Indsigelse mod anmodning om refusion af overbetaling (COC

S053C - Indsigelse mod anmodning om refusion af overbetaling (COC_RRO)
N/A

SED API version: 0.16.2 build 2
Model version: 4.2.0

Global note COC_RRO * [ SED ]

Reference for samlet RRO, forbindelsesorgan *

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Reference for samlet COC_RRO, forbindelsesorgan *

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

Samlet antal individuelle indsigelser *

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Samlet beløb for individuelle overbetalinger * [ CC ]

Beløb *

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

Valuta *

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

Indsendelsesdato *

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

Individuelle COC_RRO'er * [ SED ]

Individuel COC_RRO * [ SED ]

Kreditorinstitutionens ID * [ CC ]

Institutions-ID *

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Institutionens navn *

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Debitorinstitutionens ID * [ CC ]

Institutions-ID *

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Institutionens navn *

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

Henvisninger * [ SED ]

Reference for samlet RRO, forbindelsesorgan *

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

Reference for samlet COC_RRO, forbindelsesorgan *

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

Individuelt RRO-nummer, forbindelsesorgan *

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

Individuelt COC_RRO-nummer, forbindelsesorgan *

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

Person, der modtager ydelser * [ CC ]

Personoplysninger * [ CC ]

Efternavn(e) *

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Fornavn(e) *

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

Fødselsdato *

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Køn *

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Efternavn(e) ved fødslen

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Fornavn(e) ved fødslen

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Personnummer * [ CC ]

PIN for person i den kompetente medlemsstat *

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

PIN for person i opholds- eller bopælsmedlemsstaten

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

Refusionsperiode * [ CC ]

Startdato *

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

Slutdato *

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

Refusionsbeløb * [ CC ]

Beløb *

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

Valuta *

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

Årsager til indsigelse *

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

Udfyld følgende, hvis "Svar" = "02 - Vi accepterer ikke og anmoder om yderligere oplysninger" [ SED ]

Yderligere oplysninger, der er anmodet om *

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

Hvis "Svar" = "99 - Andet", udfyldes følgende: [ SED ]

Andet *

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

Dato for udstedelse af RPY_IMO *

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

Individuel COC_RRO

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S053C - Indsigelse mod anmodning om refusion af overbetaling (COC_RRO) N/A

S053C - Indsigelse mod anmodning om refusion af overbetaling (COC_RRO)
N/A