ORDER OF SOCIAL INSURANCE FUND OF THE RUSSIAN FEDERATION

of June 15, 2012 No. 223

About approval of forms of registers of the data necessary for appointment and payment of the corresponding type of benefit, and procedures for their filling

In pursuance of the order of the Government of the Russian Federation of April 21, 2011 N 294 "About features of financing, appointment and payment in 2012 and 2013 of insurance coverage, other payments and expenses provided by part 4 of article 6 of the Federal law "About the Budget of Social Insurance Fund of the Russian Federation for 2012 and for Planning Period of 2013 and 2014", features of payment of insurance premiums on compulsory social insurance for case of temporary disability both in connection with motherhood and on compulsory social insurance from labor accidents and occupational diseases" (The Russian Federation Code, 2011, N 18, Art. 2633; 2012, N 1, 100) I order to the Art.:

1. Approve:

form of the Register of the data necessary for appointment and allowance payment on temporary disability, on pregnancy and childbirth, lump-sum allowance to the women who were registered in medical institutions in early terms of pregnancy according to the appendix N 1;

Procedure for filling of the Register of the data necessary for appointment and allowance payment on temporary disability, on pregnancy and childbirth, lump-sum allowance to the women who were registered in medical institutions in early terms of pregnancy according to the appendix N 2;

form of the Register of the data necessary for appointment and payment of lump-sum allowance in case of the child's birth, according to the appendix N 3;

Procedure for filling of the Register of the data necessary for appointment and payment of lump-sum allowance in case of the child's birth, according to the appendix N 4;

form of the Register of the data necessary for appointment and payment of monthly allowance for child care, according to the appendix N 5;

Procedure for filling of the Register of the data necessary for appointment and payment of monthly allowance for child care, according to the appendix N 6.

Appendix No. 1

to the Order of Social Insurance Fund of the Russian Federation of June 15, 2012 No. 223

The register of the data necessary for appointment and allowance payment on temporary disability, on pregnancy and childbirth, lump-sum allowance to the women who were registered in medical institutions in early terms of pregnancy

___________________________________________________________________________
                       (name of the insurer)

Registration number of the insurer ______________ Subordination Code _______

TIN/TRRC _______________________________  PSRN (PSRNSP) ___________________

Contact phone number (with indication of code)
insurer (authorized representative of the insurer) _________________

E-mail address of the insurer
(authorized representative of the insurer) ______________________________

-------+----------------------------------------------------------------------+---------------------+------------------------------------
¦  N   ¦                     Сведения о получателе пособия                    ¦      Документ,      ¦Документ, подтверждающий постоянное¦
¦ п/п  ¦                                                                      ¦    удостоверяющий   ¦    или временное проживание на    ¦
¦      ¦                                                                      ¦       личность      ¦  территории � оссийской Федерации  ¦
¦      +-------+-----+--------+------+-----------+------------+-------+-------+------+-------+------+---------+------+------+-----------+
¦      ¦фамилия¦ имя ¦отчество¦дата  ¦   адрес   ¦адрес места ¦  ИНН  ¦ СНИЛС ¦серия ¦ номер ¦ дата ¦наиме-   ¦серия ¦номер ¦дата выдачи¦
¦      ¦       ¦     ¦        ¦рож-  ¦регистрации¦ жительства ¦       ¦       ¦      ¦       ¦выдачи¦нование  ¦      ¦      ¦(продления)¦
¦      ¦       ¦     ¦        ¦дения ¦           ¦(пребывания)¦       ¦       ¦      ¦       ¦      ¦документа¦      ¦      ¦           ¦
+------+-------+-----+--------+------+-----------+------------+-------+-------+------+-------+------+---------+------+------+-----------+
¦  1   ¦   2   ¦  3  ¦   4    ¦  5   ¦     6     ¦      7     ¦   8   ¦   9   ¦  10  ¦  11   ¦  12  ¦   13    ¦  14  ¦  15  ¦     16    ¦
+------+-------+-----+--------+------+-----------+------------+-------+-------+------+-------+------+---------+------+------+-----------+
¦      ¦       ¦     ¦        ¦      ¦           ¦            ¦       ¦       ¦      ¦       ¦      ¦         ¦      ¦      ¦           ¦
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-------------+--------+-----------+----------+--------+------+------+----------+-------------+---------+------------------
¦Листок      ¦Причина ¦  Уход за  ¦  Период  ¦Период  ¦ Дата ¦Дата  ¦Заключение¦  Справка о  ¦Нарушение¦Продолжительность¦
¦нетрудо-    ¦нетрудо-¦  больным  ¦нахождения¦освобож-¦выхода¦регис-¦бюро МС�­  ¦постановке на¦ режима  ¦ страхового стажа¦
¦способности ¦способ- ¦  членом   ¦     в    ¦дения от¦  на  ¦трации¦(установ- ¦   учет в    ¦         +-----+-----------+
+-----+------+ности   ¦  семьи,   ¦стационаре¦работы  ¦работу¦доку- ¦лена или  ¦ медицинских ¦         ¦всего¦в том числе¦
¦номер¦ дата ¦        ¦ возраст,  ¦ с больным¦        ¦      ¦ментов¦изменена  ¦учреждениях в¦         ¦     ¦нестраховые¦
¦     ¦выдачи¦        ¦родственная¦ ребенком ¦        ¦      ¦в бюро¦группа    ¦ранние сроки ¦         ¦     ¦  периоды  ¦
¦     ¦      ¦        ¦   связь   ¦          ¦        ¦      ¦МС�­   ¦инва-     ¦беременности ¦         ¦     ¦           ¦
¦     ¦      ¦        ¦           ¦          ¦        ¦      ¦      ¦лидности) +------+------+         ¦     ¦           ¦
¦     ¦      ¦        ¦           ¦          ¦        ¦      ¦      ¦          ¦ дата ¦номер ¦         ¦     ¦           ¦
¦     ¦      ¦        ¦           ¦          ¦        ¦      ¦      ¦          ¦выдачи¦      ¦         ¦     ¦           ¦
¦     ¦      ¦        ¦           ¦          ¦        ¦      ¦      ¦          ¦      ¦      ¦         ¦     ¦           ¦
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¦ 17  ¦  18  ¦   19   ¦    20     ¦    21    ¦   22   ¦  23  ¦  24  ¦    25    ¦  26  ¦  27  ¦   28    ¦ 29  ¦    30     ¦
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¦     ¦      ¦        ¦           ¦          ¦        ¦      ¦      ¦          ¦      ¦      ¦         ¦     ¦           ¦
------+------+--------+-----------+----------+-----

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