Get Formulario Solicitud Prestaciones Por Gastos Extraordinarios - Fremap

The Formulario Solicitud Prestaciones Por Gastos Extraordinarios - Fremap is essential for requesting financial assistance for extraordinary expenses related to an accident. This guide provides thorough instructions on how to complete the form accurately and efficiently online.

Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your personal information. Fill in the fields for 'Accidentado DNI', 'Población', and 'CP' to identify the individual involved in the accident.
3. Provide the 'Domicilio' and 'Empresa' details of the individual applying or associated with the application to ensure proper management of the request.
4. In section A, describe the accident. Include pertinent details that clearly outline what occurred.
5. In section B, outline the assistance requested, including the financial amount and motivation for the request. Detail the incurred expenses along with the corresponding period and attach any necessary justification documents.
6. List down particulars for associated expenses: categorize them under 'Patient' and/or 'Accompanying Person', indicating the specifics such as 'Concept', 'Period', 'Amount', and number of receipts/tickets.
7. Review the section titled 'FREMAP Informa' to understand how your personal data will be managed and your rights regarding data protection.
8. Ensure you sign and date the document at the bottom of the form to validate your application. Include the date of your signature.
9. Collect and attach necessary documentation including original receipts, the accident report, and a medical report.
10. Once all fields are filled properly and documentation is attached, you can save changes, download, print, or share the completed form.

Complete your application for extraordinary expenses online today.