With this form, a Belgian current account can be provided for the payment of a benefit by Fedris.
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Complete section 1, date and sign the form
(payments are only possible to an account of which you are the (co-)holder). -
Have section 2 completed by the bank.
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Send the original form (no copy) by post to:
Fedris
Financial Department
Sterrenkundelaan 1
1210 Brussels