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https://parkeren.be/onze-steden-en-gemeenten/brabant/asse/parkeervergunningen/hoe-je-parkeervergunning-aanvragen/onl...
Submission: On March 31 via manual from BE — Scanned from NL
Submission: On March 31 via manual from BE — Scanned from NL
Form analysis 1 forms found in the DOM
POST
<form id="formie-form-12608664269d637e180" class="fui-form fui-labels-above-input" method="post" enctype="multipart/form-data" accept-charset="utf-8" data-submit-method="page-reload" data-submit-action="message"
data-config="{"formHashId":"formie-form-12608664269d637e180","formId":126086,"formHandle":"resident_card_asse","registeredJs":[{"src":"https://parkeren.be/cpresources/c8934552/checkbox-radio.js?v=1678874077","module":"FormieCheckboxRadio"},{"src":"https://parkeren.be/cpresources/c8934552/file-upload.js?v=1678874662","module":"FormieFileUpload"},{"src":"https://parkeren.be/cpresources/c8934552/text-limit.js?v=1678874662","module":"FormieTextLimit"},{"src":"https://parkeren.be/cpresources/2b0b3bc8/recaptcha-v3.js?v=1678874077","module":"FormieRecaptchaV3","settings":{"siteKey":"6LcYLbkfAAAAAG3Kf-GC1bN0MKhTw8fm2WzF8Qiz","formId":"formie-form-12608664269d637e180","theme":"light","size":"normal","badge":"bottomright","language":"nl","submitMethod":"page-reload","hasMultiplePages":false}},{"src":"https://parkeren.be/cpresources/c8934552/conditions.js?v=1678874077","module":"FormieConditions"}],"settings":{"submitMethod":"page-reload","submitActionMessage":"We hebben je aanvraag goed ontvangen, we behandelen deze zo snel mogelijk.","submitActionMessageTimeout":"","submitActionMessagePosition":"top-form","submitActionFormHide":"","submitAction":"message","submitActionTab":null,"errorMessage":"Er is nog iets mis met je aanvraag, kijk je even na of je alle velden goed ingevuld hebt?","errorMessagePosition":"top-form","loadingIndicator":"","loadingIndicatorText":"","validationOnSubmit":"1","validationOnFocus":"","scrollToTop":"1","hasMultiplePages":false,"pages":[{"settings":{"submitButtonLabel":"Verzenden","backButtonLabel":"Back","showBackButton":false,"buttonsPosition":"left","cssClasses":null,"containerAttributes":[],"inputAttributes":[],"enableNextButtonConditions":false,"nextButtonConditions":"{\"showRule\":\"show\",\"conditionRule\":\"all\",\"conditions\":[]}","enablePageConditions":false,"pageConditions":[],"enableJsEvents":false,"jsGtmEventOptions":[{"label":"event","value":"formPageSubmission"},{"label":"formId","value":"resident_card_asse"},{"label":"pageId","value":"517"},{"label":"pageIndex","value":0}]},"id":"517","layoutId":"87","name":"Page 1","elements":[{"label":null,"instructions":null,"tip":null,"warning":null,"required":"1","width":100,"fieldUid":"516e9116-a576-47d3-9225-47caa5ae586b"},{"label":null,"instructions":null,"tip":null,"warning":null,"required":"1","width":100,"fieldUid":"a25b2cb9-05d3-45bb-93da-439f97e27c7b"},{"label":null,"instructions":null,"tip":null,"warning":null,"required":"1","width":100,"fieldUid":"128474e2-4fe0-41f7-adfa-ffcd88247a78"},{"label":null,"instructions":null,"tip":null,"warning":null,"required":"0","width":100,"fieldUid":"384941e0-931b-4704-986a-77e441b5b750"},{"label":null,"instructions":null,"tip":null,"warning":null,"required":"0","width":100,"fieldUid":"215bbece-2131-4daa-9c63-2db275d341b7"},{"label":null,"instructions":null,"tip":null,"warning":null,"required":"0","width":100,"fieldUid":"8e7595d5-9dbc-42ff-a2a5-aaea51165b68"},{"label":null,"instructions":null,"tip":null,"warning":null,"required":"1","width":100,"fieldUid":"888a0cd0-a321-471f-bb66-966b318e48fc"},{"label":null,"instructions":null,"tip":null,"warning":null,"required":"1","width":100,"fieldUid":"2d2f82d4-4615-41b9-ad5e-2e40d5fcf99f"},{"label":null,"instructions":null,"tip":null,"warning":null,"required":"1","width":100,"fieldUid":"903c29d3-19c4-41dc-8536-0bbae3bd2ccd"},{"label":null,"instructions":null,"tip":null,"warning":null,"required":"1","width":100,"fieldUid":"274a45e2-b68d-4ba9-9dd1-9e1f4f10dc86"},{"label":null,"instructions":null,"tip":null,"warning":null,"required":"1","width":100,"fieldUid":"c111cb13-8a6a-4438-8e83-af442872379c"},{"label":null,"instructions":null,"tip":null,"warning":null,"required":"1","width":100,"fieldUid":"646cdd8f-0d1a-490d-9c16-7ddd617fba72"},{"label":null,"instructions":null,"tip":null,"warning":null,"required":"1","width":100,"fieldUid":"c5091a32-282f-48a9-ac3c-e23035780977"},{"label":null,"instructions":null,"tip":null,"warning":null,"required":"0","width":100,"fieldUid":"b8482d04-52c7-4433-b25d-33abb7b18e80"},{"label":null,"instructions":null,"tip":null,"warning":null,"required":"1","width":100,"fieldUid":"301f7751-1863-4c1b-8fb3-1a08f7b4e4b6"}],"sortOrder":"0","uid":"c093e3cf-18de-4d22-8bd3-9adef6c2b60b"}],"redirectUrl":"","currentPageId":"517","outputJsTheme":true,"enableUnloadWarning":"1","ajaxTimeout":"10"}}"
novalidate="true"><input type="hidden" name="CRAFT_CSRF_TOKEN" value="hVuP6W36iGkGgvEMUEEziTdnoBo8PyK_LHmv5r6anAlyXrDURM3tzdAz9bwKwsMZbtqyZBYHXOtuHuEqeWd6xX5Ox5_7rtBYKi7fsSCFoaI=" autocomplete="off"><input type="hidden" name="action"
value="formie/submissions/submit"><input type="hidden" name="handle" value="resident_card_asse"><input type="hidden" name="siteId" value="1">
<div class="fui-form-container">
<div id="formie-form-12608664269d637e180-p-517" class="fui-page" data-index="0" data-id="517">
<div class="fui-page-container">
<div class="fui-row fui-page-row">
<div id="fields-formie-form-12608664269d637e180-document-wrap" class="fui-field fui-page-field fui-type-radio-buttons fui-label-above-input fui-subfield-label-above-input fui-instructions-above-input fui-field-required "
data-field-config="[{"module":"FormieCheckboxRadio"}]">
<div class="fui-field-container">
<div class="fui-input-container">
<fieldset class="fui-fieldset fui-layout-vertical" id="fields-formie-form-12608664269d637e180-document">
<legend class="fui-legend">Welke parkeervergunning wil je aanvragen? <span class="fui-required">*</span></legend>
<div class="fui-layout-wrap"><label class="fui-radio" for="fields-formie-form-12608664269d637e180-document-bewonerskaart"><input type="radio" id="fields-formie-form-12608664269d637e180-document-bewonerskaart"
class="fui-input fui-radio-input" name="fields[document]" value="Bewonerskaart" checked="" required="" data-fui-message="" aria-required="true" aria-checked="true"><span class="Form-indicator"></span><span
class="fui-radio-label">Bewonerskaart</span></label><label class="fui-radio" for="fields-formie-form-12608664269d637e180-document-parkeerabonnement"><input type="radio"
id="fields-formie-form-12608664269d637e180-document-parkeerabonnement" class="fui-input fui-radio-input" name="fields[document]" value="Parkeerabonnement" required="" data-fui-message="" aria-required="true"
aria-checked="false"><span class="Form-indicator"></span><span class="fui-radio-label">Parkeerabonnement</span></label><label class="fui-radio"
for="fields-formie-form-12608664269d637e180-document-kaart-voor-paramedici-en-huisartsen"><input type="radio" id="fields-formie-form-12608664269d637e180-document-kaart-voor-paramedici-en-huisartsen"
class="fui-input fui-radio-input" name="fields[document]" value="Kaart voor paramedici en huisartsen" required="" data-fui-message="" aria-required="true" aria-checked="false"><span class="Form-indicator"></span><span
class="fui-radio-label">Kaart voor paramedici en huisartsen</span></label></div>
</fieldset>
</div>
</div>
</div>
</div>
<div class="fui-row fui-page-row">
<div id="fields-formie-form-12608664269d637e180-scan-van-je-identiteitskaart-met-de-adresgegevens-wrap"
class="fui-field fui-page-field fui-type-file-upload fui-label-above-input fui-subfield-label-above-input fui-instructions-above-input fui-field-required " data-field-config="[{"module":"FormieFileUpload"}]">
<div class="fui-field-container"><label id="fields-formie-form-12608664269d637e180-scan-van-je-identiteitskaart-met-de-adresgegevens-label" class="fui-label"
for="fields-formie-form-12608664269d637e180-scan-van-je-identiteitskaart-met-de-adresgegevens">Uitlezing van je identiteitskaart met adresgegevens <span class="fui-required">*</span></label>
<div class="fui-input-container"><label class="Form-field Form-field--file" for="fields-formie-form-12608664269d637e180-scan-van-je-identiteitskaart-met-de-adresgegevens"><input type="file"
id="fields-formie-form-12608664269d637e180-scan-van-je-identiteitskaart-met-de-adresgegevens" class="fui-input" name="fields[scanVanJeIdentiteitskaartMetDeAdresgegevens][]" multiple="" required=""
accept=".avif, .bmp, .gif, .heic, .heif, .jp2, .jpeg, .jpg, .jpx, .png, .svg, .tif, .tiff, .webp, .pdf" data-size-min-limit="0" data-size-max-limit="0" data-file-limit="0" data-fui-message="" aria-required="true"><span
class="Form-indicator" data-file-text="Zoeken" data-file-multiple="{count} files selected"></span></label></div>
</div>
</div>
</div>
<div class="fui-row fui-page-row">
<div id="fields-formie-form-12608664269d637e180-scan-van-inschrijvingsbewijs-van-je-wagen-roze-kaart-wrap"
class="fui-field fui-page-field fui-type-file-upload fui-label-above-input fui-subfield-label-above-input fui-instructions-above-input fui-field-required " data-field-config="[{"module":"FormieFileUpload"}]">
<div class="fui-field-container"><label id="fields-formie-form-12608664269d637e180-scan-van-inschrijvingsbewijs-van-je-wagen-roze-kaart-label" class="fui-label"
for="fields-formie-form-12608664269d637e180-scan-van-inschrijvingsbewijs-van-je-wagen-roze-kaart">Scan van het inschrijvingsbewijs van je voertuig – deel 1 (met logo van de auto) <span class="fui-required">*</span></label>
<div class="fui-input-container"><label class="Form-field Form-field--file" for="fields-formie-form-12608664269d637e180-scan-van-inschrijvingsbewijs-van-je-wagen-roze-kaart"><input type="file"
id="fields-formie-form-12608664269d637e180-scan-van-inschrijvingsbewijs-van-je-wagen-roze-kaart" class="fui-input" name="fields[scanVanInschrijvingsbewijsVanJeWagenRozeKaart][]" multiple="" required=""
accept=".avif, .bmp, .gif, .heic, .heif, .jp2, .jpeg, .jpg, .jpx, .png, .svg, .tif, .tiff, .webp, .pdf" data-size-min-limit="0" data-size-max-limit="0" data-file-limit="0" data-fui-message="" aria-required="true"><span
class="Form-indicator" data-file-text="Zoeken" data-file-multiple="{count} files selected"></span></label></div>
</div>
</div>
</div>
<div class="fui-row fui-page-row">
<div id="fields-formie-form-12608664269d637e180-enkel-indien-je-een-leasingwagen-hebt-bewijs-van-je-bedri-wrap"
class="fui-field fui-page-field fui-type-file-upload fui-label-above-input fui-subfield-label-above-input fui-instructions-above-input " data-field-config="[{"module":"FormieFileUpload"}]">
<div class="fui-field-container"><label id="fields-formie-form-12608664269d637e180-enkel-indien-je-een-leasingwagen-hebt-bewijs-van-je-bedri-label" class="fui-label"
for="fields-formie-form-12608664269d637e180-enkel-indien-je-een-leasingwagen-hebt-bewijs-van-je-bedri">Enkel indien je over een lease- of bedrijfswagen beschikt: het bewijs van je bedrijf dat jij de hoofdbestuurder bent of de statuten
van je bedrijf als jij de bedrijfsleider bent (optioneel)</label>
<div class="fui-input-container"><label class="Form-field Form-field--file" for="fields-formie-form-12608664269d637e180-enkel-indien-je-een-leasingwagen-hebt-bewijs-van-je-bedri"><input type="file"
id="fields-formie-form-12608664269d637e180-enkel-indien-je-een-leasingwagen-hebt-bewijs-van-je-bedri" class="fui-input" name="fields[enkelIndienJeEenLeasingwagenHebtBewijsVanJeBedri][]" multiple=""
accept=".avif, .bmp, .gif, .heic, .heif, .jp2, .jpeg, .jpg, .jpx, .png, .svg, .tif, .tiff, .webp, .pdf" data-size-min-limit="0" data-size-max-limit="0" data-file-limit="0" data-fui-message="Dit i" aria-required="false"><span
class="Form-indicator" data-file-text="Zoeken" data-file-multiple="{count} files selected"></span></label></div>
</div>
</div>
</div>
<div class="fui-row fui-page-row">
<div id="fields-formie-form-12608664269d637e180-enkel-indien-je-over-een-lease-of-bedrijfswagen-beschikt-wrap"
class="fui-field fui-page-field fui-type-file-upload fui-label-above-input fui-subfield-label-above-input fui-instructions-above-input " data-field-config="[{"module":"FormieFileUpload"}]"
data-field-conditions="{"showRule":"show","conditionRule":"all","conditions":[{"field":"fields[document]","condition":"=","value":"Kaart voor paramedici en huisartsen"}],"isNested":false}"
data-conditionally-hidden="true">
<div class="fui-field-container"><label id="fields-formie-form-12608664269d637e180-enkel-indien-je-over-een-lease-of-bedrijfswagen-beschikt-label" class="fui-label"
for="fields-formie-form-12608664269d637e180-enkel-indien-je-over-een-lease-of-bedrijfswagen-beschikt">Een 'verklaring op eer' dat je huisbezoeken doet in Asse.</label>
<div class="fui-input-container"><label class="Form-field Form-field--file" for="fields-formie-form-12608664269d637e180-enkel-indien-je-over-een-lease-of-bedrijfswagen-beschikt"><input type="file"
id="fields-formie-form-12608664269d637e180-enkel-indien-je-over-een-lease-of-bedrijfswagen-beschikt" class="fui-input" name="fields[enkelIndienJeOverEenLeaseOfBedrijfswagenBeschikt][]" multiple=""
accept=".avif, .bmp, .gif, .heic, .heif, .jp2, .jpeg, .jpg, .jpx, .png, .svg, .tif, .tiff, .webp, .pdf" data-size-min-limit="0" data-size-max-limit="0" data-file-limit="0" data-fui-message="Dit i" aria-required="false"
disabled="true"><span class="Form-indicator" data-file-text="Zoeken" data-file-multiple="{count} files selected"></span></label></div>
</div>
</div>
</div>
<div class="fui-row fui-page-row">
<div id="fields-formie-form-12608664269d637e180-riziv-nummer-wrap" class="fui-field fui-page-field fui-type-single-line-text fui-label-above-input fui-subfield-label-above-input fui-instructions-above-input fui-text-input-field "
data-field-conditions="{"showRule":"show","conditionRule":"all","conditions":[{"field":"fields[document]","condition":"=","value":"Kaart voor paramedici en huisartsen"}],"isNested":false}"
data-conditionally-hidden="true">
<div class="fui-field-container has-float"><label id="fields-formie-form-12608664269d637e180-riziv-nummer-label" class="fui-label" for="fields-formie-form-12608664269d637e180-riziv-nummer">RIZIV-nummer.</label>
<div class="fui-input-container"><input type="text" id="fields-formie-form-12608664269d637e180-riziv-nummer" class="fui-input" name="fields[rizivNummer]" value="" placeholder="" data-fui-id="resident-card-asse-riziv-nummer"
data-fui-message="" aria-required="false" disabled="true"></div>
</div>
</div>
</div>
<div class="fui-row fui-page-row">
<div id="fields-formie-form-12608664269d637e180-voornaam-wrap"
class="fui-field fui-page-field fui-type-single-line-text fui-label-above-input fui-subfield-label-above-input fui-instructions-above-input fui-field-required fui-text-input-field ">
<div class="fui-field-container has-float"><label id="fields-formie-form-12608664269d637e180-voornaam-label" class="fui-label" for="fields-formie-form-12608664269d637e180-voornaam">Voornaam <span class="fui-required">*</span></label>
<div class="fui-input-container"><input type="text" id="fields-formie-form-12608664269d637e180-voornaam" class="fui-input" name="fields[voornaam]" value="" placeholder="" required="" data-fui-id="resident-card-asse-voornaam"
data-fui-message="" aria-required="true"></div>
</div>
</div>
<div id="fields-formie-form-12608664269d637e180-voornaam1-wrap"
class="fui-field fui-page-field fui-type-single-line-text fui-label-above-input fui-subfield-label-above-input fui-instructions-above-input fui-field-required fui-text-input-field ">
<div class="fui-field-container has-float"><label id="fields-formie-form-12608664269d637e180-voornaam1-label" class="fui-label" for="fields-formie-form-12608664269d637e180-voornaam1">Familienaam <span
class="fui-required">*</span></label>
<div class="fui-input-container"><input type="text" id="fields-formie-form-12608664269d637e180-voornaam1" class="fui-input" name="fields[voornaam1]" value="" placeholder="" required="" data-fui-id="resident-card-asse-voornaam1"
data-fui-message="" aria-required="true"></div>
</div>
</div>
</div>
<div class="fui-row fui-page-row">
<div id="fields-formie-form-12608664269d637e180-e-mailadres-wrap"
class="fui-field fui-page-field fui-type-email-address fui-label-above-input fui-subfield-label-above-input fui-instructions-above-input fui-field-required fui-text-input-field ">
<div class="fui-field-container has-float"><label id="fields-formie-form-12608664269d637e180-e-mailadres-label" class="fui-label" for="fields-formie-form-12608664269d637e180-e-mailadres">E-mailadres <span
class="fui-required">*</span></label>
<div class="fui-input-container"><input type="email" id="fields-formie-form-12608664269d637e180-e-mailadres" class="fui-input" name="fields[eMailadres]" value="" placeholder="" autocomplete="email" required=""
data-fui-id="resident-card-asse-e-mailadres" data-fui-message="" aria-required="true"></div>
</div>
</div>
</div>
<div class="fui-row fui-page-row">
<div id="fields-formie-form-12608664269d637e180-straat-nummer-wrap"
class="fui-field fui-page-field fui-type-single-line-text fui-label-above-input fui-subfield-label-above-input fui-instructions-above-input fui-field-required fui-text-input-field ">
<div class="fui-field-container has-float"><label id="fields-formie-form-12608664269d637e180-straat-nummer-label" class="fui-label" for="fields-formie-form-12608664269d637e180-straat-nummer">Straat + nummer <span
class="fui-required">*</span></label>
<div class="fui-input-container"><input type="text" id="fields-formie-form-12608664269d637e180-straat-nummer" class="fui-input" name="fields[straatNummer]" value="" placeholder="" required=""
data-fui-id="resident-card-asse-straat-nummer" data-fui-message="" aria-required="true"></div>
</div>
</div>
</div>
<div class="fui-row fui-page-row">
<div id="fields-formie-form-12608664269d637e180-postcode-wrap"
class="fui-field fui-page-field fui-type-single-line-text fui-label-above-input fui-subfield-label-above-input fui-instructions-above-input fui-field-required fui-text-input-field ">
<div class="fui-field-container has-float"><label id="fields-formie-form-12608664269d637e180-postcode-label" class="fui-label" for="fields-formie-form-12608664269d637e180-postcode">Postcode <span class="fui-required">*</span></label>
<div class="fui-input-container"><input type="text" id="fields-formie-form-12608664269d637e180-postcode" class="fui-input" name="fields[postcode]" value="" placeholder="" required="" data-fui-id="resident-card-asse-postcode"
data-fui-message="" aria-required="true"></div>
</div>
</div>
<div id="fields-formie-form-12608664269d637e180-stad-wrap"
class="fui-field fui-page-field fui-type-single-line-text fui-label-above-input fui-subfield-label-above-input fui-instructions-above-input fui-field-required fui-text-input-field ">
<div class="fui-field-container has-float"><label id="fields-formie-form-12608664269d637e180-stad-label" class="fui-label" for="fields-formie-form-12608664269d637e180-stad">Stad <span class="fui-required">*</span></label>
<div class="fui-input-container"><input type="text" id="fields-formie-form-12608664269d637e180-stad" class="fui-input" name="fields[stad]" value="" placeholder="" required="" data-fui-id="resident-card-asse-stad" data-fui-message=""
aria-required="true"></div>
</div>
</div>
</div>
<div class="fui-row fui-page-row">
<div id="fields-formie-form-12608664269d637e180-nummerplaat-wrap"
class="fui-field fui-page-field fui-type-single-line-text fui-label-above-input fui-subfield-label-above-input fui-instructions-above-input fui-field-required fui-text-input-field ">
<div class="fui-field-container has-float"><label id="fields-formie-form-12608664269d637e180-nummerplaat-label" class="fui-label" for="fields-formie-form-12608664269d637e180-nummerplaat">Nummerplaat <span
class="fui-required">*</span></label>
<div class="fui-input-container"><input type="text" id="fields-formie-form-12608664269d637e180-nummerplaat" class="fui-input" name="fields[nummerplaat]" value="" placeholder="" required="" data-fui-id="resident-card-asse-nummerplaat"
data-fui-message="" aria-required="true"></div>
</div>
</div>
</div>
<div class="fui-row fui-page-row">
<div id="fields-formie-form-12608664269d637e180-boodschap-optioneel-wrap" class="fui-field fui-page-field fui-type-multi-line-text fui-label-above-input fui-subfield-label-above-input fui-instructions-above-input "
data-field-config="[{"module":"FormieTextLimit"}]">
<div class="fui-field-container has-float"><label id="fields-formie-form-12608664269d637e180-boodschap-optioneel-label" class="fui-label" for="fields-formie-form-12608664269d637e180-boodschap-optioneel">Boodschap (optioneel)</label>
<div class="fui-instructions">
<p>Maximum 600 tekens.</p>
</div>
<div class="fui-input-container"><textarea id="fields-formie-form-12608664269d637e180-boodschap-optioneel" class="fui-input" name="fields[boodschapOptioneel]" placeholder="" data-fui-id="resident-card-asse-boodschap-optioneel"
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