Documentos de Académico
Documentos de Profesional
Documentos de Cultura
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1 (3)
Frskringskassans inlsningscentral
839 88 stersund
For the Swedish Social Insurance Agency to be able to assess whether you shall be registered in the social
security system you have to fill in this form.
At www.forsakringskassan.se you will find information on how to fill in the form.
Single
Divorced
Cohabitee
I am a Swedish citizen
I am a citizen of
Finland
Denmark
Iceland
Norway
State country
I am an EU/EEA citizen
State country
No
State country
Date of entry
State country
From (date)
Yes
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2 (3)
Yes
I am employed
I work as a seaman
Until (date)
Delivery address
Delivery address
Company registration no
* If you have more children you can provide information about them in point 9 under Further information
Salary
Unemployment benefit
Pension
Other compensation
Parental benefit
Sickness benefit
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Personal ID number
3 (3)
9. Further information
You can provide information here about, for example, if you have more children than those
listed in point 6.
I provide information in
an appendix
10. Signature
To the best of my knowledge and belief, the details I have given in this form are correct and
complete. I will notify Frskringskassan of any change in this information.
I am aware that it is a punishable offence to provide incorrect information, to withhold any
information or not to notify Frskringskassan when information which I have provided hanges.
Date
Signature
The information is processed by the Swedish Social Insurance Agency's data system. Read more in the brochure "Personal Data File of the
Swedish Social Insurance Agency" (Frskringskassans personregister).