Death Capital Application - 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 claim payment of the death capital.

The form contains a cerfa leaflet no. 50193#05.

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

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