Inventory of months relating to reimbursement on the basis of fixed amounts (IMO)

S100 - Inventory of months relating to reimbursement on the basis of fixed amounts (IMO)
Articles 63, 64, 65, 66, 67 of Regulation (EC) No 987/2009

SED API version: 0.15.2 build 3
Model version: 4.1.0

1. Global Note IMO * [ SED ]

1.1. Global IMO Reference Creditor Liaison Body *

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1.2. Total number of individual claims *

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1.3. Total number of months *

[ PRIM ] {{metaSection.totalNumberMonths.$$error}} {{metaSection.totalNumberMonths.$$warning}}

1.4. Financial year *

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

1.5. Lump sum legal category * [ SED ]

1.5.1. Lump sum category based on the person status *

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1.5.2. Please fill in the following if "Lump sum legal category" = "01 - IR 987/2009, Art 63, 2.a" : [ SED ]

1.5.2.1. Lump sum category

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1.5.3. Please fill in the following if "Lump sum legal category" = "02 - IR 987/2009, Art 63, 2.b" : [ SED ]

1.5.3.1. Lump sum category

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1.6. Date of submission *

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2. Individual IMOs * [ SED ]

2.1. Individual IMO * [ SED ]

2.1.1. ID Creditor Institution * [ CC ]

2.1.1.1. Institution ID *

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2.1.1.2. Institution Name *

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2.1.2. ID Debtor Institution * [ CC ]

2.1.2.1. Institution ID *

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2.1.2.2. Institution Name *

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

2.1.3. References * [ SED ]

2.1.3.1. Global IMO Reference Creditor Liaison Body *

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

2.1.3.2. Individual IMO Number Creditor Liaison Body *

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

2.1.4. Person Receiving Benefits * [ CC ]

2.1.4.1. Person Information * [ CC ]

2.1.4.1.1. Family name(s) *

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2.1.4.1.2. Forename(s) *

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

2.1.4.1.3. Date of birth *

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2.1.4.1.4. Sex *

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2.1.4.2. Family name(s) at birth

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2.1.4.3. Forename(s) at birth

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2.1.4.4. Person Identification Number * [ CC ]

2.1.4.4.1. PIN of the person in Competent Member State *

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2.1.4.4.2. PIN of the person in Member State of Stay or Residence

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2.1.5. Entitlement document *

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

2.1.6. Validity period * [ CC ]

Fixed period* [ CC ]

Open period* [ CC ]

2.1.6.1.1. Start date *

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2.1.6.1.2. End date *

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2.1.6.2.1. Type of Open Period *

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2.1.6.2.2. Start date *

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2.1.7. Accounting period * [ CC ]

2.1.7.1. Start Date *

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2.1.7.2. End Date *

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

2.1.8. Number of months *

[ PRIM ] {{metaSection.numberMonths.$$error}} {{metaSection.numberMonths.$$warning}}

2.1.9. Date of issue IMO of institution in place of residence *

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

2.1.Individual IMO

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S100 - Inventory of months relating to reimbursement on the basis of fixed amounts (IMO) Articles 63, 64, 65, 66, 67 of Regulation (EC) No 987/2009

S100 - Inventory of months relating to reimbursement on the basis of fixed amounts (IMO)
Articles 63, 64, 65, 66, 67 of Regulation (EC) No 987/2009