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