Talba għal Stima tal-kostijiet / Talba għal Kontroll Amministrattiv

H130 - Talba għal Stima tal-kostijiet / Talba għal Kontroll Amministrattiv
L-Artikoli 36(3), 21, 82 tar-Regolament (KE) Nru 883/2004, 33(1), 27(5), (10), 87(1), (3) tar-Regolament (KE) Nru 987/2009

SED API version: 0.16.2 build 2
Model version: 4.2.0

Persuna * [ SC ]

Identifikazzjoni tal-persuna * [ CC ]

Kunjom(ijiet) *

[ BDT ] {{metaSection.familyName.$$error}} {{metaSection.familyName.$$warning}}

Isem/ismijiet *

[ BDT ] {{metaSection.forename.$$error}} {{metaSection.forename.$$warning}}

Data tat-twelid *

[ BDT ] {{metaSection.dateBirth.$$error}} {{metaSection.dateBirth.$$warning}}

Sess *

[ ENUM ] {{metaSection.sex.$$error}} {{metaSection.sex.$$warning}}

Kunjom(ijiet) mat-twelid

[ BDT ] {{metaSection.familyNameAtBirth.$$error}} {{metaSection.familyNameAtBirth.$$warning}}

Isem/ismijiet mat-twelid

[ BDT ] {{metaSection.forenameAtBirth.$$error}} {{metaSection.forenameAtBirth.$$warning}}

PIN tal-persuna f’kull istituzzjoni [ CC ]

Numru/i ta' Identifikazzjoni Personali * [ CC ]

Pajjiż *

[ ENUM ] {{metaSection.country.$$error}} {{metaSection.country.$$warning}}

Numru ta' identifikazzjoni personali (PIN) *

[ BDT ] {{metaSection.personalIdentificationNumber.$$error}} {{metaSection.personalIdentificationNumber.$$warning}}

Settur

[ ENUM ] {{metaSection.sector.$$error}} {{metaSection.sector.$$warning}}

Istituzzjoni [ CC ]

ID tal-istituzzjoni *

[ BDT ] {{metaSection.institutionID.$$error}} {{metaSection.institutionID.$$warning}}

Isem l-istituzzjoni *

[ CDT ] {{metaSection.institutionName.$$error}} {{metaSection.institutionName.$$warning}}

Numru/i ta' Identifikazzjoni Personali

Jekk il-PIN ma ġiex ipprovdut għal kull istituzzjoni, jekk jogħġbok ipprovdi [ CC ]

Post tat-twelid [ CC ]

Belt *

[ CDT ] {{metaSection.town.$$error}} {{metaSection.town.$$warning}}

Reġjun

[ CDT ] {{metaSection.region.$$error}} {{metaSection.region.$$warning}}

Pajjiż *

[ ENUM ] {{metaSection.country.$$error}} {{metaSection.country.$$warning}}

Kunjom il-missier mat-twelid

[ BDT ] {{metaSection.fatherFamilyNameAtBirth.$$error}} {{metaSection.fatherFamilyNameAtBirth.$$warning}}

Isem il-missier

[ BDT ] {{metaSection.forenameFather.$$error}} {{metaSection.forenameFather.$$warning}}

Kunjom l-omm mat-twelid

[ BDT ] {{metaSection.motherFamilyNameAtBirth.$$error}} {{metaSection.motherFamilyNameAtBirth.$$warning}}

Isem l-omm

[ BDT ] {{metaSection.forenameMother.$$error}} {{metaSection.forenameMother.$$warning}}

Tagħrif addizzjonali dwar il-persuna [ SC ]

Nazzjonalità

[ ENUM ] {{metaSection.nationality.$$error}} {{metaSection.nationality.$$warning}}

Indirizzi tal-persuna assigurata [ SC ]

Indirizz tal-persuna assigurata [ SC ]

Tip ta' Indirizz

[ ENUM ] {{metaSection.typeAddress.$$error}} {{metaSection.typeAddress.$$warning}}

Indirizz [ CC ]

Triq

[ CDT ] {{metaSection.street.$$error}} {{metaSection.street.$$warning}}

Isem il-Bini

[ CDT ] {{metaSection.buildingName.$$error}} {{metaSection.buildingName.$$warning}}

Belt *

[ CDT ] {{metaSection.town.$$error}} {{metaSection.town.$$warning}}

Kodiċi postali

[ CDT ] {{metaSection.postalCode.$$error}} {{metaSection.postalCode.$$warning}}

Reġjun

[ CDT ] {{metaSection.region.$$error}} {{metaSection.region.$$warning}}

Pajjiż *

[ ENUM ] {{metaSection.country.$$error}} {{metaSection.country.$$warning}}

Indirizz tal-persuna assigurata

Jekk jogħġbok imla t-taqsima li ġejja jekk it-talba tikkonċerna s-settur tal-mard [ SC ]

Status tal-Persuna *

[ ENUM ] {{metaSection.personStatus.$$error}} {{metaSection.personStatus.$$warning}}

Jekk jogħġbok imla t-taqsima li ġejja biss jekk it-talba tikkonċerna aċċident fuq ix-xogħol jew marda okkupazzjonali: [ SC ]

Dan is-SED jirrigwarda *

[ ENUM ] {{metaSection.thisSEDRelatedTo.$$error}} {{metaSection.thisSEDRelatedTo.$$warning}}

Datat *

[ BDT ] {{metaSection.dated.$$error}} {{metaSection.dated.$$warning}}

Kodiċi tal-aċċident / tal-marda

[ CDT ] {{metaSection.accidentDiseaseCode.$$error}} {{metaSection.accidentDiseaseCode.$$warning}}

Sistema ta’ kodifikazzjoni tal-aċċident / tal-marda

[ CDT ] {{metaSection.accidentDiseaseCodingSystem.$$error}} {{metaSection.accidentDiseaseCodingSystem.$$warning}}

Konsegwenzi tal-aċċident/tip jew deskrizzjoni qasira tal-marda

[ CDT ] {{metaSection.consequencesAccidentKindOrShortDescriptionDisease.$$error}} {{metaSection.consequencesAccidentKindOrShortDescriptionDisease.$$warning}}

Status tal-persuna

[ ENUM ] {{metaSection.statusPerson.$$error}} {{metaSection.statusPerson.$$warning}}

Jekk jogħġbok imla li ġej jekk “Status tal-persuna” = “Ieħor”: [ SC ]

Oħrajn

[ CDT ] {{metaSection.other.$$error}} {{metaSection.other.$$warning}}

Impjegatur * [ CC ]

Isem *

[ CDT ] {{metaSection.name.$$error}} {{metaSection.name.$$warning}}

Numri ta’ identifikazzjoni [ CC ]

Numru ta’ identifikazzjoni [ CC ]

Għadd *

[ CDT ] {{metaSection.number.$$error}} {{metaSection.number.$$warning}}

Tip *

[ ENUM ] {{metaSection.type.$$error}} {{metaSection.type.$$warning}}

Numru ta’ identifikazzjoni

Indirizz [ CC ]

Triq

[ CDT ] {{metaSection.street.$$error}} {{metaSection.street.$$warning}}

Isem il-Bini

[ CDT ] {{metaSection.buildingName.$$error}} {{metaSection.buildingName.$$warning}}

Belt *

[ CDT ] {{metaSection.town.$$error}} {{metaSection.town.$$warning}}

Kodiċi postali

[ CDT ] {{metaSection.postalCode.$$error}} {{metaSection.postalCode.$$warning}}

Reġjun

[ CDT ] {{metaSection.region.$$error}} {{metaSection.region.$$warning}}

Pajjiż *

[ ENUM ] {{metaSection.country.$$error}} {{metaSection.country.$$warning}}

Perjodu kkonċernat * [ SED ]

Il-Kontroll Amministrattiv jittratta l-perjodu ta’ inkapaċità għax-xogħol * [ SED ]

Perjodu * [ CC ]

Data tal-bidu *

[ BDT ] {{metaSection.startDate.$$error}} {{metaSection.startDate.$$warning}}

Data tat-tmiem *

[ BDT ] {{metaSection.endDate.$$error}} {{metaSection.endDate.$$warning}}

Natura tat-talba * [ SED ]

Nitolbuk biex *

[ ENUM ] {{metaSection.weAskTo.$$error}} {{metaSection.weAskTo.$$warning}}

Naqblu li nkopru l-ispejjeż tal-kontrolli amministrattivi *

[ ENUM ] {{metaSection.weAgreeCoverCostsAdministrativeChecks.$$error}} {{metaSection.weAgreeCoverCostsAdministrativeChecks.$$warning}}

Dokumenti mehmuża [ SC ]

Dokumenti predefiniti

[ ENUM ] {{metaSection.predefinedDocuments.$$error}} {{metaSection.predefinedDocuments.$$warning}}

Dokumenti Oħrajn Mehmużin [ SC ]

Dokument ieħor [ SC ]

Dokument

[ CDT ] {{metaSection.document.$$error}} {{metaSection.document.$$warning}}

Dokument ieħor

Tagħrif addizzjonali [ SC ]

Tagħrif addizzjonali

[ CDT ] {{metaSection.additionalInformation.$$error}} {{metaSection.additionalInformation.$$warning}}

{{ row.severityMessage }} : {{ row.message }}

H130 - Talba għal Stima tal-kostijiet / Talba għal Kontroll Amministrattiv L-Artikoli 36(3), 21, 82 tar-Regolament (KE) Nru 883/2004, 33(1), 27(5), (10), 87(1), (3) tar-Regolament (KE) Nru 987/2009

H130 - Talba għal Stima tal-kostijiet / Talba għal Kontroll Amministrattiv
L-Artikoli 36(3), 21, 82 tar-Regolament (KE) Nru 883/2004, 33(1), 27(5), (10), 87(1), (3) tar-Regolament (KE) Nru 987/2009