4359
| ID | 4359 |
|---|
| Data | 2017-08-30 |
|---|
| Symbol | 2017/08/30/4359 |
|---|
| Instytucja | Ministerstwo Spraw Wewnętrznych i Administracji |
|---|
| Nazwa | ZGŁOSZENIE UTRATY LUB USZKODZENIA DOWODU OSOBISTEGO |
|---|
| Czy Aktualny | 0 |
|---|
Ustawy (1)
Pliki
Styl
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<xsl:template match="/">
<xsl:apply-templates select="wnio:Dokument"/>
</xsl:template>
<xsl:template match="wnio:Dokument">
<xsl:param name="nadawca" select="wnio:DaneDokumentu/str:Nadawcy/meta:Podmiot/oso:Osoba"/>
<xsl:param name="tresc" select="wnio:TrescDokumentu"/>
<xsl:param name="zalaczniki" select="wnio:TrescDokumentu/str:Zalaczniki"/>
<html lang="pl">
<head>
<meta name="viewport" content="width=device-width, initial-scale=1"/>
<title>Formularz zgłoszenia utraty lub uszkodzenia dowodu osobistego</title>
<style type="text/css">
/* clear for div reset */
.clear { clear: both !important; height: 0 !important; min-height: 0 !important; line-height: 0 !important; border: 0 !important; width: 100% !important; margin: 0 !important; }
.margin-page {margin: 5%;}
/* reset for all */
html, body, div, span, applet, object, iframe,
h1, h2, h3, h4, h5, h6, p, blockquote, pre,
a, abbr, acronym, address, big, cite, code,
del, dfn, em, img, ins, kbd, q, s, samp,
small, strike, strong, sub, sup, tt, var,
b, u, i, center,
dl, dt, dd, ol, ul, li,
fieldset, form, label, legend,
table, caption, tbody, tfoot, thead, tr, th, td,
article, aside, canvas, details, embed,
figure, figcaption, footer, header, hgroup,
menu, nav, output, ruby, section, summary,
time, mark, audio, video {
margin: 0;
padding: 0;
border: 0;
font-size: 100%;
font: inherit;
vertical-align: baseline;
}
/* HTML5 display-role reset for older browsers */
article, aside, details, figcaption, figure,
footer, header, hgroup, menu, nav, section {
display: block;
}
body {
line-height: 1;
}
ol, ul {
list-style: none;
}
blockquote, q {
quotes: none;
}
blockquote:before, blockquote:after,
q:before, q:after {
content: '';
content: none;
}
table {
border-collapse: collapse;
border-spacing: 0;
}
/* -------------------- end of css reset -------------------- */
body {
font-family: Arial, Helvetica, sans-serif;
background-color: #fff !important;
font-size: 10pt;
color: #000;
margin-left: 0;
margin-right: 0;
margin-top: 1cm;
margin-bottom: 1cm;
}
/* -------------------- headers -------------------- */
h1 {
font-size: 14pt;
font-weight: bold;
padding-bottom: 3pt;
border-bottom: 3pt solid #000;
}
h2 {
font-size: 12pt;
font-weight: bold;
padding-bottom: 2pt;
border-bottom: 2pt solid #000;
margin-bottom: 10pt;
margin-top: 20pt;
}
h3 {
font-size: 12pt;
font-weight: bold;
padding-bottom: 2pt;
border-bottom: 2pt solid #000;
margin-top: 10pt;
}
h4 {
font-weight: bold;
padding-bottom: 2pt;
border-bottom: 2pt solid #000;
}
/* -------------------- acapits -------------------- */
p.p1 { /* kursywa informacyjna pod nagłówkami h1 i h2 */
font-style: italic;
margin-top: 10pt;
text-align: left;
line-height: 18pt;
}
p.p2 { /* Górny tekst oświadczenia w pkt.6 */
margin-top: 10pt;
margin-bottom: 20pt;
text-align: left;
}
p.p3 { /* Dolny tekst oświadczenia w pkt.6 */
font-style: italic;
margin-top: 10pt;
margin-bottom: 20pt;
text-align: left;
}
p.p4 { /* Tekst przed drugim rzędem divów (textarea) w kolumnie td */
/* Numer lokalu */
margin-left: 5px;
margin-right: 10px;
}
p.p5 { /* Rzeczpospolita */
padding-top: 17px;
font-size: 14pt;
display:table-cell;
vertical-align:middle;
margin-top: 8px;
}
p.p6 { /* Polska */
padding-top: 4px;
font-size: 14pt;
}
p.p7 { /* Polska */
font-weight: bold;
display:table-cell;
vertical-align:middle;
font-size: 14pt;
}
/* -------------------- spans -------------------- */
span.bold { /* pogrubienie; występowanie: p.p1 , p.p2 */
font-weight: bold;
}
/* -------------------- tables -------------------- */
table.personal_data { /* height set in each table */
background-color: #fff;
width: 100%;
margin-bottom: 10pt;
}
/* -------------------- columns -------------------- */
table.personal_data col#left {
width: 120pt;
}
table.personal_data th { /* left column */
text-align: right;
padding-left: 15px;
padding-right: 15px;
padding-top: 15px;
padding-bottom: 5px;
vertical-align: top;
}
table.personal_data td { /* rigt column */
text-align: left;
padding-left: 15px;
padding-right: 15px;
padding-top: 5px;
padding-bottom: 5px;
vertical-align: top;
}
/* -------------------- divs -------------------- */
div.topright_corner {
width: 300px;
height: 45px;
border: 3pt solid #000;
top: 0;
right: 0;
margin: 0;
display: table;
text-align: center;
}
div.grey {
width: 300px;
height: 45px;
border: 3pt solid #dcdcdc;
top: 53px;
right: 0;
margin: 0;
display: table;
text-align: center;
background-color: #dcdcdc;
}
div.info {
margin-top: -2px;
font-style: italic;
font-size: 9pt;
}
div.info_kratka {
display: block;
margin-top: 2px;
font-style: italic;
font-size: 9pt;
}
div.icon {
width: 15px;
height: 15px;
text-align: center;
font-style: italic;
background: #fff;
border: 1px solid #000;
border-radius: 500px;
display: inline-block;
}
div.icon p {
padding-top: 2px;
padding-right: 1px;
}
/* -------------------- divs on right column -------------------- */
/* table #1 */
div.posredni {
float: right;
display: inline-block;
padding-top: 10px;
}
div.full { /* numer pesel */
word-wrap:break-word;
padding: 10px;
border: 1px solid #000;
word-break: break-all;
}
div.pesel { /* numer pesel */
word-wrap:break-word;
width: 35%;
border: 1px solid #000;
padding: 10px;
}
div.name { /* imię (imiona) - w dwóch miejscach */
word-wrap:break-word;
border: 1px solid #000;
padding: 10px;
}
div.surname { /* nazwisko - w dwóch miejscach */
word-wrap:break-word;
border: 1px solid #000;
padding: 10px;
}
div.family_name { /* nazwisko rodowe */
word-wrap:break-word;
border: 1px solid #000;
padding: 10px;
}
div.birthday { /* data urodzenia */
word-wrap:break-word;
width: 35%;
border: 1px solid #000;
padding: 10px;
}
div.birth_place { /* miejse urodzenia */
word-wrap:break-word;
border: 1px solid #000;
padding: 10px;
}
div.nationality { /* obywatelstwo */
word-wrap:break-word;
border: 1px solid #000;
padding: 10px;
}
div.father_name { /* imię ojca */
word-wrap:break-word;
border: 1px solid #000;
padding: 10px;
}
div.mother_name { /* imię matki */
word-wrap:break-word;
border: 1px solid #000;
padding: 10px;
}
div.mother_familyname { /* nazwisko rodowe matki */
word-wrap:break-word;
border: 1px solid #000;
padding: 10px;
}
/* table #2 */
div.street { /* ulica */
word-wrap:break-word;
border: 1px solid #000;
padding: 10px;
}
div.home_number { /* numer domu */
word-wrap:break-word;
width: 35%;
border: 1px solid #000;
padding: 10px;
/* margin-right: 50px; */
display: inline-block;
}
div.local_number { /* numer localu */
word-wrap:break-word;
border: 0px solid #000;
display: inline-block;
float: right;
}
table.dom-lokal {
width: 100%;
}
table.dom-lokal td {
padding-left: 0;
padding-right: 0;
padding-top: 0;
}
table.dom-lokal td .kratka {
min-width: 16px;
max-width: 18px;
padding-right: 4px;
}
.nr-lokal-label {
float: left;
padding-top: 9px;
margin-left: 12px;
}
div.post_code { /* kod pocztowy */
word-wrap:break-word;
width: 35%;
border: 1px solid #000;
padding: 10px;
display: inline-block;
}
div.id { /* nazwisko - w dwóch miejscach */
word-wrap:break-word;
border: 1px solid #000;
padding: 10px;
}
div.city { /* miejscowość */
word-wrap:break-word;
min-width: 220px;
border: 1px solid #000;
padding: 10px;
display: inline-block;
}
div.electronic_address { /* numer telefonu */
word-wrap:break-word;
border: 1px solid #000;
padding: 10px;
}
div.phone_number { /* numer telefonu */
word-wrap:break-word;
width: 400px;
border: 1px solid #000;
padding: 10px;
}
div.email { /* e-mail */
word-wrap:break-word;
border: 1px solid #000;
padding: 10px;
}
div.kratka {
word-wrap:break-word;
width: 23px;
border: 1px solid #000;
padding-top: 10px;
padding-bottom: 10px;
padding-left: 0px;
padding-right: 6px;
display: inline-block;
text-align: center;
}
div.kratka_kreska {
word-wrap:break-word;
width: 15px;
border: 0px solid #000;
padding-top: 10px;
padding-bottom: 10px;
padding-left: 2px;
padding-right: 4px;
display: inline-block;
text-align: center;
}
div.kratka.right {
word-wrap:break-word;
width: 15px;
border: 1px solid #000;
padding-top: 10px;
padding-bottom: 10px;
padding-left: 0px;
padding-right: 7px;
display: inline-block;
float: right;
}
div.other { /* miejscowość */
word-wrap:break-word;
vertical-align: top;
width: 80%;
border: 1px solid #000;
padding: 10px;
margin-top: 5px;
margin-left: 5px;
margin-bottom: 20px;
float: right;
display: inline-block;
}
/* -------------------- checkbox -------------------- */
input.checkbox {
width: 15px;
height: 16px;
}
/* -------------------- images -------------------- */
img.eagle{
width: 70px;
height: 70px;
margin-bottom: 40px;
margin-right: 5px;
float: left;
}
.sr-only {
position: absolute;
width: 1px;
height: 1px;
margin: -1px;
padding: 0;
overflow: hidden;
clip: rect(0, 0, 0, 0);
border: 0; }
.col-1 {
width: 100%;
margin: 4pt;
}
.col-2-l{
width:12%;
display: inline-block;
text-align: right;
margin: 4pt;
vertical-align: middle;
margin-right: 10pt;
}
.col-2-r{
width:85%;
display: inline-block;
text-align: left;
margin: 4pt;
vertical-align: middle;
}
.col-4-l-1{
width:12%;
display: inline-block;
text-align: right;
margin: 4pt;
vertical-align: middle;
margin-right: 10pt;
}
.col-4-l-2{
width:32%;
display: inline-block;
text-align: left;
margin: 4pt;
vertical-align: middle;
margin-right: 10pt;
}
.col-4-r-1{
width:12%;
display: inline-block;
text-align: right;
margin: 4pt;
vertical-align: middle;
margin-right: 10pt;
}
.col-4-r-2{
width:39%;
display: inline-block;
text-align: right;
margin: 4pt;
vertical-align: middle;
margin-right: 10pt;
}
.in-block{
display: inline-block;
}
.full_border{
border: 1px solid black; word-wrap: break-word; padding: 10px;
}
.float-r{
float: right;
}
* {
-webkit-box-sizing: border-box;
-moz-box-sizing: border-box;
box-sizing: border-box;
}
div {
margin-top: 4px;
}
@media screen and (max-width: 650px) {
.col-2-l{
width:100%;
display:block;
text-align: left;
margin-top: 2%;
line-height: 200%;
}
.col-2-r{
width:100%;
display:block;
text-align: left;
margin-bottom: 6%;
line-height: 200%;
}
p.p1, p.p2, p.p3 {margin-left: 1%;}
div.icon {
height: 20px;
width: 15px;
}
.in-block{
display: block;
}
div.info{
margin-top: -10px;
}
.float-r{
float: left;
}
}
@media screen and (min-width: 651px) and (max-width: 1024px) {
.col-2-l{
max-width:28%;
display:inline-block;
text-align: right;
margin: 1%;
vertical-align: text-top;
}
.col-2-r{
max-width:70%;
display:inline-block;
text-align: left;
margin: 1%;
vertical-align: text-top;
}
}
@media print{
.col-2-l{
width:100%;
display:block;
text-align: left;
margin-top: 2%;
line-height: 200%;
}
.col-2-r{
width:100%;
display:block;
text-align: left;
margin-bottom: 6%;
line-height: 200%;
}
p.p1, p.p2, p.p3 {margin-left: 1%;}
div.icon {
height: 20px;
width: 15px;
}
.in-block{
display: block;
}
}
</style>
</head>
<body>
<div class="page1 margin-page">
<div>
<div class="col-2-l" style="text-align: left;">
<!-- image converted to code -->
<img class="eagle" style="page-break-before: always;" 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" alt="Godło Polski"/>
<p class="p5">Rzeczpospolita</p>
<p class="p6">Polska</p></div>
<div class="col-2-r" style="width: auto; float: right">
<div class="topright_corner"><p class="p7">DO/F/2e</p></div>
<div class="grey"> </div>
</div>
<div class="clear"/></div>
<br/>
<br/><div>
<div class="col-1-l"><h1>Formularz zgłoszenia utraty lub uszkodzenia dowodu osobistego</h1></div>
</div>
<div class="col-2-l"/><div class="col-2-r"><p class="p1">Uwaga! To jest formularz elektroniczny. Nie drukuj go. Wyślij przez Internet.</p></div>
<div class="col-1"><h2>1. Dane posiadacza utraconego lub uszkodzonego dowodu</h2></div>
<div class="personal_data" style="border-spacing: 20px; border-collapse: separate;">
<div>
<div class="col-2-l">Imię (imiona)</div>
<div class="col-2-r"><div class="full"><xsl:value-of select="$tresc/wnio:Imie"/> </div></div>
</div>
<div>
<div class="col-2-l">Nazwisko</div>
<div class="col-2-r"><div class="full"><xsl:value-of select="$tresc/wnio:Nazwisko"/> </div></div>
</div>
<div>
<div class="col-2-l"><p>Nazwisko rodowe</p></div>
<div class="col-2-r"><div class="full"><xsl:value-of select="$tresc/wnio:NazwiskoRodowe"/> </div></div>
<div class="col-2-l"/><div class="info col-2-r">
<div class="icon"><p>i</p></div><div class="sr-only">Dodatkowa informacja o nazwisku rodowym</div>
Podają je zarówno kobiety, jak i mężczyźni.</div>
</div>
<div>
<div class="col-2-l"><p>Data urodzenia</p></div>
<div class="col-2-r"><div class="kratka"> <xsl:value-of select="substring($tresc/wnio:DataUrodzenia, 9, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc/wnio:DataUrodzenia, 10, 1)"/></div>
<div class="kratka_kreska">-</div>
<div class="kratka"> <xsl:value-of select="substring($tresc/wnio:DataUrodzenia, 6, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc/wnio:DataUrodzenia, 7, 1)"/></div>
<div class="kratka_kreska">-</div>
<div class="kratka"> <xsl:value-of select="substring($tresc/wnio:DataUrodzenia, 1, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc/wnio:DataUrodzenia, 2, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc/wnio:DataUrodzenia, 3, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc/wnio:DataUrodzenia, 4, 1)"/></div>
</div>
<div class="clear"/>
<div class="col-2-l"/><div class="info col-2-r">
<div class="info_kratka">
<div class="icon"><p>i</p></div><div class="sr-only">Dodatkowa informacja o formacie daty</div>
dd-mm-rrrr</div></div>
</div>
<div>
<div class="col-2-l">Miejsce urodzenia</div>
<div class="col-2-r"><div class="full"><xsl:value-of select="$tresc/wnio:MiejsceUrodzenia"/> </div></div>
</div>
<div>
<div/>
<div class="col-2-l"/><div class="col-2-r"><h3>Dane rodziców</h3></div>
</div>
<div>
<div class="col-2-l">Imię ojca (pierwsze)</div>
<div class="col-2-r"><div class="full"><xsl:value-of select="$tresc/wnio:ImieOjca"/> </div></div>
</div>
<div>
<div class="col-2-l">Imię matki (pierwsze)</div>
<div class="col-2-r"><div class="full"><xsl:value-of select="$tresc/wnio:ImieMatki"/> </div></div>
</div>
<div>
<div class="col-2-l">Nazwisko rodowe matki</div>
<div class="col-2-r"><div class="full"><xsl:value-of select="$tresc/wnio:NazwiskoRodoweMatki"/> </div></div>
</div>
</div>
<div class="col-1-l"><h2>2. Powód zgłoszenia</h2></div>
<div class="personal_data" style="border-spacing: 20px; border-collapse: separate;">
<div class="col-2-l"/>
<div class="col-2-r">
<p class="p8">Zaznacz powód zgłoszenia:</p><br/>
<xsl:choose>
<xsl:when test="$tresc/wnio:Powod='utrata'">
<input id="powod-utrata-dowodu" class="checkbox" type="checkbox" checked="checked" disabled="disabled"/>
</xsl:when>
<xsl:otherwise>
<input id="powod-utrata-dowodu" class="checkbox" type="checkbox" disabled="disabled"/>
</xsl:otherwise>
</xsl:choose><label for="powod-utrata-dowodu">utrata dowodu</label><br/>
<xsl:choose>
<xsl:when test="$tresc/wnio:Powod='uszkodzenie'">
<input id="powod-uszkodzenie-dowodu" class="checkbox" type="checkbox" checked="checked" disabled="disabled"/>
</xsl:when>
<xsl:otherwise>
<input id="powod-uszkodzenie-dowodu" class="checkbox" type="checkbox" disabled="disabled"/>
</xsl:otherwise>
</xsl:choose><label for="powod-uszkodzenie-dowodu">uszkodzenie dowodu</label>
</div>
</div>
<div>
<div class="col-2-l"><p>Seria i numer utraconego lub uszkodzonego dowodu</p></div>
<div class="col-2-r"><div class="full"><xsl:value-of select="$tresc/wnio:SeriaINumer"/> </div></div>
<div class="col-2-l"/><div class="info col-2-r">
<div class="icon"><p>i</p></div><div class="sr-only">Dodatkowa informacja o serii i numerze utraconego dowodu</div>
Jeśli nie znasz tych danych, pozostaw puste pole.</div>
</div>
<div class="personal_data" style="border: 2px #c0c0c0 dotted; border-spacing: 20px; border-collapse: separate;">
<div class="col-2-l">
</div>
<div class="col-2-r" style="line-height:40px"><p class="p8">Wypełnij w przypadku zaznaczania opcji "uszkodzenie dowodu".</p> <div>Uszkodzony dowód osobisty:</div>
<div>
<xsl:choose>
<xsl:when test="$tresc/wnio:Powod='uszkodzenie' and $tresc/wnio:Przekazanie='1'">
<input id="uszkodzony-zostal-przekazany" class="checkbox" type="checkbox" checked="checked" disabled="disabled"/>
</xsl:when>
<xsl:otherwise>
<input id="uszkodzony-zostal-przekazany" class="checkbox" type="checkbox" disabled="disabled"/>
</xsl:otherwise>
</xsl:choose><label for="uszkodzony-zostal-przekazany">został przekazany</label><br/>
<xsl:choose>
<xsl:when test="$tresc/wnio:Powod='uszkodzenie' and $tresc/wnio:Przekazanie='2'">
<input id="uszkodzony-zostanie-przekazany" class="checkbox" type="checkbox" checked="checked" disabled="disabled"/>
</xsl:when>
<xsl:otherwise>
<input id="uszkodzony-zostanie-przekazany" class="checkbox" type="checkbox" disabled="disabled"/>
</xsl:otherwise>
</xsl:choose><label for="uszkodzony-zostanie-przekazany">zostanie przekazany</label><br/>
<div>
<xsl:choose>
<xsl:when test="$tresc/wnio:Powod='uszkodzenie' and $tresc/wnio:Przekazanie='2' and $tresc/wnio:Przekazanie2='1'">
<input id="uszkodzony-osobiscie" style="margin-left: 100px;" class="checkbox" type="checkbox" checked="checked" disabled="disabled"/>
</xsl:when>
<xsl:otherwise>
<input id="uszkodzony-osobiscie" style="margin-left: 100px;" class="checkbox" type="checkbox" disabled="disabled"/>
</xsl:otherwise>
</xsl:choose><label for="uszkodzony-osobiscie">osobiście</label><br/>
<xsl:choose>
<xsl:when test="$tresc/wnio:Powod='uszkodzenie' and $tresc/wnio:Przekazanie='2' and $tresc/wnio:Przekazanie2='2'">
<input id="uszkodzony-poczta" style="margin-left: 100px;" class="checkbox" type="checkbox" checked="checked" disabled="disabled"/>
</xsl:when>
<xsl:otherwise>
<input id="uszkodzony-poczta" style="margin-left: 100px;" class="checkbox" type="checkbox" disabled="disabled"/>
</xsl:otherwise>
</xsl:choose><label for="uszkodzony-poczta">pocztą</label><br/>
</div></div>
</div>
</div>
<div class="col-1-l"><h2>3. Wniosek o wydanie zaświadczenia o zgłoszeniu utraty lub uszkodzenia dowodu</h2></div>
<div class="personal_data" style="border-spacing: 20px; border-collapse: separate;">
<div class="col-2-l">
</div>
<div class="col-2-r">
<p class="p8">Zaznacz, jak chcesz odebrać zaświadczenie:</p><br/>
<xsl:choose>
<xsl:when test="$tresc/wnio:Odbior='1'">
<input id="zaswiadczenie-osobiscie" class="checkbox" type="checkbox" checked="checked" disabled="disabled"/>
</xsl:when>
<xsl:otherwise>
<input id="zaswiadczenie-osobiscie" class="checkbox" type="checkbox" disabled="disabled"/>
</xsl:otherwise>
</xsl:choose><label for="zaswiadczenie-osobiscie">osobiście na piśmie</label><br/>
<xsl:choose>
<xsl:when test="$tresc/wnio:Odbior='2'">
<input id="zaswiadczenie-poczta" class="checkbox" type="checkbox" checked="checked" disabled="disabled"/>
</xsl:when>
<xsl:otherwise>
<input id="zaswiadczenie-poczta" class="checkbox" type="checkbox" disabled="disabled"/>
</xsl:otherwise>
</xsl:choose><label for="zaswiadczenie-poczta">pocztą na piśmie</label><br/>
</div>
</div>
<div class="personal_data" style="border: 2px #c0c0c0 dotted; border-spacing: 15px; border-collapse: separate;">
<div class="col-2-l">
</div>
<div class="col-2-r"><p class="p8">Wpisz adres korespondencyjny, jeśli chcesz otrzymać zaświadczenie pocztą.</p></div>
<div class="col-2-l">Ulica</div>
<div class="col-2-r">
<div class="full_border">
<xsl:if test="$tresc/wnio:Odbior='2'">
<xsl:value-of select="$tresc/adr:Adres/adr:Ulica"/>
</xsl:if>
</div>
</div>
<div>
<div class="col-2-l">Numer domu</div>
<div class="col-2-r">
<div class="in-block">
<xsl:choose>
<xsl:when test="$tresc/wnio:Odbior='2'">
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:Budynek, 1, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:Budynek, 2, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:Budynek, 3, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:Budynek, 4, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:Budynek, 5, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:Budynek, 6, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:Budynek, 7, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:Budynek, 8, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:Budynek, 9, 1)"/></div>
</xsl:when>
<xsl:otherwise>
<div class="kratka"> </div>
<div class="kratka"> </div>
<div class="kratka"> </div>
<div class="kratka"> </div>
<div class="kratka"> </div>
<div class="kratka"> </div>
<div class="kratka"> </div>
<div class="kratka"> </div>
<div class="kratka"> </div>
</xsl:otherwise>
</xsl:choose>
</div>
<div class="in-block float-r">
<div class="in-block">
<p class="p4">Numer lokalu</p>
</div>
<xsl:choose>
<xsl:when test="$tresc/wnio:Odbior='2'">
<div class="local_number">
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:Lokal, 1, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:Lokal, 2, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:Lokal, 3, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:Lokal, 4, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:Lokal, 5, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:Lokal, 6, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:Lokal, 7, 1)"/></div>
</div>
</xsl:when>
<xsl:otherwise>
<div class="local_number">
<div class="kratka"> </div>
<div class="kratka"> </div>
<div class="kratka"> </div>
<div class="kratka"> </div>
<div class="kratka"> </div>
<div class="kratka"> </div>
<div class="kratka"> </div>
</div>
</xsl:otherwise>
</xsl:choose>
</div>
</div></div>
<div class="clear"/>
<div>
<div class="col-2-l">Kod pocztowy</div>
<div class="col-2-r">
<div class="in-block">
<xsl:choose>
<xsl:when test="$tresc//adr:Kraj='PL'">
<xsl:choose>
<xsl:when test="$tresc/wnio:Odbior='2'">
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:KodPocztowy, 1, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:KodPocztowy, 2, 1)"/></div>
<div class="kratka_kreska">-</div>
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:KodPocztowy, 4, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:KodPocztowy, 5, 1)"/></div>
<div class="kratka"> <xsl:value-of select="substring($tresc//adr:KodPocztowy, 6, 1)"/></div>
</xsl:when>
<xsl:otherwise>
<div class="kratka"> </div>
<div class="kratka"> </div>
<div class="kratka_kreska">-</div>
<div class="kratka"> </div>
<div class="kratka"> </div>
<div class="kratka"> </div>
</xsl:otherwise>
</xsl:choose>
</xsl:when>
<xsl:otherwise>
<xsl:choose>
<xsl:when test="$tresc/wnio:Odbior='2'">
<div class="post_code"><xsl:value-of select="$tresc//adr:KodPocztowy"/> </div>
</xsl:when>
<xsl:otherwise>
<div class="kratka"> </div>
<div class="kratka"> </div>
<div class="kratka_kreska">-</div>
<div class="kratka"> </div>
<div class="kratka"> </div>
<div class="kratka"> </div>
</xsl:otherwise>
</xsl:choose>
</xsl:otherwise>
</xsl:choose>
</div>
<div class="in-block float-r">
<div class="in-block"><p class="p4">Miejscowość</p></div>
<xsl:choose>
<xsl:when test="$tresc/wnio:Odbior='2'">
<div class="city"><xsl:value-of select="$tresc//adr:Miejscowosc"/> </div>
</xsl:when>
<xsl:otherwise>
<div class="city"> </div>
</xsl:otherwise>
</xsl:choose>
</div>
</div>
</div>
<div class="clear"/>
</div>
<div class="personal_data" style="border: 0px #c0c0c0 dotted; border-spacing: 15px; border-collapse: separate;">
<div class="col-2-l">
</div>
<div class="col-2-r">
<xsl:choose>
<xsl:when test="$tresc/wnio:Odbior='3'">
<input id="forma-de" class="checkbox" type="checkbox" checked="checked" disabled="disabled"/>
</xsl:when>
<xsl:otherwise>
<input id="forma-de" class="checkbox" type="checkbox" disabled="disabled"/>
</xsl:otherwise>
</xsl:choose><label for="forma-de">w formie dokumentu elektronicznego</label>
</div>
</div>
<div class="personal_data" style="border: 2px #c0c0c0 dotted; border-spacing: 15px; border-collapse: separate;">
<div>
<div class="col-2-l"><p>Adres elektroniczny</p></div>
<div class="col-2-r"><div class="full_border">
<xsl:if test="$tresc/wnio:Odbior='3'">
<xsl:value-of select="$tresc/wnio:SkrytkaEpuap"/>
</xsl:if>
</div></div>
<div class="col-2-l"/><div class="info col-2-r">
<div class="icon"><p>i</p></div><div class="sr-only">Dodatkowa informacja o adresie elektronicznym</div>
Adres skrzynki ePUAP.</div>
</div>
</div>
<div class="col-1-l"><h2>4. Pouczenie</h2></div>
<div><div class="col-2-l"/><div class="col-2-r"><p class="p2">Zgłoszenie utraty lub uszkodzenia dowodu osobistego powoduje jego unieważnienie.
<br/>
W przypadku odnalezienia zgłoszonego dowodu nie można się nim posługiwać.</p></div></div>
<div class="col-1-l"><h2>5. Podpis osoby, która zgłasza utratę lub uszkodzenie dowodu</h2></div>
<div><div class="col-2-l"/><div class="col-2-r">
<p class="p3">Opatrz dokument kwalifikowanym podpisem elektronicznym albo podpisem potwierdzonym profilem zaufanym ePUAP.</p></div></div>
<xsl:call-template name="Podpis"/>
</div>
</body>
</html>
</xsl:template>
<xsl:template name="Zalaczniki">
<xsl:param name="zalaczniki" select="wnio:TrescDokumentu/str:Zalaczniki"/>
<xsl:if test="count($zalaczniki/str:Zalacznik) > 0">
<div style="text-align: left;">
<ol style="padding-top: 0px;margin-top: 0px;">
<xsl:for-each select="$zalaczniki/str:Zalacznik[@nazwaPliku != '']">
<li>
<xsl:if test="@kodowanie='base64'">
<xsl:value-of select="@nazwaPliku"/>
<xsl:if test="string-length(str:OpisZalacznika) > 0"> - </xsl:if>
<xsl:if test="string-length(str:OpisZalacznika) > 0">
<xsl:value-of select="str:OpisZalacznika"/>
</xsl:if>
</xsl:if>
<xsl:if test="@kodowanie='URI'">
<a href="{str:DaneZalacznika}">
<xsl:value-of select="@nazwaPliku"/>
</a>
<xsl:if test="string-length(str:OpisZalacznika) > 0"> (wartość skrótu w chwili załączania: <xsl:value-of select="str:OpisZalacznika"/>) </xsl:if>
</xsl:if>
</li>
</xsl:for-each>
</ol>
</div>
</xsl:if>
</xsl:template>
<xsl:template name="Podpis">
<div align="right" style="text-align: right;font-size: 10px;font-family: Verdana;line-height: 20px;">
<div style="float: right;">
<div>
<div style="width: 340px;">
<p align="center" style="text-align: center;font-size: 10px;font-family: Verdana;line-height: 20px;">
<xsl:choose>
<xsl:when test="string-length(//wnio:Dokument/ds:Signature/ds:SignatureValue) > 0">
<xsl:text>Dokument został podpisany, aby go zweryfikować należy użyć oprogramowania do weryfikacji podpisu</xsl:text>
<xsl:choose>
<xsl:when test="count(//wnio:Dokument/ds:Signature/ds:Object/descendant::*[local-name() = 'SigningTime']) > 1">
<br/>
<xsl:text>Daty złożenia podpisu: </xsl:text>
<xsl:for-each select="//wnio:Dokument/ds:Signature/ds:Object/descendant::*[local-name() = 'SigningTime']">
<xsl:value-of select="."/>
</xsl:for-each>
</xsl:when>
<xsl:when test="count(//wnio:Dokument/ds:Signature/ds:Object/descendant::*[local-name() = 'SigningTime']) = 1">
<br/>
<xsl:text>Data złożenia podpisu: </xsl:text>
<xsl:for-each select="//wnio:Dokument/ds:Signature/ds:Object/descendant::*[local-name() = 'SigningTime']">
<xsl:value-of select="."/>
</xsl:for-each>
</xsl:when>
<xsl:when test="0 >= count(//wnio:Dokument/ds:Signature/ds:Object/descendant::*[local-name() = 'SigningTime'])"> </xsl:when>
</xsl:choose>
</xsl:when>
<xsl:otherwise>
<xsl:text>Dokument nie zawiera podpisu</xsl:text>
</xsl:otherwise>
</xsl:choose>
<br/>
<span style="font-size: 7pt;font-weight: bold;"> Podpis elektroniczny </span>
</p>
</div>
</div>
</div>
</div>
<div style="clear: both;"/>
</xsl:template>
<xsl:template name="substitute">
<xsl:param name="string"/>
<xsl:param name="from" select="'
'"/>
<xsl:param name="to">
<br/>
</xsl:param>
<xsl:choose>
<xsl:when test="contains($string, $from)">
<xsl:value-of select="substring-before($string, $from)"/>
<xsl:copy-of select="$to"/>
<xsl:call-template name="substitute">
<xsl:with-param name="string" select="substring-after($string, $from)"/>
<xsl:with-param name="from" select="$from"/>
<xsl:with-param name="to" select="$to"/>
</xsl:call-template>
</xsl:when>
<xsl:otherwise>
<xsl:value-of select="$string"/>
</xsl:otherwise>
</xsl:choose>
</xsl:template>
</xsl:stylesheet>