F003 - Information about payment regarding priority right
883/04 Articles 1(1), 11, 67,68 and 987/09 Articles 2(2), 59, 60(1)
SED API version: 0.16.2 build 2
Model version: 4.2.0
Receipt of application for family benefits
Date of receipt of the application
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Type of claim
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Decision
Decision regarding all children mentioned in this SED
Decision regarding not all children mentioned in this SED
Decision regarding all children mentioned in this SED
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Decision regarding all children mentioned in this SED
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Child for whom this decision applies
Family Name
*
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Forename
*
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Date of Birth
*
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Periods
Period
Fixed period
*
Open period
*
Start date
*
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End date
*
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Type of Open Period
*
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Start date
*
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Decision on competence regarding priority right
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The reason for decision
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Additional information
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Claimant
*
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
{{$select.selected[ 'name']}}
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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
{{metaSection.region.$$error}}
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Country
*
{{$select.selected[ 'name']}}
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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 about nationality
Nationalities
Nationality
*
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Since
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Addresses of the person
Address of the Person
Type of address
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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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Contact Details
Telephone Numbers
Telephone Number
Type
{{option.name}}
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Number
*
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Email Addresses
Email Address
Email Address
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Is entitled to family benefit
Is not entitled to family benefit
Period of Entitlement
Fixed period
*
Open period
*
Start date
*
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End date
*
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Type of Open Period
*
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Start date
*
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Reason
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Additional information
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Information on spouse or partner
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
{{$select.selected[ 'name']}}
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Institution
Institution ID
*
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{{metaSection.institutionID.$$warning}}
Institution Name
*
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If PIN not provided for every institution, please provide
Place of birth
Town
*
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Region
{{metaSection.region.$$error}}
{{metaSection.region.$$warning}}
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 about nationality
Nationalities
Nationality
*
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Since
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Addresses of the person
Address of the Person
Type of address
{{option.name}}
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Address
Street
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Building Name
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{{metaSection.buildingName.$$warning}}
Town
*
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Postal Code
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Region
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{{metaSection.region.$$warning}}
Country
*
{{$select.selected[ 'name']}}
{{metaSection.country.$$error}}
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Contact Details
Telephone Numbers
Telephone Number
Type
{{option.name}}
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Number
*
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Email Addresses
Email Address
Email Address
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Additional information
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Information on other person
Personal Details
*
Family name(s)
*
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Forename(s)
*
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Date of birth
*
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Sex
*
{{option.name}}
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Family name(s) at birth
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Forename(s) at birth
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PIN of the person in each institution
Personal Identification Number(s)
*
Country
*
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Personal Identification Number (PIN)
*
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Sector
{{$select.selected[ 'name']}}
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Institution
Institution ID
*
{{metaSection.institutionID.$$error}}
{{metaSection.institutionID.$$warning}}
Institution Name
*
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{{metaSection.institutionName.$$warning}}
If PIN not provided for every institution, please provide
Place of birth
Town
*
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Region
{{metaSection.region.$$error}}
{{metaSection.region.$$warning}}
Country
*
{{$select.selected[ 'name']}}
{{metaSection.country.$$error}}
{{metaSection.country.$$warning}}
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 about nationality
Nationalities
Nationality
*
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Since
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Addresses of the person
Address of the Person
Type of address
{{option.name}}
{{metaSection.typeAddress.$$error}}
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Address
Street
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Building Name
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Town
*
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{{metaSection.town.$$warning}}
Postal Code
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Region
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{{metaSection.region.$$warning}}
Country
*
{{$select.selected[ 'name']}}
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{{metaSection.country.$$warning}}
Contact Details
Telephone Numbers
Telephone Number
Type
{{option.name}}
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{{metaSection.type.$$warning}}
Number
*
{{metaSection.number.$$error}}
{{metaSection.number.$$warning}}
Email Addresses
Email Address
Email Address
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{{metaSection.email.$$warning}}
Family relationship of the claimant to spouse or other person
Relationships
Family relationship
{{option.name}}
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Other relationship
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Period
Fixed period
*
Open period
*
Start date
*
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End date
*
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Type of Open Period
*
{{option.name}}
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Start date
*
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Name of person
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Date of relationship
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Is the claimant a member of the same household as the person in question
{{option.name}}
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Information on child(ren)
*
Child for whom this decision applies
*
Child Details
*
Family name(s)
*
{{metaSection.familyName.$$error}}
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Forename(s)
*
{{metaSection.forename.$$error}}
{{metaSection.forename.$$warning}}
Date of birth
*
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{{metaSection.dateBirth.$$warning}}
Sex
*
{{option.name}}
{{metaSection.sex.$$error}}
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Family name(s) at birth
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{{metaSection.familyNameAtBirth.$$warning}}
Forename(s) at birth
{{metaSection.forenameAtBirth.$$error}}
{{metaSection.forenameAtBirth.$$warning}}
PIN of the person in each institution
Personal Identification Number(s)
*
Country
*
{{$select.selected[ 'name']}}
{{metaSection.country.$$error}}
{{metaSection.country.$$warning}}
Personal Identification Number (PIN)
*
{{metaSection.personalIdentificationNumber.$$error}}
{{metaSection.personalIdentificationNumber.$$warning}}
Sector
{{$select.selected[ 'name']}}
{{metaSection.sector.$$error}}
{{metaSection.sector.$$warning}}
Institution
Institution ID
*
{{metaSection.institutionID.$$error}}
{{metaSection.institutionID.$$warning}}
Institution Name
*
{{metaSection.institutionName.$$error}}
{{metaSection.institutionName.$$warning}}
If PIN not provided for every institution, please provide
Place of birth
Town
*
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Region
{{metaSection.region.$$error}}
{{metaSection.region.$$warning}}
Country
*
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{{metaSection.country.$$warning}}
Father's family name at birth
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Forename of father
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Mother's family name at birth
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{{metaSection.motherFamilyNameAtBirth.$$warning}}
Forename of mother
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{{metaSection.forenameMother.$$warning}}
Additional information about nationality
Nationalities
Nationality
*
{{$select.selected[ 'name']}}
{{metaSection.nationality.$$error}}
{{metaSection.nationality.$$warning}}
Since
{{metaSection.since.$$error}}
{{metaSection.since.$$warning}}
Addresses of the child
Address of the Person
Type of address
{{option.name}}
{{metaSection.typeAddress.$$error}}
{{metaSection.typeAddress.$$warning}}
Address
Street
{{metaSection.street.$$error}}
{{metaSection.street.$$warning}}
Building Name
{{metaSection.buildingName.$$error}}
{{metaSection.buildingName.$$warning}}
Town
*
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{{metaSection.town.$$warning}}
Postal Code
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{{metaSection.postalCode.$$warning}}
Region
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{{metaSection.region.$$warning}}
Country
*
{{$select.selected[ 'name']}}
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Amounts, names and currencies for family benefits of the Children
Amount, name and currency for family benefits for a child
Name of child
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Name of benefit
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Family Benefit Details
Amount
Amount
*
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Currency
*
{{$select.selected[ 'name']}}
{{metaSection.currency.$$error}}
{{metaSection.currency.$$warning}}
Date for granted benefits
Start Date
*
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End Date
*
{{metaSection.endDate.$$error}}
{{metaSection.endDate.$$warning}}
Period definition
*
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Name of beneficiary
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Amounts of family benefit(s) for the entire family
Amount of Family Benefit
Name of benefit
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Number of persons benefits are granted for
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Family Benefit Details
Amount
Amount
*
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Currency
*
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Date for granted benefits
Start Date
*
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End Date
*
{{metaSection.endDate.$$error}}
{{metaSection.endDate.$$warning}}
Period definition
*
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Name of beneficiary
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