מיציתי | הגשת תביעה

from my family

Bachelor

Married

divorcee

widower

Details of work for the last 15 months (write down the details and attach salary certificates)

I didn&#39;t work at all

I worked and stopped working

I continue to work

In the last 15 months, did you receive sick pay for periods when you did not work or any payment from an insurance company due to illness?

No

Yes, the employer (attach confirmation)

Yes, the insurance company (attach confirmation)

Yes, specify and attach confirmation

Do you have or have you had in the last 15 months income other than work, such as a pension (in Israel or abroad), support for yeshiva students, compensation from the Ministry of Defense, payments from the insurance company, capital income, alimony, income from property, etc.?

No

For the purpose of checking your eligibility for an allowance, the National Insurance may proactively contact your employers and pension payers, including those you had or will have in the future, to receive your income data digitally (computerized). If you disagree, state so:

I, the plaintiff, refuse

I am the plaintiff&#39;s spouse who refuses (married/publicly known)

General disability form - online

Address (registered at the Ministry of the Interior)

Find my zip code

Address for letters (if different from the address listed on the identity card)

eligibility conditions

Find my zip code