FR: Déclarer un décès en ligne

{ "INTRODUCTION": "You can report the death of a loved one by filling out this form online. We'll get in touch with you if we need any additional information.", "WARNING": "You must have a copy of the death certificate to submit this form.", "SECTION_LABEL_1": "Your details", "SECTION_LABEL_2": "Details for the deceased", "SECTION_LABEL_3": "Cause of death", "SECTION_LABEL_4": "Copy of the death certificate", "SECTION_LABEL_5": "Comments (optional)", "FIELD_LASTNAME_LABEL": "Surname", "FIELD_LASTNAME_PLACEHOLDER": "Your surname", "FIELD_LASTNAME_ERROR_REQUIRED": "Complete this field", "FIELD_FIRSTNAME_LABEL": "First name", "FIELD_FIRSTNAME_PLACEHOLDER": "Your first name", "FIELD_FIRSTNAME_ERROR_REQUIRED": "Complete this field", "FIELD_EMAIL": "E-mail address", "FIELD_EMAIL_ERROR_REQUIRED": "Complete this field", "FIELD_EMAIL_PLACEHOLDER": "example@mail.com", "FIELD_EMAIL_ERROR_INVALID": "Enter a valid format", "FIELD_PHONE_LABEL": "Telephone number", "FIELD_PHONE_PLACEHOLDER": "Your telephone number", "FIELD_PHONE_ERROR_INVALID": "Enter a valid format", "FIELD_RELATIONSHIP_LABEL": "Your relationship to the deceased", "FIELD_RELATIONSHIP_PLACEHOLDER": "Select", "FIELD_RELATIONSHIP_OPTION_1": "Spouse", "FIELD_RELATIONSHIP_OPTION_2": "Registered domestic partner", "FIELD_RELATIONSHIP_OPTION_3": "Child", "FIELD_RELATIONSHIP_OPTION_4": "Father/mother", "FIELD_RELATIONSHIP_OPTION_5": "Cousin/niece/nephew", "FIELD_RELATIONSHIP_OPTION_6": "Civil-law notary", "FIELD_RELATIONSHIP_OPTION_7": "Other", "FIELD_RELATIONSHIP_VALIDATION_EMPTY": "Complete this field", "FIELD_RELATIONSHIP_OTHER_LABEL": "Specify your relationship with the deceased", "FIELD_RELATIONSHIP_OTHER_PLACEHOLDER": "", "FIELD_RELATIONSHIP_OTHER_ERR_REQUIRED": "Complete this field", "FIELD_LASTNAME_DECEASED_PLACEHOLDER": "Deceased's surname", "FIELD_FIRSTNAME_DECEASED_PLACEHOLDER": "Deceased's first name", "FIELD_BIRTHDATE_LABEL": "Date of birth", "FIELD_BIRTHDATE_PLACEHOLDER": "__/__/____", "FIELD_BIRTHDATE_ERR_REQUIRED": "Complete this field", "FIELD_BIRTHDATE_ERR_FUTURE": "Cannot be a future date", "FIELD_BIRTHDATE_ERR_FORMAT": "Enter a date in the right format (dd/mm/yyyy)", "FIELD_DEATHDATE_LABEL": "Date of death", "FIELD_BIRTHDATE_ERR_AFTER_DEATHDATE": "The birthdate cannot be after the date of death", "FIELD_DEATHDATE_PLACEHOLDER": "__/__/____", "FIELD_DEATHDATE_ERR_EMPTY": "Complete this field", "FIELD_DEATHDATE_ERR_FORMAT": "Enter a date in the right format (dd/mm/yyyy)", "FIELD_DEATHDATE_ERR_FUTURE": "Cannot be a future date", "FIELD_DEATHDATE_ERR_BEFORE_BIRTHDATE": "The date of death cannot be before the date of birth", "FIELD_CAUSE_OF_DEATH_LABEL_1": "Natural causes", "FIELD_CAUSE_OF_DEATH_LABEL_1_DESC": "A death arising from a spontaneously occurring pathology or physiological condition is classified as a death from natural causes (health condition or illness, old age, euthanasia, etc.).", "FIELD_CAUSE_OF_DEATH_LABEL_2": "Accident", "FIELD_CAUSE_OF_DEATH_LABEL_2_DESC": "An accidental death is the sudden loss of life of an otherwise healthy person due to any reason other than natural causes (sudden or unexpected death due to a traffic collision, a slip and fall, etc.)", "FIELD_CAUSE_OF_DEATH_LABEL_3": "Other or I don't know", "FIELD_CAUSE_OF_DEATH_ERROR": "Don't forget to select an option", "FIELD_UPLOAD_P1": "You can attach a copy of the death certificate (pdf, jpg, png or gif) below. The maximum size limit is 10 MB. You cannot report the death of your loved one online if you do not personally have a copy of the death certificate.", "FIELD_UPLOAD_DROPZONE_TEXT": "Select or drag and drop here a copy of the death certificate", "FIELD_UPLOAD_REMOVE_FILE": "Delete", "FIELD_UPLOAD_ERR_REQUIRED": "Attach a copy of the death certificate", "FIELD_UPLOAD_ERR_UNALLOWED_FILETYPES": "Sorry, we don't support that file type. Try again with a PDF, JPG, PNG or GIF file.", "FIELD_UPLOAD_ERR_UPLOADLIMIT_EXCEEDED": "Attachment(s) too big (max 10 MB)", "FIELD_UPLOAD_ERR_HAS_DUPLICATES": "Sorry, you’ve already uploaded this file", "FIELD_COMMENT_PARAGRAPH": "Have a comment or want to provide us with additional information about the death of your loved one? Let us know in the space below.", "FIELD_COMMENT_PLACEHOLDER": "Anything else you'd like us to know?", "FIELD_COMMENT_COUNTER": "Remaining characters: ", "FIELD_COMMENT_COUNTER_EXCEEDED": "Number of characters exceeded: ", "FIELD_COMMENT_COUNTER_EXCEEDED_ERROR": "Maximum 500 characters", "FIELD_RECAPTCHA_ERR": "Don't forget to tick the box", "LABEL_LEGAL_NOTICE": "By clicking \"Send\", I authorise AG to use my contact details for administrative purposes. This data will be processed in accordance with the applicable privacy legislation as well as AG's Privacy Notice and Cookie Policy. I acknowledge that I have read and understand AG's <a href=\"https://privacy.ag.be/privacy/en/privacy-policy\" target=\"_blank\">Privacy Notice</a> and <a href=\"https://privacy.ag.be/privacy/en/cookie-policy\" target=\"_blank\">Cookie Policy</a>.", "LABEL_ERROR_NOTIFICATION": "Warning. One or more fields have been filled out incorrectly. Please check your data before submitting the form. ", "LABEL_BUTTON_SEND": "Send", "LABEL_BUTTON_CANCEL": "Cancel", "LABEL_SUCCESS_TITLE": "The declaration of death form has been submitted", "LABEL_SUCCESS_P1": "We have received the declaration of death for ", "LABEL_SUCCESS_P1_B": ".", "LABEL_SUCCESS_P2": "An e-mail confirmation has been sent to ", "LABEL_SUCCESS_INFOBOX_TITLE": "What happens next?", "LABEL_SUCCESS_INFOBOX_P1": "Our teams will handle this claim. We will contact you if we need additional information or documents.", "LABEL_FEEDBACK_TITLE": "Questions?", "LABEL_FEEDBACK_P1": "Feel free to contact us on +32 2 664 15 17", "LABEL_FAILURE_TITLE": "Sorry, our website is experiencing technical difficulties", "LABEL_FAILURE_P1": "Please try again later or report the death of your loved one to his/her insurance advisor. You can also call us on 02/664.11.50 if you need help in completing your declaration.", "LABEL_CLOSE_WINDOW": "You may close this window" }

Report a death online