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Claim details

Fields marked with * are required. The attached document must include the written and signed Claim, as well as a copy of the identification document. The size of the attached document cannot exceed 2 MB. If the claim is made in the name of a company this must be indicated Company Tax Code (CIF).

Company Tax Code (CIF)
Identification Document *
Details of the Facility

Select the FREMAP facility associated with the claim. It is compulsory to enter a province and a facility.

Personal data included in this form will be incorporated into a claims form, the owner of which is FREMAP Collaborative Mutual Society with the Social Security Institute no. 61. In accordance with the provisions of Organic Law 15/1999, of 13 December, on Personal Data Protection, you can exercise your rights of opposition, access, rectification and cancellation by writing to FREMAP, at the following address: Carretera de Pozuelo no. 61, 28222 Majadahonda Madrid.