Terugbetaling ontvangen / Kennisgeving afsluiting procedure

SED API version: 0.16.2 build 2
Model version: 4.2.0

Lokale dossiernummers [ CC ]

Lokaal dossiernummer [ CC ]

Land *

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

Zaaknummer *

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

Orgaan [ CC ]

Identificatienummer van het orgaan *

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

Naam orgaan *

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

Lokaal dossiernummer

Algemene informatie * [ SED ]

ID verzoek om terugbetaling *

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

ID kennisgeving van terugbetaling *

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

ID ontvangst terugbetaling of kennisgeving afsluiting procedure *

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

Ontvangen bedrag * [ CC ]

Bedrag *

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

Munteenheid *

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

Datum ontvangst betaling *

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

Verzoek om terugbetaling afgelsoten * [ SED ]

Verzoek om terugbetaling afgelsoten *

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

Gelieve in te vullen als "Verzoek om terugbetaling afgelsoten" = "Nee": [ SED ]

Reden om verzoek om terugbetaling niet te sluiten

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

Gelieve in te vullen als "Reden voor niet-sluiting verzoek om terugbetaling " = "99 - Andere reden": [ SED ]

Reden

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

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