Contestation of Credit Note (COC

DA012C - Contestation of Credit Note (COC_CRN)
Articles 35, 41 of Regulation (EC) No 883/2004, 62, 66 (1), 67 of Regulation (EC) No 987/2009

SED API version: 0.16.2 build 2
Model version: 4.2.0

Global Note COC_CRN *

Global CLA reference Creditor Liaison Body *

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Global CRN reference Creditor Liaison Body *

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Global COC_CRN reference Debtor Liaison Body *

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Total number of Individual Credit notes contestations *

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Total Amount Of Credit Notes Contestations *

Amount *

Currency *

Date Of Submission *

Individual COC_CRNs *

Individual COC_CRN *

ID Creditor Institution *

Institution ID *

Institution Name *

ID Debtor Institution *

Institution ID *

Institution Name *

References *

Global CLA Reference Creditor Liaison Body *

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Global CRN Reference Creditor Liaison Body *

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Global COC_CRN Reference Debtor Liaison Body *

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Individual CLA Number Creditor Liaison Body *

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Individual CRN Number Creditor Liaison Body *

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Individual COC_CRN Number Debtor Liaison Body *

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Person receiving benefits *

Person Information *

Family name(s) *

Forename(s) *

Date of birth *

Sex *

Family name(s) at birth

Forename(s) at birth

Person Identification Number *

PIN of the person in Competent Member State *

PIN of the person in Member State of Stay or Residence

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Credit note contestations reasons *

Please fill in the following if "Credit note contestations reasons" = "99 - Other" :

Credit note contestation other reason

Amount contested *

Amount *

Currency *

Individual COC_CRN

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DA012C - Contestation of Credit Note (COC_CRN) Articles 35, 41 of Regulation (EC) No 883/2004, 62, 66 (1), 67 of Regulation (EC) No 987/2009

DA012C - Contestation of Credit Note (COC_CRN)
Articles 35, 41 of Regulation (EC) No 883/2004, 62, 66 (1), 67 of Regulation (EC) No 987/2009