Checklist personal information

Data Partner 1

 

Sex

M / F

Initials

 

Given names (as registered in GBA)

 

Surname

 

Nickname

 

Address of marital home

 

Temporary address

 

Mailing address

 

Telephone private

 

Telephone work

 

Telephone mobile

 

Fax

 

E-mail

 

Date of birth +

Place of birth

 

Type of identification

Passport no. |

Driver's license no. | Bring copy of identification

ID no. |

Nationality

 

Social Security Number

(BSN)

 

Data Partner 2

 

Sex

M / F

Initials

 

Given names (as registered in GBA)

 

Surname

 

Nickname

 

Address of marital home

 

Temporary address

 

Mailing address

 

Telephone private

 

Telephone work

 

Telephone mobile

 

Fax

 

E-mail

 

Date of birth +

Place of birth

 

Type of identification

Passport no. |

Driver's license no. | Bring copy of identification

ID no. |

Nationality

 

Social Security Number

(BSN)

 

Details of marriage /

civil partnership

 

Are you married?

 YES / NO

Do you have a civil

partnership?

YES / NO

Date and place of marriage

 

Date and place of

civil partnership

 

Did you sign a prenuptial agreement

before a civil-law notary?

YES / NO

If so, include prenuptial agreement

Did you sign a civil partnership agreement before a civil-law notary?

YES / NO

If so, include civil partnership agreement

Community of goods? 

YES / NO

(if you have neither a prenuptial agreement

nor a civil partnership agreement, you have community of goods)

Do you have children?

YES / NO

Child 1

 

Sex

M / F

Initials

 

Given names (as registered in GBA)

 

Surname

 

Nickname

 

Date of birth +

Place of birth

 

Nationality

 

Social Security Number

(BSN)

 

Child 2

 

Sex

M / F

Initials

 

Given names (as registered in GBA)

 

Surname

 

Nickname

 

Date of birth +

Place of birth

 

Nationality

 

Social Security Number

(BSN)

 

Child 3 etc.

 

Sex

M / F

Initials

 

Given names (as registered in GBA)

 

Surname

 

Nickname

 

Date of birth +

Place of birth

 

Nationality

 

Social Security Number

(BSN)

 

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