Accident at work Certification of wages - Occupational disease or illness (Form 11137*03)
National Health Insurance Fund (Cnam) - Cerfa n° 11137*03
Autre numéro : S6202j
Vous pouvez aussi utiliser :
Online wage certificate for payment of daily subsistence allowances
Go to the online administrative form
Verified 01 April 2021 - Directorate for Legal and Administrative Information (Prime Minister)
To whom shall I send this form ?
Contact the entity in charge of this form
For details, please use the practical information sheets :
J'ai réalisé une démarche administrative
Je donne mon avis sur Services Publics +. L'administration concernée me répondra.