CETTE ATTESTATION EST DELIVREE PAR L'INSTITUTION DU LIEU DE RESIDENCE DES MEMBRES DE LA FAMILLE.

This certified statement shall be issued by the institution of the place of residence of the members of the family.

UNE COPIE DE CETTE FICHE EST DELIVREE AU DEMANDEUR .

A COPY OF THIS CERTIFICATE SHALL BE ISSUED TO THE APPLICANT .

CETTE ATTESTATION EST DELIVREE PAR L'INSTITUTION DE CET AUTRE ETAT MEMBRE QUI EST COMPETENTE POUR LES PRESTATIONS EN NATURE.

This certified statement shall be issued by the institution of that other Member State which is responsible for benefits in kind.

CETTE ATTESTATION EST DELIVREE PAR L'INSTITUTION COMPETENTE , AU VU DES RENSEIGNEMENTS FOURNIS PAR L'EMPLOYEUR , LE CAS ECHEANT.

Such certified statement shall be issued by the competent institution, if need be in the light of information furnished by the employer.

CETTE ATTESTATION EST DELIVREE PAR L'INSTITUTION COMPETENTE , AU VU DES RENSEIGNEMENTS FOURNIS PAR L'EMPLOYEUR , LE CAS ECHEANT.

This certified statement, based upon information supplied by the employer, where appropriate, shall be issued by the competent institution.

CETTE ATTESTATION EST DELIVREE , A LA DEMANDE DE L'INTERESSE , PAR L'INSTITUTION OU LES INSTITUTIONS QUI APPLIQUENT LES LEGISLATIONS SOUS LESQUELLES IL A ACCOMPLI CES PERIODES D'ASSURANCE.

Such certified statement shall be issued, at the request of the person concerned, by the institution or institutions who administer the legislations under which he has completed those insurance periods.

CETTE ATTESTATION EST DELIVREE A LA DEMANDE DU TRAVAILLEUR , PAR L'INSTITUTION OU LES INSTITUTIONS DE L'ETAT MEMBRE A LA LEGISLATION DUQUEL IL A ETE SOUMIS ANTERIEUREMENT EN DERNIER LIEU.

This certified statement shall be issued at the request of the worker by the institution or institutions of the Member State to whose legislation he was last subject.

CETTE ATTESTATION EST DELIVREE PAR L'INSTITUTION DESIGNEE PAR L'AUTORITE COMPETENTE DE L'ETAT MEMBRE SUR LE TERRITOIRE DUQUEL CES MEMBRES DE LA FAMILLE RESIDENT.

This certified statement shall be issued by the institution designated by the competent authority of the Member State in whose territory those members of the family reside.

CETTE ATTESTATION EST DELIVREE , A LA DEMANDE DU REQUERANT , PAR L'INSTITUTION D'ASSURANCE-MALADIE OU L'INSTITUTION D'ASSURANCE-VIEILLESSE , SELON LE CAS , A LAQUELLE LE TRAVAILLEUR A ETE AFFILIE EN DERNIER LIEU.

This certified statement shall be issued, at the request of the claimant by the sickness insurance institution, as the case may be, with which the worker was last insured.

CETTE ATTESTATION QUI EST DELIVREE PAR L'INSTITUTION COMPETENTE INDIQUE NOTAMMENT , LE CAS ECHEANT , LA DUREE MAXIMALE D'OCTROI DES PRESTATIONS EN NATURE , TELLE QU'ELLE EST PREVUE PAR LA LEGISLATION DE L'ETAT COMPETENT.

This certified statement, which shall be issued by the competent institution, shall specify in particular, where necessary, the maximum period during which benefits in kind may be granted in accordance with the legislation of the competent State.

CETTE ATTESTATION , QUI EST DELIVREE PAR L'INSTITUTION DU LIEU DE RESIDENCE DU TITULAIRE , RESTE VALABLE AUSSI LONGTEMPS QUE L'INSTITUTION DU LIEU DE RESIDENCE DES MEMBRES DE LA FAMILLE N'A PAS RECU NOTIFICATION DE SON ANNULATION.

This certified statement, which shall be issued by the institution of the pensioner's place of residence, shall remain valid as long as the institution of his family's place of residence has not been notified of its cancellation.

CETTE ATTESTATION EST DELIVREE PAR L'INSTITUTION D'ASSURANCE-MALADIE DU LIEU DE RESIDENCE DES MEMBRES DE LA FAMILLE OU PAR UNE AUTRE INSTITUTION DESIGNEE PAR L'AUTORITE COMPETENTE DE L'ETAT MEMBRE SUR LE TERRITOIRE DUQUEL ILS ONT LEUR RESIDENCE.

This certified statement shall be issued by the sickness insurance institution of the place of residence of the members of the family or by another institution designated by the competent authority of the Member State in whose territory they are resident.

CETTE ATTESTATION EST DELIVREE PAR L'INSTITUTION D'ASSURANCE-MALADIE DU LIEU DE RESIDENCE DES MEMBRES DE LA FAMILLE , OU PAR UNE AUTRE INSTITUTION DESIGNEE PAR L'AUTORITE COMPETENTE DE L'ETAT MEMBRE SUR LE TERRITOIRE DUQUEL ILS ONT LEUR RESIDENCE.

This certified statement shall be issued by the sickness insurance institution of the place of residence of the members of the family, or by another institution designated by the competent authority of the Member State in whose territory they are resident.

CETTE ATTESTATION QUI EST DELIVREE PAR L'INSTITUTION COMPETENTE , INDIQUE NOTAMMENT , LE CAS ECHEANT , LA DUREE MAXIMALE PENDANT LAQUELLE LES PRESTATIONS EN NATURE PEUVENT ENCORE ETRE SERVIES , SELON LES DISPOSITIONS DE LA LEGISLATION DE L'ETAT COMPETENT.

This certified statement, which shall be issued by the competent institution, shall specify in particular, where necessary, the maximum period during which such benefits may continue to be provided, in accordance with the provisions of the legislation of the competent State.

CETTE ATTESTATION , QUI EST DELIVREE PAR L'INSTITUTION COMPETENTE , INDIQUE NOTAMMENT , LE CAS ECHEANT , LA DUREE MAXIMALE PENDANT LAQUELLE LES PRESTATIONS EN NATURE PEUVENT ENCORE ETRE SERVIES , SELON LES DISPOSITIONS DE LA LEGISLATION DE L'ETAT COMPETENT.

This certified statement, which shall be issued by the competent institution, shall specify in particular, where necessary, the maximum period during which such benefits may continue to be provided, in accordance with the legislation of the competent State.

CETTE ATTESTATION EST DELIVREE , A LA DEMANDE DE L'INTERESSE SOIT PAR L'INSTITUTION COMPETENTE EN MATIERE DE CHOMAGE DE L'ETAT MEMBRE A LA LEGISLATION DUQUEL IL A ETE SOUMIS ANTERIEUREMENT EN DERNIER LIEU , SOIT PAR UNE AUTRE INSTITUTION DESIGNEE PAR L'AUTORITE COMPETENTE DUDIT ETAT MEMBRE.

This certified statement shall be issued, at the request of the person concerned, either by the institution competent in matters of unemployment of the Member State to whose legislation he was last subject, or by another institution designated by the competent authority of the said Member State.

CETTE ATTESTATION EST DELIVREE , A LA DEMANDE DE L'INTERESSE , SOIT PAR L'INSTITUTION COMPETENTE EN MATIERE DE PRESTATIONS FAMILIALES DE L'ETAT MEMBRE A LAQUELLE IL A ETE AFFILIE ANTERIEUREMENT EN DERNIER LIEU , SOIT PAR UNE AUTRE INSTITUTION DESIGNEE PAR L'AUTORITE COMPETENTE DUDIT ETAT MEMBRE.

That certified statement shall be issued, at the request of the person concerned, either by the institution competent in respect of family benefits of the Member State with which he was last insured, or by another institution designated by the competent authority of the said Member State.

L'ATTESTATION PEUT ETRE DELIVREE APRES LE DEPART ET A LA DEMANDE DU TRAVAILLEUR LORSQU'ELLE N'A PU ETRE ETABLIE ANTERIEUREMENT POUR DES RAISONS DE FORCE MAJEURE.

The certified statement may, at the worker's request, be issued after his departure if, for reasons of force majeure, it cannot be drawn up beforehand.

CETTE ATTESTATION EST DELIVREE , A LA DEMANDE DU TITULAIRE , PAR L'INSTITUTION OU PAR L'UNE DES INSTITUTIONS DEBITRICES DE PENSION OU DE RENTE , OU LE CAS ECHEANT , PAR L'INSTITUTION HABILITEE A DECIDER DU DROIT AUX PRESTATIONS EN NATURE , DES QUE LE TITULAIRE SATISFAIT AUX CONDITIONS D'OUVERTURE DU DROIT A CES PRESTATIONS.

This certified statement shall be issued, at the request of the pensioner, by the institution or one of the institutions responsible for payment of the pension or, where appropriate, by the institution empowered to determine entitlement to benefits in kind, as soon as the pensioner satisfies the conditions for acquisition of the right to such benefits.

CETTE ATTESTATION , QUI EST DELIVREE PAR L'INSTITUTION COMPETENTE A LA DEMANDE DU TRAVAILLEUR , SI POSSIBLE AVANT QU'IL NE QUITTE LE TERRITOIRE DE L'ETAT MEMBRE OU IL RESIDE , INDIQUE NOTAMMENT , LE CAS ECHEANT , LA DUREE MAXIMALE D'OCTROI DES PRESTATIONS EN NATURE , TELLE QU'ELLE EST PREVUE PAR LA LEGISLATION DE L'ETAT COMPETENT.

Such certified statement, which shall be issued by the competent institution at the worker's request, if possible before he leaves the territory of the Member State in which he resides, shall specify in particular, where necessary, the maximum period during which benefits in kind may be granted, in accordance with the legislation of the competent State.