National pensions office
Original Please send back
information regarding social benefits and income from employment
National number: 54.00.02-326.69
1.Social benefits and income from employment
Do you qualify for an allowance paid for by Belgium or another country owing to illness,disability or unemployment, early retirement, a career break, or a reduction in working hours ?
type of benefit:
starting date
Gross monthly amount on 01.02.2015
Name and address of the payment body