Application for Metzingen-Card

The Metzingen Card is issued to those who receive benefits according to

Social Security Code II (citizens' allowance)
Social Security Code XII (basic income support)
Housing Benefit Act (housing benefit)
Asylum Seekers' Benefits Act
the regulations for supplementary child allowance under the Child Benefit Act

Applicant

Salutation*

Last name*

First name*

Date of birth*

Street*

No.*

Zip code*

Location*

Telephone No.*

E-Mail address*

Members of the household

Each eligible household member will receive their own card. Please enter all members of the household.

Last name

First name

Date of birth

Last name

First name

Date of birth

Last name

First name

Date of birth

Last name

First name

Date of birth

Last name

First name

Date of birth

Last name

First name

Date of birth

Please send us a scan of your authorization letter and a valid ID card.

Upload a scan of your authorization letter*

Upload a scan of your ID card.*