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Get BE Xerius Declaration of Affiliation for the Self-Employed 2015-2024

Mber Male Female (on the back of your identity card) Nationality Date of birth Place of birth Country Bank account number Main place of residence Number Street Postcode City Box Country Email Telephone Language Dutch French Postal address German (if different from main place of residence) Street Number Postcode City Box Country Telephone 2 The spouse or legally cohabiting partner (assisting spouse) First name Surname National identification number (on the back of y.

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