1 <%= t("verification.step_1") %>

2 <%= t("verification.step_2") %>

3 <%= t("verification.step_3") %>

<%= link_to account_path, class: "left back clear" do %> <%= t("verification.back") %> <% end %>

<%= t("verification.residence.new.title") %>

<%= form_for @residence, as: "residence", url: residence_path do |f| %> <%= render "errors" %>

<%= f.label t("verification.residence.new.document_type_label") %> <%= f.select :document_type, document_types, prompt: "", label: false %>

<%= f.label t("verification.residence.new.document_number") %> <%= f.text_field :document_number, label: false %>

<%= f.label t("verification.residence.new.date_of_birth") %> <%= f.date_select :date_of_birth, prompt: true, start_year: 1900, end_year: 16.years.ago.year, label: false %>

<%= f.label t("verification.residence.new.postal_code") %> <%= f.text_field :postal_code, label: false %>

<%= f.label :terms_of_service do %> <%= f.check_box :terms_of_service, label: false %> <%= t("verification.residence.new.accept_terms_text", terms_url: link_to(t("verification.residence.new.terms"), "/census_terms", target: "_blank")).html_safe %> <% end %>

<%= f.submit t("verification.residence.new.verify_residence") %>

<% end %>