HollandZorg uses cookies

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Application Form for payment of the compulsory excess in instalments

Paying the compulsory excess in instalments

Would you like to utilise the arrangement that enables you to pay the compulsory excess in instalments? If so, please complete the form below and register online. After 1 February 2016, you will only be able to register for payment in instalments after receipt of an invoice. This means that you must have received an invoice before you will be able to apply for a payment arrangement.

 

By registering, you agree to the conditions for the payment of the compulsory excess in instalments.