Insurance Record - Cross border Worker

U017 - Insurance Record - Cross border Worker
Articles 61, 65 of Regulation (EC) No 883/2004; Article 54(1) 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 *

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

1.1.2. Case number *

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

1.1.3. Institution

[ CC ]

1.1.3.1. Institution ID *

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

1.1.3.2. Institution Name *

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

1.1.Local Case Number

2. 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 *

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

2.1.5. Family name(s) at birth

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

2.1.6. Forename(s) at birth

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

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 *

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

2.1.7.1.2. Personal Identification Number (PIN) *

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

2.1.7.1.3. Sector

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

2.1.7.1.4. Institution

[ CC ]

2.1.7.1.4.1. Institution ID *

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

2.1.7.1.4.2. Institution Name *

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

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 *

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

2.1.8.1.2. Region

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

2.1.8.1.3. Country *

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

2.1.8.2. Father's family name at birth

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

2.1.8.3. Forename of father

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

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. Nationality

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

3. Reference period *

[ CC ]

Fixed period* [ CC ]

Open period* [ CC ]

3.1.1. Start date *

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

3.1.2. End date *

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

3.2.1. Type of Open Period *

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

3.2.2. Start date *

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

4. Entitled to benefits *

[ SED ]

4.1. Entitled? *

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

Please fill in the following if "Entitled?" = "Yes" : [ SED ]

Please fill in the following if "Entitled?" = "No" : [ SED ]

4.2.1. Article number

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

4.2.2. Entitlement period

[ CC ]

Fixed period* [ CC ]

Open period* [ CC ]

4.2.2.1.1. Start date *

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

4.2.2.1.2. End date *

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

4.2.2.2.1. Type of Open Period *

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

4.2.2.2.2. Start date *

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

4.3.1. Reason

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

5. Periods of insurance, employment or self-employment

[ SC ]

5.1. Period of insurance, employment or self-employment [ SC ]

5.1.1. Period * [ CC ]

Fixed period* [ CC ]

Open period* [ CC ]

5.1.1.1.1. Start date *

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

5.1.1.1.2. End date *

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

5.1.1.2.1. Type of Open Period *

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

5.1.1.2.2. Start date *

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

5.1.2. Type of period *

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

Please fill in the following if "Type of period" = "01 - Employment that is insurance period" or "Type of period" = "02 - Self-employment that is insurance period" : [ SC ]

Please fill in the following if "Type of period" = "03 - Employment that is not insurance period" or "Type of period" = "04 - Self-employment that is not insurance period" : [ SC ]

Please fill in the following if "Type of period" = "10 - Other period that is insurance period or treated as insurance period" : [ SC ]

5.1.3.1. Employer or self-employment details

[ CC ]

5.1.3.1.1. Name *

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

5.1.3.1.2. Identification numbers

[ CC ]

5.1.3.1.2.1. Identification number

[ CC ]

5.1.3.1.2.1.1. Number *

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

5.1.3.1.2.1.2. Type *

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

5.1.3.1.2.1.Identification number

5.1.3.1.3. Address

[ CC ]

5.1.3.1.3.1. Street

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

5.1.3.1.3.2. Building Name

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

5.1.3.1.3.3. Town *

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

5.1.3.1.3.4. Postal Code

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

5.1.3.1.3.5. Region

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

5.1.3.1.3.6. Country *

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

5.1.4.1. Requested additional details

[ SC ]

5.1.4.1.1. Earnings and or hours [ SC ]

5.1.4.1.1.1. Earnings and or hours [ SC ]

5.1.4.1.1.1.1. Period * [ CC ]

Fixed period* [ CC ]

Open period* [ CC ]

5.1.4.1.1.1.1.1.1. Start date *

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

5.1.4.1.1.1.1.1.2. End date *

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

5.1.4.1.1.1.1.2.1. Type of Open Period *

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

5.1.4.1.1.1.1.2.2. Start date *

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

5.1.4.1.1.1.2. Gross earnings

[ CC ]

5.1.4.1.1.1.2.1. Amount *

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

5.1.4.1.1.1.2.2. Currency *

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

5.1.4.1.1.1.3. Number of working hours

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

5.1.4.1.1.1.Earnings and or hours

5.1.4.1.2. Employment or self-employment nature

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

5.1.4.2. Employer or Self-employment details

[ CC ]

5.1.4.2.1. Name *

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

5.1.4.2.2. Identification numbers

[ CC ]

5.1.4.2.2.1. Identification number

[ CC ]

5.1.4.2.2.1.1. Number *

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

5.1.4.2.2.1.2. Type *

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

5.1.4.2.2.1.Identification number

5.1.4.2.3. Address

[ CC ]

5.1.4.2.3.1. Street

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

5.1.4.2.3.2. Building Name

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

5.1.4.2.3.3. Town *

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

5.1.4.2.3.4. Postal Code

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

5.1.4.2.3.5. Region

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

5.1.4.2.3.6. Country *

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

5.1.5.1. Type

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

Please fill in the following if "Type" = "02 - Other period treated as a period of insurance" : [ SC ]

Please fill in the following if "Type" = "03 - Compensation for vacation not taken" : [ SC ]

5.1.5.2.1. Type of 'Other period treated as a period of insurance'

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

5.1.5.3.1. Vacation not taken [ SC ]

5.1.5.3.1.1. Amount * [ CC ]

5.1.5.3.1.1.1. Amount *

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

5.1.5.3.1.1.2. Currency *

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

5.1.Period of insurance, employment or self-employment

6. Elements concerning the last employment or self-employment important for starting date of benefits

[ SC ]

6.1. Type of amounts [ SC ]

6.1.1. Type of amount [ SC ]

6.1.1.1. Type of amount

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

6.1.1.2. Payment * [ CC ]

6.1.1.2.1. Amount *

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

6.1.1.2.2. Currency *

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

Please fill in the following if "Type of amount" = "01 - Wages for period after termination of employment or self-employment" : [ SC ]

Please fill in the following if "Type of amount" = "02 - Compensation for vacation not taken (Annual leave)" : [ SC ]

6.1.2.1. Received for period until

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

6.1.3.1. Number of days

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

6.1.Type of amounts

6.2. Waived rights

[ SC ]

6.2.1. Waived rights

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

6.2.2. Reason

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

6.3. Other benefit(s)

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

7. Reason for termination of the last employment or self-employment

[ SC ]

7.1. Termination reason of employment

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

7.2. Please fill in the following if "Termination reason of employment" = "99 - Other" : [ SC ]

7.2.1. Other termination

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

7.3. Termination reason of self-employment

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

8. Unemployment benefits periods

[ SC ]

8.1. Unemployment benefits period [ SC ]

8.1.1. Period * [ CC ]

Fixed period* [ CC ]

Open period* [ CC ]

8.1.1.1.1. Start date *

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

8.1.1.1.2. End date *

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

8.1.1.2.1. Type of Open Period *

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

8.1.1.2.2. Start date *

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

8.1.2. Local institution

[ SC ]

8.1.2.1. Institution ID is known *

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

Please fill in the following if "Institution ID is known" = "Yes" : [ CC ]

Please fill in the following if "Institution ID is known" = "No" : [ SC ]

8.1.2.2.1. Institution ID *

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

8.1.2.2.2. Institution Name *

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

8.1.2.3.1. Institution name *

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

8.1.2.3.2. Institution address *

[ CC ]

8.1.2.3.2.1. Street

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

8.1.2.3.2.2. Building Name

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

8.1.2.3.2.3. Town *

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

8.1.2.3.2.4. Postal Code

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

8.1.2.3.2.5. Region

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

8.1.2.3.2.6. Country *

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

8.1.Unemployment benefits period

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U017 - Insurance Record - Cross border Worker Articles 61, 65 of Regulation (EC) No 883/2004; Article 54(1) of Regulation (EC) No 987/2009

U017 - Insurance Record - Cross border Worker
Articles 61, 65 of Regulation (EC) No 883/2004; Article 54(1) of Regulation (EC) No 987/2009