{"id":18563,"date":"2022-01-11T09:33:32","date_gmt":"2022-01-11T07:33:32","guid":{"rendered":"https:\/\/socialsecurity.gov.mt\/?page_id=18563"},"modified":"2022-01-11T15:44:25","modified_gmt":"2022-01-11T13:44:25","slug":"retrospective-invalidity","status":"publish","type":"page","link":"https:\/\/socialsecurity.gov.mt\/en\/retrospective-invalidity\/","title":{"rendered":"eform \u2013 Retrospective Invalidity"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.6.6&#8243; _module_preset=&#8221;default&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.9.7&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||0px|||&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.6.6&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.14.5&#8243; _module_preset=&#8221;557e4842-4fc2-416f-a04e-fbcf20070da9&#8243; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]<\/p>\n<h1>Retrospective Payment of Social Security Contributions<\/h1>\n<p>Invalidity<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=&#8221;4.6.6&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.6.6&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_code _builder_version=&#8221;4.14.5&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;]<div class=\"frm_forms  with_frm_style frm_style_webinar\" id=\"frm_form_42_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_ajax_submit  frm_pro_form \" id=\"form_invalidityen\"  >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">Retrospective Invalidity EN<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"42\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_42\" id=\"frm_hide_fields_42\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"invalidityen\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_42\" name=\"frm_submit_entry_42\" value=\"995e44bd3b\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/pages\/18563\" \/><div id=\"frm_field_1357_container\" class=\"frm_form_field frm_section_heading form-field  frm_capitalize\">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Applicant\u2019s Details<\/h3>\r\n\r\n\r\n<div id=\"frm_field_1359_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_r65qlb214022b4a5f5317bdc582f3e3cfe7\" id=\"field_r65qlb214022b4a5f5317bdc582f3e3cfe7_label\" class=\"frm_primary_label\">Name\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_r65qlb214022b4a5f5317bdc582f3e3cfe7\" name=\"item_meta[1359]\" value=\"\"  data-sectionid=\"1357\" data-reqmsg=\"Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1360_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_c487af769b800fdad85da6a21fa5da3e6d3\" id=\"field_c487af769b800fdad85da6a21fa5da3e6d3_label\" class=\"frm_primary_label\">Surname\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_c487af769b800fdad85da6a21fa5da3e6d3\" name=\"item_meta[1360]\" value=\"\"  data-sectionid=\"1357\" data-reqmsg=\"Surname cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1358_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_cw3yka28dbb88d84f84da46c43b4e4c0c04\" id=\"field_cw3yka28dbb88d84f84da46c43b4e4c0c04_label\" class=\"frm_primary_label\">Identity Card Number\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_cw3yka28dbb88d84f84da46c43b4e4c0c04\" name=\"item_meta[1358]\" value=\"\"  data-sectionid=\"1357\" data-reqmsg=\"Identity Card Number cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1409_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_ayj25\" id=\"field_ayj25_label\" class=\"frm_primary_label\">Civil Status\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[1409]\" id=\"field_ayj25\"  data-sectionid=\"1357\" data-reqmsg=\"Civil Status cannot be blank.\" aria-required=\"true\" data-invmsg=\"Civil Status is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"Civil Union\">Civil Union<\/option><option  value=\"Cohabitation\">Cohabitation<\/option><option  value=\"Divorced\">Divorced<\/option><option  value=\"Married\">Married<\/option><option  value=\"Separated\">Separated<\/option><option  value=\"Single\">Single<\/option><option  value=\"Widow \/ Widower\">Widow \/ Widower<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1362_container\" class=\"frm_form_field  frm12 frm_first frm_html_container form-field\">\n<p>\u00a0<\/p>\n<p><b>Contact Details<\/b><\/p>\n<\/div>\n<div id=\"frm_field_1363_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_third\">\r\n    <label for=\"field_oq5jde30c356c9e\" id=\"field_oq5jde30c356c9e_label\" class=\"frm_primary_label\">House Name\/Number\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_oq5jde30c356c9e\" name=\"item_meta[1363]\" value=\"\"  data-sectionid=\"1357\" data-reqmsg=\"House Name\/Number cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1364_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_8p1dbdcf7ea7c7e\" id=\"field_8p1dbdcf7ea7c7e_label\" class=\"frm_primary_label\">Street\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_8p1dbdcf7ea7c7e\" name=\"item_meta[1364]\" value=\"\"  data-sectionid=\"1357\" data-reqmsg=\"Street cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1365_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_oi6a4f0d296a997\" id=\"field_oi6a4f0d296a997_label\" class=\"frm_primary_label\">Locality\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_oi6a4f0d296a997\" name=\"item_meta[1365]\" value=\"\"  data-sectionid=\"1357\" data-reqmsg=\"Locality cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1366_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_ictcne16949e387\" id=\"field_ictcne16949e387_label\" class=\"frm_primary_label\">Post Code\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_ictcne16949e387\" name=\"item_meta[1366]\" value=\"\"  data-sectionid=\"1357\" data-reqmsg=\"Post Code cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1367_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\r\n    <label for=\"field_e9pw9f3268616b14f10365f8b7380031b60\" id=\"field_e9pw9f3268616b14f10365f8b7380031b60_label\" class=\"frm_primary_label\">Contact Number\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_e9pw9f3268616b14f10365f8b7380031b60\" name=\"item_meta[1367]\" value=\"\"  data-sectionid=\"1357\" data-invmsg=\"Number is invalid\" aria-invalid=\"false\"   min=\"0\" max=\"99999999999\" step=\"any\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1368_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\r\n    <label for=\"field_2rqzq1073466a63448a6de27a62ec81555d\" id=\"field_2rqzq1073466a63448a6de27a62ec81555d_label\" class=\"frm_primary_label\">Email\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_2rqzq1073466a63448a6de27a62ec81555d\" name=\"item_meta[1368]\" value=\"\"  data-sectionid=\"1357\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1369_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first horizontal_radio\">\r\n    <div  id=\"field_2djbi5af2035a30_label\" class=\"frm_primary_label\">Are you a mother?\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_2djbi5af2035a30_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_1369-1357-0\"><label for=\"field_2djbi5af2035a30-0\">\t\t<input type=\"radio\" name=\"item_meta[1369]\" id=\"field_2djbi5af2035a30-0\" value=\"Yes\"\n\t\t   data-sectionid=\"1357\" data-reqmsg=\"Are you a mother? cannot be blank.\" data-invmsg=\"Are you a mother? is invalid\" aria-invalid=\"false\"  \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_1369-1357-1\"><label for=\"field_2djbi5af2035a30-1\">\t\t<input type=\"radio\" name=\"item_meta[1369]\" id=\"field_2djbi5af2035a30-1\" value=\"No\"\n\t\t   data-sectionid=\"1357\" data-reqmsg=\"Are you a mother? cannot be blank.\" data-invmsg=\"Are you a mother? is invalid\" aria-invalid=\"false\"  \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_1371_container\" class=\"frm_form_field frm_section_heading form-field  frm_hide_section\">\r\n<h3 class=\"frm_pos_none frm_section_spacing\"><\/h3>\r\n\r\n\r\n<div id=\"frm_field_1372_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container horizontal_radio\">\r\n    <div  id=\"field_vz14z6b0d0ce9b1_label\" class=\"frm_primary_label\">Have you ever had a career break to bring up your children?\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_vz14z6b0d0ce9b1_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_1372-1371-0\"><label for=\"field_vz14z6b0d0ce9b1-0\">\t\t<input type=\"radio\" name=\"item_meta[1372]\" id=\"field_vz14z6b0d0ce9b1-0\" value=\"Yes\"\n\t\t   data-sectionid=\"1371\" data-reqmsg=\"Have you ever had a career break to bring up your children? cannot be blank.\" data-invmsg=\"Have you ever had a career break to bring up your children? is invalid\" aria-invalid=\"false\"  \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_1372-1371-1\"><label for=\"field_vz14z6b0d0ce9b1-1\">\t\t<input type=\"radio\" name=\"item_meta[1372]\" id=\"field_vz14z6b0d0ce9b1-1\" value=\"No\"\n\t\t   data-sectionid=\"1371\" data-reqmsg=\"Have you ever had a career break to bring up your children? cannot be blank.\" data-invmsg=\"Have you ever had a career break to bring up your children? is invalid\" aria-invalid=\"false\"  \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1373_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container horizontal_radio\">\r\n    <div  id=\"field_bkb65c33274fcac_label\" class=\"frm_primary_label\">Did you return to a gainful occupation after the career break?\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_bkb65c33274fcac_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_1373-1371-0\"><label for=\"field_bkb65c33274fcac-0\">\t\t<input type=\"radio\" name=\"item_meta[1373]\" id=\"field_bkb65c33274fcac-0\" value=\"Yes\"\n\t\t   data-sectionid=\"1371\" data-reqmsg=\"Did you return to a gainful occupation after the career break? cannot be blank.\" data-invmsg=\"Did you return to a gainful occupation after the career break? is invalid\" aria-invalid=\"false\"  \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_1373-1371-1\"><label for=\"field_bkb65c33274fcac-1\">\t\t<input type=\"radio\" name=\"item_meta[1373]\" id=\"field_bkb65c33274fcac-1\" value=\"No\"\n\t\t   data-sectionid=\"1371\" data-reqmsg=\"Did you return to a gainful occupation after the career break? cannot be blank.\" data-invmsg=\"Did you return to a gainful occupation after the career break? is invalid\" aria-invalid=\"false\"  \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1374_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_2ekah6c5769aa61\" id=\"field_2ekah6c5769aa61_label\" class=\"frm_primary_label\">How may children do you have? \r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_2ekah6c5769aa61\" name=\"item_meta[1374]\" value=\"1\"  data-sectionid=\"1371\" style=\"width:150px\" data-frmval=\"1\" data-reqmsg=\"How may children do you have?  cannot be blank.\" aria-required=\"true\" data-invmsg=\"Number is invalid\" class=\"auto_width\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_2ekah6c5769aa61\" min=\"0\" max=\"8\" step=\"any\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_2ekah6c5769aa61\">Indicate the number of children<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_1375_container\" class=\"frm_form_field  frm12 frm_first frm_html_container form-field\">\n<p>Birth dates of children:<\/p>\n<\/div>\n<div id=\"frm_field_1376_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3 frm_first\">\r\n    <label for=\"field_41pga655ac87fa5\" id=\"field_41pga655ac87fa5_label\" class=\"frm_primary_label\">Child\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_41pga655ac87fa5\" name=\"item_meta[1376]\" value=\"\"  data-sectionid=\"1371\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Child cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1377_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_we1d943d0569d5c\" id=\"field_we1d943d0569d5c_label\" class=\"frm_primary_label\">Child\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_we1d943d0569d5c\" name=\"item_meta[1377]\" value=\"\"  data-sectionid=\"1371\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Child cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1378_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_53rnzb75ccf786d\" id=\"field_53rnzb75ccf786d_label\" class=\"frm_primary_label\">Child\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_53rnzb75ccf786d\" name=\"item_meta[1378]\" value=\"\"  data-sectionid=\"1371\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Child cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1379_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_lypuub9b1661d98\" id=\"field_lypuub9b1661d98_label\" class=\"frm_primary_label\">Child\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_lypuub9b1661d98\" name=\"item_meta[1379]\" value=\"\"  data-sectionid=\"1371\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Child cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1380_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3 frm_first\">\r\n    <label for=\"field_zgtj88879be473c\" id=\"field_zgtj88879be473c_label\" class=\"frm_primary_label\">Child\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_zgtj88879be473c\" name=\"item_meta[1380]\" value=\"\"  data-sectionid=\"1371\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Child cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1381_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_1zva4944bb829db\" id=\"field_1zva4944bb829db_label\" class=\"frm_primary_label\">Child\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_1zva4944bb829db\" name=\"item_meta[1381]\" value=\"\"  data-sectionid=\"1371\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Child cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1382_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_o18enb43da6f55f\" id=\"field_o18enb43da6f55f_label\" class=\"frm_primary_label\">Child\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_o18enb43da6f55f\" name=\"item_meta[1382]\" value=\"\"  data-sectionid=\"1371\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Child cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1383_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_2z6ms9eb48aa5bc\" id=\"field_2z6ms9eb48aa5bc_label\" class=\"frm_primary_label\">Child\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_2z6ms9eb48aa5bc\" name=\"item_meta[1383]\" value=\"\"  data-sectionid=\"1371\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Child cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1384_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container horizontal_radio\">\r\n    <div  id=\"field_t3sbyc5c7f1de2d_label\" class=\"frm_primary_label\">Are you currently benefitting from Invalidity Pension?\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_t3sbyc5c7f1de2d_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_1384-1371-0\"><label for=\"field_t3sbyc5c7f1de2d-0\">\t\t<input type=\"radio\" name=\"item_meta[1384]\" id=\"field_t3sbyc5c7f1de2d-0\" value=\"Yes\"\n\t\t   data-sectionid=\"1371\" data-reqmsg=\"Are you currently benefitting from Invalidity Pension? cannot be blank.\" data-invmsg=\"Are you currently benefitting from Invalidity Pension? is invalid\" aria-invalid=\"false\"  \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_1384-1371-1\"><label for=\"field_t3sbyc5c7f1de2d-1\">\t\t<input type=\"radio\" name=\"item_meta[1384]\" id=\"field_t3sbyc5c7f1de2d-1\" value=\"No\"\n\t\t   data-sectionid=\"1371\" data-reqmsg=\"Are you currently benefitting from Invalidity Pension? cannot be blank.\" data-invmsg=\"Are you currently benefitting from Invalidity Pension? is invalid\" aria-invalid=\"false\"  \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_1386_container\" class=\"frm_form_field frm_section_heading form-field  frm_hide_section\">\r\n<h3 class=\"frm_pos_none frm_section_spacing\"><\/h3>\r\n\r\n\r\n<div id=\"frm_field_1387_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first horizontal_radio\">\r\n    <div  id=\"field_op4r3787e2072c6_label\" class=\"frm_primary_label\">Have you ever lived abroad? \r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_op4r3787e2072c6_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_1387-1386-0\"><label for=\"field_op4r3787e2072c6-0\">\t\t<input type=\"radio\" name=\"item_meta[1387]\" id=\"field_op4r3787e2072c6-0\" value=\"Yes\"\n\t\t   data-sectionid=\"1386\" data-reqmsg=\"Have you ever lived abroad?  cannot be blank.\" data-invmsg=\"Have you ever lived abroad?  is invalid\" aria-invalid=\"false\"  \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_1387-1386-1\"><label for=\"field_op4r3787e2072c6-1\">\t\t<input type=\"radio\" name=\"item_meta[1387]\" id=\"field_op4r3787e2072c6-1\" value=\"No\"\n\t\t   data-sectionid=\"1386\" data-reqmsg=\"Have you ever lived abroad?  cannot be blank.\" data-invmsg=\"Have you ever lived abroad?  is invalid\" aria-invalid=\"false\"  \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1388_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first\">\r\n    <label for=\"field_o5cyi24e669ea21\" id=\"field_o5cyi24e669ea21_label\" class=\"frm_primary_label\">Indicate the number of foreign countries where you lived\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_o5cyi24e669ea21\" name=\"item_meta[1388]\" value=\"1\"  data-sectionid=\"1386\" style=\"width:150px\" data-frmval=\"1\" data-reqmsg=\"Indicate the number of foreign countries where you lived cannot be blank.\" aria-required=\"true\" data-invmsg=\"Number is invalid\" class=\"auto_width\" aria-invalid=\"false\"   min=\"0\" max=\"3\" step=\"any\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1389_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_nm6fo7702d639bb\" id=\"field_nm6fo7702d639bb_label\" class=\"frm_primary_label\">Foreign Country where you lived:\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_nm6fo7702d639bb\" name=\"item_meta[1389]\" value=\"\"  data-sectionid=\"1386\" data-reqmsg=\"Foreign Country where you lived: cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1390_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_fourth\">\r\n    <label for=\"field_a4tftdf220d8116\" id=\"field_a4tftdf220d8116_label\" class=\"frm_primary_label\">From\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_a4tftdf220d8116\" name=\"item_meta[1390]\" value=\"\"  data-sectionid=\"1386\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"From cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_a4tftdf220d8116\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_a4tftdf220d8116\">Indicate the period<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_1391_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_fourth\">\r\n    <label for=\"field_pjynp5fac5e9009\" id=\"field_pjynp5fac5e9009_label\" class=\"frm_primary_label\">To\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_pjynp5fac5e9009\" name=\"item_meta[1391]\" value=\"\"  data-sectionid=\"1386\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"To cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1392_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_wufw072d21546bc\" id=\"field_wufw072d21546bc_label\" class=\"frm_primary_label\">Foreign Country where you lived:\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_wufw072d21546bc\" name=\"item_meta[1392]\" value=\"\"  data-sectionid=\"1386\" data-reqmsg=\"Foreign Country where you lived: cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1393_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_ge2o9edc2fb9fde\" id=\"field_ge2o9edc2fb9fde_label\" class=\"frm_primary_label\">From\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_ge2o9edc2fb9fde\" name=\"item_meta[1393]\" value=\"\"  data-sectionid=\"1386\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"From cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_ge2o9edc2fb9fde\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_ge2o9edc2fb9fde\">Indicate the period<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_1394_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_3go6f4615c93653\" id=\"field_3go6f4615c93653_label\" class=\"frm_primary_label\">To\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_3go6f4615c93653\" name=\"item_meta[1394]\" value=\"\"  data-sectionid=\"1386\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"To cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1395_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_3tffzafa53d9686\" id=\"field_3tffzafa53d9686_label\" class=\"frm_primary_label\">Foreign Country where you lived:\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_3tffzafa53d9686\" name=\"item_meta[1395]\" value=\"\"  data-sectionid=\"1386\" data-reqmsg=\"Foreign Country where you lived: cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1396_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_fourth\">\r\n    <label for=\"field_sdqmq30a12b2c18\" id=\"field_sdqmq30a12b2c18_label\" class=\"frm_primary_label\">From\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_sdqmq30a12b2c18\" name=\"item_meta[1396]\" value=\"\"  data-sectionid=\"1386\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"From cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_sdqmq30a12b2c18\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_sdqmq30a12b2c18\">Indicate the period<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_1397_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_fourth\">\r\n    <label for=\"field_k988pca53acd0a5\" id=\"field_k988pca53acd0a5_label\" class=\"frm_primary_label\">To\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_k988pca53acd0a5\" name=\"item_meta[1397]\" value=\"\"  data-sectionid=\"1386\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"To cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_1399_container\" class=\"frm_form_field  frm12 frm_first frm_html_container form-field\">\n<p>\u00a0<\/p>\n<p>Note: Applies to Maltese residents aged from 59 years but not yet 65 years old and who are current beneficiaries of Invalidity Pension.<\/p>\n<p>\u00a0<\/p>\n<\/div>\n<div id=\"frm_field_1400_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_o4nyz2436b70164\" id=\"field_o4nyz2436b70164_label\" class=\"frm_primary_label\">Comments\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[1400]\" id=\"field_o4nyz2436b70164\" rows=\"5\"  data-invmsg=\"Comments is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1403_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p><\/br><\/p>\n<\/div>\n<div id=\"frm_field_1404_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Declaration<\/h3>\r\n\r\n\r\n<div id=\"frm_field_1401_container\" class=\"frm_form_field  frm_two_thirds frm_html_container form-field\"><strong>Retrospective Payment of Social Security Contributions\u00a0- Invalidity <\/strong><\/p>\n<p><a href=\"https:\/\/socialsecurityforms.blob.core.windows.net\/dssforms\/Declaration - RetrospectiveInvalidityEN.pdf\" target=\"_blank\" rel=\"noopener\">Click Here<\/a> to download the Declaration form and attach a signed copy to this form.<\/div>\n<div id=\"frm_field_1418_container\" class=\"frm_form_field form-field  frm_required_field frm_none_container frm_third\">\r\n    <label for=\"field_593qk\" id=\"field_593qk_label\" class=\"frm_primary_label\">File Upload\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"hidden\"  data-sectionid=\"1404\" data-reqmsg=\"File Upload cannot be blank.\" data-invmsg=\"File Upload is invalid\" class=\"auto_width\" aria-invalid=\"false\"   name=\"item_meta[1418]\"  data-reqmsg=\"File Upload cannot be blank.\"  value=\"\" data-frmfile=\"1418\" \/>\n\n<div class=\"frm_dropzone frm_single_upload frm_clearfix\" id=\"file1418_dropzone\" role=\"group\" >\n\t<div class=\"fallback\">\n\t\t<input type=\"file\" name=\"file1418\" id=\"field_593qk\"\n\t\t\t data-sectionid=\"1404\" data-reqmsg=\"File Upload cannot be blank.\" data-invmsg=\"File Upload is invalid\" class=\"auto_width\" aria-invalid=\"false\"  \t\t\t\/>\n\t\t\t\t<div class=\"frm_clearfix \"><\/div>\n\t<\/div>\n\t<div class=\"dz-message needsclick\">\n\t\t\t\t<svg  viewBox=\"0 0 18 18\" class=\"frmsvg frm-svg-icon\">\n\t<path viewBox=\"0 0 18 18\" fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M8.2 4v8a.8.8 0 001.5 0V4l2.1 2.2A.7.7 0 1013 5L9.5 1.7a.7.7 0 00-1.1 0L5.1 5.2a.8.8 0 001 1l2.1-2zm7.6 4.3c.4 0 .7.3.7.7v6.8c0 .4-.3.7-.8.7H2.3a.8.8 0 01-.8-.8V9A.8.8 0 013 9v6h12V9c0-.4.3-.8.8-.8z\"><\/path>\n<\/svg>\t\t<span class=\"frm_upload_text\"><button type=\"button\" aria-label=\"File Upload. Attach file here. Maximum file size: 5MB\">Attach file here<\/button><\/span>\n\t\t<span class=\"frm_compact_text\"><button type=\"button\" aria-label=\"File Upload. Choose File. Maximum file size: 5MB\">Choose File<\/button><\/span>\n\t\t<div class=\"frm_small_text\">\n\t\t\t<p>Maximum file size: 5MB<\/p>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1417_container\" class=\"frm_form_field  frm12 frm_first frm_html_container form-field\">\n<p><\/br><\/p>\n<\/div>\n<div id=\"frm_field_1405_container\" class=\"frm_form_field  frm12 frm_first frm_html_container form-field\">\n<p><strong>Data Protection Declaration<\/strong><\/p>\n<p>The Department of Social Security collects all relevant personal information to provide its services to individuals who qualify for assistance, allowance or non-contributory pensions in accordance with the Social Security Act (Cap. 318.). The Department may verify the information submitted by you in line with article 133 (b) of the Social Security Act to ensure its accuracy in relation to the claim. Personal data may be disclosed to departments \/ third parties, who may also have access to your data as authorised by law. Personal information may also be exchanged with benefits institutions of other countries to combat and deter fraud, as provided for in international treaties or bilateral agreements to which Malta is a party. You will be informed in due course of the result of your claim after it has been assessed.<\/p>\n<p>Pursuant to the General Data Protection Regulation (EU) 2016\/679 (GDPR) and the Data Protection Act (Cap. 586.), we have a legal duty to respect and protect any personal information we collect from you and we will abide by such duty. We take all safeguards necessary to prevent unauthorised access and we do not pass on your details collected from you as a visitor and\/or user, to any third party unless you give us your consent to do so or as authorised by law. You may request in writing to access information held about you, and eventually to rectify, and where applicable to erase incorrect information. Such a request is to be addressed to \u201cThe Data Controller\u201d, Department of Social Security, 38, Ordnance Street, Valletta VLT 1021 or by e-mail to dpsocialsecurity.dss@gov.mt and appropriate action would be taken at the earliest possible time. In making such a request, kindly quote your identity card number, social security number, your name and address and other relevant documentation to identify your case.<\/p>\n<\/div>\n<div id=\"frm_field_1406_container\" class=\"frm_form_field form-field  frm_required_field frm_hidden_container vertical_radio\">\r\n    <div  id=\"field_v3dp97bbefba3af7e0f95783e6514f49e4_label\" class=\"frm_primary_label\">\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_v3dp97bbefba3af7e0f95783e6514f49e4_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_1406-1404-0\"><label for=\"field_v3dp97bbefba3af7e0f95783e6514f49e4-0\"><input type=\"checkbox\" name=\"item_meta[1406][]\" id=\"field_v3dp97bbefba3af7e0f95783e6514f49e4-0\" value=\"I accept the Data Protection Declaration\"  data-sectionid=\"1404\" data-reqmsg=\"Accept the declaration\" data-invmsg=\"This field is invalid\" aria-invalid=\"false\"   aria-required=\"true\"  \/> I accept the Data Protection Declaration<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_7765_container\" class=\"frm_form_field form-field  frm_hidden_container frm_half\">\r\n    <label for=\"field_n4v3b\" id=\"field_n4v3b_label\" class=\"frm_primary_label\">Insert email address here to receive a copy of your application.\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_n4v3b\" name=\"item_meta[7765]\" value=\"\"  placeholder=\"Insert email address here to receive a copy of your application.\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1408_container\" class=\"frm_form_field form-field  frm_none_container\">\r\n    <label for=\"g-recaptcha-response\" id=\"field_u2lrc69f10101c7600b9c63f7_label\" class=\"frm_primary_label\">Captcha\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <div  id=\"field_u2lrc69f10101c7600b9c63f7\" class=\"g-recaptcha\" data-sitekey=\"6Lc7QVEnAAAAAHP0Dud5W1R-R32HtY5g3tEx7i_L\" data-size=\"invisible\" data-theme=\"light\" data-callback=\"frmAfterRecaptcha\"><\/div>\r\n    \r\n    \r\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t\t<div class=\"frm__655dc7164682e\">\n\t\t\t\t<label for=\"frm_email_42\" >\n\t\t\t\t\tIf you are human, leave this field blank.\t\t\t\t<\/label>\n\t\t\t\t<input  id=\"frm_email_42\" type=\"text\" class=\"frm_verify\" name=\"frm__655dc7164682e\" value=\"\" autocomplete=\"false\"  \/>\n\t\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"w2phKzfykQ2mhP+2AQDfTVnTolNq3+Vhs+py2+n\/NTF5r06VeUj8whW6JHfO1JQD\" \/><div class=\"frm_submit\">\r\n<button class=\"frm_button\" type=\"button\"  onClick=\"window.print()\">Print<\/button>\r\n\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"   formnovalidate=\"formnovalidate\">Submit<\/button>\r\n\r\n<\/div><\/div>\n<\/fieldset>\n<\/div>\n<\/form>\n<\/div>\n[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Retrospective Payment of Social Security Contributions Invalidity<div class=\"frm_forms  with_frm_style frm_style_webinar\" id=\"frm_form_42_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_ajax_submit  frm_pro_form \" id=\"form_invalidityen\"  >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">Retrospective Invalidity EN<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"42\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_42\" id=\"frm_hide_fields_42\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"invalidityen\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_42\" name=\"frm_submit_entry_42\" value=\"995e44bd3b\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/pages\/18563\" \/><div id=\"frm_field_1357_container\" class=\"frm_form_field frm_section_heading form-field  frm_capitalize\">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Applicant\u2019s Details<\/h3>\r\n\r\n\r\n<div id=\"frm_field_1359_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_r65qlb214022b4a5f5317bdc582f3e3cfe7\" id=\"field_r65qlb214022b4a5f5317bdc582f3e3cfe7_label\" class=\"frm_primary_label\">Name\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_r65qlb214022b4a5f5317bdc582f3e3cfe7\" name=\"item_meta[1359]\" value=\"\"  data-sectionid=\"1357\" data-reqmsg=\"Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1360_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_c487af769b800fdad85da6a21fa5da3e6d3\" id=\"field_c487af769b800fdad85da6a21fa5da3e6d3_label\" class=\"frm_primary_label\">Surname\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_c487af769b800fdad85da6a21fa5da3e6d3\" name=\"item_meta[1360]\" value=\"\"  data-sectionid=\"1357\" data-reqmsg=\"Surname cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1358_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_cw3yka28dbb88d84f84da46c43b4e4c0c04\" id=\"field_cw3yka28dbb88d84f84da46c43b4e4c0c04_label\" class=\"frm_primary_label\">Identity Card Number\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_cw3yka28dbb88d84f84da46c43b4e4c0c04\" name=\"item_meta[1358]\" value=\"\"  data-sectionid=\"1357\" data-reqmsg=\"Identity Card Number cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1409_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_ayj25\" id=\"field_ayj25_label\" class=\"frm_primary_label\">Civil Status\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[1409]\" id=\"field_ayj25\"  data-sectionid=\"1357\" data-reqmsg=\"Civil Status cannot be blank.\" aria-required=\"true\" data-invmsg=\"Civil Status is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"Civil Union\">Civil Union<\/option><option  value=\"Cohabitation\">Cohabitation<\/option><option  value=\"Divorced\">Divorced<\/option><option  value=\"Married\">Married<\/option><option  value=\"Separated\">Separated<\/option><option  value=\"Single\">Single<\/option><option  value=\"Widow \/ Widower\">Widow \/ Widower<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1362_container\" class=\"frm_form_field  frm12 frm_first frm_html_container form-field\">\n<p>\u00a0<\/p>\n<p><b>Contact Details<\/b><\/p>\n<\/div>\n<div id=\"frm_field_1363_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_third\">\r\n    <label for=\"field_oq5jde30c356c9e\" id=\"field_oq5jde30c356c9e_label\" class=\"frm_primary_label\">House Name\/Number\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_oq5jde30c356c9e\" name=\"item_meta[1363]\" value=\"\"  data-sectionid=\"1357\" data-reqmsg=\"House Name\/Number cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1364_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_8p1dbdcf7ea7c7e\" id=\"field_8p1dbdcf7ea7c7e_label\" class=\"frm_primary_label\">Street\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_8p1dbdcf7ea7c7e\" name=\"item_meta[1364]\" value=\"\"  data-sectionid=\"1357\" data-reqmsg=\"Street cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1365_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_oi6a4f0d296a997\" id=\"field_oi6a4f0d296a997_label\" class=\"frm_primary_label\">Locality\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_oi6a4f0d296a997\" name=\"item_meta[1365]\" value=\"\"  data-sectionid=\"1357\" data-reqmsg=\"Locality cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1366_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_ictcne16949e387\" id=\"field_ictcne16949e387_label\" class=\"frm_primary_label\">Post Code\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_ictcne16949e387\" name=\"item_meta[1366]\" value=\"\"  data-sectionid=\"1357\" data-reqmsg=\"Post Code cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1367_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\r\n    <label for=\"field_e9pw9f3268616b14f10365f8b7380031b60\" id=\"field_e9pw9f3268616b14f10365f8b7380031b60_label\" class=\"frm_primary_label\">Contact Number\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_e9pw9f3268616b14f10365f8b7380031b60\" name=\"item_meta[1367]\" value=\"\"  data-sectionid=\"1357\" data-invmsg=\"Number is invalid\" aria-invalid=\"false\"   min=\"0\" max=\"99999999999\" step=\"any\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1368_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\r\n    <label for=\"field_2rqzq1073466a63448a6de27a62ec81555d\" id=\"field_2rqzq1073466a63448a6de27a62ec81555d_label\" class=\"frm_primary_label\">Email\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_2rqzq1073466a63448a6de27a62ec81555d\" name=\"item_meta[1368]\" value=\"\"  data-sectionid=\"1357\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1369_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first horizontal_radio\">\r\n    <div  id=\"field_2djbi5af2035a30_label\" class=\"frm_primary_label\">Are you a mother?\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_2djbi5af2035a30_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_1369-1357-0\"><label for=\"field_2djbi5af2035a30-0\">\t\t<input type=\"radio\" name=\"item_meta[1369]\" id=\"field_2djbi5af2035a30-0\" value=\"Yes\"\n\t\t   data-sectionid=\"1357\" data-reqmsg=\"Are you a mother? cannot be blank.\" data-invmsg=\"Are you a mother? is invalid\" aria-invalid=\"false\"  \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_1369-1357-1\"><label for=\"field_2djbi5af2035a30-1\">\t\t<input type=\"radio\" name=\"item_meta[1369]\" id=\"field_2djbi5af2035a30-1\" value=\"No\"\n\t\t   data-sectionid=\"1357\" data-reqmsg=\"Are you a mother? cannot be blank.\" data-invmsg=\"Are you a mother? is invalid\" aria-invalid=\"false\"  \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_1371_container\" class=\"frm_form_field frm_section_heading form-field  frm_hide_section\">\r\n<h3 class=\"frm_pos_none frm_section_spacing\"><\/h3>\r\n\r\n\r\n<div id=\"frm_field_1372_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container horizontal_radio\">\r\n    <div  id=\"field_vz14z6b0d0ce9b1_label\" class=\"frm_primary_label\">Have you ever had a career break to bring up your children?\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_vz14z6b0d0ce9b1_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_1372-1371-0\"><label for=\"field_vz14z6b0d0ce9b1-0\">\t\t<input type=\"radio\" name=\"item_meta[1372]\" id=\"field_vz14z6b0d0ce9b1-0\" value=\"Yes\"\n\t\t   data-sectionid=\"1371\" data-reqmsg=\"Have you ever had a career break to bring up your children? cannot be blank.\" data-invmsg=\"Have you ever had a career break to bring up your children? is invalid\" aria-invalid=\"false\"  \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_1372-1371-1\"><label for=\"field_vz14z6b0d0ce9b1-1\">\t\t<input type=\"radio\" name=\"item_meta[1372]\" id=\"field_vz14z6b0d0ce9b1-1\" value=\"No\"\n\t\t   data-sectionid=\"1371\" data-reqmsg=\"Have you ever had a career break to bring up your children? cannot be blank.\" data-invmsg=\"Have you ever had a career break to bring up your children? is invalid\" aria-invalid=\"false\"  \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1373_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container horizontal_radio\">\r\n    <div  id=\"field_bkb65c33274fcac_label\" class=\"frm_primary_label\">Did you return to a gainful occupation after the career break?\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_bkb65c33274fcac_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_1373-1371-0\"><label for=\"field_bkb65c33274fcac-0\">\t\t<input type=\"radio\" name=\"item_meta[1373]\" id=\"field_bkb65c33274fcac-0\" value=\"Yes\"\n\t\t   data-sectionid=\"1371\" data-reqmsg=\"Did you return to a gainful occupation after the career break? cannot be blank.\" data-invmsg=\"Did you return to a gainful occupation after the career break? is invalid\" aria-invalid=\"false\"  \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_1373-1371-1\"><label for=\"field_bkb65c33274fcac-1\">\t\t<input type=\"radio\" name=\"item_meta[1373]\" id=\"field_bkb65c33274fcac-1\" value=\"No\"\n\t\t   data-sectionid=\"1371\" data-reqmsg=\"Did you return to a gainful occupation after the career break? cannot be blank.\" data-invmsg=\"Did you return to a gainful occupation after the career break? is invalid\" aria-invalid=\"false\"  \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1374_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_2ekah6c5769aa61\" id=\"field_2ekah6c5769aa61_label\" class=\"frm_primary_label\">How may children do you have? \r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_2ekah6c5769aa61\" name=\"item_meta[1374]\" value=\"1\"  data-sectionid=\"1371\" style=\"width:150px\" data-frmval=\"1\" data-reqmsg=\"How may children do you have?  cannot be blank.\" aria-required=\"true\" data-invmsg=\"Number is invalid\" class=\"auto_width\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_2ekah6c5769aa61\" min=\"0\" max=\"8\" step=\"any\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_2ekah6c5769aa61\">Indicate the number of children<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_1375_container\" class=\"frm_form_field  frm12 frm_first frm_html_container form-field\">\n<p>Birth dates of children:<\/p>\n<\/div>\n<div id=\"frm_field_1376_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3 frm_first\">\r\n    <label for=\"field_41pga655ac87fa5\" id=\"field_41pga655ac87fa5_label\" class=\"frm_primary_label\">Child\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_41pga655ac87fa5\" name=\"item_meta[1376]\" value=\"\"  data-sectionid=\"1371\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Child cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1377_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_we1d943d0569d5c\" id=\"field_we1d943d0569d5c_label\" class=\"frm_primary_label\">Child\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_we1d943d0569d5c\" name=\"item_meta[1377]\" value=\"\"  data-sectionid=\"1371\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Child cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1378_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_53rnzb75ccf786d\" id=\"field_53rnzb75ccf786d_label\" class=\"frm_primary_label\">Child\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_53rnzb75ccf786d\" name=\"item_meta[1378]\" value=\"\"  data-sectionid=\"1371\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Child cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1379_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_lypuub9b1661d98\" id=\"field_lypuub9b1661d98_label\" class=\"frm_primary_label\">Child\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_lypuub9b1661d98\" name=\"item_meta[1379]\" value=\"\"  data-sectionid=\"1371\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Child cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1380_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3 frm_first\">\r\n    <label for=\"field_zgtj88879be473c\" id=\"field_zgtj88879be473c_label\" class=\"frm_primary_label\">Child\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_zgtj88879be473c\" name=\"item_meta[1380]\" value=\"\"  data-sectionid=\"1371\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Child cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1381_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_1zva4944bb829db\" id=\"field_1zva4944bb829db_label\" class=\"frm_primary_label\">Child\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_1zva4944bb829db\" name=\"item_meta[1381]\" value=\"\"  data-sectionid=\"1371\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Child cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1382_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_o18enb43da6f55f\" id=\"field_o18enb43da6f55f_label\" class=\"frm_primary_label\">Child\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_o18enb43da6f55f\" name=\"item_meta[1382]\" value=\"\"  data-sectionid=\"1371\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Child cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1383_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_2z6ms9eb48aa5bc\" id=\"field_2z6ms9eb48aa5bc_label\" class=\"frm_primary_label\">Child\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_2z6ms9eb48aa5bc\" name=\"item_meta[1383]\" value=\"\"  data-sectionid=\"1371\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Child cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1384_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container horizontal_radio\">\r\n    <div  id=\"field_t3sbyc5c7f1de2d_label\" class=\"frm_primary_label\">Are you currently benefitting from Invalidity Pension?\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_t3sbyc5c7f1de2d_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_1384-1371-0\"><label for=\"field_t3sbyc5c7f1de2d-0\">\t\t<input type=\"radio\" name=\"item_meta[1384]\" id=\"field_t3sbyc5c7f1de2d-0\" value=\"Yes\"\n\t\t   data-sectionid=\"1371\" data-reqmsg=\"Are you currently benefitting from Invalidity Pension? cannot be blank.\" data-invmsg=\"Are you currently benefitting from Invalidity Pension? is invalid\" aria-invalid=\"false\"  \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_1384-1371-1\"><label for=\"field_t3sbyc5c7f1de2d-1\">\t\t<input type=\"radio\" name=\"item_meta[1384]\" id=\"field_t3sbyc5c7f1de2d-1\" value=\"No\"\n\t\t   data-sectionid=\"1371\" data-reqmsg=\"Are you currently benefitting from Invalidity Pension? cannot be blank.\" data-invmsg=\"Are you currently benefitting from Invalidity Pension? is invalid\" aria-invalid=\"false\"  \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_1386_container\" class=\"frm_form_field frm_section_heading form-field  frm_hide_section\">\r\n<h3 class=\"frm_pos_none frm_section_spacing\"><\/h3>\r\n\r\n\r\n<div id=\"frm_field_1387_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first horizontal_radio\">\r\n    <div  id=\"field_op4r3787e2072c6_label\" class=\"frm_primary_label\">Have you ever lived abroad? \r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_op4r3787e2072c6_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_1387-1386-0\"><label for=\"field_op4r3787e2072c6-0\">\t\t<input type=\"radio\" name=\"item_meta[1387]\" id=\"field_op4r3787e2072c6-0\" value=\"Yes\"\n\t\t   data-sectionid=\"1386\" data-reqmsg=\"Have you ever lived abroad?  cannot be blank.\" data-invmsg=\"Have you ever lived abroad?  is invalid\" aria-invalid=\"false\"  \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_1387-1386-1\"><label for=\"field_op4r3787e2072c6-1\">\t\t<input type=\"radio\" name=\"item_meta[1387]\" id=\"field_op4r3787e2072c6-1\" value=\"No\"\n\t\t   data-sectionid=\"1386\" data-reqmsg=\"Have you ever lived abroad?  cannot be blank.\" data-invmsg=\"Have you ever lived abroad?  is invalid\" aria-invalid=\"false\"  \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1388_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first\">\r\n    <label for=\"field_o5cyi24e669ea21\" id=\"field_o5cyi24e669ea21_label\" class=\"frm_primary_label\">Indicate the number of foreign countries where you lived\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_o5cyi24e669ea21\" name=\"item_meta[1388]\" value=\"1\"  data-sectionid=\"1386\" style=\"width:150px\" data-frmval=\"1\" data-reqmsg=\"Indicate the number of foreign countries where you lived cannot be blank.\" aria-required=\"true\" data-invmsg=\"Number is invalid\" class=\"auto_width\" aria-invalid=\"false\"   min=\"0\" max=\"3\" step=\"any\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1389_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_nm6fo7702d639bb\" id=\"field_nm6fo7702d639bb_label\" class=\"frm_primary_label\">Foreign Country where you lived:\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_nm6fo7702d639bb\" name=\"item_meta[1389]\" value=\"\"  data-sectionid=\"1386\" data-reqmsg=\"Foreign Country where you lived: cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1390_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_fourth\">\r\n    <label for=\"field_a4tftdf220d8116\" id=\"field_a4tftdf220d8116_label\" class=\"frm_primary_label\">From\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_a4tftdf220d8116\" name=\"item_meta[1390]\" value=\"\"  data-sectionid=\"1386\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"From cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_a4tftdf220d8116\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_a4tftdf220d8116\">Indicate the period<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_1391_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_fourth\">\r\n    <label for=\"field_pjynp5fac5e9009\" id=\"field_pjynp5fac5e9009_label\" class=\"frm_primary_label\">To\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_pjynp5fac5e9009\" name=\"item_meta[1391]\" value=\"\"  data-sectionid=\"1386\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"To cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1392_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_wufw072d21546bc\" id=\"field_wufw072d21546bc_label\" class=\"frm_primary_label\">Foreign Country where you lived:\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_wufw072d21546bc\" name=\"item_meta[1392]\" value=\"\"  data-sectionid=\"1386\" data-reqmsg=\"Foreign Country where you lived: cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1393_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_ge2o9edc2fb9fde\" id=\"field_ge2o9edc2fb9fde_label\" class=\"frm_primary_label\">From\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_ge2o9edc2fb9fde\" name=\"item_meta[1393]\" value=\"\"  data-sectionid=\"1386\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"From cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_ge2o9edc2fb9fde\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_ge2o9edc2fb9fde\">Indicate the period<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_1394_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_3go6f4615c93653\" id=\"field_3go6f4615c93653_label\" class=\"frm_primary_label\">To\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_3go6f4615c93653\" name=\"item_meta[1394]\" value=\"\"  data-sectionid=\"1386\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"To cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1395_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_3tffzafa53d9686\" id=\"field_3tffzafa53d9686_label\" class=\"frm_primary_label\">Foreign Country where you lived:\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_3tffzafa53d9686\" name=\"item_meta[1395]\" value=\"\"  data-sectionid=\"1386\" data-reqmsg=\"Foreign Country where you lived: cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1396_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_fourth\">\r\n    <label for=\"field_sdqmq30a12b2c18\" id=\"field_sdqmq30a12b2c18_label\" class=\"frm_primary_label\">From\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_sdqmq30a12b2c18\" name=\"item_meta[1396]\" value=\"\"  data-sectionid=\"1386\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"From cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_sdqmq30a12b2c18\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_sdqmq30a12b2c18\">Indicate the period<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_1397_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_fourth\">\r\n    <label for=\"field_k988pca53acd0a5\" id=\"field_k988pca53acd0a5_label\" class=\"frm_primary_label\">To\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_k988pca53acd0a5\" name=\"item_meta[1397]\" value=\"\"  data-sectionid=\"1386\" maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"To cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_1399_container\" class=\"frm_form_field  frm12 frm_first frm_html_container form-field\">\n<p>\u00a0<\/p>\n<p>Note: Applies to Maltese residents aged from 59 years but not yet 65 years old and who are current beneficiaries of Invalidity Pension.<\/p>\n<p>\u00a0<\/p>\n<\/div>\n<div id=\"frm_field_1400_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_o4nyz2436b70164\" id=\"field_o4nyz2436b70164_label\" class=\"frm_primary_label\">Comments\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[1400]\" id=\"field_o4nyz2436b70164\" rows=\"5\"  data-invmsg=\"Comments is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1403_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p><\/br><\/p>\n<\/div>\n<div id=\"frm_field_1404_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Declaration<\/h3>\r\n\r\n\r\n<div id=\"frm_field_1401_container\" class=\"frm_form_field  frm_two_thirds frm_html_container form-field\"><strong>Retrospective Payment of Social Security Contributions\u00a0- Invalidity <\/strong><\/p>\n<p><a href=\"https:\/\/socialsecurityforms.blob.core.windows.net\/dssforms\/Declaration - RetrospectiveInvalidityEN.pdf\" target=\"_blank\" rel=\"noopener\">Click Here<\/a> to download the Declaration form and attach a signed copy to this form.<\/div>\n<div id=\"frm_field_1418_container\" class=\"frm_form_field form-field  frm_required_field frm_none_container frm_third\">\r\n    <label for=\"field_593qk\" id=\"field_593qk_label\" class=\"frm_primary_label\">File Upload\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"hidden\"  data-sectionid=\"1404\" data-reqmsg=\"File Upload cannot be blank.\" data-invmsg=\"File Upload is invalid\" class=\"auto_width\" aria-invalid=\"false\"   name=\"item_meta[1418]\"  data-reqmsg=\"File Upload cannot be blank.\"  value=\"\" data-frmfile=\"1418\" \/>\n\n<div class=\"frm_dropzone frm_single_upload frm_clearfix\" id=\"file1418_dropzone\" role=\"group\" >\n\t<div class=\"fallback\">\n\t\t<input type=\"file\" name=\"file1418\" id=\"field_593qk\"\n\t\t\t data-sectionid=\"1404\" data-reqmsg=\"File Upload cannot be blank.\" data-invmsg=\"File Upload is invalid\" class=\"auto_width\" aria-invalid=\"false\"  \t\t\t\/>\n\t\t\t\t<div class=\"frm_clearfix \"><\/div>\n\t<\/div>\n\t<div class=\"dz-message needsclick\">\n\t\t\t\t<svg  viewBox=\"0 0 18 18\" class=\"frmsvg frm-svg-icon\">\n\t<path viewBox=\"0 0 18 18\" fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M8.2 4v8a.8.8 0 001.5 0V4l2.1 2.2A.7.7 0 1013 5L9.5 1.7a.7.7 0 00-1.1 0L5.1 5.2a.8.8 0 001 1l2.1-2zm7.6 4.3c.4 0 .7.3.7.7v6.8c0 .4-.3.7-.8.7H2.3a.8.8 0 01-.8-.8V9A.8.8 0 013 9v6h12V9c0-.4.3-.8.8-.8z\"><\/path>\n<\/svg>\t\t<span class=\"frm_upload_text\"><button type=\"button\" aria-label=\"File Upload. Attach file here. Maximum file size: 5MB\">Attach file here<\/button><\/span>\n\t\t<span class=\"frm_compact_text\"><button type=\"button\" aria-label=\"File Upload. Choose File. Maximum file size: 5MB\">Choose File<\/button><\/span>\n\t\t<div class=\"frm_small_text\">\n\t\t\t<p>Maximum file size: 5MB<\/p>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1417_container\" class=\"frm_form_field  frm12 frm_first frm_html_container form-field\">\n<p><\/br><\/p>\n<\/div>\n<div id=\"frm_field_1405_container\" class=\"frm_form_field  frm12 frm_first frm_html_container form-field\">\n<p><strong>Data Protection Declaration<\/strong><\/p>\n<p>The Department of Social Security collects all relevant personal information to provide its services to individuals who qualify for assistance, allowance or non-contributory pensions in accordance with the Social Security Act (Cap. 318.). The Department may verify the information submitted by you in line with article 133 (b) of the Social Security Act to ensure its accuracy in relation to the claim. Personal data may be disclosed to departments \/ third parties, who may also have access to your data as authorised by law. Personal information may also be exchanged with benefits institutions of other countries to combat and deter fraud, as provided for in international treaties or bilateral agreements to which Malta is a party. You will be informed in due course of the result of your claim after it has been assessed.<\/p>\n<p>Pursuant to the General Data Protection Regulation (EU) 2016\/679 (GDPR) and the Data Protection Act (Cap. 586.), we have a legal duty to respect and protect any personal information we collect from you and we will abide by such duty. We take all safeguards necessary to prevent unauthorised access and we do not pass on your details collected from you as a visitor and\/or user, to any third party unless you give us your consent to do so or as authorised by law. You may request in writing to access information held about you, and eventually to rectify, and where applicable to erase incorrect information. Such a request is to be addressed to \u201cThe Data Controller\u201d, Department of Social Security, 38, Ordnance Street, Valletta VLT 1021 or by e-mail to dpsocialsecurity.dss@gov.mt and appropriate action would be taken at the earliest possible time. In making such a request, kindly quote your identity card number, social security number, your name and address and other relevant documentation to identify your case.<\/p>\n<\/div>\n<div id=\"frm_field_1406_container\" class=\"frm_form_field form-field  frm_required_field frm_hidden_container vertical_radio\">\r\n    <div  id=\"field_v3dp97bbefba3af7e0f95783e6514f49e4_label\" class=\"frm_primary_label\">\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_v3dp97bbefba3af7e0f95783e6514f49e4_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_1406-1404-0\"><label for=\"field_v3dp97bbefba3af7e0f95783e6514f49e4-0\"><input type=\"checkbox\" name=\"item_meta[1406][]\" id=\"field_v3dp97bbefba3af7e0f95783e6514f49e4-0\" value=\"I accept the Data Protection Declaration\"  data-sectionid=\"1404\" data-reqmsg=\"Accept the declaration\" data-invmsg=\"This field is invalid\" aria-invalid=\"false\"   aria-required=\"true\"  \/> I accept the Data Protection Declaration<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_7765_container\" class=\"frm_form_field form-field  frm_hidden_container frm_half\">\r\n    <label for=\"field_n4v3b\" id=\"field_n4v3b_label\" class=\"frm_primary_label\">Insert email address here to receive a copy of your application.\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_n4v3b\" name=\"item_meta[7765]\" value=\"\"  placeholder=\"Insert email address here to receive a copy of your application.\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1408_container\" class=\"frm_form_field form-field  frm_none_container\">\r\n    <label for=\"g-recaptcha-response\" id=\"field_u2lrc69f10101c7600b9c63f7_label\" class=\"frm_primary_label\">Captcha\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <div  id=\"field_u2lrc69f10101c7600b9c63f7\" class=\"g-recaptcha\" data-sitekey=\"6Lc7QVEnAAAAAHP0Dud5W1R-R32HtY5g3tEx7i_L\" data-size=\"invisible\" data-theme=\"light\" data-callback=\"frmAfterRecaptcha\"><\/div>\r\n    \r\n    \r\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t\t<div class=\"frm__655dc7164682e\">\n\t\t\t\t<label for=\"frm_email_42\" >\n\t\t\t\t\tIf you are human, leave this field blank.\t\t\t\t<\/label>\n\t\t\t\t<input  id=\"frm_email_42\" type=\"text\" class=\"frm_verify\" name=\"frm__655dc7164682e\" value=\"\" autocomplete=\"false\"  \/>\n\t\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"w2phKzfykQ2mhP+2AQDfTVz8wQf+rZcdYL7zxZBLBVM=\" \/><div class=\"frm_submit\">\r\n<button class=\"frm_button\" type=\"button\"  onClick=\"window.print()\">Print<\/button>\r\n\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"   formnovalidate=\"formnovalidate\">Submit<\/button>\r\n\r\n<\/div><\/div>\n<\/fieldset>\n<\/div>\n<\/form>\n<\/div>\n<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","_lmt_disableupdate":"no","_lmt_disable":"","footnotes":""},"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>eform \u2013 Retrospective Invalidity - Social Security<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/socialsecurity.gov.mt\/en\/retrospective-invalidity\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"eform \u2013 Retrospective Invalidity - Social Security\" \/>\n<meta property=\"og:description\" content=\"Customer Care and Contact InformationDepartment of Social Security in Malta 38, Ordnance Street Valletta VLT 1021 Tel \u2013 Freephone 153 International Customers (+356) 21255153 (This is not a freephone number) Email - social.security@gov.mt Website - www.socialsecurity.gov.mt International Relations Unit in Malta 38, Ordnance Street Valletta VLT 1021 Tel \u2013 (+356) 25903420 Email - iru.dss@gov.mt Website [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/socialsecurity.gov.mt\/en\/retrospective-invalidity\/\" \/>\n<meta property=\"og:site_name\" content=\"Social Security\" \/>\n<meta property=\"article:modified_time\" content=\"2022-01-11T13:44:25+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/socialsecurity.gov.mt\/en\/retrospective-invalidity\/\",\"url\":\"https:\/\/socialsecurity.gov.mt\/en\/retrospective-invalidity\/\",\"name\":\"eform \u2013 Retrospective Invalidity - 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