Document ID: 31996D0732

DECISION No 158 of 27 November 1995 on the model forms necessary for the application of Council Regulations (EEC) No 1408/71 and (EEC) No 574/72 (E 201 to E 215) (Text with EEA relevance) (96/732/EC)
THE ADMINISTRATIVE COMMISSION OF THE EUROPEAN COMMUNITIES ON SOCIAL SECURITY FOR MIGRANT WORKERS,
Having regard to Article 81 (a) of Council Regulation (EEC) No 1408/71 of 14 June 1971 on the application of social security schemes to employed persons, to self-employed persons and to members of their family moving within the Community, pursuant to which it is the duty of the Administrative Commission to deal with all administrative matters arising from Regulation (EEC) No 1408/71 and subsequent regulations,
Having regard to Article 2 (1) of Council Regulation (EEC) No 574/72 of 21 March 1972, pursuant to which it is the duty of the Administrative Commission to draw up models of certificates, certified statements, declarations, applications and other documents necessary for the application of the Regulations,
Having regard to Decision No 130 of 17 October 1985 laying down and adapting the model forms necessary for the application of the Regulations,
Whereas the model forms should be adapted for the purpose of taking account of Regulation (EEC) No 1248/92 amending the provisions regulating the award and calculation of pension;
Whereas the Agreement on the European Economic Area of 2 May 1992, as adjusted by the Protocol of 17 March 1993, Annex VI, implements Regulations (EEC) No 1408/71 and (EEC) No 574/72 within the European Economic Area;
Whereas by Decision of the EEA Joint Committee the model forms necessary for the application of Regulations (EEC) No 1408/71 and (EEC) No 574/72 will be adapted and implemented within the European Economic Area;
Whereas for practical reasons identical forms should be used within the Community and within the European Economic Area;
Whereas these model forms should be adapted with a view to their utilization in the Community as enlarged through the accession of Austria, Finland and Sweden;
Whereas these model forms should be adapted for the purpose of taking account of the amendments which have been introduced into the national legislation of Member States;
Whereas the language in which the forms should be drawn up has been decided by recommendation No 15 of the Administrative Commission,
HAS DECIDED AS FOLLOWS:
1. The model forms E 201 to E 215 printed in Decision No 130 of 17 October 1985 shall be replaced by the models appended hereto, with the following adjustments:
(a) model forms E 201, E 202, E 203, E 204, E 205 (Belgium, Denmark, Germany, Greece, Spain, France, Ireland, Italy, Luxembourg, the Netherlands, Portugal and the United Kingdom), E 206, E 207, E 210, E 211, E 212, E 213 and E 215 are amended;
(b) model forms E 208, E 209 and E 214 are repealed;
(c) model forms E 205 (Austria, Finland, Sweden, Iceland, Liechtenstein and Norway) are introduced.
2. The competent authorities of the Member States shall make available to the person concerned (rightful claimants, institutions, employers, etc.) the forms according to the attached models.
3. Each form shall be available in the official languages of the Community and laid out in such manner that the different versions are perfectly superposable, thereby making it possible for each person or body to which a form is addressed (rightful claimant, institution, employer, etc.) to receive the form printed in their own language.
4. This Decision shall be applicable from the first day of the month following its publication in the Official Journal of the European Communities.
The Chairman of the Administrative Commission
Carlos GARCÍA DE CORTÁZAR Y NEBREDA
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E 201
CERTIFICATE CONCERNING THE AGGREGATION OF PERIODS OF INSURANCE OR PERIODS OF RESIDENCE
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E 202
INVESTIGATION OF A CLAIM FOR AN OLD-AGE PENSION
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E 202 additional page No 1
ITEM 12 'CHILDREN'
ADDITIONAL INFORMATION
(complete a separate page for each child)
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E 202 additional page No 2
ITEM 10.2
ADDITIONAL INFORMATION FOR THE PURPOSES OF PORTUGUESE INSTITUTIONS
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E 202 additional page No 3
ADDITIONAL INFORMATION FOR THE PURPOSES OF NORWEGIAN INSTITUTIONS
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E 203
INVESTIGATION OF A CLAIM FOR A SURVIVOR'S PENSION
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E 203 additional page No 1
ITEM 11 'RIGHTFUL CLAIMANTS OTHER THAN CHILDREN'
ADDITIONAL INFORMATION FOR ITALIAN INSTITUTIONS
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E 203 additional page No 2
ITEM 15 'CHILDREN'
ADDITIONAL INFORMATION
(complete a separate page for each child)
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E 203 additional page No 3
ITEM 12 (12.8)
ADDITIONAL INFORMATION FOR THE PURPOSES OF PORTUGUESE INSTITUTIONS
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E 203 additional page No 4
ITEM 15 'CHILDREN'
ADDITIONAL INFORMATION FOR THE PURPOSES OF PORTUGUESE INSTITUTIONS
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E 203 additional page No 5
ADDITIONAL INFORMATION FOR THE PURPOSES OF NORWEGIAN INSTITUTIONS
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E 203 additional page Nos 6 to 8
ITEM 11
ADDITIONAL INFORMATION FOR THE PURPOSES OF SWEDISH INSTITUTIONS
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E 204
INVESTIGATION OF A CLAIM FOR AN INVALIDITY PENSION
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E 204 additional page No 1
ITEM 12 'CHILDREN'
ADDITIONAL INFORMATION
(complete a separate page for each child)
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E 204 additional page No 2
ITEM 9 (9.10)
ADDITIONAL INFORMATION FOR THE PURPOSES OF PORTUGUESE INSTITUTIONS
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E 204 additional page No 3
ADDITIONAL INFORMATION FOR THE PURPOSES OF FINNISH INSTITUTIONS
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E 204 additional page No 4
ADDITIONAL INFORMATION FOR THE PURPOSES OF NORWEGIAN INSTITUTIONS
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E 205
B
CERTIFICATE CONCERNING INSURANCE HISTORY IN BELGIUM
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E 205
DK
CERTIFICATE CONCERNING PERIODS OF INSURANCE AND PERIODS OF RESIDENCE IN DENMARK
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E 205
D
CERTIFICATE CONCERNING INSURANCE HISTORY IN GERMANY
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E 205
GR
CERTIFICATE CONCERNING INSURANCE HISTORY IN GREECE
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E 205
E
CERTIFICATE CONCERNING INSURANCE HISTORY IN SPAIN
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E 205
F
CERTIFICATE CONCERNING INSURANCE HISTORY IN FRANCE
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E 205
IRL
CERTIFICATE CONCERNING INSURANCE HISTORY IN IRELAND
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EUROPEAN COMMUNITIES
E 205
I
CERTIFICATE CONCERNING INSURANCE HISTORY IN ITALY
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EUROPEAN COMMUNITIES
E 205
L
CERTIFICATE CONCERNING INSURANCE HISTORY IN LUXEMBOURG
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E 205
NL
CERTIFICATE CONCERNING INSURANCE HISTORY IN THE NETHERLANDS
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E 205
A
CERTIFICATE CONCERNING INSURANCE HISTORY IN AUSTRIA
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E 205
P
CERTIFICATE CONCERNING INSURANCE HISTORY IN PORTUGAL
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E 205
FIN
CERTIFICATE CONCERNING INSURANCE HISTORY IN FINLAND
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E 205
S
CERTIFICATE CONCERNING INSURANCE HISTORY IN SWEDEN
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E 205
GB
CERTIFICATE CONCERNING INSURANCE HISTORY IN THE UNITED KINGDOM
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E 205
IS
CERTIFICATE CONCERNING INSURANCE HISTORY IN ICELAND
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E 205
FL
CERTIFICATE CONCERNING INSURANCE HISTORY IN LIECHTENSTEIN
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E 205
N
CERTIFICATE CONCERNING INSURANCE HISTORY IN NORWAY
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E 206
CERTIFICATE CONCERNING PERIODS OF EMPLOYMENT IN MINES AND SIMILAR UNDERTAKINGS
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E 207
INFORMATION CONCERNING THE INSURED PERSON'S INSURANCE HISTORY
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E 207 additional page No 1
ADDITIONAL INFORMATION FOR SWEDISH INSTITUTIONS
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E 210
NOTIFICATION OF DECISION CONCERNING A CLAIM FOR A PENSION
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E 211
SUMMARY OF DECISIONS
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E 212
APPEALS AND PERIODS ALLOWED FOR APPEALS
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E 213
DETAILED MEDICAL REPORT
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E 213 additional page No 1
ADDITIONAL INFORMATION FOR THE PURPOSES OF INSTITUTIONS IN THE NETHERLANDS
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E 213 additional page No 2
ADDITIONAL PAGE FOR THE PURPOSES OF THE UNITED KINGDOM INSTITUTIONS
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E 213 additional page No 3
ADDITIONAL INFORMATION FOR THE PURPOSES OF NORWEGIAN INSTITUTIONS
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E 215
ADMINISTRATIVE REPORT ON THE POSITION OF A PENSIONER
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