Request for information on amount of income - special non-contributory cash benefits

M050 - Request for information on amount of income - special non-contributory cash benefits
Article 70 of Regulation (EC) No 883/2004

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

1. Person Income Requested *

1.1. Person *

1.1.1. Person Identification *

1.1.1.1. Family name(s) *

1.1.1.2. Forename(s) *

1.1.1.3. Date of birth *

1.1.1.4. Sex *

1.1.1.5. Family name(s) at birth

1.1.1.6. Forename(s) at birth

1.1.1.7. PIN of the person in each institution

1.1.1.7.1. Personal Identification Number(s) *

1.1.1.7.1.1. Country *

1.1.1.7.1.2. Personal Identification Number (PIN) *

1.1.1.7.1.3. Sector

1.1.1.7.1.4. Institution

1.1.1.7.1.4.1. Institution ID *

1.1.1.7.1.4.2. Institution Name *

1.1.1.7.1.Personal Identification Number(s)

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

1.1.1.8.1. Place of birth

1.1.1.8.1.1. Town *

1.1.1.8.1.2. Region

1.1.1.8.1.3. Country *

1.1.1.8.2. Father's family name at birth

1.1.1.8.3. Forename of father

1.1.1.8.4. Mother's family name at birth

1.1.1.8.5. Forename of mother

1.1.2. Additional information on the person

1.1.2.1. Nationality

1.1.2.2. Previous name(s)

1.1.2.2.1. Previous family name(s)

1.1.2.2.2. Previous forename

1.1.2.3. Address of the person

1.1.2.3.1. Type of address

1.1.2.3.2. Address

1.1.2.3.2.1. Street

1.1.2.3.2.2. Building Name

1.1.2.3.2.3. Town *

1.1.2.3.2.4. Postal Code

1.1.2.3.2.5. Region

1.1.2.3.2.6. Country *

1.1.2.4. Pursues a professional or trade activity

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1.2. Request *

1.2.1. Please provide us information with following type(s)/source(s) of income

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1.2.2. Please fill in the following if "Please provide us information with following type(s)/source(s) of income" = "Other type of income" :

1.2.2.1. Other type of income

1.2.3. Period in respect of which information is requested with following type(s)/source(s) of income *

Fixed period*
Open period*

1.2.3.1.1. Start date *

1.2.3.1.2. End date *

1.2.3.2.1. Type of Open Period *

1.2.3.2.2. Start date *

1.2.Request

2. Spouse/Partner Income Requested

2.1. Spouse/Partner

2.1.1. Person Identification *

2.1.1.1. Family name(s) *

2.1.1.2. Forename(s) *

2.1.1.3. Date of birth *

2.1.1.4. Sex *

2.1.1.5. Family name(s) at birth

2.1.1.6. Forename(s) at birth

2.1.1.7. PIN of the person in each institution

2.1.1.7.1. Personal Identification Number(s) *

2.1.1.7.1.1. Country *

2.1.1.7.1.2. Personal Identification Number (PIN) *

2.1.1.7.1.3. Sector

2.1.1.7.1.4. Institution

2.1.1.7.1.4.1. Institution ID *

2.1.1.7.1.4.2. Institution Name *

2.1.1.7.1.Personal Identification Number(s)

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

2.1.1.8.1. Place of birth

2.1.1.8.1.1. Town *

2.1.1.8.1.2. Region

2.1.1.8.1.3. Country *

2.1.1.8.2. Father's family name at birth

2.1.1.8.3. Forename of father

2.1.1.8.4. Mother's family name at birth

2.1.1.8.5. Forename of mother

2.1.2. Additional information on the person

2.1.2.1. Nationality

2.1.2.2. Relationship to the person named in section 1

2.1.2.3. Please fill in the following if "Relationship to the person named in section 1" = "Other" :

2.1.2.3.1. Other

2.1.2.4. Address of the person

2.1.2.4.1. Type of address

2.1.2.4.2. Address

2.1.2.4.2.1. Street

2.1.2.4.2.2. Building Name

2.1.2.4.2.3. Town *

2.1.2.4.2.4. Postal Code

2.1.2.4.2.5. Region

2.1.2.4.2.6. Country *

2.1.2.4.Address of the person

2.1.2.5. Pursues a professional or trade activity

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2.2. Request

2.2.1. Please provide us information with following type(s)/source(s) of income

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2.2.2. Please fill in the following if "Please provide us information with following type(s)/source(s) of income" = "Other type of income" :

2.2.2.1. Other type of income

2.2.3. Period in respect of which information is requested with following type(s)/source(s) of income *

Fixed period*
Open period*

2.2.3.1.1. Start date *

2.2.3.1.2. End date *

2.2.3.2.1. Type of Open Period *

2.2.3.2.2. Start date *

2.2.Request

3. Member(s) of the family other than the spouse/partner income requested

3.1. Member of the family other than the spouse/partner income requested

3.1.1. Member of the family other than the spouse/partner

3.1.1.1. Person Identification *

3.1.1.1.1. Family name(s) *

3.1.1.1.2. Forename(s) *

3.1.1.1.3. Date of birth *

3.1.1.1.4. Sex *

3.1.1.1.5. Family name(s) at birth

3.1.1.1.6. Forename(s) at birth

3.1.1.1.7. PIN of the person in each institution

3.1.1.1.7.1. Personal Identification Number(s) *

3.1.1.1.7.1.1. Country *

3.1.1.1.7.1.2. Personal Identification Number (PIN) *

3.1.1.1.7.1.3. Sector

3.1.1.1.7.1.4. Institution

3.1.1.1.7.1.4.1. Institution ID *

3.1.1.1.7.1.4.2. Institution Name *

3.1.1.1.7.1.Personal Identification Number(s)

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

3.1.1.1.8.1. Place of birth

3.1.1.1.8.1.1. Town *

3.1.1.1.8.1.2. Region

3.1.1.1.8.1.3. Country *

3.1.1.1.8.2. Father's family name at birth

3.1.1.1.8.3. Forename of father

3.1.1.1.8.4. Mother's family name at birth

3.1.1.1.8.5. Forename of mother

3.1.1.2. Additional information on the person

3.1.1.2.1. Nationality

3.1.1.2.2. Relationship to person named in section 1

3.1.1.2.3. Other relative

3.1.1.2.4. Address of the person

3.1.1.2.4.1. Type of address

3.1.1.2.4.2. Address

3.1.1.2.4.2.1. Street

3.1.1.2.4.2.2. Building Name

3.1.1.2.4.2.3. Town *

3.1.1.2.4.2.4. Postal Code

3.1.1.2.4.2.5. Region

3.1.1.2.4.2.6. Country *

3.1.1.2.4.Address of the person

3.1.1.2.5. Pursues a professional or trade activity

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3.1.2. Request

3.1.2.1. Please provide us information with following type(s)/source(s) of income

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3.1.2.2. Please fill in the following if "Please provide us information with following type(s)/source(s) of income" = "Other type of income" :

3.1.2.2.1. Other type of income

3.1.2.3. Period in respect of which information is requested with following type(s)/source(s) of income *

Fixed period*
Open period*

3.1.2.3.1.1. Start date *

3.1.2.3.1.2. End date *

3.1.2.3.2.1. Type of Open Period *

3.1.2.3.2.2. Start date *

3.1.2.Request

3.1.Member of the family other than the spouse/partner income requested

4. Additional Information

4.1. Additional Information

5. Documents supporting the request attached

5.1. Attached document(s)

5.2. Other document(s)

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M050 - Request for information on amount of income - special non-contributory cash benefits Article 70 of Regulation (EC) No 883/2004

M050 - Request for information on amount of income - special non-contributory cash benefits
Article 70 of Regulation (EC) No 883/2004