Kulude tagasimaksmise taotlus

R028 - Kulude tagasimaksmise taotlus
Määruse (EÜ) nr 987/2009 artikli 85 lõiked 2 ja 3

SED API version: 0.16.2 build 2
Model version: 4.2.0

Kohalikud juhtumite numbrid [ CC ]

Kohalik juhtumi number [ CC ]

Riik *

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

Juhtumi number *

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

Asutus

[ CC ]

Asutuse identifitseerimisnumber *

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

Asutuse nimi *

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

Kohalik juhtumi number

Puudutab * [ SC ]

Puudutab *

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

Palun esitage järgmised andmed, kui „Puudutab“ = „Isik“: [ SED ]

Palun esitage järgmised andmed, kui „Puudutab“ = „Tööandja“: [ SC ]

Isikud [ SC ]

Isik * [ SC ]

Isiku identifitseerimine * [ CC ]

Perekonnanimi(-nimed) *

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

Eesnimi (-nimed) *

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

Sünniaeg *

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

Sugu *

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

Sünnijärgne perekonnanimi (-nimed)

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

Sünnijärgne eesnimi (-nimed)

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

Isiku PIN igas asutuses

[ CC ]

Isikukood (-id) * [ CC ]

Riik *

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

Personaalne identifitseerimisnumber (PIN) *

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

Valdkond

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

Asutus

[ CC ]

Asutuse identifitseerimisnumber *

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

Asutuse nimi *

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

Isikukood (-id)

Kui asutuse kohta ei ole esitatud identifitseerimisnumbrit, esitage see nüüd

[ CC ]

Sünnikoht

[ CC ]

Linn *

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

Piirkond

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

Riik *

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

Isa perekonnanimi sündimisel

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

Isa eesnimi

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

Ema perekonnanimi sündimisel

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

Ema eesnimi

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

Lisateave isiku kohta * [ SC ]

Isiku staatus *

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

Palun esitage järgmised andmed, kui „Isiku staatus“ = „Muu“: [ SC ]

Isiku muu staatus

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

kodakondsus

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

Varasem(ad) perekonnanimi (-nimed) [ SC ]

Varasem(ad) perekonnanimi (-nimed)

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

Varasem(ad) perekonnanimi (-nimed)

Varasemad eesnimed [ SC ]

Varasem eesnimi [ SC ]

Varasem eesnimi

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

Varasem eesnimi

Praegune perekonnaseis

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

Surmakuupäev

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

Isik

Tööandja *

[ CC ]

Nimi *

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

Identifitseerimisnumbrid

[ CC ]

Identifitseerimisnumber

[ CC ]

Number *

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

Liik *

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

Identifitseerimisnumber

Aadress

[ CC ]

Tänav

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

Hoone nimi

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

Linn *

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

Sihtnumber

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

Piirkond

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

Riik *

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

Vastutav isik või osakond [ SC ]

Vastutav isik või osakond

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

Kontaktteave [ CC ]

Telefoninumbrid [ CC ]

Telefoninumber [ CC ]

Liik

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

Number *

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

Telefoninumber

E-posti aadressid [ CC ]

E-posti aadress [ CC ]

E-posti aadress

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

E-posti aadress

Isikud

[ SC ]

Isik * [ SC ]

Isiku identifitseerimine * [ CC ]

Perekonnanimi(-nimed) *

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

Eesnimi (-nimed) *

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

Sünniaeg *

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

Sugu *

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

Sünnijärgne perekonnanimi (-nimed)

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

Sünnijärgne eesnimi (-nimed)

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

Isiku PIN igas asutuses

[ CC ]

Isikukood (-id) * [ CC ]

Riik *

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

Personaalne identifitseerimisnumber (PIN) *

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

Valdkond

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

Asutus

[ CC ]

Asutuse identifitseerimisnumber *

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

Asutuse nimi *

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

Isikukood (-id)

Kui asutuse kohta ei ole esitatud identifitseerimisnumbrit, esitage see nüüd

[ CC ]

Sünnikoht

[ CC ]

Linn *

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

Piirkond

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

Riik *

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

Isa perekonnanimi sündimisel

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

Isa eesnimi

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

Ema perekonnanimi sündimisel

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

Ema eesnimi

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

Lisateave isiku kohta * [ SC ]

Isiku staatus *

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

Palun esitage järgmised andmed, kui „Isiku staatus“ = „Muu“: [ SC ]

Isiku muu staatus

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

kodakondsus

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

Varasem(ad) perekonnanimi (-nimed) [ SC ]

Varasem(ad) perekonnanimi (-nimed)

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

Varasem(ad) perekonnanimi (-nimed)

Varasemad eesnimed [ SC ]

Varasem eesnimi [ SC ]

Varasem eesnimi

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

Varasem eesnimi

Praegune perekonnaseis

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

Surmakuupäev

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

Isik

Taotluse põhjus * [ SED ]

Tagasimakse taotlemise alus *

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

Tegelikud kulud ja/või kahjud

[ SED ]

Summad vääringus asutuse kohta [ SED ]

Summad vääringus [ SED ]

Asutuse ID *

[ CC ]

Asutuse identifitseerimisnumber *

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

Asutuse nimi *

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

Vääring

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

Kulud

[ PRIM ] {{metaSection.costs.$$error}} {{metaSection.costs.$$warning}}

Kahjum

[ PRIM ] {{metaSection.losses.$$error}} {{metaSection.losses.$$warning}}

Kokku

[ PRIM ] {{metaSection.total.$$error}} {{metaSection.total.$$warning}}

Summad vääringus

Tagasimakset taotletakse

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

Lisateave [ SC ]

Lisateave

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

Hinnangulised kulud ja/või kahjud

[ SED ]

Summad vääringus asutuse kohta [ SED ]

Summad vääringus [ SED ]

Asutuse ID *

[ CC ]

Asutuse identifitseerimisnumber *

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

Asutuse nimi *

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

Vääring

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

Kulud

[ PRIM ] {{metaSection.costs.$$error}} {{metaSection.costs.$$warning}}

Kahjum

[ PRIM ] {{metaSection.losses.$$error}} {{metaSection.losses.$$warning}}

Kokku

[ PRIM ] {{metaSection.total.$$error}} {{metaSection.total.$$warning}}

Summad vääringus

Taotletakse ajutist kokkulepet tagasimakse kohta, mis on seotud

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

Lisateave [ SC ]

Lisateave

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

Kui sissenõudemenetlus ei olnud põhjendatud, märkige kuupäev, mil nõutakse sisse tegelikud kulutused/kahjud

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

Kui hinnanguliste kulude ja/või kahjudega on seotud edasised sissenõudmismeetmed, esitage andmed kavandatava tegevuse kohta

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

Palun esitage järgmised andmed, kui „Taotluse liik“ = „Lõplik“: [ SED ]

Pangarekvisiidid [ SC ]

SEPA pangaandmed *

[ CC ]

IBAN *

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

BIC-SWIFT

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

Kontoomaniku nimi *

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

Makse selgitus *

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

Saabub panga aadress

[ CC ]

Tänav

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

Hoone nimi

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

Linn *

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

Sihtnumber

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

Piirkond

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

Riik *

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

Päring *

[ SED ]

Palun

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

Kui edasiste sissenõudmismeetmete tõttu tekivad tasumata kulud/kahjud, peate sissenõudmise jätkamise võimaldamiseks andma nõusoleku kiita heaks kohustus maksta tagasi hinnangulised kulud/kahjud järgmiseks kuupäevaks

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

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

R028 - Kulude tagasimaksmise taotlus Määruse (EÜ) nr 987/2009 artikli 85 lõiked 2 ja 3

R028 - Kulude tagasimaksmise taotlus
Määruse (EÜ) nr 987/2009 artikli 85 lõiked 2 ja 3