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field_type=»text» field_title=»APELLIDO» field_id=»Field_04″ field_help=»Ingrese únicamente su(s) apellido(s)» tab_label=»Apellido» half_col=»on» required=»on» reqd_txt=»*» _builder_version=»4.11.1″ _module_preset=»default» hover_enabled=»0″ global_colors_info=»{}» sticky_enabled=»0″][/et_pb_kkcompform_field][et_pb_kkcompform_field field_type=»email» field_title=»Dirección de correo electrónico» field_id=»Field_05″ field_help=»Ingrese únicamente su correo electrónico» tab_label=»Mail» half_col=»on» required=»on» reqd_txt=»*» _builder_version=»4.11.1″ _module_preset=»default» hover_enabled=»0″ global_colors_info=»{}» sticky_enabled=»0″][/et_pb_kkcompform_field][et_pb_kkcompform_field field_type=»text» field_title=»Celular» field_id=»Field_06″ field_help=»Ingrese su número de teléfono celular» tab_label=»Celular» half_col=»on» required=»on» reqd_txt=»*» _builder_version=»4.11.1″ _module_preset=»default» hover_enabled=»0″ global_colors_info=»{}» sticky_enabled=»0″][/et_pb_kkcompform_field][et_pb_kkcompform_field field_type=»select» select_group=»%91{%22value%22:%22Cédula%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22NIT%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Pasaporte%22,%22checked%22:0,%22dragID%22:1}%93″ select_options=»%91{%22value%22:%22Cédula%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22NIT%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Pasaporte%22,%22checked%22:0,%22dragID%22:1}%93″ field_title=»Tipo de documento» field_id=»Field_07″ field_help=»Ingrese su número de teléfono celular» tab_label=»Selección» half_col=»on» required=»on» reqd_txt=»*» _builder_version=»4.11.1″ _module_preset=»default» custom_margin=»||||false|false» custom_padding=»||||false|false» hover_enabled=»0″ border_color_all=»RGBA(0,0,0,0)» global_colors_info=»{}» sticky_enabled=»0″][/et_pb_kkcompform_field][et_pb_kkcompform_field field_type=»text» field_title=»Número de documento» field_id=»Field_08″ field_help=»Ingrese su número de documento» tab_label=»No. documento» half_col=»on» required=»on» reqd_txt=»*» _builder_version=»4.11.1″ _module_preset=»default» hover_enabled=»0″ global_colors_info=»{}» sticky_enabled=»0″][/et_pb_kkcompform_field][et_pb_kkcompform_field field_type=»text» field_title=»CARGO» field_id=»Field_09″ field_help=»Ingrese su cargo en la empresa» tab_label=»Cargo» required=»on» reqd_txt=»*» _builder_version=»4.11.1″ _module_preset=»default» custom_margin=»||||false|false» custom_padding=»||||false|false» hover_enabled=»0″ global_colors_info=»{}» sticky_enabled=»0″][/et_pb_kkcompform_field][et_pb_kkcompform_field field_type=»select» select_group=»%91{%22value%22:%22Petición%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Queja%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Reclamo%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Felicitación%22,%22checked%22:0,%22dragID%22:2}%93″ select_options=»%91{%22value%22:%22Petición%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Queja%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Reclamo%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Felicitación%22,%22checked%22:0,%22dragID%22:2}%93″ field_title=»Tipo de PQRF» field_id=»Field_10″ field_help=»Seleccione una opción» tab_label=»PQR» _builder_version=»4.11.1″ _module_preset=»default» hover_enabled=»0″ global_colors_info=»{}» sticky_enabled=»0″][/et_pb_kkcompform_field][et_pb_kkcompform_field field_type=»textarea» field_title=»Mensaje» field_id=»Field_11″ field_help=»Ingrese su mensaje» tab_label=»Mensaje» _builder_version=»4.11.1″ _module_preset=»default» hover_enabled=»0″ global_colors_info=»{}» sticky_enabled=»0″][/et_pb_kkcompform_field][et_pb_kkcompform_field field_type=»file» fileupload=»on|off|on|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off|off» upload_btn=»Seleccione un archivo» uploadsize=»250000″ make_mult=»on» field_title=»Subir evidencia» field_id=»Field_12″ field_help=»Seleccione la evidencia » tab_label=»Seleccione imágenes» _builder_version=»4.11.1″ _module_preset=»default» hover_enabled=»0″ global_colors_info=»{}» sticky_enabled=»0″][/et_pb_kkcompform_field][/et_pb_kkcomplex_form]