Data Request Form

Personnel data

Title

Last Name

First Name

Date of birth

Birthplace

Country of Birth

Nationality

Private Contact Information

Street

Street Details

ZIP/Postal Code

City

Country

Telephone

Mobile

E-Mail

Bank account

Bank

IBAN

BIC

Income tax

Tax Identification Number (IDNo)

Tax Class

Child Allowance

Tax free amount per year

Is Detecon your main employer?

NoYes

Social- and health insurance

Social Insurance Number

Health Insurance

Health Insurance Company Number

(can be requested from the health insurance company)

By which compulsory health insurance your social pension fund contribution have been paid?

Please enclose certification (health- and long term care insurance) as per § 257 SGB V and § 61 SGB XI.

Similar

Your highest degree

Highest school-leaving qualification

Highest educational qualification/ vocational training

Student Status (Only for Student)

Registered Student

If yes, please hand in a valid attestation of your university.

Internship

If prescribed, please hand in certificate.

Student working on diploma thesis

Have you been working for other employers during this calendar year? (Only for Students)

Other Employment During Current Calendar Year

NoYes

From

Final

I commit myself to inform my employer immediately if the above given facts change. I certify the accuracy of statement.

LinkID

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