge<\/option><option value='Nouvelle-Cal\u00e9donie' >Nouvelle-Cal\u00e9donie<\/option><option value='Nouvelle-Z\u00e9lande' >Nouvelle-Z\u00e9lande<\/option><option value='N\u00e9pal' >N\u00e9pal<\/option><option value='Oman' >Oman<\/option><option value='Ouganda' >Ouganda<\/option><option value='Ouzb\u00e9kistan' >Ouzb\u00e9kistan<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Panama' >Panama<\/option><option value='Papouasie-Nouvelle-Guin\u00e9e' >Papouasie-Nouvelle-Guin\u00e9e<\/option><option value='Paraguay' >Paraguay<\/option><option value='Pays-Bas' >Pays-Bas<\/option><option value='Philippines' >Philippines<\/option><option value='Pologne' >Pologne<\/option><option value='Polyn\u00e9sie fran\u00e7aise' selected='selected'>Polyn\u00e9sie fran\u00e7aise<\/option><option value='Porto Rico' >Porto Rico<\/option><option value='Portugal' >Portugal<\/option><option value='P\u00e9rou' >P\u00e9rou<\/option><option value='Qatar' >Qatar<\/option><option value='Roumanie' >Roumanie<\/option><option value='Royaume-Uni' >Royaume-Uni<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9publique Dominicaine' >R\u00e9publique Dominicaine<\/option><option value='R\u00e9publique Tch\u00e8que' >R\u00e9publique Tch\u00e8que<\/option><option value='R\u00e9publique arabe syrienne' >R\u00e9publique arabe syrienne<\/option><option value='R\u00e9publique centrafricaine' >R\u00e9publique centrafricaine<\/option><option value='R\u00e9publique d\u00e9mocratique du Congo' >R\u00e9publique d\u00e9mocratique du Congo<\/option><option value='R\u00e9publique d\u00e9mocratique populaire du Laos' >R\u00e9publique d\u00e9mocratique populaire du Laos<\/option><option value='Sahara occidental' >Sahara occidental<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre et Miquelon' >Saint Pierre et Miquelon<\/option><option value='Saint-Christophe-et-Nevis' >Saint-Christophe-et-Nevis<\/option><option value='Saint-Marin' >Saint-Marin<\/option><option value='Saint-Si\u00e8ge' >Saint-Si\u00e8ge<\/option><option value='Saint-Vincent-et-les Grenadines' >Saint-Vincent-et-les Grenadines<\/option><option value='Sainte-H\u00e9l\u00e8ne, Ascension et Tristan da Cunha' >Sainte-H\u00e9l\u00e8ne, Ascension et Tristan da Cunha<\/option><option value='Sainte-Lucie' >Sainte-Lucie<\/option><option value='Salvador' >Salvador<\/option><option value='Samoa' >Samoa<\/option><option value='Samoa am\u00e9ricaines' >Samoa am\u00e9ricaines<\/option><option value='Sao Tom\u00e9 et Principe' >Sao Tom\u00e9 et Principe<\/option><option value='Serbie' >Serbie<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapour' >Singapour<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovaquie' >Slovaquie<\/option><option value='Slov\u00e9nie' >Slov\u00e9nie<\/option><option value='Somalie' >Somalie<\/option><option value='Soudan' >Soudan<\/option><option value='Soudan du Sud' >Soudan du Sud<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Suisse' >Suisse<\/option><option value='Suriname' >Suriname<\/option><option value='Su\u00e8de' >Su\u00e8de<\/option><option value='S\u00e9n\u00e9gal' >S\u00e9n\u00e9gal<\/option><option value='Tadjikistan' >Tadjikistan<\/option><option value='Tanzanie (R\u00e9publique-Unie de)' >Tanzanie (R\u00e9publique-Unie de)<\/option><option value='Ta\u00efwan' >Ta\u00efwan<\/option><option value='Tchad' >Tchad<\/option><option value='Terres Australes Fran\u00e7aises' >Terres Australes Fran\u00e7aises<\/option><option value='Territoire britannique de l\u2019oc\u00e9an Indien' >Territoire britannique de l\u2019oc\u00e9an Indien<\/option><option value='Tha\u00eflande' >Tha\u00eflande<\/option><option value='Timor oriental' >Timor oriental<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinit\u00e9 et Tobago' >Trinit\u00e9 et Tobago<\/option><option value='Tunisie' >Tunisie<\/option><option value='Turkm\u00e9nistan' >Turkm\u00e9nistan<\/option><option value='Turquie' >Turquie<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='Ukraine' >Ukraine<\/option><option value='Uruguay' >Uruguay<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/option><option value='Wallis et Futuna' >Wallis et Futuna<\/option><option value='Y\u00e9men' >Y\u00e9men<\/option><option value='Zambie' >Zambie<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c9gypte' >\u00c9gypte<\/option><option value='\u00c9mirats arabes unis' >\u00c9mirats arabes unis<\/option><option value='\u00c9quateur' >\u00c9quateur<\/option><option value='\u00c9rythr\u00e9e' >\u00c9rythr\u00e9e<\/option><option value='\u00c9tat palestinien' >\u00c9tat palestinien<\/option><option value='\u00c9tats-Unis' >\u00c9tats-Unis<\/option><option value='\u00c9thiopie' >\u00c9thiopie<\/option><option value='\u00cele Bouvet' >\u00cele Bouvet<\/option><option value='\u00cele Christmas' >\u00cele Christmas<\/option><option value='\u00cele Maurice' >\u00cele Maurice<\/option><option value='\u00cele Norfolk' >\u00cele Norfolk<\/option><option value='\u00cele de Man' >\u00cele de Man<\/option><option value='\u00celes Cayman' >\u00celes Cayman<\/option><option value='\u00celes Cocos' >\u00celes Cocos<\/option><option value='\u00celes Cook' >\u00celes Cook<\/option><option value='\u00celes Falkland' >\u00celes Falkland<\/option><option value='\u00celes F\u00e9ro\u00e9' >\u00celes F\u00e9ro\u00e9<\/option><option value='\u00celes Heard et McDonald' >\u00celes Heard et McDonald<\/option><option value='\u00celes Mariannes du Nord' >\u00celes Mariannes du Nord<\/option><option value='\u00celes Marshall' >\u00celes Marshall<\/option><option value='\u00celes Pitcairn' >\u00celes Pitcairn<\/option><option value='\u00celes Salomon' >\u00celes Salomon<\/option><option value='\u00celes Turques et Ca\u00efques' >\u00celes Turques et Ca\u00efques<\/option><option value='\u00celes Vierges am\u00e9ricaines' >\u00celes Vierges am\u00e9ricaines<\/option><option value='\u00celes Vierges britanniques' >\u00celes Vierges britanniques<\/option><option value='\u00celes de Svalbard et Jan Mayen' >\u00celes de Svalbard et Jan Mayen<\/option><option value='\u00celes mineures am\u00e9ricaines' >\u00celes mineures am\u00e9ricaines<\/option><option value='\u00celes \u00c5land' >\u00celes \u00c5land<\/option><\/select>\n                                        <label for='input_4_34_6' id='input_4_34_6_label' class='gform-field-label gform-field-label--type-sub '>Pays<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_4_5\" class=\"gfield gfield--type-email field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_5\" ><label class='gfield_label gform-field-label' for='input_4_5'>Mail<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_4_5' type='email' value='' class='medium'     aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_4_16\" class=\"gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_16\" ><label class='gfield_label gform-field-label' for='input_4_16'>T\u00e9l\u00e9phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_16' id='input_4_16' type='tel' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_4_57\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_57\" ><p style=\"text-align: center\"><span style=\"font-size: small\"><font color=\"#800080\"><strong>Pour importer des v\u00e9g\u00e9taux en Polyn&eacute;sie Fran&ccedil;aise, votre dossier doit faire l'objet d'une demande de permis d'importation pr&eacute;alable. <\/strong><\/font><br \/><font size=\"2\"><br \/><font color=\"#FF0000\">Veuillez remplir le formulaire ci-dessous.<\/font><\/font><\/span><\/p><\/li><li id=\"field_4_69\" class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_69\" ><label class='gfield_label gform-field-label' for='input_4_69'>Nature du ou des produit(s) que vous souhaitez importer<\/label><div class='ginput_container ginput_container_select'><select name='input_69' id='input_4_69' class='medium gfield_select'     aria-invalid=\"false\" ><option value='S\u00e9lectionnez' >S\u00e9lectionnez<\/option><option value='Algues' >Algues<\/option><option value='Aliments pour animaux' >Aliments pour animaux<\/option><option value='Bois' >Bois<\/option><option value='Bourre de coco' >Bourre de coco<\/option><option value='Champignon' >Champignon<\/option><option value='Engrais' >Engrais<\/option><option value='Fibres v\u00e9g\u00e9tales' >Fibres v\u00e9g\u00e9tales<\/option><option value='Fleurs, feuillages coup\u00e9s' >Fleurs, feuillages coup\u00e9s<\/option><option value='Fruits Feuilles Racines Grains s\u00e9ch\u00e9s' >Fruits Feuilles Racines Grains s\u00e9ch\u00e9s<\/option><option value='Liti\u00e8re' >Liti\u00e8re<\/option><option value='Mousse' >Mousse<\/option><option value='Plant in vitro' >Plant in vitro<\/option><option value='Semence' >Semence<\/option><option value='Support de culture' >Support de culture<\/option><\/select><\/div><\/li><li id=\"field_4_61\" class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_61\" ><label class='gfield_label gform-field-label' for='input_4_61'>Pays de provenance<\/label><div class='ginput_container ginput_container_select'><select name='input_61' id='input_4_61' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Afghanistan' >Afghanistan<\/option><option value='\u00celes \u00c5land' >\u00celes \u00c5land<\/option><option value='Albanie' >Albanie<\/option><option value='Alg\u00e9rie' >Alg\u00e9rie<\/option><option value='Samoa am\u00e9ricaines' >Samoa am\u00e9ricaines<\/option><option value='Andorre' >Andorre<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctique' >Antarctique<\/option><option value='Antigua-et-Barbuda' >Antigua-et-Barbuda<\/option><option value='Argentine' >Argentine<\/option><option value='Arm\u00e9nie' >Arm\u00e9nie<\/option><option value='Aruba' >Aruba<\/option><option value='Australie' >Australie<\/option><option value='Autriche' >Autriche<\/option><option value='Azerba\u00efdjan' >Azerba\u00efdjan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahre\u00efn' >Bahre\u00efn<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='La Barbade' >La Barbade<\/option><option value='Belarus' >Belarus<\/option><option value='Belgique' >Belgique<\/option><option value='Belize' >Belize<\/option><option value='B\u00e9nin' >B\u00e9nin<\/option><option value='Bermudes' >Bermudes<\/option><option value='Bhoutan' >Bhoutan<\/option><option value='Bolivie' >Bolivie<\/option><option value='Bonaire, Saint-Eustache et Saba' >Bonaire, Saint-Eustache et Saba<\/option><option value='Bosnie-Herz\u00e9govine' >Bosnie-Herz\u00e9govine<\/option><option value='Botswana' >Botswana<\/option><option value='\u00cele Bouvet' >\u00cele Bouvet<\/option><option value='Br\u00e9sil' >Br\u00e9sil<\/option><option value='Territoire britannique de l\u2019oc\u00e9an Indien' >Territoire britannique de l\u2019oc\u00e9an Indien<\/option><option value='Negara Brunei Darussalam' >Negara Brunei Darussalam<\/option><option value='Bulgarie' >Bulgarie<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodge' >Cambodge<\/option><option value='Cameroun' >Cameroun<\/option><option value='Canada' >Canada<\/option><option value='Cap-Vert' >Cap-Vert<\/option><option value='\u00celes Cayman' >\u00celes Cayman<\/option><option value='R\u00e9publique centrafricaine' >R\u00e9publique centrafricaine<\/option><option value='Tchad' >Tchad<\/option><option value='Chili' >Chili<\/option><option value='Chine' >Chine<\/option><option value='\u00cele Christmas' >\u00cele Christmas<\/option><option value='\u00celes Cocos' >\u00celes Cocos<\/option><option value='Colombie' >Colombie<\/option><option value='Comores' >Comores<\/option><option value='R\u00e9publique d\u00e9mocratique du Congo' >R\u00e9publique d\u00e9mocratique du Congo<\/option><option value='R\u00e9publique du Congo' >R\u00e9publique du Congo<\/option><option value='\u00celes Cook' >\u00celes Cook<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='C\u00f4te d\u2019Ivoire' >C\u00f4te d\u2019Ivoire<\/option><option value='Croatie' >Croatie<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Chypre' >Chypre<\/option><option value='R\u00e9publique tch\u00e8que' >R\u00e9publique tch\u00e8que<\/option><option value='Danemark' >Danemark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominique' >Dominique<\/option><option value='R\u00e9publique Dominicaine' >R\u00e9publique Dominicaine<\/option><option value='\u00c9quateur' >\u00c9quateur<\/option><option value='\u00c9gypte' >\u00c9gypte<\/option><option value='Salvador' >Salvador<\/option><option value='Guin\u00e9e \u00e9quatoriale' >Guin\u00e9e \u00e9quatoriale<\/option><option value='\u00c9rythr\u00e9e' >\u00c9rythr\u00e9e<\/option><option value='Estonie' >Estonie<\/option><option value='Eswatini (Swaziland)' >Eswatini (Swaziland)<\/option><option value='\u00c9thiopie' >\u00c9thiopie<\/option><option value='\u00celes Falkland' >\u00celes Falkland<\/option><option value='\u00celes F\u00e9ro\u00e9' >\u00celes F\u00e9ro\u00e9<\/option><option value='Fidji' >Fidji<\/option><option value='Finlande' >Finlande<\/option><option value='France' selected='selected'>France<\/option><option value='Guyane' >Guyane<\/option><option value='Polyn\u00e9sie fran\u00e7aise' >Polyn\u00e9sie fran\u00e7aise<\/option><option value='Terres Australes Fran\u00e7aises' >Terres Australes Fran\u00e7aises<\/option><option value='Gabon' >Gabon<\/option><option value='Gambie' >Gambie<\/option><option value='G\u00e9orgie' >G\u00e9orgie<\/option><option value='Allemagne' >Allemagne<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Gr\u00e8ce' >Gr\u00e8ce<\/option><option value='Groenland' >Groenland<\/option><option value='Grenade' >Grenade<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guin\u00e9e' >Guin\u00e9e<\/option><option value='Guin\u00e9e-Bissau' >Guin\u00e9e-Bissau<\/option><option value='Guyane' >Guyane<\/option><option value='Ha\u00efti' >Ha\u00efti<\/option><option value='\u00celes Heard et McDonald' >\u00celes Heard et McDonald<\/option><option value='Saint-Si\u00e8ge' >Saint-Si\u00e8ge<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hongrie' >Hongrie<\/option><option value='Islande' >Islande<\/option><option value='Inde' >Inde<\/option><option value='Indon\u00e9sie' >Indon\u00e9sie<\/option><option value='Iran' >Iran<\/option><option value='Irak' >Irak<\/option><option value='Irlande' >Irlande<\/option><option value='\u00cele de Man' >\u00cele de Man<\/option><option value='Isra\u00ebl' >Isra\u00ebl<\/option><option value='Italie' >Italie<\/option><option value='Jama\u00efque' >Jama\u00efque<\/option><option value='Japon' >Japon<\/option><option value='Jersey' >Jersey<\/option><option value='Jordanie' >Jordanie<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Kowe\u00eft' >Kowe\u00eft<\/option><option value='Kirghizistan' >Kirghizistan<\/option><option value='R\u00e9publique d\u00e9mocratique populaire du Laos' >R\u00e9publique d\u00e9mocratique populaire du Laos<\/option><option value='Lettonie' >Lettonie<\/option><option value='Liban' >Liban<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libye' >Libye<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lituanie' >Lituanie<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Mac\u00e9doine' >Mac\u00e9doine<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaisie' >Malaisie<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malte' >Malte<\/option><option value='\u00celes Marshall' >\u00celes Marshall<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritanie' >Mauritanie<\/option><option value='\u00cele Maurice' >\u00cele Maurice<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexique' >Mexique<\/option><option value='Micron\u00e9sie' >Micron\u00e9sie<\/option><option value='Moldavie' >Moldavie<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolie' >Mongolie<\/option><option value='Mont\u00e9n\u00e9gro' >Mont\u00e9n\u00e9gro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Maroc' >Maroc<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibie' >Namibie<\/option><option value='Nauru' >Nauru<\/option><option value='N\u00e9pal' >N\u00e9pal<\/option><option value='Pays-Bas' >Pays-Bas<\/option><option value='Nouvelle-Cal\u00e9donie' >Nouvelle-Cal\u00e9donie<\/option><option value='Nouvelle-Z\u00e9lande' >Nouvelle-Z\u00e9lande<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nig\u00e9ria' >Nig\u00e9ria<\/option><option value='Niu\u00e9' >Niu\u00e9<\/option><option value='\u00cele Norfolk' >\u00cele Norfolk<\/option><option value='Cor\u00e9e du Nord' >Cor\u00e9e du Nord<\/option><option value='\u00celes Mariannes du Nord' >\u00celes Mariannes du Nord<\/option><option value='Norv\u00e8ge' >Norv\u00e8ge<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='\u00c9tat palestinien' >\u00c9tat palestinien<\/option><option value='Panama' >Panama<\/option><option value='Papouasie-Nouvelle-Guin\u00e9e' >Papouasie-Nouvelle-Guin\u00e9e<\/option><option value='Paraguay' >Paraguay<\/option><option value='P\u00e9rou' >P\u00e9rou<\/option><option value='Philippines' >Philippines<\/option><option value='\u00celes Pitcairn' >\u00celes Pitcairn<\/option><option value='Pologne' >Pologne<\/option><option value='Portugal' >Portugal<\/option><option value='Porto Rico' >Porto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='La R\u00e9union' >La R\u00e9union<\/option><option value='Roumanie' >Roumanie<\/option><option value='Russie' >Russie<\/option><option value='Rwanda' >Rwanda<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Sainte H\u00e9l\u00e8ne' >Sainte H\u00e9l\u00e8ne<\/option><option value='Saint-Christophe-et-Nevis' >Saint-Christophe-et-Nevis<\/option><option value='Sainte-Lucie' >Sainte-Lucie<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre et Miquelon' >Saint Pierre et Miquelon<\/option><option value='Saint-Vincent-et-les Grenadines' >Saint-Vincent-et-les Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='Saint-Marin' >Saint-Marin<\/option><option value='Sao Tom\u00e9 et Principe' >Sao Tom\u00e9 et Principe<\/option><option value='Arabie Saoudite' >Arabie Saoudite<\/option><option value='S\u00e9n\u00e9gal' >S\u00e9n\u00e9gal<\/option><option value='Serbie' >Serbie<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapour' >Singapour<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovaquie' >Slovaquie<\/option><option value='Slov\u00e9nie' >Slov\u00e9nie<\/option><option value='\u00celes Salomon' >\u00celes Salomon<\/option><option value='Somalie' >Somalie<\/option><option value='Afrique du Sud' >Afrique du Sud<\/option><option value='\u00cele de G\u00e9orgie du Sud' >\u00cele de G\u00e9orgie du Sud<\/option><option value='Cor\u00e9e du Sud' >Cor\u00e9e du Sud<\/option><option value='Soudan du Sud' >Soudan du Sud<\/option><option value='Espagne' >Espagne<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Soudan' >Soudan<\/option><option value='Suriname' >Suriname<\/option><option value='\u00celes de Svalbard et Jan Mayen' >\u00celes de Svalbard et Jan Mayen<\/option><option value='Su\u00e8de' >Su\u00e8de<\/option><option value='Suisse' >Suisse<\/option><option value='Syrie' >Syrie<\/option><option value='Ta\u00efwan' >Ta\u00efwan<\/option><option value='Tadjikistan' >Tadjikistan<\/option><option value='Tanzanie' >Tanzanie<\/option><option value='Tha\u00eflande' >Tha\u00eflande<\/option><option value='Timor oriental' >Timor oriental<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinit\u00e9 et Tobago' >Trinit\u00e9 et Tobago<\/option><option value='Tunisie' >Tunisie<\/option><option value='Turquie' >Turquie<\/option><option value='Turkm\u00e9nistan' >Turkm\u00e9nistan<\/option><option value='\u00celes Turques et Ca\u00efques' >\u00celes Turques et Ca\u00efques<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='Ouganda' >Ouganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='\u00c9mirats arabes unis' >\u00c9mirats arabes unis<\/option><option value='Royaume-Uni' >Royaume-Uni<\/option><option value='\u00c9tats-Unis' >\u00c9tats-Unis<\/option><option value='Uruguay' >Uruguay<\/option><option value='\u00celes mineures am\u00e9ricaines' >\u00celes mineures am\u00e9ricaines<\/option><option value='Ouzb\u00e9kistan' >Ouzb\u00e9kistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/option><option value='\u00celes Vierges britanniques' >\u00celes Vierges britanniques<\/option><option value='\u00celes Vierges am\u00e9ricaines' >\u00celes Vierges am\u00e9ricaines<\/option><option value='Wallis et Futuna' >Wallis et Futuna<\/option><option value='Sahara occidental' >Sahara occidental<\/option><option value='Y\u00e9men' >Y\u00e9men<\/option><option value='Zambie' >Zambie<\/option><option value='Zimbabwe' >Zimbabwe<\/option><\/select><\/div><\/li><li id=\"field_4_51\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_51\" ><label class='gfield_label gform-field-label' >Dur\u00e9e de validit\u00e9 du permis d&#039;importation souhait\u00e9e<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_4_51'>\n\t\t\t<li class='gchoice gchoice_4_51_0'>\n\t\t\t\t<input name='input_51' type='radio' value='6 mois pour 1 envoi (1500 xpf)'  id='choice_4_51_0'    \/>\n\t\t\t\t<label for='choice_4_51_0' id='label_4_51_0' class='gform-field-label gform-field-label--type-inline'>6 mois pour 1 envoi (1500 xpf)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_4_51_1'>\n\t\t\t\t<input name='input_51' type='radio' value='12 mois pour plusieurs envois (5000 xpf)'  id='choice_4_51_1'    \/>\n\t\t\t\t<label for='choice_4_51_1' id='label_4_51_1' class='gform-field-label gform-field-label--type-inline'>12 mois pour plusieurs envois (5000 xpf)<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_4_49\" class=\"gfield gfield--type-list field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_4_49\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Indiquer vos produits v\u00e9g\u00e9taux<\/label><div class='gfield_description' id='gfield_description_4_49'>Indiquez dans la nature du produit s'il s'agit de bois, rhizome, semences, fleurs, feuillages frais ou s\u00e9ch\u00e9s, fruits, etc.<\/div><style type=\"text\/css\">\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons {\n\t\t\t\t\t\t\tvertical-align: middle !important;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons img {\n\t\t\t\t\t\t\tbackground-color: transparent !important;\n\t\t\t\t\t\t\tbackground-position: 0 0;\n\t\t\t\t\t\t\tbackground-size: 16px 16px !important;\n\t\t\t\t\t\t\tbackground-repeat: no-repeat;\n\t\t\t\t\t\t\tborder: none !important;\n\t\t\t\t\t\t\twidth: 16px !important;\n\t\t\t\t\t\t\theight: 16px !important;\n\t\t\t\t\t\t\topacity: 0.5;\n\t\t\t\t\t\t\ttransition: opacity .5s ease-out;\n\t\t\t\t\t\t    -moz-transition: opacity .5s ease-out;\n\t\t\t\t\t\t    -webkit-transition: opacity .5s ease-out;\n\t\t\t\t\t\t    -o-transition: opacity .5s ease-out;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons a:hover img {\n\t\t\t\t\t\t\topacity: 1.0;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\t<\/style><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_49_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_49_col_2' class='gfield_list_col_even' \/><col id='gfield_list_49_col_3' class='gfield_list_col_odd' \/><\/colgroup><thead><tr><th scope=\"col\">Nom scientifique (genre et esp\u00e8ce)<\/th><th scope=\"col\">Nature<\/th><td>&nbsp;<\/td><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_49_cell1' data-label='Nom scientifique (genre et esp\u00e8ce)'><input aria-invalid='false'  aria-describedby=\"gfield_description_4_49\" aria-label='Nom scientifique (genre et esp\u00e8ce), Row 1' data-aria-label-template='Nom scientifique (genre et esp\u00e8ce), Row {0}' type='text' name='input_49[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_49_cell2' data-label='Nature'><input aria-invalid='false'  aria-describedby=\"gfield_description_4_49\" aria-label='Nature, Row 1' data-aria-label-template='Nature, Row {0}' type='text' name='input_49[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Ajouter une autre ligne' onclick='gformAddListItem(this, 20)' onkeypress='gformAddListItem(this, 20)'><img src='https:\/\/www.service-public.pf\/biosecurite\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Ajouter une nouvelle ligne' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Supprimer cette ligne' onclick='gformDeleteListItem(this, 20)' onkeypress='gformDeleteListItem(this, 20)' style=\"visibility:hidden;\"><img src='https:\/\/www.service-public.pf\/biosecurite\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Supprimer cette ligne' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id=\"field_4_50\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_50\" ><label class='gfield_label gform-field-label' >Les articles import\u00e9s ont-ils \u00e9t\u00e9 g\u00e9n\u00e9tiquement modifi\u00e9s ou contiennent-ils des produits g\u00e9n\u00e9tiquement modifi\u00e9s?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_4_50'>\n\t\t\t<li class='gchoice gchoice_4_50_0'>\n\t\t\t\t<input name='input_50' type='radio' value='Oui'  id='choice_4_50_0'    \/>\n\t\t\t\t<label for='choice_4_50_0' id='label_4_50_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_4_50_1'>\n\t\t\t\t<input name='input_50' type='radio' value='Non'  id='choice_4_50_1'    \/>\n\t\t\t\t<label for='choice_4_50_1' id='label_4_50_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_4_40\" class=\"gfield gfield--type-fileupload field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_4_40\" ><label class='gfield_label gform-field-label' for='gform_browse_button_4_40'>Vous avez r\u00e9pondu Oui<\/label><div class='gfield_description' id='gfield_description_4_40'>Veuillez fournir des informations compl\u00e9mentaires (envoyez vos documents justificatifs ou veuillez contactez la cellule phytosanitaire au +00 689 40 544 585)<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_4_40' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_4_40&quot;,&quot;container&quot;:&quot;gform_multifile_upload_4_40&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_4_40&quot;,&quot;filelist&quot;:&quot;gform_preview_4_40&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.service-public.pf\\\/biosecurite\\\/?gf_page=0e8550eed077e71&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.service-public.pf\\\/biosecurite\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.service-public.pf\\\/biosecurite\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Fichiers autoris\\u00e9s&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;25600000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:4,&quot;field_id&quot;:40},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_4_40&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_4_40' 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'>D\u00e9poser les fichiers ici ou <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_4_40' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_4_40 gfield_description_4_40\"  >S\u00e9lectionnez des fichiers<\/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_4_40'>Taille max. des fichiers\u00a0: 24 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_4_40'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_4_40' class='ginput_preview_list'><\/div><\/li><li id=\"field_4_73\" class=\"gfield gfield--type-fileupload field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_4_73\" ><label class='gfield_label gform-field-label' for='gform_browse_button_4_73'>Fiches techniques<\/label><div class='gfield_description' id='gfield_description_4_73'>Transmettre les fiches techniques des produits ou toute preuve justifiant de leur composition. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_4_73' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_4_73&quot;,&quot;container&quot;:&quot;gform_multifile_upload_4_73&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_4_73&quot;,&quot;filelist&quot;:&quot;gform_preview_4_73&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.service-public.pf\\\/biosecurite\\\/?gf_page=0e8550eed077e71&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.service-public.pf\\\/biosecurite\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.service-public.pf\\\/biosecurite\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Fichiers autoris\\u00e9s&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;25600000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:4,&quot;field_id&quot;:73},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_4_73&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_4_73' 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'>D\u00e9poser les fichiers ici ou <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_4_73' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_4_73 gfield_description_4_73\"  >S\u00e9lectionnez des fichiers<\/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_4_73'>Taille max. des fichiers\u00a0: 24 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_4_73'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_4_73' class='ginput_preview_list'><\/div><\/li><li id=\"field_4_55\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_55\" ><p><span style=\"font-family: verdana, geneva;font-size: x-small\">Le d&eacute;lai de d&eacute;livrance du permis d'importation est de <strong>deux semaines<\/strong> apr&egrave;s paiement de la demande. Il peut &ecirc;tre prolong&eacute; pour compl&eacute;ment d'&eacute;tudes et soumission &agrave; l'avis du Comit&eacute; consultatif de la protection des v&eacute;g&eacute;taux.<\/span><\/p><\/li><li id=\"field_4_53\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_53\" ><div class='ginput_container ginput_container_text'><input name='input_53' id='input_4_53' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='04\/05\/2024' \/><\/div><\/li><li id=\"field_4_7\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_7\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Conditions d&#039;exploitations des donn\u00e9es personnelles<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_consent'><input name='input_7.1' id='input_4_7_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_4_7_1' >J\u2019accepte la <a href=\"https:\/\/www.service-public.pf\/biosecurite\/politique-de-protection-des-donnees-de-la-dbs\/\" target=\"_blank\">politique de confidentialit\u00e9.<\/a><\/label><input type='hidden' name='input_7.2' value='J\u2019accepte la &lt;a href=&quot;https:\/\/www.service-public.pf\/biosecurite\/politique-de-protection-des-donnees-de-la-dbs\/&quot; target=&quot;_blank&quot;&gt;politique de confidentialit\u00e9.&lt;\/a&gt;' class='gform_hidden' \/><input type='hidden' name='input_7.3' value='3' class='gform_hidden' \/><\/div><\/li><li id=\"field_4_74\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_74\" ><label class='gfield_label gform-field-label' for='input_4_74'>Email<\/label><div class='ginput_container'><input name='input_74' id='input_4_74' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_4_74'>Ce champ n\u2019est utilis\u00e9 qu\u2019\u00e0 des fins de validation et devrait rester inchang\u00e9.<\/div><\/li><\/ul><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_4' class='gform_button button' value='Envoyer ma demande'  onclick='if(window[\"gf_submitting_4\"]){return false;}  if( !jQuery(\"#gform_4\")[0].checkValidity || jQuery(\"#gform_4\")[0].checkValidity()){window[\"gf_submitting_4\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_4\"]){return false;} if( !jQuery(\"#gform_4\")[0].checkValidity || jQuery(\"#gform_4\")[0].checkValidity()){window[\"gf_submitting_4\"]=true;}  jQuery(\"#gform_4\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_4' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='4' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_4' value='WyJ7XCI3LjFcIjpcImE3OTJkZmJiY2Q0MDIxMzA4ZWFjNjRkMDM4NmY0NWYzXCIsXCI3LjJcIjpcIjllYWUzNjg4NjI1OGFjZTM5NzE1MTAwMDFlMmNmYTU1XCIsXCI3LjNcIjpcImEwZTk0ZjVmM2Y3YjAxNmRhMDMwOWY3MTIyZGQyZTNjXCJ9IiwiZWZmNTNiNjI5OTc0MzNjYmZjMjhjYzljYmJiNGQwNzgiXQ==' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_4' id='gform_target_page_number_4' value='0' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_4' id='gform_source_page_number_4' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            <input type='hidden' name='gform_uploaded_files' id='gform_uploaded_files_4' value='' \/>\n        <\/div>\n                        <\/form>\n                        <\/div><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\n gform.initializeOnLoaded( function() {gformInitSpinner( 4, 'https:\/\/www.service-public.pf\/biosecurite\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_4').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_4');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_4').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! 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