Effect to Entitlement - Export

U011 - Effect to Entitlement - Export
Article 64, 65(5)(b), 65a(3) of Regulation (EC) No 883/2004; Article 55(4) of Regulation (EC) No 987/2009

SED API version: 0.16.2 build 2
Model version: 4.2.0

Local case numbers

Local Case Number

Country *

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Case number *

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Institution

Institution ID *

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Institution Name *

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Local Case Number

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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Personal Identification Number(s)

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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Effect on entitlement *

Effect on entitlement *

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Please fill in the following if "Effect on entitlement" = "03 - The entitlement to unemployment benefit is interrupted" :

Period of interruption *

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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