Information on Payment of Single Claim

DA018 - Information on Payment of Single Claim - Benefits in Kind (PAY)
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 PAY *

Global CLA reference Creditor Liaison Body *

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Global PAY reference Debtor Liaison Body *

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Total Number of Individual Payments *

Total Payment Amount to be paid*
Total Payment Amount to be refunded*

Amount *

Currency *

Amount *

Currency *

Total Amount of Credit Notes *

Amount *

Currency *

Total Amount of Contestations *

Amount *

Currency *

Total Amount of Benefits *

Amount *

Currency *

Total Amount of Down Payment *

Amount *

Currency *

Total Amount of Overpayment

Amount *

Currency *

Overpayment References

Overpayment References Details

Overpayment reference

Reference number *

Amount *

Currency *

Overpayment reference

Overpayment References Details

Offsetting references

Offsetting reference

Reference number *

Amount *

Currency *

Offsetting reference

Date Of Submission *

Individual PAYs *

Individual PAY *

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 PAY Reference Debtor Liaison Body *

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Individual CLA Number Creditor Liaison Body *

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COC References Debtor Liaison Body

COC Reference Debtor Liaison Body

Global COC Reference Debtor Liaison Body

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Individual COC number Debtor Liaison Body

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COC Reference Debtor Liaison Body

Individual PAY 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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Total Individual Amount of Payment *

Amount *

Currency *

Total Individual Amount Of Benefits *

Amount *

Currency *

Total Individual Amount Of Credit Notes

Amount *

Currency *

PAY information On Credit Note

PAY information On Credit Note Details

Original Global CLA Reference Creditor Liaison Body

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Global CRN Reference Creditor Liaison Body

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Individual CRN number Creditor Liaison Body

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PAY information On Credit Note Details

Total Individual Amount Of Contestations

Amount *

Currency *

Individual PAY

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DA018 - Information on Payment of Single Claim - Benefits in Kind (PAY) Articles 35, 41 of Regulation (EC) No 883/2004, 62, 66 (1), 67 of Regulation (EC) No 987/2009

DA018 - Information on Payment of Single Claim - Benefits in Kind (PAY)
Articles 35, 41 of Regulation (EC) No 883/2004, 62, 66 (1), 67 of Regulation (EC) No 987/2009