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 - 227,35 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;
  • send us back the completed form by post mail (Agence fédérale des risques professionnels, service Indemnités, avenue de l'Astronomie 1, 1210 Bruxelles).

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

 

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 - 334,4 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 (Agence fédérale des risques professionnels, service Indemnités, avenue de l'Astronomie 1, 1210 Bruxelles, Belgium).

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