application

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To apply for a laissez-passer for a corpse please fill in all the information on this page.
Then scan and upload the three legal documents necessary to obtain the laissez-passer.

Name and first name of the deceased : (Value Required)

Place of death : (Value Required)

Cause of death: Communicable disease : (Value Required)

Yes

Place of birth (as on the ID card) : (Value Required)

Country : (Value Required)

Means of transport : (Value Required)

Transport from : (Value Required)

Country : (Value Required)

Belgium

Destination : (Value Required)

Country : (Value Required)

Entreprise number : (Value Required)

Type of applicant : (Value Required)

Undertaker

Embassy or Consulate

Legal name : (Value Required)

Legal form :

Country :

Address : Street :

Number :

City :

City : (Value Required)

ATTENTION : The address is not correcte : (Value Required)

Enter correct address (Value Required)

Street : (Value Required)

Number : (Value Required)

City : (Value Required)

e-mail address : (Value Required)

Confirm the e-mail address : (Value Required)

Telephone or mobile number : (Value Required)

Language : (Value Required)

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Deceased

Applicant