{"id":1032,"date":"2025-07-09T19:46:04","date_gmt":"2025-07-09T17:46:04","guid":{"rendered":"https:\/\/obronca.secretcats.pl\/en\/?page_id=1032"},"modified":"2025-07-22T12:19:49","modified_gmt":"2025-07-22T10:19:49","slug":"formularz-szkody-osobowej","status":"publish","type":"page","link":"https:\/\/obronca.eu\/en\/formularz-szkody-osobowej\/","title":{"rendered":"Formularz szkody osobowej"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1032\" class=\"elementor elementor-1032\" data-elementor-settings=\"{&quot;ha_cmc_init_switcher&quot;:&quot;no&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e3f79a4 e-flex e-con-boxed wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no e-con e-parent\" data-id=\"e3f79a4\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;slideshow&quot;,&quot;background_slideshow_gallery&quot;:[{&quot;id&quot;:1749,&quot;url&quot;:&quot;https:\\\/\\\/obronca.eu\\\/en\\\/wp-content\\\/uploads\\\/2025\\\/07\\\/slider-2-1.jpg&quot;}],&quot;background_slideshow_transition_duration&quot;:800,&quot;background_slideshow_ken_burns&quot;:&quot;yes&quot;,&quot;background_slideshow_loop&quot;:&quot;yes&quot;,&quot;background_slideshow_slide_duration&quot;:5000,&quot;background_slideshow_slide_transition&quot;:&quot;fade&quot;,&quot;background_slideshow_ken_burns_zoom_direction&quot;:&quot;in&quot;,&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-88056f9 e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no e-con e-child\" data-id=\"88056f9\" data-element_type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c13eb06 elementor-widget elementor-widget-heading\" data-id=\"c13eb06\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\"><b><strong>Legal and administrative assistance <\/strong><\/b> in the Netherlands<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0a35f3f elementor-widget elementor-widget-heading\" data-id=\"0a35f3f\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">\u00b7 Accident compensation \u00b7 Labour, civil, and family law \u00b7 Translations \u00b7 Meeting assistance<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-0609e0f e-flex e-con-boxed wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no e-con e-parent\" data-id=\"0609e0f\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-d645a88 e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no e-con e-child\" data-id=\"d645a88\" data-element_type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-43c3a45 elementor-widget elementor-widget-spacer\" data-id=\"43c3a45\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b56baa7 e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no e-con e-child\" data-id=\"b56baa7\" data-element_type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t<div class=\"elementor-element elementor-element-207baa8 e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no e-con e-child\" data-id=\"207baa8\" data-element_type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2fbb75a elementor-widget elementor-widget-heading\" data-id=\"2fbb75a\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Personal injury claim form<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-316c267 ha-has-bg-overlay elementor-widget elementor-widget-shortcode\" data-id=\"316c267\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f111-o1\" lang=\"pl-PL\" dir=\"ltr\" data-wpcf7-id=\"111\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/pages\/1032#wpcf7-f111-o1\" method=\"post\" class=\"wpcf7-form init wpcf7-acceptance-as-validation\" aria-label=\"Formularz kontaktowy\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"111\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"pl_PL\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f111-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_uacf7_hidden_conditional_fields\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<div class=\"uacf7-form-111  \"><h3 class=\"contact-headline\">Client data<\/h3>\n\n<div style=\"margin: 10px 0px !important;\">\n<label>1. Last name and first name: <span class=\"wpcf7-form-control-wrap\" data-name=\"imie-nazwisko\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"imie-nazwisko\" \/><\/span><\/label>\n<label>2. Date of birth: <span class=\"wpcf7-form-control-wrap\" data-name=\"data-urodzenia\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"data-urodzenia\" \/><\/span><\/label>\n<label>3. Address: <span class=\"wpcf7-form-control-wrap\" data-name=\"adres\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"adres\" \/><\/span><\/label>\n<label>4. Postal code and city: <span class=\"wpcf7-form-control-wrap\" data-name=\"kod-pocztowy-miejscowosc\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"kod-pocztowy-miejscowosc\" \/><\/span><\/label>\n<label>5. Are you registered in the Netherlands?: <span class=\"wpcf7-form-control-wrap\" data-name=\"zameldowany-w-holandii\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"zameldowany-w-holandii\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span><\/label>\n<label>6. Phone number: <span class=\"wpcf7-form-control-wrap\" data-name=\"numer-telefonu\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"numer-telefonu\" \/><\/span><\/label>\n<label>7. Email address: <span class=\"wpcf7-form-control-wrap\" data-name=\"email-44\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" autocomplete=\"email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email-44\" \/><\/span><\/label>\n<label>8. BSN number (identification number in the Netherlands):   <span class=\"wpcf7-form-control-wrap\" data-name=\"numerbsn\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"numerbsn\" \/><\/span><\/label>\n<label>9. Marital status: <span class=\"wpcf7-form-control-wrap\" data-name=\"stan-cywilny\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"stan-cywilny\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Bachelor\">Bachelor<\/option><option value=\"Single woman\">Single woman<\/option><option value=\"Married\">Married<\/option><option value=\"Married\">Married<\/option><option value=\"Cohabiting\">Cohabiting<\/option><\/select><\/span><\/label>\n<label>10. Children (under 18 years old): <span class=\"wpcf7-form-control-wrap\" data-name=\"dzieci\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"dzieci\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span><\/label>\n<\/div>\n\n<h3 class=\"contact-headline\">Accident details<\/h3>\n<div style=\"margin: 10px 0px !important;\">\n\n<label>11. Type of accident: <span class=\"wpcf7-form-control-wrap\" data-name=\"rodzaj-wypadku\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"rodzaj-wypadku\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Workplace accident\">Workplace accident<\/option><option value=\"Road accident\">Road accident<\/option><\/select><\/span> <\/label>\n<div class=\"uacf7_conditional rodzaj-wypadku-wypadek-na-drodze\">\n<label>11a. As: <span class=\"wpcf7-form-control-wrap\" data-name=\"wypadek-na-drodze\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"wypadek-na-drodze\"><option value=\"Driver\">Driver<\/option><option value=\"Passenger\">Passenger<\/option><option value=\"Pedestrian\">Pedestrian<\/option><option value=\"Cyclist\">Cyclist<\/option><option value=\"Motorcyclist\">Motorcyclist<\/option><\/select><\/span> <\/label>\n<\/div>\n\n\n<label>12. Date of accident: <span class=\"wpcf7-form-control-wrap\" data-name=\"data-wypadku\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"data-wypadku\" \/><\/span> <\/label>\n<label>13. Location: <span class=\"wpcf7-form-control-wrap\" data-name=\"miejsce\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"miejsce\" \/><\/span> <\/label>\n<label>14. Circumstances of the accident: <span class=\"wpcf7-form-control-wrap\" data-name=\"okolicznosci-wypadku\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"okolicznosci-wypadku\" \/><\/span> <\/label>\n<label>15. Type of injuries: <span class=\"wpcf7-form-control-wrap\" data-name=\"rodzaj-obrazen\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"rodzaj-obrazen\" \/><\/span> <\/label>\n<label>16. Witnesses: <span class=\"wpcf7-form-control-wrap\" data-name=\"swiadkowie\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"swiadkowie\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span> <\/label>\n<label>17. Has the accident been reported?: <span class=\"wpcf7-form-control-wrap\" data-name=\"wypadek-zgloszony\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"wypadek-zgloszony\" \/><\/span> <\/label>\n<label>18. Ambulance transport: <span class=\"wpcf7-form-control-wrap\" data-name=\"transport-karetka-tak-nie\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"transport-karetka-tak-nie\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span><\/label>\n<div class=\"uacf7_conditional transportkaretka\">\n<label>18a. From... to: <span class=\"wpcf7-form-control-wrap\" data-name=\"transport-karetka-od-do\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"transport-karetka-od-do\" \/><\/span> <\/label>\n<\/div>\n<label>19. Hospitalizacja: <span class=\"wpcf7-form-control-wrap\" data-name=\"hospitalizacja-tak-nie\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"hospitalizacja-tak-nie\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span><\/label>\n<div class=\"uacf7_conditional hospitalizacja\">\n<label>19a. Where: <span class=\"wpcf7-form-control-wrap\" data-name=\"gdzie-hospitalizacja\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"gdzie-hospitalizacja\" \/><\/span> <\/label>\n<\/div>\n<\/div>\n\n<h3 class=\"contact-headline\">Course of treatment and therapies applied<\/h3>\n<div style=\"margin: 10px 0px !important;\">\n<label>20. Family doctor: <span class=\"wpcf7-form-control-wrap\" data-name=\"lekarz-rodzinny\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"lekarz-rodzinny\" \/><\/span> <\/label>\n<label>21. Physiotherapist: <span class=\"wpcf7-form-control-wrap\" data-name=\"fizjoterapeuta\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"fizjoterapeuta\" \/><\/span> <\/label>\n<label>22. Specialists: <span class=\"wpcf7-form-control-wrap\" data-name=\"specjalisci\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"specjalisci\" \/><\/span> <\/label>\n<label>23. Description of treatment: <span class=\"wpcf7-form-control-wrap\" data-name=\"opis-leczenia\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"opis-leczenia\" \/><\/span> <\/label>\n<\/div>\n<h3 class=\"contact-headline\">Current complaints and limitations<\/h3>\n<div style=\"margin: 10px 0px!important;\">\n<label>24. Description of current complaints: <span class=\"wpcf7-form-control-wrap\" data-name=\"opis-aktualnych-dolegliwosci\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"opis-aktualnych-dolegliwosci\" \/><\/span> <\/label>\n<\/div>\n\n<h3 class=\"contact-headline\">Employment details<\/h3>\n<div style=\"margin: 10px 0px !important;\">\n<label>25. Employer:  <span class=\"wpcf7-form-control-wrap\" data-name=\"pracodawca\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"pracodawca\" \/><\/span>  <\/label>\n<label>26. Self-employed:    <span class=\"wpcf7-form-control-wrap\" data-name=\"dzialalnoscnawlasnyrachunek\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"dzialalnoscnawlasnyrachunek\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span><\/label>\n<label>27. Employment through an agency:  <span class=\"wpcf7-form-control-wrap\" data-name=\"zatrudnienie-przez-agencje\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"zatrudnienie-przez-agencje\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span> <\/label>\n<\/div>\n\n<h3 class=\"contact-headline\">Losses related to the damage<\/h3>\n<div style=\"margin: 10px 0px !important;\">\n<label>28. Loss of work capacity:    <span class=\"wpcf7-form-control-wrap\" data-name=\"utratazdol\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"utratazdol\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span><\/label>\n<\/div>\n\n<h3 class=\"contact-headline\">Additional information<\/h3>\n<div style=\"margin: 10px !important;\">\n<label>29. Health insurance:   <span class=\"wpcf7-form-control-wrap\" data-name=\"ubezpieczeniezdrowotne\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"ubezpieczeniezdrowotne\" \/><\/span><\/label>\n<label>30. Passenger insurance (if applicable):   <span class=\"wpcf7-form-control-wrap\" data-name=\"ubezpieczeniepasazerow\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"ubezpieczeniepasazerow\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span><\/label>\n<label>31. Legal protection insurance:   <span class=\"wpcf7-form-control-wrap\" data-name=\"ubezpieczenieochronyprawnej\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"ubezpieczenieochronyprawnej\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span><\/label>\n<\/div>\n\n<h3 class=\"contact-headline\">Information about the opposing party<\/h3>\n<div style=\"margin: 10px 0px!important;\">\n<label>32. Company name or name of the offender: <span class=\"wpcf7-form-control-wrap\" data-name=\"nazwafirmynazwiskosprawcy\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nazwafirmynazwiskosprawcy\" \/><\/span><\/label>\n<label>33. Offender\u2019s address: <span class=\"wpcf7-form-control-wrap\" data-name=\"adressprawcy\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"adressprawcy\" \/><\/span><\/label>\n<label>34. City: <span class=\"wpcf7-form-control-wrap\" data-name=\"miejscowosc\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"miejscowosc\" \/><\/span><\/label>\n<\/div>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"acceptance-689\"><span class=\"wpcf7-form-control wpcf7-acceptance optional\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-689\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">I consent to the processing of my personal data by the website administrator: Obronca.eu B.V, Zuidwenk 80 M, 3751 CG Bunschoten Spakenburg, The Netherlands, for the purpose of being contacted by the company. Detailed information about the processing of personal data can be found in the  <a href=\"https:\/\/obronca.eu\/polityka-prywatnosci\/\">Privacy Policy.<\/a><\/span><\/label><\/span><\/span><\/span>\n<input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/><\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Legal and administrative assistance in the Netherlands \u00b7 Accident compensation \u00b7 Labour, civil, and family law \u00b7 Translations \u00b7 Meeting assistance Personal injury claim form<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-1032","page","type-page","status-publish","hentry"],"aioseo_notices":[],"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"admin","author_link":"https:\/\/obronca.eu\/en\/blog\/author\/admin\/"},"rttpg_comment":0,"rttpg_category":null,"rttpg_excerpt":"Legal and administrative assistance in the Netherlands \u00b7 Accident compensation \u00b7 Labour, civil, and family law \u00b7 Translations \u00b7 Meeting assistance Personal injury claim form","_links":{"self":[{"href":"https:\/\/obronca.eu\/en\/wp-json\/wp\/v2\/pages\/1032","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/obronca.eu\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/obronca.eu\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/obronca.eu\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/obronca.eu\/en\/wp-json\/wp\/v2\/comments?post=1032"}],"version-history":[{"count":49,"href":"https:\/\/obronca.eu\/en\/wp-json\/wp\/v2\/pages\/1032\/revisions"}],"predecessor-version":[{"id":2618,"href":"https:\/\/obronca.eu\/en\/wp-json\/wp\/v2\/pages\/1032\/revisions\/2618"}],"wp:attachment":[{"href":"https:\/\/obronca.eu\/en\/wp-json\/wp\/v2\/media?parent=1032"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}