A005 - Request for more information
Title II of Regulation(EC) 883/2004
SED API version: 0.16.2 build 2
Model version: 4.2.0
Person
*
Person Identification
*
Family name(s)
*
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Forename(s)
*
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Date of birth
*
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Sex
*
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Family name(s) at birth
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Forename(s) at birth
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PIN of the person in each institution
Personal Identification Number(s)
*
Country
*
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Personal Identification Number (PIN)
*
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Sector
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Institution
Institution ID
*
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Institution Name
*
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If PIN not provided for every institution, please provide
Place of birth
Town
*
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Region
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Country
*
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Father's family name at birth
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Forename of father
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Mother's family name at birth
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Forename of mother
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Additional information on the person
*
Nationality
*
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More information requested for situations covered by Article (Regulation (EC) No 883/2004 and Regulation (EC) No 987/2009)
*
Articles Basic Regulation for which more info is requested
*
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Other
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Employer activities for which more info is required in other Member State concerned
Employed Activity
Name
*
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Identification numbers
Identification number
Number
*
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Type
*
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Address
Street
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Building Name
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Town
*
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Postal Code
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Region
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Country
*
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Self Employer activities for which more info is required in other Member State concerned
Self-Employed Activity
Name
*
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Identification numbers
Identification number
Number
*
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Type
*
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Address
Street
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Building Name
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Town
*
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Postal Code
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Region
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Country
*
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More information for 11(2)
More Information
More information
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Additional information
Additional information
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More information for 11(3)(a)
More Information
More information
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Additional information
Additional information
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More information for 11(4) or 11(5)
More Information
More information
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Additional information
Additional information
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More information for 12(1)
More Information
More information
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Additional information
Additional information
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More information for 12(2)
More Information
More information
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Additional information
Additional information
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More information for 13(1)
More Information
More information
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Additional information
Additional information
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More information for 13(2)
More Information
More information
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Additional information
Additional information
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More information for 13(3)
More Information
More information
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Additional information
Additional information
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Information concerning other articles of Basic or Implementing Regulation
Information concerning other articles of Basic or Implementing Regulation
More information
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Article of Regulation for which information is requested
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Additional information
Additional information
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Reason for requesting the information
*
Reason
*
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