<div class="{{ class is defined ? class }}">
<p class="c4">
<span class="c1"></span>
</p>
<p class="c4">
<span class="c1"></span>
</p>
<p class="c4">
<span class="c1"></span>
</p>
<p class="c4">
<span class="c1"></span>
</p>
<p>Fait à Paris {{ "now"|format_date('long', locale='fr') }},</p>
<p class="c4">
<span class="c1"></span>
</p>
<p class="c4">
<span class="c1"></span>
</p>
<table>
<tr>
<td>
Le DOMICILIATAIRE
</td>
<td>
Le DOMICILIÉ
</td>
</tr>
<tr style="height: 170px;">
<td class="block-signature">
<div>
{{ '{{s1|mention|Lu et approuvé}}' }}
</div>
<div>
{{ '{{s1|signature|160|80}}' }}
</div>
</td>
<td class="block-signature">
<div>
{{ '{{s2|mention|Lu et approuvé}}' }}
</div>
<div>
{{ '{{s2|signature|160|80}}' }}
</div>
</td>
</tr>
<tr>
<td>Au nom et pour le compte de KOAH</td>
<td>
Au nom et pour le compte de
<span class="uppercase">{{ organization.legalName }}</span>
</td>
</tr>
</table>
</div>