R016 - Reply to request for notification
Article 77 of Regulation (EC) No 987/2009
SED API version: 0.15.2 build 3
Model version: 4.1.0
1. Local Case Numbers
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1.1. Local Case Number
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1.1.1. Country
*
{{$select.selected[ 'name']}}
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{{metaSection.country.$$error}}
{{metaSection.country.$$warning}}
1.1.2. Case number
*
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1.1.3. Institution
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1.1.3.1. Institution ID
*
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1.1.3.2. Institution Name
*
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2. Concerns
*
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2.1. Concerns
*
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Please fill in the following if "Concerns" = "Person" :
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Please fill in the following if "Concerns" = "Employer" :
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3.1. Persons
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3.1.1. Person
*
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3.1.1.1. Person Identification
*
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3.1.1.1.1. Family name(s)
*
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3.1.1.1.2. Forename(s)
*
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{{metaSection.forename.$$error}}
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3.1.1.1.3. Date of birth
*
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{{metaSection.dateBirth.$$error}}
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3.1.1.1.4. Sex
*
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[ ENUM ]
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3.1.1.1.5. Family name(s) at birth
[ BDT ]
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3.1.1.1.6. Forename(s) at birth
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3.1.1.1.7. PIN of the person in each institution
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3.1.1.1.7.1. Personal Identification Number(s)
*
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3.1.1.1.7.1.1. Country
*
{{$select.selected[ 'name']}}
[ ENUM ]
{{metaSection.country.$$error}}
{{metaSection.country.$$warning}}
3.1.1.1.7.1.2. Personal Identification Number (PIN)
*
[ BDT ]
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3.1.1.1.7.1.3. Sector
{{$select.selected[ 'name']}}
[ ENUM ]
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3.1.1.1.7.1.4. Institution
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3.1.1.1.7.1.4.1. Institution ID
*
[ BDT ]
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3.1.1.1.7.1.4.2. Institution Name
*
[ CDT ]
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3.1.1.1.8. If PIN not provided for every institution, please provide
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3.1.1.1.8.1. Place of birth
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3.1.1.1.8.1.1. Town
*
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3.1.1.1.8.1.2. Region
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3.1.1.1.8.1.3. Country
*
{{$select.selected[ 'name']}}
[ ENUM ]
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3.1.1.1.8.2. Father's family name at birth
[ BDT ]
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3.1.1.1.8.3. Forename of father
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{{metaSection.forenameFather.$$error}}
{{metaSection.forenameFather.$$warning}}
3.1.1.1.8.4. Mother's family name at birth
[ BDT ]
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3.1.1.1.8.5. Forename of mother
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3.1.1.2. Additional information about a person
*
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3.1.1.2.1. Status of the person
*
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[ ENUM ]
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3.1.1.2.2. Please fill in the following if "Status of the person" = "Other" :
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3.1.1.2.2.1. Other status of the person
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3.1.1.2.3. Nationality
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{{metaSection.nationality.$$warning}}
3.1.1.2.4. Previous family name(s)
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3.1.1.2.4.1. Previous family name(s)
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3.1.1.2.4.1.1. Previous family name(s)
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3.1.1.2.5. Previous forenames
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3.1.1.2.5.1. Previous forename
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3.1.1.2.5.1.1. Previous forename
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3.1.1.2.6. Current family status
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[ ENUM ]
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3.1.1.2.7. Date of death
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4.1. Employer
*
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4.1.1. Name
*
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4.1.2. Identification numbers
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4.1.2.1. Identification number
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4.1.2.1.1. Number
*
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4.1.2.1.2. Type
*
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4.1.3. Address
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4.1.3.1. Street
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4.1.3.2. Building Name
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4.1.3.3. Town
*
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4.1.3.4. Postal Code
[ CDT ]
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4.1.3.5. Region
[ CDT ]
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4.1.3.6. Country
*
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[ ENUM ]
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4.2. Responsible person or section
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4.2.1. Responsible person or section
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4.2.2. Contact Information
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4.2.2.1. Telephone Numbers
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4.2.2.1.1. Telephone Number
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4.2.2.1.1.1. Type
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4.2.2.1.1.2. Number
*
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4.2.2.2. Email Addresses
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4.2.2.2.1. Email Address
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4.2.2.2.1.1. Email Address
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4.3. Persons
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4.3.1. Person
*
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4.3.1.1. Person Identification
*
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4.3.1.1.1. Family name(s)
*
[ BDT ]
{{metaSection.familyName.$$error}}
{{metaSection.familyName.$$warning}}
4.3.1.1.2. Forename(s)
*
[ BDT ]
{{metaSection.forename.$$error}}
{{metaSection.forename.$$warning}}
4.3.1.1.3. Date of birth
*
[ BDT ]
{{metaSection.dateBirth.$$error}}
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4.3.1.1.4. Sex
*
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[ ENUM ]
{{metaSection.sex.$$error}}
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4.3.1.1.5. Family name(s) at birth
[ BDT ]
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4.3.1.1.6. Forename(s) at birth
[ BDT ]
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4.3.1.1.7. PIN of the person in each institution
[ CC ]
4.3.1.1.7.1. Personal Identification Number(s)
*
[ CC ]
4.3.1.1.7.1.1. Country
*
{{$select.selected[ 'name']}}
[ ENUM ]
{{metaSection.country.$$error}}
{{metaSection.country.$$warning}}
4.3.1.1.7.1.2. Personal Identification Number (PIN)
*
[ BDT ]
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4.3.1.1.7.1.3. Sector
{{$select.selected[ 'name']}}
[ ENUM ]
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4.3.1.1.7.1.4. Institution
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4.3.1.1.7.1.4.1. Institution ID
*
[ BDT ]
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4.3.1.1.7.1.4.2. Institution Name
*
[ CDT ]
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4.3.1.1.8. If PIN not provided for every institution, please provide
[ CC ]
4.3.1.1.8.1. Place of birth
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4.3.1.1.8.1.1. Town
*
[ CDT ]
{{metaSection.town.$$error}}
{{metaSection.town.$$warning}}
4.3.1.1.8.1.2. Region
[ CDT ]
{{metaSection.region.$$error}}
{{metaSection.region.$$warning}}
4.3.1.1.8.1.3. Country
*
{{$select.selected[ 'name']}}
[ ENUM ]
{{metaSection.country.$$error}}
{{metaSection.country.$$warning}}
4.3.1.1.8.2. Father's family name at birth
[ BDT ]
{{metaSection.fatherFamilyNameAtBirth.$$error}}
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4.3.1.1.8.3. Forename of father
[ BDT ]
{{metaSection.forenameFather.$$error}}
{{metaSection.forenameFather.$$warning}}
4.3.1.1.8.4. Mother's family name at birth
[ BDT ]
{{metaSection.motherFamilyNameAtBirth.$$error}}
{{metaSection.motherFamilyNameAtBirth.$$warning}}
4.3.1.1.8.5. Forename of mother
[ BDT ]
{{metaSection.forenameMother.$$error}}
{{metaSection.forenameMother.$$warning}}
4.3.1.2. Additional information about a person
*
[ SC ]
4.3.1.2.1. Status of the person
*
{{$select.selected[ 'name']}}
[ ENUM ]
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4.3.1.2.2. Please fill in the following if "Status of the person" = "Other" :
[ SC ]
4.3.1.2.2.1. Other status of the person
[ CDT ]
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4.3.1.2.3. Nationality
[ ENUM ]
{{metaSection.nationality.$$error}}
{{metaSection.nationality.$$warning}}
4.3.1.2.4. Previous family name(s)
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4.3.1.2.4.1. Previous family name(s)
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4.3.1.2.4.1.1. Previous family name(s)
[ BDT ]
{{metaSection.previousFamilyName.$$error}}
{{metaSection.previousFamilyName.$$warning}}
4.3.1.2.5. Previous forenames
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4.3.1.2.5.1. Previous forename
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4.3.1.2.5.1.1. Previous forename
[ BDT ]
{{metaSection.previousForename.$$error}}
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4.3.1.2.6. Current family status
{{$select.selected[ 'name']}}
[ ENUM ]
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4.3.1.2.7. Date of death
[ BDT ]
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5. Notification made
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5.1. Notification form
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5.1.1. Notification form
*
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5.1.2. Please fill in the following if Notification form = "Otherwise"
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5.1.2.1. Specify other notification form
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5.2. Notification date
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5.3. Notification made after the requested date because
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6. Notification not made
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6.1. Notification not made
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[ ENUM ]
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6.2. Please fill in the following if "Notification not made" = "Other reason" :
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6.2.1. State the reason
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