U020_Master

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 *

1.1.2. Case number *

1.1.3. Institution

1.1.3.1. Institution ID *

1.1.3.2. Institution Name *

1.1.Local Case Number

2. General information *

2.1. Reimbursement request ID *

2.2. Number of individual claims *

2.3. Total amount requested *

2.3.1. Amount *

2.3.2. Currency *

2.4. Bank information *

2.4.1. SEPA Bank Details *

2.4.1.1. IBAN *

2.4.1.2. BIC-SWIFT

2.4.2. Bank transfer: subject or transaction reference *

{{metaSection.bankTransferSubjectOrTransactionReference.$$error}} {{metaSection.bankTransferSubjectOrTransactionReference.$$warning}}

{{ row.severity }} : {{ row.message }}