Reply to request for information on amount of income - special non-contributory cash benefits

M051 - Reply to request for information on amount of income - special non-contributory cash benefits
Article 70 of Regulation (EC) No 883/2004

SED API version: 0.16.2 build 2
Model version: 4.2.0

Person Income Received *

Person *

Person Identification *

Family name(s) *

Forename(s) *

Date of birth *

Sex *

Family name(s) at birth

Forename(s) at birth

PIN of the person in each institution

Personal Identification Number(s) *

Country *

Personal Identification Number (PIN) *

Sector

Institution

Institution ID *

Institution Name *

Personal Identification Number(s)

If PIN not provided for every institution, please provide

Place of birth

Town *

Region

Country *

Father's family name at birth

Forename of father

Mother's family name at birth

Forename of mother

Additional information on the person

Nationality

Status of the person

Please fill in the following if "Status of the person" = "Other" :

Other status

Address of the person

Type of address

Address

Street

Building Name

Town *

Postal Code

Region

Country *

Pursues a professional or trade activity

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Income received during the period in respect of which information is requested

Type of income received: *

Please fill in the following if "Type of income received" = "Social security benefits":

Social security benefit

Income received during the period in respect of which information is requested *

Start date

End date

Amount

Currency

Income received during the period in respect of which information is requested

Information on fixed assets during the period in respect of which information is requested

Property in respect of which the person is either the owner or the holder of a beneficial interest

Type of ownership

Type of property

Taxable income from each of these properties (fixed assets)

Amount *

Currency *

Present value of these properties (fixed assets)

Amount *

Currency *

Address in the country where these properties (fixed assets) are

Street

Building Name

Town *

Postal Code

Region

Country *

Address in the country where these properties (fixed assets) are

The Person occupies a dwelling in respect of which he/she, his/her spouse/partner or his/her member of the family is either the owner or the holder of a beneficial life interest?

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Please fill in the following if "The person named in this section occupy a dwelling in respect of which he/she is either the owner or the holder of a beneficial life interest" = "Yes" :

Taxable income of the dwelling occupied

Amount *

Currency *

Information on fixed assets during the period in respect of which information is requested

Information on transferred property during the period in respect of which information is requested

Property has been transferred either in return for payment or free of charge within the period in respect of which information is requested by the person named

Type of property

Date of transfer

Value of property at the time of transfer

Amount *

Currency *

Is the person named in this section in possession of the proceeds from the transferred property?

Answer

Please fill in the following if "Answer" = "Yes" :

Details

What is the nature of these proceeds?

What is the amount involved?

Amount *

Currency *

Is the person named in this section in possession of the proceeds from the transferred property?

Information on transferred property during the period in respect of which information is requested

Information on enclosed "Statement(s) of income" if you fail to provide information about income or its part

The person submitted a "Statement(s) of Income" that can replace the information requested, related to the following type of income *

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Please fill in the following if "The person submitted a "Statement(s) of Income" that can replace the information referred to the following income" = "Other type of income":

Other type of income

Information on enclosed "Statement(s) of income" if you fail to provide information about income or its part

Spouse / Partner Income Received

Spouse/Partner

Person Identification *

Family name(s) *

Forename(s) *

Date of birth *

Sex *

Family name(s) at birth

Forename(s) at birth

PIN of the person in each institution

Personal Identification Number(s) *

Country *

Personal Identification Number (PIN) *

Sector

Institution

Institution ID *

Institution Name *

Personal Identification Number(s)

If PIN not provided for every institution, please provide

Place of birth

Town *

Region

Country *

Father's family name at birth

Forename of father

Mother's family name at birth

Forename of mother

Additional information on the person

Nationality

Relationship to the person named in section 1

Please fill in the following if "Relationship to the person named in section 1" = "Other" :

Other

Address of the person

Type of address

Address

Street

Building Name

Town *

Postal Code

Region

Country *

Address of the person

Pursues a professional or trade activity

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Income received during the period in respect of which information is requested

Type of income received: *

Please fill in the following if "Type of income received" = "Social security benefits":

Social security benefit

Income received during the period in respect of which information is requested *

Start date

End date

Amount

Currency

Income received during the period in respect of which information is requested

Information on fixed assets during the period in respect of which information is requested

Property in respect of which the person is either the owner or the holder of a beneficial interest

Type of ownership

Type of property

Taxable income from each of these properties (fixed assets)

Amount *

Currency *

Present value of these properties (fixed assets)

Amount *

Currency *

Address in the country where these properties (fixed assets) are

Street

Building Name

Town *

Postal Code

Region

Country *

Address in the country where these properties (fixed assets) are

The Person occupies a dwelling in respect of which he/she, his/her spouse/partner or his/her member of the family is either the owner or the holder of a beneficial life interest?

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Please fill in the following if "The person named in this section occupy a dwelling in respect of which he/she is either the owner or the holder of a beneficial life interest" = "Yes" :

Taxable income of the dwelling occupied

Amount *

Currency *

Information on fixed assets during the period in respect of which information is requested

Information on transferred property during the period in respect of which information is requested

Property has been transferred either in return for payment or free of charge within the period in respect of which information is requested by the person named

Type of property

Date of transfer

Value of property at the time of transfer

Amount *

Currency *

Is the person named in this section in possession of the proceeds from the transferred property?

Answer

Please fill in the following if "Answer" = "Yes" :

Details

What is the nature of these proceeds?

What is the amount involved?

Amount *

Currency *

Is the person named in this section in possession of the proceeds from the transferred property?

Information on transferred property during the period in respect of which information is requested

Information on enclosed "Statement(s) of income" if you fail to provide information about income or its part

The person submitted a "Statement(s) of Income" that can replace the information requested, related to the following type of income *

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Please fill in the following if "The person submitted a "Statement(s) of Income" that can replace the information referred to the following income" = "Other type of income":

Other type of income

Information on enclosed "Statement(s) of income" if you fail to provide information about income or its part

Member of the family other than the spouse/partner income received

Member of the family other than the spouse/partner

Person Identification *

Family name(s) *

Forename(s) *

Date of birth *

Sex *

Family name(s) at birth

Forename(s) at birth

PIN of the person in each institution

Personal Identification Number(s) *

Country *

Personal Identification Number (PIN) *

Sector

Institution

Institution ID *

Institution Name *

Personal Identification Number(s)

If PIN not provided for every institution, please provide

Place of birth

Town *

Region

Country *

Father's family name at birth

Forename of father

Mother's family name at birth

Forename of mother

Additional information on the person

Nationality

Relationship to person named in section 1

Other relative

Address of the person

Type of address

Address

Street

Building Name

Town *

Postal Code

Region

Country *

Address of the person

Pursues a professional or trade activity

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Income received during the period in respect of which information is requested

Type of income received: *

Please fill in the following if "Type of income received" = "Social security benefits":

Social security benefit

Income received during the period in respect of which information is requested *

Start date

End date

Amount

Currency

Income received during the period in respect of which information is requested

Information on fixed assets during the period in respect of which information is requested

Property in respect of which the person is either the owner or the holder of a beneficial interest

Type of ownership

Type of property

Taxable income from each of these properties (fixed assets)

Amount *

Currency *

Present value of these properties (fixed assets)

Amount *

Currency *

Address in the country where these properties (fixed assets) are

Street

Building Name

Town *

Postal Code

Region

Country *

Address in the country where these properties (fixed assets) are

The Person occupies a dwelling in respect of which he/she, his/her spouse/partner or his/her member of the family is either the owner or the holder of a beneficial life interest?

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Please fill in the following if "The person named in this section occupy a dwelling in respect of which he/she is either the owner or the holder of a beneficial life interest" = "Yes" :

Taxable income of the dwelling occupied

Amount *

Currency *

Information on fixed assets during the period in respect of which information is requested

Information on transferred property during the period in respect of which information is requested

Property has been transferred either in return for payment or free of charge within the period in respect of which information is requested by the person named

Type of property

Date of transfer

Value of property at the time of transfer

Amount *

Currency *

Is the person named in this section in possession of the proceeds from the transferred property?

Answer

Please fill in the following if "Answer" = "Yes" :

Details

What is the nature of these proceeds?

What is the amount involved?

Amount *

Currency *

Is the person named in this section in possession of the proceeds from the transferred property?

Information on transferred property during the period in respect of which information is requested

Information on enclosed "Statement(s) of income" if you fail to provide information about income or its part

The person submitted a "Statement(s) of Income" that can replace the information requested, related to the following type of income *

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Please fill in the following if "The person submitted a "Statement(s) of Income" that can replace the information referred to the following income" = "Other type of income":

Other type of income

Information on enclosed "Statement(s) of income" if you fail to provide information about income or its part

Member of the family other than the spouse/partner income received

Additional Information

Please find attached following document(s)

Attached document(s)

M051 - Reply to request for information on amount of income - special non-contributory cash benefits Article 70 of Regulation (EC) No 883/2004

M051 - Reply to request for information on amount of income - special non-contributory cash benefits
Article 70 of Regulation (EC) No 883/2004