P11000 - Request for pension amount
Article 58 of Regulation (EC) No 883/2004
SED API version: 0.15.3 build preview 1
Model version: 4.1.0
1. Local case numbers
1.1. Local Case Number
1.1.1. Country
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1.1.2. Case number
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1.1.3. Institution
1.1.3.1. Institution ID
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1.1.3.2. Institution Name
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2. Insured person
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2.1. Person identification
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2.1.1. Family name(s)
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2.1.2. Forename(s)
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2.1.3. Date of birth
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2.1.4. Sex
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2.1.5. Family name(s) at birth
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2.1.6. Forename(s) at birth
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2.1.7. PIN of the person in each institution
2.1.7.1. Personal Identification Number(s)
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2.1.7.1.1. Country
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2.1.7.1.2. Personal Identification Number (PIN)
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2.1.7.1.3. Sector
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2.1.7.1.4. Institution
2.1.7.1.4.1. Institution ID
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2.1.7.1.4.2. Institution Name
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2.1.8. If PIN not provided for every institution, please provide
2.1.8.1. Place of birth
2.1.8.1.1. Town
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2.1.8.1.2. Region
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2.1.8.1.3. Country
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2.1.8.2. Father's family name at birth
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2.1.8.3. Forename of father
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2.1.8.4. Mother's family name at birth
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2.1.8.5. Forename of mother
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2.2. Additional Information on the person
2.2.1. Additional Information on the person
2.2.1.1. Nationality
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2.2.1.2. Previous family name(s)
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2.2.1.3. Previous forename(s)
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2.2.2. Address
2.2.2.1. Street
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2.2.2.2. Building Name
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2.2.2.3. Town
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2.2.2.4. Postal Code
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2.2.2.5. Region
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2.2.2.6. Country
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2.2.3. Contact information on the person
2.2.3.1. Telephone Numbers
2.2.3.1.1. Telephone Number
2.2.3.1.1.1. Type
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2.2.3.1.1.2. Number
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2.2.3.2. Email Addresses
2.2.3.2.1. Email Address
2.2.3.2.1.1. Email Address
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3. Recipient of survivor's pension
3.1. Person identification
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3.1.1. Family name(s)
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3.1.2. Forename(s)
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3.1.3. Date of birth
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3.1.4. Sex
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3.1.5. Family name(s) at birth
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3.1.6. Forename(s) at birth
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3.1.7. PIN of the person in each institution
3.1.7.1. Personal Identification Number(s)
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3.1.7.1.1. Country
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3.1.7.1.2. Personal Identification Number (PIN)
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3.1.7.1.3. Sector
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3.1.7.1.4. Institution
3.1.7.1.4.1. Institution ID
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3.1.7.1.4.2. Institution Name
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3.1.8. If PIN not provided for every institution, please provide
3.1.8.1. Place of birth
3.1.8.1.1. Town
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3.1.8.1.2. Region
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3.1.8.1.3. Country
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3.1.8.2. Father's family name at birth
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3.1.8.3. Forename of father
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3.1.8.4. Mother's family name at birth
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3.1.8.5. Forename of mother
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3.2. Additional information on the person
3.2.1. Additional information on the person
3.2.1.1. Nationality
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3.2.1.2. Previous family name(s)
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3.2.1.3. Previous forename(s)
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3.2.2. Address
3.2.2.1. Street
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3.2.2.2. Building Name
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3.2.2.3. Town
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3.2.2.4. Postal Code
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3.2.2.5. Region
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3.2.2.6. Country
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3.2.3. Contact information on the person
3.2.3.1. Telephone Numbers
3.2.3.1.1. Telephone Number
3.2.3.1.1.1. Type
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3.2.3.1.1.2. Number
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3.2.3.2. Email Addresses
3.2.3.2.1. Email Address
3.2.3.2.1.1. Email Address
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4. Reference to the person
4.1. This request is made with reference to the person named in
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5. Request for pension amount
5.1. Request
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5.2. Period for which pension amount is requested
Fixed period
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Open period
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5.2.1.1. Start date
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5.2.1.2. End date
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5.2.2.1. Type of Open Period
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5.2.2.2. Start date
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6. Additional information
6.1. Additional information
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7. Attachments
7.1. List of attachments
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