Prašymas gauti išmokas pinigais

S055 - Prašymas gauti išmokas pinigais
Reglamento (EB) Nr. 883/2004 21 straipsnis, Reglamento (EB) Nr. 987/2009 27 straipsnio 3, 8, 10 dalys

SED API version: 0.16.2 build 2
Model version: 4.2.0

Asmuo * [ SC ]

Asmens tapatybės duomenys * [ CC ]

Pavardė (-ės) *

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Vardas (-ai) *

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

Gimimo data *

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

Lytis *

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

Pavardė (-ės) (gimus)

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Vardas (-ai) gimus

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

Asmens PIN kiekvienoje įstaigoje [ CC ]

Asmens identifikavimo numeris (-iai) * [ CC ]

Šalis *

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

Asmens identifikavimo numeris (-iai) *

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

Sektorius

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

Įstaiga [ CC ]

Įstaigos identifikavimo numeris *

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

Įstaigos pavadinimas *

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

Asmens identifikavimo numeris (-iai)

Jei PIN nepateiktas kiekvienai įstaigai, pateikite [ CC ]

Gimimo vieta [ CC ]

Miestas *

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

Rajonas

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

Šalis *

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

Tėvo pavardė (gimus)

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

Tėvo vardas

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

Motinos pavardė (gimus)

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

Motinos vardas

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

Papildoma informacija apie asmenį [ SC ]

Pilietybė

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

Asmens adresas [ CC ]

Gatvė

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

Pastato pavadinimas

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

Miestas *

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

Pašto kodas

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

Rajonas

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

Šalis *

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

Nedarbingumo pažyma * [ SED ]

Pirmiau nurodytas asmuo pateikė prašymą išmokėti išmokas pinigais (data) *

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

Išmokos rūšis *

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

Pridedama *

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

Jei punkte „Pridedama“ pažymėjote „Kitas dokumentas“, toliau įrašykite: [ SED ]

Kitas dokumentas

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

Remiantis pirmiau nurodytu dokumentu, asmuo yra nedarbingas * [ CC ]

Nustatytas laikotarpis * [ CC ]

Nesibaigęs laikotarpis * [ CC ]

Pradžios data *

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

Pabaigos data *

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

Nesibaigusio laikotarpio rūšis *

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Pradžios data *

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

Vaiko gimimas [ SED ]

Numatoma gimdymo data

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

Vaiko gimimo data

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

Darbdavys [ CC ]

Pavadinimas *

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

Identifikavimo numeriai [ CC ]

Identifikavimo numeris [ CC ]

Numeris *

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

Rūšis *

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

Identifikavimo numeris

Adresas [ CC ]

Gatvė

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

Pastato pavadinimas

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

Miestas *

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

Pašto kodas

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

Rajonas

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

Šalis *

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

Papildoma informacija [ SC ]

Papildoma informacija

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

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S055 - Prašymas gauti išmokas pinigais Reglamento (EB) Nr. 883/2004 21 straipsnis, Reglamento (EB) Nr. 987/2009 27 straipsnio 3, 8, 10 dalys

S055 - Prašymas gauti išmokas pinigais
Reglamento (EB) Nr. 883/2004 21 straipsnis, Reglamento (EB) Nr. 987/2009 27 straipsnio 3, 8, 10 dalys