Förnamn{name-1-first-name}
Efternamn{name-1-last-name}
Personnummer {text-1}
Telefon{phone-1}
Email{email-1}
Adress frĂĄn{address-1-street_address} {address-1-city} {address-1-zip}
Adress till{address-2-street_address} {address-2-city} {address-2-zip}
Städning önskas{checkbox-1}
Ă–vrig information{textarea-3}