Request for Exception

A001 - Request for Exception
Article 16 (1) of Regulation (EC) No 883/2004, Article 18 of Regulation(EC) No 987/2009

SED API version: 0.16.2 build 2
Model version: 4.2.0

Person *

Person Identification *

Family name(s) *

Forename(s) *

Date of birth *

Sex *

Family name(s) at birth

Forename(s) at birth

PIN of the person in each institution

Personal Identification Number(s) *

Country *

Personal Identification Number (PIN) *

Sector

Institution

Institution ID *

Institution Name *

Personal Identification Number(s)

If PIN not provided for every institution, please provide

Place of birth

Town *

Region

Country *

Father's family name at birth

Forename of father

Mother's family name at birth

Forename of mother

Additional information on the person *

Nationality *

Addresses *

Address *

Type *

Address *

Street

Building Name

Town *

Postal Code

Region

Country *

Address

Identification of the employer(s)

Employer

Name *

Identification numbers

Identification number

Number *

Type *

Identification number

Address

Street

Building Name

Town *

Postal Code

Region

Country *

Employer

Identification of the self-employment(s)

Self-Employment

Name *

Identification numbers

Identification number

Number *

Type *

Identification number

Address

Street

Building Name

Town *

Postal Code

Region

Country *

Self-Employment

Place(s) of work

Place of Work

Company name / vessel name *

Flag state/home base

Address *

Street

Building Name

Town *

Postal Code

Region

Country *

No fixed address in State(s) of work

Place of Work

Employer in the Host Country (if relevant)

Name *

Identification numbers

Identification number

Number *

Type *

Identification number

Address

Street

Building Name

Town *

Postal Code

Region

Country *

Requested period *

Start Date *

End Date *

Articles of Basic Regulation referring to situation for which agreement on exception is proposed *

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Other

Applicable legislation *

Applicable legislation - current situation *

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Applicable legislation - requested situation *

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More information

Type of request

Amendment

Dates of previous request

Date of previous request

Date

Date of previous request

Previous periods

Period

Fixed period*
Open period*

Start date *

End date *

Type of Open Period *

Start date *

Period

PD A1 issued on basis of article

Special circumstances

Description of the other situation

Date on which contract with sending employer started

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Date on which employee was first insured in sending country

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Justification

Additional information

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A001 - Request for Exception Article 16 (1) of Regulation (EC) No 883/2004, Article 18 of Regulation(EC) No 987/2009

A001 - Request for Exception
Article 16 (1) of Regulation (EC) No 883/2004, Article 18 of Regulation(EC) No 987/2009