Enter your bank account number

You have a bank account in Belgium?

Fill in the request form for payment of benefits into a current account in Belgium (pdf - 145,97 KB)

• fill in section 1 of the attached form, date it and sign it. Please note that we can only pay your benefits if you are the (joint) account holder;
• ask your financial institution to fill in section 2;
• send us back the completed form by post mail: Fedris, département Gestion des paiements, avenue de l'Astronomie 1, 1210 Brussels.

We will send you a confirmation as soon as we have treated your request.

* Please carefully read the GDPR appendix (96,02 KB) that informs you about the use of your personal information by Fedris and about your rights regarding those data. If you print this form for another person, also print the GDPR appendix so that they are informed of their rights.

You have a bank account outside Belgium?

Fill in the request form for payment of benefits into a current account in a country other than Belgium (pdf - 252,35 KB)

• fill in section 1 of the attached form, date it and sign it. Please note that we can only pay your benefits if you are the (joint) account holder;
• ask your financial institution to fill in section 2;
• add a bank document stating your bank account number in order to avoid any mistake;
• send us back the completed form by post mail: Fedris, département Gestion des paiements, avenue de l'Astronomie 1, 1210 Brussels, Belgium.

We will send you a confirmation as soon as we have treated your request.

The same request form exists also in Italian, Spanish, Portuguese and Polish:

• Pedido de pagamento das indemnizações de acidentes de trabalho na conta bancária aberta no estrangeiro
• Podanie o zapłacenie moich odszkodowań za wypadek przy pracy na mój rachunek bankowy w instytucji finansowej poza Belgią
• Richiesta di pagamento indennità per infortunio sul lavoro su un conto aperto all’estero
• Solicitud de pago de prestaciones por accidente de trabajo en una cuenta abierta en el extranjero

* Please carefully read the GDPR appendix (96,02 KB) that informs you about the use of your personal information by Fedris and about your rights regarding those data. If you print this form for another person, also print the GDPR appendix so that they are informed of their rights.