Credit Note - Benefits in Kind (CRN)

DA012 - Credit Note - Benefits in Kind (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 CRN *

Global CLA reference Creditor Liaison Body *

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Global CRN reference Creditor Liaison Body *

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Total number of Individual Credit notes *

Total Amount Of Credit Notes *

Amount *

Currency *

Date Of Submission *

Individual CRNs *

Individual 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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Individual CLA Number Creditor Liaison Body *

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Individual CRN Number Creditor 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 Benefits *

Benefit related to *

Date *

Benefits Period *

Start Date *

End Date *

Detailed benefits amount *

Medical Care Amount

Medicine Amount

Dental Care Amount

Long-term Care Amount

Hospitalisation Benefits

Hospitalisation benefit

Hospitalisation period

Start Date *

End Date *

Hospitalisation Amount *

Hospitalisation benefit

Other benefit(s)

Other benefit

Other Benefit Description *

Other Benefits Amount *

Other benefit

Total Amount of Individual CRN *

Amount *

Currency *

Individual CRN

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DA012 - Credit Note - Benefits in Kind (CRN) Articles 35, 41 of Regulation (EC) No 883/2004, 62, 66 (1), 67 of Regulation (EC) No 987/2009

DA012 - Credit Note - Benefits in Kind (CRN)
Articles 35, 41 of Regulation (EC) No 883/2004, 62, 66 (1), 67 of Regulation (EC) No 987/2009