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General enquiry

Intro text

This procedure is used to communicate a change in the personal or professional situation of the recipient of social security benefits that is relevant to these benefits.

Responsibility

Insurance provider selection

Please your insurance provider.

Insurance provider*

Personal information

Title (preceding)

First name*

Last name*

Title (postpositioned)

Social security number

Date of birth (DD.MM.YYYY)*

Address

Street*

House number*

Stairway

Floor/Door

Postcode*

Town*

Contact details

* Please provide at least a telephone number or email address.

Telephone

Request

Your request (maximum 1,000 characters)*

Attachment(s)

Attachment

Sie können weitere 4 Beilagen hinzufügen

Amount of elements to add

Security check

Please answer the security check (Captcha)

no-captcha-needed

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(FORMGEN_FORMSERVER / 1.2.2) 2026-09-04 19:11:00.586