<?xml version='1.0' encoding='UTF-8'?>
<VBLV001 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:noNamespaceSchemaLocation="VBLV001_20261.xsd">
	<Form>
		<Identification>VBLV001</Identification>
		<FormCreationDate>2022-08-11</FormCreationDate>
		<FormCreationHour>09:28:58.082</FormCreationHour>
		<AttestationStatus>0</AttestationStatus>
		<TypeForm>SU</TypeForm>
		<RiskIdentification>
			<IdentificationOfRisk>001</IdentificationOfRisk>
		</RiskIdentification>
		<Reference>
			<ReferenceType>1</ReferenceType>
			<ReferenceOrigin>1</ReferenceOrigin>
			<ReferenceNbr>ref123A</ReferenceNbr>
		</Reference>
		<EmployerDeclarationLink>
			<NOSSRegistrationNbr>114135340</NOSSRegistrationNbr>
			<Trusteeship>0</Trusteeship>
			<CompanyID>1999999943</CompanyID>
			<OperationalOffice>
				<Street>Munkkaai</Street>
				<HouseNbr>2</HouseNbr>
				<ZIPCode>1000</ZIPCode>
				<City>Brussel</City>
			</OperationalOffice>
			<CoordinatesContactPerson>
				<Name>Janssens</Name>
				<FirstName>Jean</FirstName>
				<Address>
					<Street>Ganzepas</Street>
					<HouseNbr>118</HouseNbr>
					<PostBox>C</PostBox>
					<ZIPCode>9050</ZIPCode>
					<City>Gentbrugge</City>
					<Country>00150</Country>
				</Address>
				<Communication>
					<PhoneNbr>09/211.21.12</PhoneNbr>
					<EmailAddress>J.VHeerwege@internet.be</EmailAddress>
				</Communication>
			</CoordinatesContactPerson>
			<NaturalPerson>
				<NaturalPersonSequenceNbr>1</NaturalPersonSequenceNbr>
				<INSS>74101199805</INSS>
			</NaturalPerson>
			<ReferencePeriod>
				<RefStartingDate>2013-07-01</RefStartingDate>
				<RefEndingDate>2013-07-31</RefEndingDate>
			</ReferencePeriod>
			<ControlCard>
				<C32ANbr>SS1000101</C32ANbr>
				<SocialSecretariatNumber>710</SocialSecretariatNumber>
			</ControlCard>
		</EmployerDeclarationLink>
		<CommentDeclaration>
			<CommentOfDeclaration>Cardnumber granted by social secretary</CommentOfDeclaration>
		</CommentDeclaration>
	</Form>
</VBLV001>