Decision on deductions from arrears/ongoing payments

R003 - Decision on deductions from arrears/ongoing payments
Article 72(1) 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

Persons *

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 about a person *

Status of the person *

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

Other status of the person

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Nationality

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Previous family name(s)

Previous family name(s)

Previous family name(s)

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Previous family name(s)

Previous forenames

Previous forename

Previous forename

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Previous forename

Current family status

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Date of death

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Person

Acceptance *

Acceptance of deduction from arrears *

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Acceptance of deduction from ongoing payments *

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Comments

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