This form is to be filled out by a person who does not have an Israeli ID number and belongs to one of the following 3 categories:
- A Yeshiva student or his family member currently staying in Israel and asking to establish residency and affiliate to a HMO.
- A East-Jerusalem resident asking to establish residency for his child who has not receive an ID number yet
- A foreign worker submitting a bankruptcy claim
In case you are submitting claims for several individuals in the same family, you must fill out a separate claim for each family member.