5.2.Maintenance claim()
5.2.1.Maintenance claim A
5.2.1.1.The maintenance is to be paid
by … (surname and given name(s))
to … (surname and given name(s) of the person to whom the sum must actually be paid)
Person for whom maintenance is owed:
… (surname and given name(s))
5.2.1.2.
Amount to be paid in one sum
…
(from date (dd/mm/yyyy) to date (dd/mm/yyyy) or event)
Due date: … (dd/mm/yyyy)
Amount: …
5.2.1.3.
Amount to be paid in instalments
Due date(dd/mm/yyyy) | Amount |
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| |
| |
| |
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5.2.1.4.
Sum to be paid regularly
From: … (dd/mm/yyyy)
Due day/date: …
If applicable, until (date (dd/mm/yyyy) or event):
…
If the maintenance claim is subject to indexation, please indicate how that indexation is to be calculated:
…
Indexation applicable as from … (dd/mm/yyyy)
5.2.1.5.
Amount due retroactively
Amount: …
Form of payment: …
…
…
5.2.1.6.
Interest (if specified in the decision/court settlement)
Interest due as from: … (dd/mm/yyyy)
5.2.1.7.
Payment in kind (please specify): …
…
…
5.2.1.8.
Other form of payment (please specify): …
…
…
5.2.2.Maintenance claim B
5.2.2.1.The maintenance is to be paid
by … (surname and given name(s))
to … (surname and given name(s) of the person to whom the sum must actually be paid)
Person for whom maintenance is owed:
… (surname and given name(s))
5.2.2.2.
Amount to be paid in one sum
…
(from date (dd/mm/yyyy) to date (dd/mm/yyyy) or event)
Due date: … (dd/mm/yyyy)
Amount: …
5.2.2.3.
Amount to be paid in instalments
Due date(dd/mm/yyyy) | Amount |
---|
| |
| |
| |
| |
5.2.2.4.
Sum to be paid regularly
From: … (dd/mm/yyyy)
Due day/date: …
If applicable, until (date (dd/mm/yyyy) or event):
…
If the maintenance claim is subject to indexation, please indicate how that indexation is to be calculated: …
Indexation applicable as from … (dd/mm/yyyy)
5.2.2.5.
Amount due retroactively
Amount: …
Form of payment: …
…
…
5.2.2.6.
Interest (if specified in the decision/court settlement)
Interest due as from: … (dd/mm/yyyy)
5.2.2.7.
Payment in kind (please specify): …
…
…
5.2.2.8.
Other form of payment (please specify): …
…
…
5.2.3.Maintenance claim C
5.2.3.1.The maintenance is to be paid
by … (surname and given name(s))
to … (surname and given name(s) of the person to whom the sum must actually be paid)
Person for whom maintenance is owed:
… (surname and given name(s))
5.2.3.2.
Amount to be paid in one sum
…
(from date (dd/mm/yyyy) to date (dd/mm/yyyy) or event)
Due date: … (dd/mm/yyyy)
Amount: …
5.2.3.3.
Amount to be paid in instalments
Due date(dd/mm/yyyy) | Amount |
---|
| |
| |
| |
| |
5.2.3.4.
Sum to be paid regularly
From: … (dd/mm/yyyy)
Due day/date: …
If applicable, until (date (dd/mm/yyyy) or event):
…
If the maintenance claim is subject to indexation, please indicate how that indexation is to be calculated: …
Indexation applicable as from … (dd/mm/yyyy)
5.2.3.5.
Amount due retroactively
Amount: …
Form of payment: …
…
…
5.2.3.6.
Interest (if specified in the decision/court settlement)
Interest due as from: … (dd/mm/yyyy)
5.2.3.7.
Payment in kind (please specify): …
…
…
5.2.3.8.
Other form of payment (please specify): …
…
…