Application ALIVIO

Person

Velden met een * zijn verplicht.

Name *

First Name(s) *

ID Number *

Date of Birth *

Address *

Phone Number *

Email Address *

1.1 Do you have a partner or co-residents aged 18 or older in your household?

1.3 What is your situation? (indicate which is applicable to you) *

Job seeker

No longer have sufficient work hours due to Covid crisis

Independent entrepreneur

Director and major shareholder

1.4 Are you registered with “Plenchi di Trabou”? *

Yes

Person

Location

Partner

Income

Expenses

Relief measures

Bank account details

Overzicht