|
<?xml version="1.0" encoding="utf-8"?> |
|
<tmx version="1.4"> |
|
<header adminlang="en" creationdate="20170629T094754Z" creationid="TLDJanisS\janis.slapins" creationtool="Tilde Plaintext-to-TMX Converter" creationtoolversion="1.0" datatype="plaintext" o-tmf="Moses file pair" segtype="sentence" srclang="en"> |
|
<prop type="x-tucount">287</prop> |
|
</header> |
|
<body> |
|
<tu tuid="1"> |
|
<tuv xml:lang="en"> |
|
<seg>Your case has been sent to the county administrative court [förvaltningsrätten] in which will consider it.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Votre dossier a été transmis au Tribunal administratif départemental [förvaltningsrätten] de , qui en connaîtra.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="2"> |
|
<tuv xml:lang="en"> |
|
<seg>Please contact the county administrative court if you require further information.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Pour toutes questions relatives à votre dossier, adressez-vous au Tribunal administratif départemental.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="3"> |
|
<tuv xml:lang="en"> |
|
<seg>Försäkringskassan</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Försäkringskassan</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="4"> |
|
<tuv xml:lang="en"> |
|
<seg>Jessica Selander</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Jessica Selander</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="5"> |
|
<tuv xml:lang="en"> |
|
<seg>Date of birth:</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Date de naissance:</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="6"> |
|
<tuv xml:lang="en"> |
|
<seg>It is hereby certified that X date of birth X has a Swedish sickness compensation.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Je soussigné/e certifie que X né/e le X perçoit une indemnité maladie suédoise.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="7"> |
|
<tuv xml:lang="en"> |
|
<seg>The annual amount for X is X Swedish kronor.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Le montant annuel pour l’an X s’élève à X couronnes suédoises.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="8"> |
|
<tuv xml:lang="en"> |
|
<seg>Deduction for tax is X Swedish kronor.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>La retenue à la source est de X couronnes suédoises.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="9"> |
|
<tuv xml:lang="en"> |
|
<seg>The tax-free part, the “exempt” amount is X Swedish kronor.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>La fraction exonérée d’impôt, dite franchise, s’élève à X couronnes suédoises.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="10"> |
|
<tuv xml:lang="en"> |
|
<seg>Försäkringskassan</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Försäkringskassan</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="11"> |
|
<tuv xml:lang="en"> |
|
<seg>Jessica Selander</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Jessica Selander</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="12"> |
|
<tuv xml:lang="en"> |
|
<seg>Försäkringskassan [The Swedish Social Insurance Agency] has decided not to pay your from and including .</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Försäkringskassan [l’Agence suédoise de la sécurité sociale] a décidé de ne plus verser votre pension ou toute autre prestation à compter du .</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="13"> |
|
<tuv xml:lang="en"> |
|
<seg>Description of the case</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Description du dossier</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="14"> |
|
<tuv xml:lang="en"> |
|
<seg>Försäkringskassan has granted you .</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Vous percevez une pension ou une autre prestation versée par Försäkringskassan.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="15"> |
|
<tuv xml:lang="en"> |
|
<seg>Since you live outside Sweden, you must show that you are still entitled to the benefit.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Comme vous résidez hors de Suède, vous êtes tenu/e de prouver que vous avez toujours le droit de percevoir cette prestation.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="16"> |
|
<tuv xml:lang="en"> |
|
<seg>You do this by sending us a life certificate.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Vous le faites en nous envoyant un certificat de vie.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="17"> |
|
<tuv xml:lang="en"> |
|
<seg>Reasoning</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Motifs</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="18"> |
|
<tuv xml:lang="en"> |
|
<seg>The payments have ceased because you have not submitted a correctly completed life certificate.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Les versements cesseront parce que vous n’avez pas envoyé un certificat de vie complet à Försäkringskassan.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="19"> |
|
<tuv xml:lang="en"> |
|
<seg>A life certificate shall be made on the designated form and it shall be certified by one of the authorities stated below:</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Pour prouver que vous êtes en vie, il faut remplir le formulaire prescrit et faire attester ce certificat de vie par une des autorités ou institutions suivantes:</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="20"> |
|
<tuv xml:lang="en"> |
|
<seg>• Försäkringskassan</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>• Försäkringskassan</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="21"> |
|
<tuv xml:lang="en"> |
|
<seg>• A Swedish embassy</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>• une ambassade suédoise</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="22"> |
|
<tuv xml:lang="en"> |
|
<seg>• A Swedish consulate</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>• un consulat suédois</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="23"> |
|
<tuv xml:lang="en"> |
|
<seg>• A foreign social insurance institution</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>• un organisme étranger de sécurité sociale</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="24"> |
|
<tuv xml:lang="en"> |
|
<seg>• A foreign police authority</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>• un notaire public</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="25"> |
|
<tuv xml:lang="en"> |
|
<seg>• A foreign authority responsible for population registration.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>• un service de police étranger</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="26"> |
|
<tuv xml:lang="en"> |
|
<seg>• Chapter 110, section 15 of the Swedish Social Insurance Code</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>• le chap. 110 art. 15 du code de la sécurité sociale suédoise</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="27"> |
|
<tuv xml:lang="en"> |
|
<seg>• Försäkringskassan’ Regulations (2006:2) on Life Certificates</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>• les prescriptions de Försäkringskassan (2006:2) relatives au certificat de vie.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="28"> |
|
<tuv xml:lang="en"> |
|
<seg>Are you unsatisfied with the decision?</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Vous n’êtes pas satisfait de la décision ?</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="29"> |
|
<tuv xml:lang="en"> |
|
<seg>Read more about your options on the next page.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Lisez sur la page suivante ce que vous pouvez faire.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="30"> |
|
<tuv xml:lang="en"> |
|
<seg>Försäkringskassan</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Försäkringskassan</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="31"> |
|
<tuv xml:lang="en"> |
|
<seg>Jessica Selander</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Jessica Selander</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="32"> |
|
<tuv xml:lang="en"> |
|
<seg>Are you not satisfied with the decision?</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Vous n’êtes pas satisfait de la décision ?</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="33"> |
|
<tuv xml:lang="en"> |
|
<seg>If you consider that this decision is wrong you can request that Försäkringskassan shall reconsider it.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Si vous estimez que cette décision n'est pas juste, vous pouvez demander que la Försäkringskassan la réexamine.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="34"> |
|
<tuv xml:lang="en"> |
|
<seg>If this is the case, write a letter to Försäkringskassan.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Dans ce cas, vous devez écrire une lettre à la Försäkringskassan.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="35"> |
|
<tuv xml:lang="en"> |
|
<seg>The letter must be received within two months of the day of your getting information about the decision.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>La lettre doit parvenir à la Försäkringskassan dans un délai de deux mois à partir du jour où vous avez été avisé de la décision.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="36"> |
|
<tuv xml:lang="en"> |
|
<seg>It must contain the following information:</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Elle devra contenir les renseignements suivants:</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="37"> |
|
<tuv xml:lang="en"> |
|
<seg>• Which decision you would like to be reconsidered.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>• Quelle est la décision qui doit être réexaminée.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="38"> |
|
<tuv xml:lang="en"> |
|
<seg>• How and why you would like the decision changed.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>• Dans quel sens et pourquoi désirez-vous que la décision soit modifiée.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="39"> |
|
<tuv xml:lang="en"> |
|
<seg>• Your name, Swedish personal identity number, address and telephone number.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>• Votre nom, numéro personnel d'identité, adresse et numéro de téléphone.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="40"> |
|
<tuv xml:lang="en"> |
|
<seg>If you employ a deputy, there must be a power of attorney.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Si vous avez recours à un représentant, un pouvoir en original devra être joint à la demande.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="41"> |
|
<tuv xml:lang="en"> |
|
<seg>The request for reconsideration shall be sent to Försäkringskassan, OMP – SA, , Sweden.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>La demande de réexamen doit être adressée à la Försäkringskassan, OMP – SA, , Suède.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="42"> |
|
<tuv xml:lang="en"> |
|
<seg>Do you have any questions?</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Si vous avez des questions à poser</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="43"> |
|
<tuv xml:lang="en"> |
|
<seg>You are welcome to call our customer centre at +46 771-524 524 if you have any questions about your case.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Vous pouvez téléphoner à notre Service clientèle au +46 771-524 524, si vous avez des questions à poser concernant votre affaire.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="44"> |
|
<tuv xml:lang="en"> |
|
<seg>1.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>1.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="45"> |
|
<tuv xml:lang="en"> |
|
<seg>State your most recent employment in your country of residence</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Indiquez votre dernière situation de travail dans votre pays de résidence</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="46"> |
|
<tuv xml:lang="en"> |
|
<seg>a.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>a.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="47"> |
|
<tuv xml:lang="en"> |
|
<seg>Occupation/employment:</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Profession/activité:</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="48"> |
|
<tuv xml:lang="en"> |
|
<seg>b.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>b.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="49"> |
|
<tuv xml:lang="en"> |
|
<seg>Working hours per week:</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Horaire par semain:</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="50"> |
|
<tuv xml:lang="en"> |
|
<seg>c.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>c.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="51"> |
|
<tuv xml:lang="en"> |
|
<seg>Wage per month:</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Salaire mensuel:</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="52"> |
|
<tuv xml:lang="en"> |
|
<seg>d.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>d.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="53"> |
|
<tuv xml:lang="en"> |
|
<seg>Last working day:</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Dernier jour de travail:</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="54"> |
|
<tuv xml:lang="en"> |
|
<seg>2.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>2.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="55"> |
|
<tuv xml:lang="en"> |
|
<seg>Do you have or have you had any of the following benefits?</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Percevez-vous ou avez-vous perçu une des prestations suivantes?</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="56"> |
|
<tuv xml:lang="en"> |
|
<seg>Sickness benefit</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Indemnité journalière de maladie</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="57"> |
|
<tuv xml:lang="en"> |
|
<seg>time period:</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>période:</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="58"> |
|
<tuv xml:lang="en"> |
|
<seg>Unemployment benefit</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Allocation de chômage</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="59"> |
|
<tuv xml:lang="en"> |
|
<seg>time period:</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>période:</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="60"> |
|
<tuv xml:lang="en"> |
|
<seg>Social assistance</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Aide sociale</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="61"> |
|
<tuv xml:lang="en"> |
|
<seg>time period:</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>période:</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="62"> |
|
<tuv xml:lang="en"> |
|
<seg>Other benefit, state which</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Autre prestation, à préciser</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="63"> |
|
<tuv xml:lang="en"> |
|
<seg>time period:</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>période:</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="64"> |
|
<tuv xml:lang="en"> |
|
<seg>Datum</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Date</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="65"> |
|
<tuv xml:lang="en"> |
|
<seg>Signature</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Signature</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="66"> |
|
<tuv xml:lang="en"> |
|
<seg>Please send your reply to Försäkringskassan signed and dated at the latest by .</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Envoyez votre réponse, datée et signée, à Försäkringskassan au plus tard le .</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="67"> |
|
<tuv xml:lang="en"> |
|
<seg>Otherwise, Försäkringskassan will make a decision on the basis of the documentation available to us today.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Faute d’avoir de vos nouvelles, Försäkringskassan basera sa décision sur les éléments dont nous disposons aujourd’hui.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="68"> |
|
<tuv xml:lang="en"> |
|
<seg>Do you have any questions?</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Si vous avez des questions à poser</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="69"> |
|
<tuv xml:lang="en"> |
|
<seg>You are welcome to call our customer centre at +46 771-524 524 if you have any questions about your case.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Vous pouvez téléphoner à notre Service clientèle au +46 771-524 524, si vous avez des questions à poser concernant votre affaire.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="70"> |
|
<tuv xml:lang="en"> |
|
<seg>Yours sincerely</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Sincères salutations</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="71"> |
|
<tuv xml:lang="en"> |
|
<seg>Försäkringskassan</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Försäkringskassan</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="72"> |
|
<tuv xml:lang="en"> |
|
<seg>Jessica Selander</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Jessica Selander</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="73"> |
|
<tuv xml:lang="en"> |
|
<seg>Application</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Demande</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="74"> |
|
<tuv xml:lang="en"> |
|
<seg>Sickness compensation</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Indemnité de maladie</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="75"> |
|
<tuv xml:lang="en"> |
|
<seg>1 (3)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>1 (3)</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="76"> |
|
<tuv xml:lang="en"> |
|
<seg>0771-524 524 www.forsakringskassan.se</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>0771-524 524 www.forsakringskassan.se</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="77"> |
|
<tuv xml:lang="en"> |
|
<seg>Personal ID no.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Numéro personnel d'identité</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="78"> |
|
<tuv xml:lang="en"> |
|
<seg>Send this form to</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Adressez le formulaire à</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="79"> |
|
<tuv xml:lang="en"> |
|
<seg>Försäkringskassans inläsningscentral 839 88 Östersund</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Försäkringskassans inläsningscentral 839 88 Östersund</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="80"> |
|
<tuv xml:lang="en"> |
|
<seg>Applicant</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Le demandeur</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="81"> |
|
<tuv xml:lang="en"> |
|
<seg>Name and surname</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Prénom et nom</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="82"> |
|
<tuv xml:lang="en"> |
|
<seg>Personal ID no. (12 digits)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Numéro national d'identité (12 chiffres)</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="83"> |
|
<tuv xml:lang="en"> |
|
<seg>Postal address</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Adresse postale</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="84"> |
|
<tuv xml:lang="en"> |
|
<seg>Postal code and city</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Code postal et localité</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="85"> |
|
<tuv xml:lang="en"> |
|
<seg>Application refers to</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Objet de la demande</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="86"> |
|
<tuv xml:lang="en"> |
|
<seg>I am applying for</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Je souhaite percevoir un quart</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="87"> |
|
<tuv xml:lang="en"> |
|
<seg>1/4</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>une moitié</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="88"> |
|
<tuv xml:lang="en"> |
|
<seg>full</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>la totalité</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="89"> |
|
<tuv xml:lang="en"> |
|
<seg>Describe why you are unable to work</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Décrivez pourquoi vous ne pouvez pas travailler</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="90"> |
|
<tuv xml:lang="en"> |
|
<seg>Give a brief description of why you are unable to work.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Décrivez en quelques mots pourquoi vous ne pouvez pas travailler.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="91"> |
|
<tuv xml:lang="en"> |
|
<seg>We need this information to prepare your case.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Nous avons besoin de ce renseignement pour pouvoir traiter votre affaire.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="92"> |
|
<tuv xml:lang="en"> |
|
<seg>I am providing information I wish to give this information in an appendix verbally to Försäkringskassan</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Je fournis les renseignements Je veux fournir les renseignements oralement dans une annexe à l'Agence suédoise de la sécurité sociale</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="93"> |
|
<tuv xml:lang="en"> |
|
<seg>I have attached a doctor's certificate</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Je joins un certificat médical</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="94"> |
|
<tuv xml:lang="en"> |
|
<seg>We need a doctor's certificate to consider your application.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Nous avons besoin d'un certificat médical pour pouvoir prendre position sur votre demande.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="95"> |
|
<tuv xml:lang="en"> |
|
<seg>and will send it at a later date</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>et je l'enverrai plus tard</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="96"> |
|
<tuv xml:lang="en"> |
|
<seg>(name of physician)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>(Nom du médecin)</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="97"> |
|
<tuv xml:lang="en"> |
|
<seg>Yes No.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Oui Non.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="98"> |
|
<tuv xml:lang="en"> |
|
<seg>Please specify where you have lived</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Indiquez ci-dessous où vous avez habité (en Suède ou dans d'autres pays).</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="99"> |
|
<tuv xml:lang="en"> |
|
<seg>Country</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Pays</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="100"> |
|
<tuv xml:lang="en"> |
|
<seg>Until (year, month, day)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Jusqu'à (année, mois, jour)</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="101"> |
|
<tuv xml:lang="en"> |
|
<seg>Country</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Pays</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="102"> |
|
<tuv xml:lang="en"> |
|
<seg>Until (year, month, day)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Jusqu'à (année, mois, jour)</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="103"> |
|
<tuv xml:lang="en"> |
|
<seg>Country</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Pays</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="104"> |
|
<tuv xml:lang="en"> |
|
<seg>Until (year, month, day)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Jusqu'à (année, mois, jour)</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="105"> |
|
<tuv xml:lang="en"> |
|
<seg>Country</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Pays</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="106"> |
|
<tuv xml:lang="en"> |
|
<seg>I am a contractor</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Je suis prestataire de services</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="107"> |
|
<tuv xml:lang="en"> |
|
<seg>I am self-employed</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Je suis entrepreneur individuel</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="108"> |
|
<tuv xml:lang="en"> |
|
<seg>Are you unemployed?</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Êtes-vous chômeur?</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="109"> |
|
<tuv xml:lang="en"> |
|
<seg>Yes</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Oui</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="110"> |
|
<tuv xml:lang="en"> |
|
<seg>No</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Non</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="111"> |
|
<tuv xml:lang="en"> |
|
<seg>Name of your employer, principal or company</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Nom de votre employeur, de votre donneur d'ordre ou de votre entreprise</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="112"> |
|
<tuv xml:lang="en"> |
|
<seg>Have you claimed unemployment benefit in the past four months?</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Appartenez-vous à une caisse d'assurance-chômage (a-kassa)?</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="113"> |
|
<tuv xml:lang="en"> |
|
<seg>Have you worked in a country other than Sweden?</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Avez-vous travaillé dans un autre pays que la Suède?</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="114"> |
|
<tuv xml:lang="en"> |
|
<seg>No</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Non</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="115"> |
|
<tuv xml:lang="en"> |
|
<seg>Yes, I have worked in</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Oui, j'ai</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="116"> |
|
<tuv xml:lang="en"> |
|
<seg>Country</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Pays</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="117"> |
|
<tuv xml:lang="en"> |
|
<seg>As of (year, month, day)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>travaillé</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="118"> |
|
<tuv xml:lang="en"> |
|
<seg>Until (year, month, day)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>dans un</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="119"> |
|
<tuv xml:lang="en"> |
|
<seg>Country</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Pays</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="120"> |
|
<tuv xml:lang="en"> |
|
<seg>Until (year, month, day)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>autre pays</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="121"> |
|
<tuv xml:lang="en"> |
|
<seg>Do you receive compensation, or have you applied for compensation, from a country other than Sweden?</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Percevez-vous une prestation ou avez-vous demandé une prestation dans un autre pays que la Suède?</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="122"> |
|
<tuv xml:lang="en"> |
|
<seg>No</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Non</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="123"> |
|
<tuv xml:lang="en"> |
|
<seg>Yes Sickness benefit Pension</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Oui Indemnité de maladie Retraite</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="124"> |
|
<tuv xml:lang="en"> |
|
<seg>Perpetual annuity or pension due to occupational injury</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Rente d'invalidité ou une pension en raison d'un accident de travail</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="125"> |
|
<tuv xml:lang="en"> |
|
<seg>Name and address of the paying authority</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Nom et adresse de l'autorité qui effectue le versement</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="126"> |
|
<tuv xml:lang="en"> |
|
<seg>Will you have any other income than the potential sickness compensation, such as a salary or an occupational pension?</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Aurez-vous un autre revenu qu'une éventuelle indemnité de maladie, par exemple salaire ou retraite?</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="127"> |
|
<tuv xml:lang="en"> |
|
<seg>No Yes, fill in below</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Non Oui, je l'indique ci-dessous</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="128"> |
|
<tuv xml:lang="en"> |
|
<seg>We need to know if you have any other income in order to determine who is entitled to deduct tax according to tax tables.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Nous avons besoin de savoir si vous avez un autre revenu pour pouvoir décider qui devra percevoir l'impôt d'après le barème d'imposition.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="129"> |
|
<tuv xml:lang="en"> |
|
<seg>Payer</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Payeur</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="130"> |
|
<tuv xml:lang="en"> |
|
<seg>SEK per month</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>SEK par mois</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="131"> |
|
<tuv xml:lang="en"> |
|
<seg>Payer</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Payeur</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="132"> |
|
<tuv xml:lang="en"> |
|
<seg>Account number</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Numéro de compte PlusGiro</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="133"> |
|
<tuv xml:lang="en"> |
|
<seg>PlusGiro account</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Compte bancaire</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="134"> |
|
<tuv xml:lang="en"> |
|
<seg>Personal ID no.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Numéro de compte</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="135"> |
|
<tuv xml:lang="en"> |
|
<seg>Complete this section if you want to grant another person power of attorney to handle all matters on your behalf.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Vous ne devez remplir ce point que si vous voulez donner à quelqu'un d'autre un pouvoir pour vous représenter.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="136"> |
|
<tuv xml:lang="en"> |
|
<seg>The person you appoint will receive correspondence and get access to all documentation relating to your case.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Autrement, vous devez aller aux points suivants du formulaire.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="137"> |
|
<tuv xml:lang="en"> |
|
<seg>The power of attorney is valid until a final decision is rendered in this matter.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Le pouvoir est valable jusqu'à ce que je l'annule.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="138"> |
|
<tuv xml:lang="en"> |
|
<seg>Personal ID no. (12 digits)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Numéro national d'identité (renseignement facultatif)</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="139"> |
|
<tuv xml:lang="en"> |
|
<seg>Telephone, evening, including area code</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Téléphone au domicile, y compris indicatif</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="140"> |
|
<tuv xml:lang="en"> |
|
<seg>Additional information (optional)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Renseignements divers</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="141"> |
|
<tuv xml:lang="en"> |
|
<seg>Additional information provided separately</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Je fournis des renseignements dans une annexe</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="142"> |
|
<tuv xml:lang="en"> |
|
<seg>Signature</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Signature</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="143"> |
|
<tuv xml:lang="en"> |
|
<seg>I solemnly declare that the information provided in this form is correct and complete.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Je certifie sur l'honneur que les renseignements fournis dans le formulaire sont exacts et complets.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="144"> |
|
<tuv xml:lang="en"> |
|
<seg>Should this information change, I am obliged to inform Försäkringskassan.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Lorsque ces renseignements changeront, je dois le communiquer à l'Agence suédoise de la sécurité sociale.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="145"> |
|
<tuv xml:lang="en"> |
|
<seg>I am aware that it is a punishable offense to provide false information, omit information or to not notify Försäkringskassan if any of the information I have provided should change.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Je sais qu'il est punissable par la loi de fournir des renseignements inexacts, de dissimuler quelque chose ou de ne pas indiquer à l'Agence suédoise de la sécurité sociale les changements survenus dans les renseignements que j'ai fournis.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="146"> |
|
<tuv xml:lang="en"> |
|
<seg>Telephone, daytime, including area code</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Téléphone au lieu de travail, y compris indicatif</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="147"> |
|
<tuv xml:lang="en"> |
|
<seg>Telephone, evening, including area code</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Téléphone au domicile, y compris indicatif</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="148"> |
|
<tuv xml:lang="en"> |
|
<seg>Date</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Date</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="149"> |
|
<tuv xml:lang="en"> |
|
<seg>Signature</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Signature</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="150"> |
|
<tuv xml:lang="en"> |
|
<seg>Complete this section if you are signing on behalf of the applicant as a trustee or administrator Please enclose with this document a register extract showing that you have been appointed as a trustee or administrator.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Remplissez la partie ci-dessous si vous signez en tant que tuteur ou curateur de la personne qui fait la demande</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="151"> |
|
<tuv xml:lang="en"> |
|
<seg>The information provided above is held in the database of the Swedish Social Insurance Agency.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Ces renseignements sont traités dans le système informatique de l'Agence suédoise de la sécurité sociale.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="152"> |
|
<tuv xml:lang="en"> |
|
<seg>Once we are in receipt of your application, you will be contacted by one of our administrators.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Un conseiller vous contactera dans un délai d'une semaine après que votre demande nous soit parvenue.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="153"> |
|
<tuv xml:lang="en"> |
|
<seg>You will then together go through your application and you will be advised of how long you can expect to wait for a decision in the matter.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Il ou elle vous aidera à compléter éventuellement votre demande et vous pourrez savoir dans quel délai vous recevrez la décision.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="154"> |
|
<tuv xml:lang="en"> |
|
<seg>You may be entitled to housing supplement</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Vous pouvez avoir droit à une allocation logement complémentaire</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="155"> |
|
<tuv xml:lang="en"> |
|
<seg>If you are receiving sickness compensation and live in Sweden, you may also be entitled to housing supplement.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Si vous percevez une indemnité d'activité et que vous habitez en Suède, vous pouvez éventuellement vous voir accorder une allocation-logement complémentaire.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="156"> |
|
<tuv xml:lang="en"> |
|
<seg>For more information and to download the relevant application form, visit www.forsakringskassan.se.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Téléchargez un formulaire de demande et lisez les informations sur forsakringskassan.se.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="157"> |
|
<tuv xml:lang="en"> |
|
<seg>Application</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Demande</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="158"> |
|
<tuv xml:lang="en"> |
|
<seg>Activity compensation for</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Indemnité d'activité en cas de</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="159"> |
|
<tuv xml:lang="en"> |
|
<seg>1 (3)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>1 (3)</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="160"> |
|
<tuv xml:lang="en"> |
|
<seg>0771-524 524 www.forsakringskassan.se</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>0771-524 524 www.forsakringskassan.se</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="161"> |
|
<tuv xml:lang="en"> |
|
<seg>impaired working ability</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>capacité de travail réduite</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="162"> |
|
<tuv xml:lang="en"> |
|
<seg>Personal ID no.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Numéro personnel d'identité</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="163"> |
|
<tuv xml:lang="en"> |
|
<seg>Send this form to</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Adressez le formulaire à</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="164"> |
|
<tuv xml:lang="en"> |
|
<seg>Försäkringskassans inläsningscentral 839 88 Östersund</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Försäkringskassans inläsningscentral 839 88 Östersund</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="165"> |
|
<tuv xml:lang="en"> |
|
<seg>Applicant</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Le demandeur</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="166"> |
|
<tuv xml:lang="en"> |
|
<seg>Name and surname</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Prénom et nom</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="167"> |
|
<tuv xml:lang="en"> |
|
<seg>Personal ID no. (12 digits)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Numéro national d'identité (12 chiffres)</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="168"> |
|
<tuv xml:lang="en"> |
|
<seg>Postal address</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Adresse postale</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="169"> |
|
<tuv xml:lang="en"> |
|
<seg>Postal code and city</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Code postal et localité</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="170"> |
|
<tuv xml:lang="en"> |
|
<seg>Application refers to</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Objet de la demande</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="171"> |
|
<tuv xml:lang="en"> |
|
<seg>I am applying for</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Je souhaite percevoir un quart</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="172"> |
|
<tuv xml:lang="en"> |
|
<seg>1/4</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>une moitié</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="173"> |
|
<tuv xml:lang="en"> |
|
<seg>As of year, month</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>À partir de année, mois</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="174"> |
|
<tuv xml:lang="en"> |
|
<seg>Describe why you are unable to work</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Décrivez pourquoi vous ne pouvez pas travailler</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="175"> |
|
<tuv xml:lang="en"> |
|
<seg>Give a brief description of why you are unable to work.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Décrivez en quelques mots pourquoi vous ne pouvez pas travailler.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="176"> |
|
<tuv xml:lang="en"> |
|
<seg>We need this information to prepare your case.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Nous avons besoin de ce renseignement pour pouvoir traiter votre affaire.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="177"> |
|
<tuv xml:lang="en"> |
|
<seg>I am providing information I wish to give this information in an appendix verbally to Försäkringskassan</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Je fournis les renseignements Je veux fournir les renseignements oralement dans une annexe. à l'Agence suédoise de la sécurité sociale.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="178"> |
|
<tuv xml:lang="en"> |
|
<seg>I have attached a doctor's certificate</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Je joins un certificat médical.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="179"> |
|
<tuv xml:lang="en"> |
|
<seg>We need a doctor's certificate to consider your application.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Nous avons besoin d'un certificat médical pour pouvoir prendre position sur votre demande.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="180"> |
|
<tuv xml:lang="en"> |
|
<seg>and will submit it later on</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>et je l'enverrai plus tard</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="181"> |
|
<tuv xml:lang="en"> |
|
<seg>(name of physician)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>(Nom du médecin)</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="182"> |
|
<tuv xml:lang="en"> |
|
<seg>Yes No.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Oui Non.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="183"> |
|
<tuv xml:lang="en"> |
|
<seg>Please specify where you have lived</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Indiquez ci-dessous où vous avez habité</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="184"> |
|
<tuv xml:lang="en"> |
|
<seg>Country</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Pays</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="185"> |
|
<tuv xml:lang="en"> |
|
<seg>As of (year, month, day)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Depuis (année, mois, jour)</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="186"> |
|
<tuv xml:lang="en"> |
|
<seg>Until (year, month, day)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Jusqu'à (année, mois, jour)</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="187"> |
|
<tuv xml:lang="en"> |
|
<seg>Country</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Pays</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="188"> |
|
<tuv xml:lang="en"> |
|
<seg>As of (year, month, day)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Depuis (année, mois, jour)</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="189"> |
|
<tuv xml:lang="en"> |
|
<seg>No Yes</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>No Oui</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="190"> |
|
<tuv xml:lang="en"> |
|
<seg>Personal ID no.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Oui, j'ai</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="191"> |
|
<tuv xml:lang="en"> |
|
<seg>2 (3)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Pays</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="192"> |
|
<tuv xml:lang="en"> |
|
<seg>No</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>travaillé</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="193"> |
|
<tuv xml:lang="en"> |
|
<seg>Yes, I have worked in</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>dans un</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="194"> |
|
<tuv xml:lang="en"> |
|
<seg>Country</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Pays</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="195"> |
|
<tuv xml:lang="en"> |
|
<seg>As of (year, month, day)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Depuis (année, mois, jour)</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="196"> |
|
<tuv xml:lang="en"> |
|
<seg>Until (year, month, day)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Jusqu'à (année, mois, jour)</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="197"> |
|
<tuv xml:lang="en"> |
|
<seg>Country</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>autre pays</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="198"> |
|
<tuv xml:lang="en"> |
|
<seg>Do you receive compensation, or have you applied for compensation, from a country other than Sweden?</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Percevez-vous une prestation ou avez-vous demandé une prestation dans un autre pays que la Suède?</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="199"> |
|
<tuv xml:lang="en"> |
|
<seg>No</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Non</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="200"> |
|
<tuv xml:lang="en"> |
|
<seg>Yes Sickness benefit Pension</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Oui Indemnité de maladie Retraite</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="201"> |
|
<tuv xml:lang="en"> |
|
<seg>Perpetual annuity or pension due to occupational injury</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Rente d'invalidité ou une pension en raison d'un accident de travail</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="202"> |
|
<tuv xml:lang="en"> |
|
<seg>Name and address of the paying authority</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Nom et adresse de l'autorité qui effectue le versement</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="203"> |
|
<tuv xml:lang="en"> |
|
<seg>Will you have any other income than the potential sickness compensation, such as a salary or an occupational pension?</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Aurez-vous un autre revenu qu'une éventuelle indemnité de maladie, par exemple salaire ou retraite?</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="204"> |
|
<tuv xml:lang="en"> |
|
<seg>No Yes, fill in below</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Non Oui, je l'indique ci-dessous</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="205"> |
|
<tuv xml:lang="en"> |
|
<seg>We need to know if you have any other income in order to determine who is entitled to deduct tax according to tax tables.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Nous avons besoin de savoir si vous avez un autre revenu pour pouvoir décider qui devra percevoir l'impôt d'après le barème d'imposition.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="206"> |
|
<tuv xml:lang="en"> |
|
<seg>Payer</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Payeur</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="207"> |
|
<tuv xml:lang="en"> |
|
<seg>SEK per month</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>SEK par mois</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="208"> |
|
<tuv xml:lang="en"> |
|
<seg>Payer</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Payeur</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="209"> |
|
<tuv xml:lang="en"> |
|
<seg>Account number</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Numéro de compte PlusGiro</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="210"> |
|
<tuv xml:lang="en"> |
|
<seg>PlusGiro account</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Compte bancaire</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="211"> |
|
<tuv xml:lang="en"> |
|
<seg>Personal ID no.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Numéro de compte</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="212"> |
|
<tuv xml:lang="en"> |
|
<seg>Complete this section if you want to grant another person power of attorney to handle all matters on your behalf.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Vous ne devez remplir ce point que si vous voulez donner à quelqu'un d'autre un pouvoir pour vous représenter.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="213"> |
|
<tuv xml:lang="en"> |
|
<seg>The person you appoint will receive correspondence and get access to all documentation relating to your case.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Autrement, vous devez aller aux points suivants du formulaire.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="214"> |
|
<tuv xml:lang="en"> |
|
<seg>The power of attorney is valid until a final decision is rendered in this matter.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Le pouvoir est valable jusqu'à ce que je l'annule.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="215"> |
|
<tuv xml:lang="en"> |
|
<seg>Personal ID no. (12 digits)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Numéro national d'identité (renseignement facultatif)</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="216"> |
|
<tuv xml:lang="en"> |
|
<seg>Telephone, evening, including area code</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Téléphone au domicile, y compris indicatif</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="217"> |
|
<tuv xml:lang="en"> |
|
<seg>Additional information (optional)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Renseignements divers</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="218"> |
|
<tuv xml:lang="en"> |
|
<seg>Additional information provided separately</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Je fournis des renseignements dans une annexe</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="219"> |
|
<tuv xml:lang="en"> |
|
<seg>Signature</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Signature</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="220"> |
|
<tuv xml:lang="en"> |
|
<seg>I solemnly declare that the information provided in this form is correct and complete.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Je certifie sur l'honneur que les renseignements fournis dans le formulaire sont exacts et complets.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="221"> |
|
<tuv xml:lang="en"> |
|
<seg>Should this information change, I am obliged to inform Försäkringskassan.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Lorsque ces renseignements changeront, je dois en informer l'Agence suédoise de la sécurité sociale.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="222"> |
|
<tuv xml:lang="en"> |
|
<seg>I am aware that it is a punishable offense to provide false information, omit information or to not notify Försäkringskassan if any of the information I have provided should change.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Je sais qu'il est répréhensible de fournir des informations erronées, d'omettre des éléments ou de ne pas informer l'Agence suédoise de la sécurité sociale lorsque les informations que j'ai communiquées changent.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="223"> |
|
<tuv xml:lang="en"> |
|
<seg>Date</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Date</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="224"> |
|
<tuv xml:lang="en"> |
|
<seg>Signature</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Signature</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="225"> |
|
<tuv xml:lang="en"> |
|
<seg>Complete this section if you are signing on behalf of the applicant as a trustee or administrator Please enclose with this document a register extract showing that you have been appointed as a trustee or administrator.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Remplissez la partie ci-dessous si vous signez en tant que tuteur ou curateur de la personne qui fait la demande</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="226"> |
|
<tuv xml:lang="en"> |
|
<seg>The information provided above is held in the database of the Swedish Social Insurance Agency.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Ces renseignements sont traités dans le système informatique de l'Agence suédoise de la sécurité sociale.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="227"> |
|
<tuv xml:lang="en"> |
|
<seg>Once we are in receipt of your application, you will be contacted by one of our administrators.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Un conseiller vous contactera dans un délai d'une semaine après que votre demande nous soit parvenue.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="228"> |
|
<tuv xml:lang="en"> |
|
<seg>You will then together go through your application and you will be advised of how long you can expect to wait for a decision in the matter.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Il ou elle vous aidera à compléter éventuellement votre demande et vous pourrez savoir dans quel délai vous recevrez la décision.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="229"> |
|
<tuv xml:lang="en"> |
|
<seg>You may be entitled to housing supplement</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Vous pouvez avoir droit à une allocation logement complémentaire</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="230"> |
|
<tuv xml:lang="en"> |
|
<seg>If you are receiving activity compensation and live in Sweden, you may also be entitled to housing supplement.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Si vous percevez une indemnité d'activité et que vous habitez en Suède, vous pouvez éventuellement vous voir accorder une allocation-logement complémentaire.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="231"> |
|
<tuv xml:lang="en"> |
|
<seg>For more information and to download the relevant application form, visit www.forsakringskassan.se.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Téléchargez un formulaire de demande et lisez les informations sur forsakringskassan.se.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="232"> |
|
<tuv xml:lang="en"> |
|
<seg>Agreement on child support</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Accord sur la pension alimentaire pour un(e) enfant</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="233"> |
|
<tuv xml:lang="en"> |
|
<seg>1 (1)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>1 (1)</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="234"> |
|
<tuv xml:lang="en"> |
|
<seg>Child who is to receive child support</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Enfant qui bénéficiera de la pension alimentaire</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="235"> |
|
<tuv xml:lang="en"> |
|
<seg>Forname(s) and Surname Child's personal ID no.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Prénom et nom</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="236"> |
|
<tuv xml:lang="en"> |
|
<seg>Parent with whom the child lives</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Parent avec qui l'enfant vit</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="237"> |
|
<tuv xml:lang="en"> |
|
<seg>Forname(s) and Surname</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Prénom et nom</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="238"> |
|
<tuv xml:lang="en"> |
|
<seg>Parent who is to pay child support (child support debtor)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Parent qui versera la pension alimentaire</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="239"> |
|
<tuv xml:lang="en"> |
|
<seg>Forname(s) and Surname</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Prénom et nom</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="240"> |
|
<tuv xml:lang="en"> |
|
<seg>Child support which is to be paid to the child</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Pension alimentaire à verser pour l'enfant</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="241"> |
|
<tuv xml:lang="en"> |
|
<seg>Starting date of payment of child support</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>La pension alimentaire sera versée à compter du</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="242"> |
|
<tuv xml:lang="en"> |
|
<seg>Child support is to be paid until the child attains the age of 18</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>La pension alimentaire sera payée jusqu'à ce que l'enfant atteigne l'âge de 18 ans, date</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="243"> |
|
<tuv xml:lang="en"> |
|
<seg>Other date</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Autre date</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="244"> |
|
<tuv xml:lang="en"> |
|
<seg>Amount to be paid, Swedish kronor (SEK) per month (in words)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Montant à payer, couronnes suédoises par mois en toute lettres</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="245"> |
|
<tuv xml:lang="en"> |
|
<seg>Amount in figures, SEK</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Montant en chiffres, couronnes suédoises</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="246"> |
|
<tuv xml:lang="en"> |
|
<seg>Provisions on payment</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Dispositions relatives au paiement</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="247"> |
|
<tuv xml:lang="en"> |
|
<seg>Child support for the coming month falls due for payment on the last day of the previous month according to Chapter 7, section 7, of the Children and Parents Code.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>La pension alimentaire arrive à échéance le dernier jour du mois et se rapporte au mois suivant, conformément au chap. 7, art. 7 du Code suédois de la filiation et de la minorité.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="248"> |
|
<tuv xml:lang="en"> |
|
<seg>According to the Swedish Ordinance (1966:680) on Changes to Certain Child Support Amounts, the amount will be annually adjusted to the cost of living.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Conformément à la loi (1966:680) sur la modification de certaines pensions alimentaires, le montant est révisé chaque année compte tenu des changements de la valeur monétaire.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="249"> |
|
<tuv xml:lang="en"> |
|
<seg>Any increases will apply from 1 February.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Tout relèvement éventuel prend effet le 1er février.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="250"> |
|
<tuv xml:lang="en"> |
|
<seg>Signature of the child support debtor</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Signature du parent qui versera la pension alimentaire</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="251"> |
|
<tuv xml:lang="en"> |
|
<seg>Date of signature of agreement Parent's signature</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Date de la signature de l'accord Signature du parent</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="252"> |
|
<tuv xml:lang="en"> |
|
<seg>The parent's signature witnessed by two persons</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>La signature du parent est certifiée authentique par deux personnes</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="253"> |
|
<tuv xml:lang="en"> |
|
<seg>Signature</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Signature</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="254"> |
|
<tuv xml:lang="en"> |
|
<seg>Signature</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Signature</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="255"> |
|
<tuv xml:lang="en"> |
|
<seg>Name in block letters</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Nom en caractères moulés</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="256"> |
|
<tuv xml:lang="en"> |
|
<seg>Name in block letters</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Nom en caractères moulés</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="257"> |
|
<tuv xml:lang="en"> |
|
<seg>Address</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Adresse</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="258"> |
|
<tuv xml:lang="en"> |
|
<seg>Address</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Adresse</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="259"> |
|
<tuv xml:lang="en"> |
|
<seg>Approval, on behalf of the child, by the parent with whom the child lives</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Le parent avec qui l'enfant vit accepte l'accord pour le compte de l'enfant</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="260"> |
|
<tuv xml:lang="en"> |
|
<seg>FK 5251en (003 F 002) Fastställd av Försäkringskassan</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>FK 5251fr (002 F 002) Fastställd av Försäkringskassan</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="261"> |
|
<tuv xml:lang="en"> |
|
<seg>FK 5251en (003 F 002) Fastställd av Försäkringskassan</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>FK 5251fr (002 F 002) Fastställd av Försäkringskassan</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="262"> |
|
<tuv xml:lang="en"> |
|
<seg>Date Parent's signature</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Date Signature du parent</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="263"> |
|
<tuv xml:lang="en"> |
|
<seg>Agreement on child support</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Accord sur la pension alimentaire pour un(e) enfant</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="264"> |
|
<tuv xml:lang="en"> |
|
<seg>1 (1)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>1 (1)</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="265"> |
|
<tuv xml:lang="en"> |
|
<seg>Forname(s) and Surname</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Prénom et nom</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="266"> |
|
<tuv xml:lang="en"> |
|
<seg>Parent who is to pay child support (child support debtor)</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Parent qui versera la pension alimentaire</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="267"> |
|
<tuv xml:lang="en"> |
|
<seg>Forname(s) and Surname Parent's personal ID no.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Prénom et nom</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="268"> |
|
<tuv xml:lang="en"> |
|
<seg>Child support which is to be paid</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Pension alimentaire à verser</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="269"> |
|
<tuv xml:lang="en"> |
|
<seg>Starting date of payment of child support</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>La pension alimentaire sera versée à compter du</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="270"> |
|
<tuv xml:lang="en"> |
|
<seg>Child support is to be paid during the period of study, which is expected to continue until</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>La pension alimentaire sera payée pendant la durée des études, qui, selon les estimations, se poursuivront jusqu'au</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="271"> |
|
<tuv xml:lang="en"> |
|
<seg>Provisions on payment</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Dispositions relatives au paiement</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="272"> |
|
<tuv xml:lang="en"> |
|
<seg>Child support for the coming month falls due for payment on the last day of the previous month according to Chapter 7, section 7, of the Children and Parents Code.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>La pension alimentaire arrive à échéance le dernier jour du mois et se rapporte au mois suivant, conformément au chap. 7, art. 7 du Code suédois de la filiation et de la minorité.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="273"> |
|
<tuv xml:lang="en"> |
|
<seg>According to the Swedish Ordinance (1966:680) on Changes to Certain Child Support Amounts, the amount will be annually adjusted to the cost of living.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Conformément à la loi (1966:680) sur la modification de certaines pensions alimentaires, le montant est révisé chaque année compte tenu des changements de la valeur monétaire.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="274"> |
|
<tuv xml:lang="en"> |
|
<seg>Any increases will apply from 1 February.</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Tout relèvement éventuel prend effet le 1er février.</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="275"> |
|
<tuv xml:lang="en"> |
|
<seg>Signature of the child support debtor</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Signature du parent qui versera la pension alimentaire</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="276"> |
|
<tuv xml:lang="en"> |
|
<seg>Date of signature of agreement Parent's signature</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Date de la signature de l'accord Signature du parent</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="277"> |
|
<tuv xml:lang="en"> |
|
<seg>The parent's signature witnessed by two persons</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>La signature du parent est certifiée authentique par deux personnes</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="278"> |
|
<tuv xml:lang="en"> |
|
<seg>Signature</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Signature</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="279"> |
|
<tuv xml:lang="en"> |
|
<seg>Signature</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Signature</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="280"> |
|
<tuv xml:lang="en"> |
|
<seg>Name in block letters</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Nom en caractères moulés</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="281"> |
|
<tuv xml:lang="en"> |
|
<seg>Name in block letters</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Nom en caractères moulés</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="282"> |
|
<tuv xml:lang="en"> |
|
<seg>Address</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Adresse</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="283"> |
|
<tuv xml:lang="en"> |
|
<seg>Address</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Adresse</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="284"> |
|
<tuv xml:lang="en"> |
|
<seg>Approval of the agreement by the school student</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>L'étudiant accepte l'accord pour son compte personnel</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="285"> |
|
<tuv xml:lang="en"> |
|
<seg>FK 5252en (003 F 003) Fastställd av Försäkringskassan</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>FK 5252fr (002 F 002) Fastställd av Försäkringskassan</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="286"> |
|
<tuv xml:lang="en"> |
|
<seg>FK 5252en (003 F 003) Fastställd av Försäkringskassan</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>FK 5252fr (002 F 002) Fastställd av Försäkringskassan</seg> |
|
</tuv> |
|
</tu> |
|
<tu tuid="287"> |
|
<tuv xml:lang="en"> |
|
<seg>Date School student's signature</seg> |
|
</tuv> |
|
<tuv xml:lang="fr"> |
|
<seg>Date Signature de l'étudiant</seg> |
|
</tuv> |
|
</tu> |
|
</body> |
|
</tmx> |
|
|
