Reply with information on finally payable benefits

R009 - Reply with information on finally payable benefits
Article 73(1) of Regulation (EC) No 987/2009

SED API version: 0.14.2 PREVIEW build 3
Model version: 4.0.16

1. Local Case Numbers

1.1. Local Case Number

1.1.1. Country *

1.1.2. Case number *

1.1.3. Institution

1.1.3.1. Institution ID *

1.1.3.2. Institution Name *

1.1.Local Case Number

2. Persons *

2.1. Person *

2.1.1. Person Identification *

2.1.1.1. Family name(s) *

2.1.1.2. Forename(s) *

2.1.1.3. Date of birth *

2.1.1.4. Sex *

2.1.1.5. Family name(s) at birth

2.1.1.6. Forename(s) at birth

2.1.1.7. PIN of the person in each institution

2.1.1.7.1. Personal Identification Number(s) *

2.1.1.7.1.1. Country *

2.1.1.7.1.2. Personal Identification Number (PIN) *

2.1.1.7.1.3. Sector

2.1.1.7.1.4. Institution

2.1.1.7.1.4.1. Institution ID *

2.1.1.7.1.4.2. Institution Name *

2.1.1.7.1.Personal Identification Number(s)

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

2.1.1.8.1. Place of birth

2.1.1.8.1.1. Town *

2.1.1.8.1.2. Region

2.1.1.8.1.3. Country *

2.1.1.8.2. Father's family name at birth

2.1.1.8.3. Forename of father

2.1.1.8.4. Mother's family name at birth

2.1.1.8.5. Forename of mother

2.1.2. Additional information about a person *

2.1.2.1. Status of the person *

2.1.2.2. Please fill in the following if "Status of the person" = "Other" :

2.1.2.2.1. Other status of the person

2.1.2.3. Nationality

2.1.2.4. Previous family name(s)

2.1.2.4.1. Previous family name(s)

2.1.2.4.1.1. Previous family name(s)

2.1.2.4.1.Previous family name(s)

2.1.2.5. Previous forenames

2.1.2.5.1. Previous forename

2.1.2.5.1.1. Previous forename

2.1.2.5.1.Previous forename

2.1.2.6. Current family status

2.1.2.7. Date of death

2.1.Person

3. Entitlement to benefits *

3.1. Entitlement to benefits *

3.2. Request has been made within the 3 months period? *

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4. Please fill in the following if "Entitlement to benefits" = "Yes" AND "Request has been made within the 3 months period?" = "Yes":

4.1. Entitlement to arrears of a corresponding benefit

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4.2. Please fill in the following if "Entitlement to arrears of a corresponding benefit" = "Yes" :

4.2.1. Payable arrears period

4.2.1.1. Start Date *

4.2.1.2. End Date *

4.2.2. Arrears total amount

4.2.2.1. Amount *

4.2.2.2. Currency *

4.2.3. Amount of arrears covers the full amount of the provisional payment

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5. Please fill in the following if "Entitlement to arrears of a corresponding benefit" = "No" OR "Amount of arrears covers the full amount of the provisional payment" = "No" :

5.1. Deduction possible in periodic rates from ongoing payments

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5.2. Please fill in the following if "Deduction possible in periodic rates from ongoing payments" = "Yes"

5.2.1. Type of benefits from which deduction from ongoing payments is possible

5.2.1.1. Type of benefit from which deduction from ongoing payments is possible

5.2.1.1.1. Type of benefit

5.2.1.1.2. Please fill in the following if "Type of benefit" = "Other benefit" :

5.2.1.1.2.1. Type of other benefits

5.2.1.2. Institution competent for deduction from ongoing payment(s) *

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5.2.1.3. Periodic amount

5.2.1.3.1. Frequency *

5.2.1.3.2. Please fill in the following if "Frequency" = "Other" :

5.2.1.3.2.1. Other frequency

5.2.1.3.3. Number of periodic units *

5.2.1.3.4. Amount per unit *

5.2.1.3.4.1. Amount *

5.2.1.3.4.2. Currency *

5.2.1.4. Please fill in the following if "Institution competent for deduction from ongoing payment(s)" = "Other institution(s)" :

5.2.1.4.1. Other institutions competent for ongoing payment(s)

5.2.1.4.1.1. Other institution competent for ongoing payment(s)

5.2.1.4.1.1.1. Institution ID *

5.2.1.4.1.1.2. Institution Name *

5.2.1.4.1.1.Other institution competent for ongoing payment(s)

5.2.1.Type of benefits from which deduction from ongoing payments is possible

6. Additional information

6.1. Additional information

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R009 - Reply with information on finally payable benefits Article 73(1) of Regulation (EC) No 987/2009

R009 - Reply with information on finally payable benefits
Article 73(1) of Regulation (EC) No 987/2009