TMHP aanvraagstraat Crowdsurance Engels

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Collectiviteitscode

Hidden

ProductHealthcoach*

Nee

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ProductFund*

Ja

Profession*

Startdate Crowdsurance*

Which income amount would you like to receive?*

Income:
The income amount you choose is net per month. It does need to be in proportion to your current income. Are you in doubt? You can always change this later! When you submit a claim, you will receive your payment after a six-week waiting period. The amount you choose also determines the amount of your contribution to others.

Contribution:
Your monthly contribution is a maximum of 5% of your own desired benefit in the event of incapacity for work. Experience shows that your monthly contribution is usually much lower, on average it is around €30 per month (with a chosen income amount of €2,000).

Administration fees:
A monthly administration fee of €10 will be charged. In addition, you normally pay a one-time registration fee of €175, but we have a temporary discount exclusively for The Models Health Pledge participants! You now only pay €43.75 registration costs!

Gender*

Male

Female

First name*

Tussenvoegsel

Last name*

Nationality*

Date of birth*

E-mail*

Phone number*

Zip code*

House number*

addition

Street*

City*

Land*

IBAN*

Do you have a Chamber of Commerce number?

Yes

No

Fill in your Chamber of Commerce number*

I provide goods and/or services (for example, I sell bicycles or am a photographer)

Yes

No

I am asking more than symbolic compensation for this. (For example, invoice the costs and the hourly rate)

Yes

No

I participate in (normal) economic traffic. (For example, I shoot on behalf of a customer and not for family and friends)

Yes

No

Sort your income protection within 2 minutes!