Notification/request for information

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

SED API version: 0.15.2 build 3
Model version: 4.1.0

1. Notification/request for information * [ SED ]

Person* [ SED ]

Employer* [ SED ]

Reimbursement bulk SED* [ SED ]

1.1.1. Person identification * [ SC ]

1.1.1.1. Person Identification * [ CC ]

1.1.1.1.1. Family name(s) *

[ BDT ] {{metaSection.familyName.$$error}} {{metaSection.familyName.$$warning}}

1.1.1.1.2. Forename(s) *

[ BDT ] {{metaSection.forename.$$error}} {{metaSection.forename.$$warning}}

1.1.1.1.3. Date of birth *

[ BDT ] {{metaSection.dateBirth.$$error}} {{metaSection.dateBirth.$$warning}}

1.1.1.1.4. Sex *

[ ENUM ] {{metaSection.sex.$$error}} {{metaSection.sex.$$warning}}

1.1.1.1.5. Family name(s) at birth

[ BDT ] {{metaSection.familyNameAtBirth.$$error}} {{metaSection.familyNameAtBirth.$$warning}}

1.1.1.1.6. Forename(s) at birth

[ BDT ] {{metaSection.forenameAtBirth.$$error}} {{metaSection.forenameAtBirth.$$warning}}

1.1.1.1.7. PIN of the person in each institution

[ CC ]

1.1.1.1.7.1. Personal Identification Number(s) * [ CC ]

1.1.1.1.7.1.1. Country *

[ ENUM ] {{metaSection.country.$$error}} {{metaSection.country.$$warning}}

1.1.1.1.7.1.2. Personal Identification Number (PIN) *

[ BDT ] {{metaSection.personalIdentificationNumber.$$error}} {{metaSection.personalIdentificationNumber.$$warning}}

1.1.1.1.7.1.3. Sector

[ ENUM ] {{metaSection.sector.$$error}} {{metaSection.sector.$$warning}}

1.1.1.1.7.1.4. Institution

[ CC ]

1.1.1.1.7.1.4.1. Institution ID *

[ BDT ] {{metaSection.institutionID.$$error}} {{metaSection.institutionID.$$warning}}

1.1.1.1.7.1.4.2. Institution Name *

[ CDT ] {{metaSection.institutionName.$$error}} {{metaSection.institutionName.$$warning}}

1.1.1.1.7.1.Personal Identification Number(s)

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

[ CC ]

1.1.1.1.8.1. Place of birth

[ CC ]

1.1.1.1.8.1.1. Town *

[ CDT ] {{metaSection.town.$$error}} {{metaSection.town.$$warning}}

1.1.1.1.8.1.2. Region

[ CDT ] {{metaSection.region.$$error}} {{metaSection.region.$$warning}}

1.1.1.1.8.1.3. Country *

[ ENUM ] {{metaSection.country.$$error}} {{metaSection.country.$$warning}}

1.1.1.1.8.2. Father's family name at birth

[ BDT ] {{metaSection.fatherFamilyNameAtBirth.$$error}} {{metaSection.fatherFamilyNameAtBirth.$$warning}}

1.1.1.1.8.3. Forename of father

[ BDT ] {{metaSection.forenameFather.$$error}} {{metaSection.forenameFather.$$warning}}

1.1.1.1.8.4. Mother's family name at birth

[ BDT ] {{metaSection.motherFamilyNameAtBirth.$$error}} {{metaSection.motherFamilyNameAtBirth.$$warning}}

1.1.1.1.8.5. Forename of mother

[ BDT ] {{metaSection.forenameMother.$$error}} {{metaSection.forenameMother.$$warning}}

1.1.1.2. Additional information on the person [ SC ]

1.1.1.2.1. Nationality

[ ENUM ] {{metaSection.nationality.$$error}} {{metaSection.nationality.$$warning}}

1.1.1.2.2. Status of the person

[ ENUM ] {{metaSection.statusPerson.$$error}} {{metaSection.statusPerson.$$warning}}

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

1.1.1.2.3.1. Other

[ CDT ] {{metaSection.other.$$error}} {{metaSection.other.$$warning}}

1.1.2. Address of the person

[ SED ]

1.1.2.1. Addresses of the person [ SED ]

Notification of Address [ SED ]

Request of address [ SED ]

1.1.2.1.1.1. Notification of Address [ SED ]

1.1.2.1.1.1.1. Type of Address *

[ ENUM ] {{metaSection.typeAddress.$$error}} {{metaSection.typeAddress.$$warning}}

1.1.2.1.1.1.2. Address

[ CC ]

1.1.2.1.1.1.2.1. Street

[ CDT ] {{metaSection.street.$$error}} {{metaSection.street.$$warning}}

1.1.2.1.1.1.2.2. Building Name

[ CDT ] {{metaSection.buildingName.$$error}} {{metaSection.buildingName.$$warning}}

1.1.2.1.1.1.2.3. Town *

[ CDT ] {{metaSection.town.$$error}} {{metaSection.town.$$warning}}

1.1.2.1.1.1.2.4. Postal Code

[ CDT ] {{metaSection.postalCode.$$error}} {{metaSection.postalCode.$$warning}}

1.1.2.1.1.1.2.5. Region

[ CDT ] {{metaSection.region.$$error}} {{metaSection.region.$$warning}}

1.1.2.1.1.1.2.6. Country *

[ ENUM ] {{metaSection.country.$$error}} {{metaSection.country.$$warning}}

1.1.2.1.1.1.Notification of Address

1.1.2.1.2.1. Type of Address

[ ENUM ] {{metaSection.typeAddress.$$error}} {{metaSection.typeAddress.$$warning}}

1.1.2.1.Addresses of the person

1.1.3. Request for information for identification of the person [ SED ]

1.1.3.1. Person [ SED ]

1.1.3.1.1. Type of information

[ ENUM ] {{metaSection.typeInformation.$$error}} {{metaSection.typeInformation.$$warning}}

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

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

[ ENUM ] {{metaSection.sectorPINReceivingInstitution.$$error}} {{metaSection.sectorPINReceivingInstitution.$$warning}}

1.1.4.2. Other Sector PIN

[ CDT ] {{metaSection.otherSectorPIN.$$error}} {{metaSection.otherSectorPIN.$$warning}}

1.1.5. Request for Information [ SED ]

1.1.5.1. Date of request

[ BDT ] {{metaSection.dateRequest.$$error}} {{metaSection.dateRequest.$$warning}}

1.1.5.2. Please provide [ SED ]

1.1.5.2.1. The following document(s)

[ CDT ] {{metaSection.document.$$error}} {{metaSection.document.$$warning}}

1.1.5.2.2. The following information

[ CDT ] {{metaSection.information.$$error}} {{metaSection.information.$$warning}}

1.1.5.2.3. The following SED(s)

[ CDT ] {{metaSection.followingSED.$$error}} {{metaSection.followingSED.$$warning}}

1.1.6. Notification of change in circumstances

[ SED ]

1.1.6.1. Family name(s)

[ BDT ] {{metaSection.familyName.$$error}} {{metaSection.familyName.$$warning}}

1.1.6.2. Forename(s)

[ BDT ] {{metaSection.forename.$$error}} {{metaSection.forename.$$warning}}

1.1.6.3. Date of birth

[ BDT ] {{metaSection.dateBirth.$$error}} {{metaSection.dateBirth.$$warning}}

1.1.6.4. Sex

[ ENUM ] {{metaSection.sex.$$error}} {{metaSection.sex.$$warning}}

1.1.6.5. Family name(s) at birth

[ BDT ] {{metaSection.familyNameAtBirth.$$error}} {{metaSection.familyNameAtBirth.$$warning}}

1.1.6.6. Forename(s) at birth

[ BDT ] {{metaSection.forenameAtBirth.$$error}} {{metaSection.forenameAtBirth.$$warning}}

1.1.6.7. Place of birth

[ CDT ] {{metaSection.placeBirth.$$error}} {{metaSection.placeBirth.$$warning}}

1.1.6.8. Father's family name at birth

[ BDT ] {{metaSection.fatherFamilyNameAtBirth.$$error}} {{metaSection.fatherFamilyNameAtBirth.$$warning}}

1.1.6.9. Forename of father

[ BDT ] {{metaSection.forenameFather.$$error}} {{metaSection.forenameFather.$$warning}}

1.1.6.10. Mother's family name at birth

[ BDT ] {{metaSection.motherFamilyNameAtBirth.$$error}} {{metaSection.motherFamilyNameAtBirth.$$warning}}

1.1.6.11. Forename of mother

[ BDT ] {{metaSection.forenameMother.$$error}} {{metaSection.forenameMother.$$warning}}

1.1.6.12. Previous family name(s)

[ BDT ] {{metaSection.previousFamilyName.$$error}} {{metaSection.previousFamilyName.$$warning}}

1.1.6.13. Previous forename(s)

[ BDT ] {{metaSection.previousForename.$$error}} {{metaSection.previousForename.$$warning}}

1.1.6.14. Nationality

[ ENUM ] {{metaSection.nationality.$$error}} {{metaSection.nationality.$$warning}}

1.1.6.15. Other

[ CDT ] {{metaSection.other.$$error}} {{metaSection.other.$$warning}}

1.1.7. Additional information/Change in circumstances [ SED ]

1.1.7.1. Notification/Request for additional information

[ ENUM ] {{metaSection.notificationRequestForAdditionalInformation.$$error}} {{metaSection.notificationRequestForAdditionalInformation.$$warning}}

1.1.7.2. Additional information/Change in circumstances

[ CDT ] {{metaSection.additionalInformationChangeInCircumstances.$$error}} {{metaSection.additionalInformationChangeInCircumstances.$$warning}}

1.1.8. Please find attached the following documents: [ SC ]

1.1.8.1. Predefined Documents

[ ENUM ] {{metaSection.predefinedDocuments.$$error}} {{metaSection.predefinedDocuments.$$warning}}

1.1.8.2. Other Documents Attached [ SC ]

1.1.8.2.1. Other Document [ SC ]

1.1.8.2.1.1. Document

[ CDT ] {{metaSection.document.$$error}} {{metaSection.document.$$warning}}

1.1.8.2.1.Other Document

1.2.1. Employer *

[ CC ]

1.2.1.1. Name *

[ CDT ] {{metaSection.name.$$error}} {{metaSection.name.$$warning}}

1.2.1.2. Identification numbers

[ CC ]

1.2.1.2.1. Identification number

[ CC ]

1.2.1.2.1.1. Number *

[ CDT ] {{metaSection.number.$$error}} {{metaSection.number.$$warning}}

1.2.1.2.1.2. Type *

[ ENUM ] {{metaSection.type.$$error}} {{metaSection.type.$$warning}}

1.2.1.2.1.Identification number

1.2.1.3. Address

[ CC ]

1.2.1.3.1. Street

[ CDT ] {{metaSection.street.$$error}} {{metaSection.street.$$warning}}

1.2.1.3.2. Building Name

[ CDT ] {{metaSection.buildingName.$$error}} {{metaSection.buildingName.$$warning}}

1.2.1.3.3. Town *

[ CDT ] {{metaSection.town.$$error}} {{metaSection.town.$$warning}}

1.2.1.3.4. Postal Code

[ CDT ] {{metaSection.postalCode.$$error}} {{metaSection.postalCode.$$warning}}

1.2.1.3.5. Region

[ CDT ] {{metaSection.region.$$error}} {{metaSection.region.$$warning}}

1.2.1.3.6. Country *

[ ENUM ] {{metaSection.country.$$error}} {{metaSection.country.$$warning}}

1.2.2. Request for information [ SED ]

1.2.2.1. Date of request

[ BDT ] {{metaSection.dateRequest.$$error}} {{metaSection.dateRequest.$$warning}}

1.2.2.2. Please provide [ SED ]

1.2.2.2.1. The following document(s)

[ CDT ] {{metaSection.document.$$error}} {{metaSection.document.$$warning}}

1.2.2.2.2. The following information

[ CDT ] {{metaSection.information.$$error}} {{metaSection.information.$$warning}}

1.2.2.2.3. The following SED(s)

[ CDT ] {{metaSection.followingSED.$$error}} {{metaSection.followingSED.$$warning}}

1.2.3. Additional information / Change in circumstances [ SED ]

1.2.3.1. Notification/Request for additional information

[ ENUM ] {{metaSection.notificationRequestForAdditionalInformation.$$error}} {{metaSection.notificationRequestForAdditionalInformation.$$warning}}

1.2.3.2. Additional information/Change in circumstances

[ CDT ] {{metaSection.additionalInformationChangeInCircumstances.$$error}} {{metaSection.additionalInformationChangeInCircumstances.$$warning}}

1.2.4. Please find attached the following documents: [ SC ]

1.2.4.1. Predefined Documents

[ ENUM ] {{metaSection.predefinedDocuments.$$error}} {{metaSection.predefinedDocuments.$$warning}}

1.2.4.2. Other Documents Attached [ SC ]

1.2.4.2.1. Other Document [ SC ]

1.2.4.2.1.1. Document

[ CDT ] {{metaSection.document.$$error}} {{metaSection.document.$$warning}}

1.2.4.2.1.Other Document

1.3.1. Reimbursement identification * [ SC ]

1.3.1.1. Reimbursement Request ID *

[ BDT ] {{metaSection.reimbursementRequestID.$$error}} {{metaSection.reimbursementRequestID.$$warning}}

1.3.2. Request for information [ SED ]

1.3.2.1. Date of request

[ BDT ] {{metaSection.dateRequest.$$error}} {{metaSection.dateRequest.$$warning}}

1.3.2.2. Please provide [ SED ]

1.3.2.2.1. The following document(s)

[ CDT ] {{metaSection.document.$$error}} {{metaSection.document.$$warning}}

1.3.2.2.2. The following information

[ CDT ] {{metaSection.information.$$error}} {{metaSection.information.$$warning}}

1.3.2.2.3. The following SED(s)

[ CDT ] {{metaSection.followingSED.$$error}} {{metaSection.followingSED.$$warning}}

1.3.3. Additional information / Change in circumstances [ SED ]

1.3.3.1. Notification/Request for additional information

[ ENUM ] {{metaSection.notificationRequestForAdditionalInformation.$$error}} {{metaSection.notificationRequestForAdditionalInformation.$$warning}}

1.3.3.2. Additional information/Change in circumstances

[ CDT ] {{metaSection.additionalInformationChangeInCircumstances.$$error}} {{metaSection.additionalInformationChangeInCircumstances.$$warning}}

1.3.4. Please find attached the following documents: [ SC ]

1.3.4.1. Predefined Documents

[ ENUM ] {{metaSection.predefinedDocuments.$$error}} {{metaSection.predefinedDocuments.$$warning}}

1.3.4.2. Other Documents Attached [ SC ]

1.3.4.2.1. Other Document [ SC ]

1.3.4.2.1.1. Document

[ CDT ] {{metaSection.document.$$error}} {{metaSection.document.$$warning}}

1.3.4.2.1.Other Document

{{ row.severityMessage }} : {{ row.message }}

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