| 3352
| <![CDATA[<input type="number" min="2010" max="2023" id="ano_ocorrencia" name="ano_ocorrencia_denuncia" placeholder="Ano da ocorrência*" class="input txtacess input-p" style="display: none;" />]]>
|
| 3361
| <![CDATA[<input type="text" class="input txtacess" placeholder="Nome Completo*" name="full_name">]]>
|
| 3363
| <![CDATA[<input type="text" class="input txtacess" placeholder="E-mail*" name="email">]]>
|
| 3365
| <![CDATA[<input type="text" class="input txtacess input2_w" placeholder="Cidade*" name="city">]]>
|
| 3351
| <![CDATA[<textarea type="text" class="input txtacess tamanhotext" placeholder="Descrição*" name="form_description" cols="50" rows="10"></textarea>]]>
|
| 3349
| <![CDATA[<select class="input txtacess" name="form_type"><option selected="selected" value="">Qual a sua solicitação?*</option><option value="1">Dúvida</option><option value="2">Elogio</option><option value="3">Denúncia</option><option value="5">Reclamação</option><option value="6">Sugestão</option></select>]]>
|
| 3367
| <![CDATA[<select class="input txtacess input3_w" name="state"><option selected="selected" value="">Estado *</option><option value="AC">AC</option><option value="AL">AL</option><option value="AM">AM</option><option value="AP">AP</option><option value="BA">BA</option><option value="CE">CE</option><option value="DF">DF</option><option value="ES">ES</option><option value="GO">GO</option><option value="MA">MA</option><option value="MG">MG</option><option value="MS">MS</option><option value="MT">MT</option><option value="PA">PA</option><option value="PB">PB</option><option value="PE">PE</option><option value="PI">PI</option><option value="PR">PR</option><option value="RJ">RJ</option><option value="RN">RN</option><option value="RO">RO</option><option value="RR">RR</option><option value="RS">RS</option><option value="SC">SC</option><option value="SP">SP</option><option value="SE">SE</option><option value="TO">TO</option></select>]]>
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