End of Entitlement - Export

U016 - End of Entitlement - Export
Article 64, 65(5)(b), 65a(3) of Regulation (EC) No 883/2004; Article 55 of Regulation (EC) No 987/2009

SED API version: 0.14.2 PREVIEW build 3
Model version: 4.0.16

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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1.1.Local Case Number

2. Person *

2.1. Person identification *

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) *

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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2.1.7.1.Personal Identification Number(s)

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. Nationality

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3. Date of end of entitlement *

3.1. Date *

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