{"id":15060,"date":"2022-11-11T17:00:46","date_gmt":"2022-11-11T16:00:46","guid":{"rendered":"https:\/\/www.checkstar-techblog.it\/?page_id=15060"},"modified":"2025-11-04T09:29:01","modified_gmt":"2025-11-04T08:29:01","slug":"request-for-intervention-instrument-diagnosis-form-2","status":"publish","type":"page","link":"https:\/\/www.checkstar-techblog.it\/en\/forms\/request-for-intervention-instrument-diagnosis-form-2\/","title":{"rendered":"Intervention Request Form Diagnosis Tool"},"content":{"rendered":"<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_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_5' style='display:none'>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>\"<span class=\"gfield_required gfield_required_asterisk\">*<\/span>\"indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_5'  action='\/en\/wp-json\/wp\/v2\/pages\/15060' data-formid='5' novalidate data-trp-original-action=\"\/en\/wp-json\/wp\/v2\/pages\/15060\"> \r\n <input type='hidden' class='gforms-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/>\n                        <div class='gform-body gform_body'><div id='gform_fields_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_5_1\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_1\" ><label class='gfield_label gform-field-label' for='input_5_1'>Workshop name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_5_1' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_5_6\" class=\"gfield gfield--type-text gfield--width-third gf_readonly gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_6\" ><label class='gfield_label gform-field-label' for='input_5_6'>Login<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_5_6' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_5_3\" class=\"gfield gfield--type-text gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_3\" ><label class='gfield_label gform-field-label' for='input_5_3'>MM Code<\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_5_3' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_5_4\" class=\"gfield gfield--type-text gfield--width-two-thirds field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_4\" ><label class='gfield_label gform-field-label' for='input_5_4'>Reference Spare Parts Dealer<\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_5_4' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_5_20\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_20\" ><label class='gfield_label gform-field-label' for='input_5_20'>Date of intervention<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_20' id='input_5_20' type='text' value='' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon'   placeholder='dd\/mm\/yyyy' aria-describedby=\"input_5_20_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_5_20_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_5_20' class='gform_hidden' value='https:\/\/www.checkstar-techblog.it\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_5_8\" class=\"gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_8\" ><label class='gfield_label gform-field-label' for='input_5_8'>Contact person for the request<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_5_8' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_5_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_23\" ><legend class='gfield_label gform-field-label' >Place of reference<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_23'>\n\t\t\t<div class='gchoice gchoice_5_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Presso Officina'  id='choice_5_23_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_23_0' id='label_5_23_0' class='gform-field-label gform-field-label--type-inline'>At the Workshop<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Presso Ricambista'  id='choice_5_23_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_23_1' id='label_5_23_1' class='gform-field-label gform-field-label--type-inline'>At Spare Parts Dealers<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_5_19\" class=\"gfield gfield--type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_19\" ><label class='gfield_label gform-field-label' for='input_5_19'>Email for confirmation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_19' id='input_5_19' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_5_18\" class=\"gfield gfield--type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_18\" ><label class='gfield_label gform-field-label' for='input_5_18'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_18' id='input_5_18' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_5_7\" class=\"gfield gfield--type-address gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_7\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Product delivery address<\/legend><div class='gfield_description' id='gfield_description_5_7'>Requested as an alternative to workshop<\/div>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip ginput_container_address gform-grid-row' id='input_5_7' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_5_7_1_container' >\n                                        <input type='text' name='input_7.1' id='input_5_7_1' value=''    aria-required='false'    \/>\n                                        <label for='input_5_7_1' id='input_5_7_1_label' class='gform-field-label gform-field-label--type-sub'>Street Address<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_5_7_3_container' >\n                                    <input type='text' name='input_7.3' id='input_5_7_3' value=''    aria-required='false'    \/>\n                                    <label for='input_5_7_3' id='input_5_7_3_label' class='gform-field-label gform-field-label--type-sub'>City<\/label>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_7.4' id='input_5_7_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_5_7_5_container' >\n                                    <input type='text' name='input_7.5' id='input_5_7_5' value=''    aria-required='false'    \/>\n                                    <label for='input_5_7_5' id='input_5_7_5_label' class='gform-field-label gform-field-label--type-sub'>ZIP \/ Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_7.6' id='input_5_7_6' value='Italia' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_5_36\" class=\"gfield gfield--type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_36\" ><label class='gfield_label gform-field-label' for='input_5_36'>Service Area Manager<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_36' id='input_5_36' class='large gfield_select'  aria-describedby=\"gfield_description_5_36\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select a Service Area Manager<\/option><option value='Donadio Raffaele' >Donadio Raffaele<\/option><option value='D&#039;Onofrio Giovanni' >D'Onofrio Giovanni<\/option><option value='Falcicchio Gianluca' >Falcicchio Gianluca<\/option><option value='Garagozzo Andrea' >Garagozzo Andrea<\/option><option value='Garbin Marco' >Garbin Marco<\/option><option value='Mancini Mirko' >Mancini Mirko<\/option><option value='Novara Giorgio' >Novara Giorgio<\/option><option value='Scognamiglio Luca' >Scognamiglio Luca<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_5_36'>This form will also be sent to the e-mail address of the selected SAM<\/div><\/div><div id=\"field_5_10\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_10\" ><hr style=\"color: var(--bs-blue);\">\n<h5>Repair work is required for the following Diagnosis Tool:<\/h5><\/div><div id=\"field_5_26\" class=\"gfield gfield--type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_26\" ><label class='gfield_label gform-field-label' for='input_5_26'>Diagnostic tool<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_26' id='input_5_26' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choose tool<\/option><option value='DIV.0' >DIV.0<\/option><option value='DATA BOX' >DATA BOX<\/option><option value='DATA PLUS' >DATA PLUS<\/option><option value='FLEX' >FLEX<\/option><option value='LOGIC' >LOGIC<\/option><option value='SECURITY PASS' >SECURITY PASS<\/option><option value='VISION' >VISION<\/option><option value='VISION PRO' >VISION PRO<\/option><option value='VISUAL PLUS' >VISUAL PLUS<\/option><\/select><\/div><\/div><div id=\"field_5_27\" class=\"gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_27\" ><label class='gfield_label gform-field-label' for='input_5_27'>SN<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_27' id='input_5_27' type='text' value='' class='large'    placeholder='Serial number' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_5_28\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_28\" ><legend class='gfield_label gform-field-label' >Warranty<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_28'>\n\t\t\t<div class='gchoice gchoice_5_28_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='IN GARANZIA (allegare alla richiesta il documento di acquisto e\/o fattura di vendita)'  id='choice_5_28_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_28_0' id='label_5_28_0' class='gform-field-label gform-field-label--type-inline'>IN WARRANTY (attach purchase document and\/or sales invoice to request)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_28_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='FUORI GARANZIA (la garanzia di 24 mesi decorre dalla data di attivazione del prodotto)'  id='choice_5_28_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_28_1' id='label_5_28_1' class='gform-field-label gform-field-label--type-inline'>OUT OF WARRANTY (the 24-month warranty runs from the date of activation of the product)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_5_21\" class=\"gfield gfield--type-fileupload gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_21\" ><label class='gfield_label gform-field-label' for='gform_browse_button_5_21'>Attachments<\/label><div class='gfield_description' id='gfield_description_5_21'>Upload purchase document and\/or sales invoice here<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_5_21' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_5_21&quot;,&quot;container&quot;:&quot;gform_multifile_upload_5_21&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_5_21&quot;,&quot;filelist&quot;:&quot;gform_preview_5_21&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.checkstar-techblog.it\\\/?gf_page=1c2a1e5744daff5&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.checkstar-techblog.it\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.checkstar-techblog.it\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;doc,jpeg,jpg,pdf,png,rar,zip,xls,xlsx&quot;}],&quot;max_file_size&quot;:&quot;67108864b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:5,&quot;field_id&quot;:21},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_5_21&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_5_21' 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'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_5_21' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_5_21 gfield_description_5_21\"  >Select files<\/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_5_21'>Accepted file types: doc, jpeg, jpg, pdf, png, rar, zip, xls, xlsx, Max. file size: 64 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_5_21'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_5_21' class='ginput_preview_list'><\/div><\/div><fieldset id=\"field_5_30\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_30\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Type of fault<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_5_30'><div class='gchoice gchoice_5_30_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.1' type='checkbox'  value='Errore di comunicazione durante aggiornamento'  id='choice_5_30_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_30_1' id='label_5_30_1' class='gform-field-label gform-field-label--type-inline'>Communication error during update<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_30_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.2' type='checkbox'  value='Display oscurato all\u2019accensione o rotto'  id='choice_5_30_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_30_2' id='label_5_30_2' class='gform-field-label gform-field-label--type-inline'>Display obscured when switching on or broken<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_30_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.3' type='checkbox'  value='Non entra in diagnosi su nessuna vettura'  id='choice_5_30_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_30_3' id='label_5_30_3' class='gform-field-label gform-field-label--type-inline'>Does not enter into diagnosis on any car<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_30_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.4' type='checkbox'  value='Non entra in diagnosi su'  id='choice_5_30_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_30_4' id='label_5_30_4' class='gform-field-label gform-field-label--type-inline'>Does not enter into diagnosis on<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_30_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.5' type='checkbox'  value='LED di comunicazione spento'  id='choice_5_30_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_30_5' id='label_5_30_5' class='gform-field-label gform-field-label--type-inline'>Communication LED off<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_30_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.6' type='checkbox'  value='Altro'  id='choice_5_30_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_30_6' id='label_5_30_6' class='gform-field-label gform-field-label--type-inline'>More<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_5_31\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_31\" ><label class='gfield_label gform-field-label' for='input_5_31'>Error Message<\/label><div class='ginput_container ginput_container_text'><input name='input_31' id='input_5_31' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_5_33\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_33\" ><label class='gfield_label gform-field-label' for='input_5_33'>Vehicle specification<\/label><div class='ginput_container ginput_container_text'><input name='input_33' id='input_5_33' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_5_34\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_34\" ><label class='gfield_label gform-field-label' for='input_5_34'>Specify other anomaly<\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_5_34' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_5_37\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_37\" ><label class='gfield_label gform-field-label' for='input_5_37'>Additional notes<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_37' id='input_5_37' class='textarea small'    placeholder='Specify special conditions here (different prices, deferments, etc.).'  aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_11\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_11\" ><hr style=\"color: var(--bs-blue);\"><\/div><div id=\"field_5_35\" class=\"gfield gfield--type-html gfield--width-quarter gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_35\" ><label class=\"gfield_label\" >Date<\/label><br>25\/06\/2026<\/div><div id=\"field_5_17\" class=\"gfield gfield--type-text gfield--width-five-twelfths gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_17\" ><label class='gfield_label gform-field-label' for='input_5_17'>Place<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_5_17' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_5_9\" class=\"gfield gfield--type-consent gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_5_9\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Consent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_9.1' id='input_5_9_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_5_9\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_5_9_1' >I have read and agree to the site's Privacy Policy.<\/label><input type='hidden' name='input_9.2' value='Ho letto e sottoscrivo la Privacy Policy del sito.' class='gform_hidden' \/><input type='hidden' name='input_9.3' value='2' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_5_9'>Marelli Aftermarket Italy S.p.A., owner of the processing of your personal data, pursuant to art. 13 Legislative Decree 30.06.2003 no. 196 (privacy code) informs you that the personal data provided during contractual, commercial and promotional relations are subject to computer or paper processing for legal obligations for the purposes of market analysis and statistics. 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