Notification/request for information

H001 - Notification/request for information
Article 76 of Regulation (EC) No 883/2004

SED API version: 0.15.3 build preview 1
Model version: 4.1.0

1. Notification/request for information *

Person*
Employer*
Reimbursement bulk SED*

1.1.1. Person identification *

1.1.1.1. Person Identification *

1.1.1.1.1. Family name(s) *

1.1.1.1.2. Forename(s) *

1.1.1.1.3. Date of birth *

1.1.1.1.4. Sex *

1.1.1.1.5. Family name(s) at birth

1.1.1.1.6. Forename(s) at birth

1.1.1.1.7. PIN of the person in each institution

1.1.1.1.7.1. Personal Identification Number(s) *

1.1.1.1.7.1.1. Country *

1.1.1.1.7.1.2. Personal Identification Number (PIN) *

1.1.1.1.7.1.3. Sector

1.1.1.1.7.1.4. Institution

1.1.1.1.7.1.4.1. Institution ID *

1.1.1.1.7.1.4.2. Institution Name *

1.1.1.1.7.1.Personal Identification Number(s)

1.1.1.1.8. If PIN not provided for every institution, please provide

1.1.1.1.8.1. Place of birth

1.1.1.1.8.1.1. Town *

1.1.1.1.8.1.2. Region

1.1.1.1.8.1.3. Country *

1.1.1.1.8.2. Father's family name at birth

1.1.1.1.8.3. Forename of father

1.1.1.1.8.4. Mother's family name at birth

1.1.1.1.8.5. Forename of mother

1.1.1.2. Additional information on the person

1.1.1.2.1. Nationality

1.1.1.2.2. Status of the person

1.1.1.2.3. Please fill in if "Status of the person" = "Other":

1.1.1.2.3.1. Other

1.1.2. Address of the person

1.1.2.1. Addresses of the person

Notification of Address
Request of address

1.1.2.1.1.1. Notification of Address

1.1.2.1.1.1.1. Type of Address *

1.1.2.1.1.1.2. Address

1.1.2.1.1.1.2.1. Street

1.1.2.1.1.1.2.2. Building Name

1.1.2.1.1.1.2.3. Town *

1.1.2.1.1.1.2.4. Postal Code

1.1.2.1.1.1.2.5. Region

1.1.2.1.1.1.2.6. Country *

1.1.2.1.1.1.Notification of Address

1.1.2.1.2.1. Type of Address

1.1.2.1.Addresses of the person

1.1.3. Request for information for identification of the person

1.1.3.1. Person

1.1.3.1.1. Type of information

1.1.4. Request for sector PIN of the person in the receiving institution

1.1.4.1. Sector PIN (Personal Identification Number of the receiving institution)

1.1.4.2. Other Sector PIN

1.1.5. Request for Information

1.1.5.1. Date of request

1.1.5.2. Please provide

1.1.5.2.1. The following document(s)

1.1.5.2.2. The following information

1.1.5.2.3. The following SED(s)

1.1.6. Notification of change in circumstances

1.1.6.1. Family name(s)

1.1.6.2. Forename(s)

1.1.6.3. Date of birth

1.1.6.4. Sex

1.1.6.5. Family name(s) at birth

1.1.6.6. Forename(s) at birth

1.1.6.7. Place of birth

1.1.6.8. Father's family name at birth

1.1.6.9. Forename of father

1.1.6.10. Mother's family name at birth

1.1.6.11. Forename of mother

1.1.6.12. Previous family name(s)

1.1.6.13. Previous forename(s)

1.1.6.14. Nationality

1.1.6.15. Other

1.1.7. Additional information/Change in circumstances

1.1.7.1. Notification/Request for additional information

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1.1.7.2. Additional information/Change in circumstances

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1.1.8. Please find attached the following documents:

1.1.8.1. Predefined Documents

1.1.8.2. Other Documents Attached

1.1.8.2.1. Other Document

1.1.8.2.1.1. Document

1.1.8.2.1.Other Document

1.2.1. Employer *

1.2.1.1. Name *

1.2.1.2. Identification numbers

1.2.1.2.1. Identification number

1.2.1.2.1.1. Number *

1.2.1.2.1.2. Type *

1.2.1.2.1.Identification number

1.2.1.3. Address

1.2.1.3.1. Street

1.2.1.3.2. Building Name

1.2.1.3.3. Town *

1.2.1.3.4. Postal Code

1.2.1.3.5. Region

1.2.1.3.6. Country *

1.2.2. Request for information

1.2.2.1. Date of request

1.2.2.2. Please provide

1.2.2.2.1. The following document(s)

1.2.2.2.2. The following information

1.2.2.2.3. The following SED(s)

1.2.3. Additional information / Change in circumstances

1.2.3.1. Notification/Request for additional information

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1.2.3.2. Additional information/Change in circumstances

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1.2.4. Please find attached the following documents:

1.2.4.1. Predefined Documents

1.2.4.2. Other Documents Attached

1.2.4.2.1. Other Document

1.2.4.2.1.1. Document

1.2.4.2.1.Other Document

1.3.1. Reimbursement identification *

1.3.1.1. Reimbursement Request ID *

1.3.2. Request for information

1.3.2.1. Date of request

1.3.2.2. Please provide

1.3.2.2.1. The following document(s)

1.3.2.2.2. The following information

1.3.2.2.3. The following SED(s)

1.3.3. Additional information / Change in circumstances

1.3.3.1. Notification/Request for additional information

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1.3.3.2. Additional information/Change in circumstances

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1.3.4. Please find attached the following documents:

1.3.4.1. Predefined Documents

1.3.4.2. Other Documents Attached

1.3.4.2.1. Other Document

1.3.4.2.1.1. Document

1.3.4.2.1.Other Document

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H001 - Notification/request for information Article 76 of Regulation (EC) No 883/2004

H001 - Notification/request for information
Article 76 of Regulation (EC) No 883/2004