Request for child raising periods

P1000 - Request for child raising periods
Article 44 of Regulation (EC) No 987/2009

SED API version: 0.15.2 build 3
Model version: 4.1.0

1. Local case numbers [ CC ]

1.1. Local Case Number [ CC ]

1.1.1. Country *

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1.1.2. Case number *

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1.1.3. Institution [ CC ]

1.1.3.1. Institution ID *

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1.1.3.2. Institution Name *

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

1.1.Local Case Number

2. Insured person * [ SC ]

2.1. Person identification * [ CC ]

2.1.1. Family name(s) *

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

2.1.2. Forename(s) *

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

2.1.3. Date of birth *

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

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 [ CC ]

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

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 [ CC ]

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 [ CC ]

2.1.8.1. Place of birth [ CC ]

2.1.8.1.1. Town *

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2.1.8.1.2. Region

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

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

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

2.1.8.5. Forename of mother

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

2.2. Additional information on the person [ SC ]

2.2.1. Additional information on the person [ SC ]

2.2.1.1. Nationality

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2.2.1.2. Previous family name(s)

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

2.2.1.3. Previous forename(s)

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

2.2.2. Address [ CC ]

2.2.2.1. Street

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2.2.2.2. Building Name

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

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 [ CC ]

2.2.3.1. Telephone Numbers [ CC ]

2.2.3.1.1. Telephone Number [ CC ]

2.2.3.1.1.1. Type

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2.2.3.1.1.2. Number *

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

2.2.3.1.1.Telephone Number

2.2.3.2. Email Addresses [ CC ]

2.2.3.2.1. Email Address [ CC ]

2.2.3.2.1.1. Email Address

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

2.2.3.2.1.Email Address

3. Claimant (survivor's pension) [ SC ]

3.1. Person identification * [ CC ]

3.1.1. Family name(s) *

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3.1.2. Forename(s) *

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

3.1.3. Date of birth *

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

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

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

3.1.7. PIN of the person in each institution [ CC ]

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

3.1.7.1.1. Country *

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3.1.7.1.2. Personal Identification Number (PIN) *

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

3.1.7.1.3. Sector

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3.1.7.1.4. Institution [ CC ]

3.1.7.1.4.1. Institution ID *

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

3.1.7.1.4.2. Institution Name *

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

3.1.7.1.Personal Identification Number(s)

3.1.8. If PIN not provided for every institution, please provide [ CC ]

3.1.8.1. Place of birth [ CC ]

3.1.8.1.1. Town *

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3.1.8.1.2. Region

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

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

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

3.2. Additional information on the person [ SC ]

3.2.1. Additional information on the person [ SC ]

3.2.1.1. Nationality

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3.2.1.2. Previous family name(s)

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

3.2.1.3. Previous forename(s)

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

3.2.2. Address [ CC ]

3.2.2.1. Street

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

3.2.2.2. Building Name

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

3.2.2.3. Town *

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

3.2.2.4. Postal Code

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

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 [ CC ]

3.2.3.1. Telephone Numbers [ CC ]

3.2.3.1.1. Telephone Number [ CC ]

3.2.3.1.1.1. Type

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

3.2.3.1.1.2. Number *

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

3.2.3.1.1.Telephone Number

3.2.3.2. Email Addresses [ CC ]

3.2.3.2.1. Email Address [ CC ]

3.2.3.2.1.1. Email Address

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

3.2.3.2.1.Email Address

4. Child * [ SED ]

4.1. Person identification * [ CC ]

4.1.1. Family name(s) *

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4.1.2. Forename(s) *

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

4.1.3. Date of birth *

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

4.1.4. Sex *

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4.1.5. Family name(s) at birth

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4.1.6. Forename(s) at birth

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4.1.7. PIN of the person in each institution [ CC ]

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

4.1.7.1.1. Country *

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4.1.7.1.2. Personal Identification Number (PIN) *

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

4.1.7.1.3. Sector

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4.1.7.1.4. Institution [ CC ]

4.1.7.1.4.1. Institution ID *

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

4.1.7.1.4.2. Institution Name *

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

4.1.7.1.Personal Identification Number(s)

4.1.8. If PIN not provided for every institution, please provide [ CC ]

4.1.8.1. Place of birth [ CC ]

4.1.8.1.1. Town *

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4.1.8.1.2. Region

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

4.1.8.1.3. Country *

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4.1.8.2. Father's family name at birth

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4.1.8.3. Forename of father

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4.1.8.4. Mother's family name at birth

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4.1.8.5. Forename of mother

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5. Additional information on the child [ SC ]

5.1. Relationship to the insured person

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5.2. Please fill in the following if "Relationship to the insured person" = "Other child" [ SC ]

5.2.1. Specifics on "Other child"

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5.3. Date of death

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6. Information concerning child raising periods from the requesting institution * [ SED ]

6.1. Child raising alleged * [ SED ]

6.1.1. Period * [ CC ]

Fixed period* [ CC ]

Open period* [ CC ]

6.1.1.1.1. Start date *

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6.1.1.1.2. End date *

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6.1.1.2.1. Type of Open Period *

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6.1.1.2.2. Start date *

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6.1.2. Country of child raising *

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

6.1.Child raising alleged

6.2. Activity of the insured person as an employed or self-employed person according to Article 44 (2) of Regulation (EC) No 987/2009 *

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6.3. Remarks

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P1000 - Request for child raising periods Article 44 of Regulation (EC) No 987/2009

P1000 - Request for child raising periods
Article 44 of Regulation (EC) No 987/2009