№. of payment order

Name of personal data

Chapter 1. Purpose of retirement benefits on age

1

Surname

2

Name

3

Middle name (in case of its availability)

4

Individual identification number (further – IIN)

5

Data on the birth: birth date, birthplace, registration of the birth

6

Data on the identity document (the passport of the citizen of the Republic of Kazakhstan, the identity certificate of the citizen of the Republic of Kazakhstan, the certificate of the stateless person, the residence permit of the foreigner, the certificate of the oralman before receipt of nationality of the Republic of Kazakhstan), or requested from the corresponding state information systems through lock of "the electronic government" (further – information systems)

7

Place of residence: the residential address, the name of area, area (city), street, house number, apartments, document number, date of issue, the body which issued the document, place of residence (the address reference or the reference of rural akims) or from information systems; for residents Baikonur the reference of department of accounting and registration of citizens of housing of the city of Baikonur

8

Data on availability of the bank account: full name of bank in which the bank account, surname, name, middle name (is opened in case of its availability), birth date of person who is the bank account holder, the data on bank account number opened in the banks of the second level, the organization having licenses of authorized body on regulation and supervision of the financial market and the financial organizations on the corresponding types of banking activities, territorial subdivisions of Kazpochta joint-stock company or the control account of cash of organization of criminal executive system, medico-social organization (organization)

9

Data on the income: about the average monthly income from January 1, 1995 for any 3 years in a row, the archive reference with indication of data on earnings or the electronic copy of the archive document certified by the digital signature of the authorized employee of the Public Records Office or departmental archive, the certificate of the income amounts paid to physical person and performed from the income of compulsory pension contributions or the document on the income of individual entrepreneurs, lawyers, private notaries, private legal executives and professional mediators issued by body of state revenues.

10

The data confirming working life: the data containing in the service record; to the reference of archive organizations, the electronic copy of archive documents, the witnessed digital signature of the authorized employee of the Public Records Office or departmental archive, or from place of employment in case of absence or worthlessness of the service record, lack of the corresponding employment records, availability of corrections, inaccuracies, discrepancies; the marriage certficate (the certificate of civil registration) either the certificate on annulment of marriage or the statement from assembly record about marriage (in case of change of surname). The education document, the military ID or the reference of managements (department) for defense, the certificate of birth of children (the statement from the birth record, or the certificate of the birth, the civil registrations issued by departments), the certificate of rehabilitation issued by bodies of prosecutor's office, the certificate of military commissariat of participation in fighting, the judgment confirming the fact of implementation and the period of care of the disabled person of the first group, the lonely disabled person of the second group and the retirement pensioner needing assistance, aged who reached eighty-year age, the handicapped child aged up to sixteen years, the document confirming accommodation abroad of the spouse (spouse) worker and the former Soviet organizations, organizations of the Republic of Kazakhstan, the international organization, the document confirming accommodation of the spouse (spouse) of the serviceman are in the presence provided the employee of special state body in areas where there was no employment opportunity. The documents confirming the fact of education of children: the documents confirming the personality of children, the marriage certficate (the certificate of civil registration) either the certificate on annulment of marriage or the statement from assembly record about marriage (in case of change of surname) children, the document on training in educational institution of children, the document confirming place of registration in the permanent place to residence of children, the death certificate of children (the statement from assembly record about death, or the certificate of death issued by department of civil registration), the document confirming passing of military service on children; the military ID, the judgment about factual determination of education, adoption (adoption) of child(children); the document confirming the accommodation fact in zones of extreme and maximum radiation risk from August 29, 1949 to July 5, 1963 within 5 years; in case of establishment of guardianship (guardianship) the document confirming establishment of guardianship (guardianship).

Chapter 2. Purpose of the state base retirement benefit

1

Surname

2

Name

3

Middle name (in case of its availability)

4

IIN

5

Data on the birth: birth date, birthplace, registration of the birth