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Application for Death Capital - Declaration to be completed by the applicant (Form 10431*05)

National Health Insurance Fund (Cnam) - Cerfa n° 10431*05
Autre numéro : S3180i

Allows a person who has lost a loved one, under certain conditions, to apply for payment of the death capital.

This form contains explanatory note cerfa n°50193#05.

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Verified 11 March 2022 - Legal and Administrative Information Directorate (Prime Minister)

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