Selecting a language will automatically trigger the translation of the page content.

Salary certificate for the payment of daily allowances (Form 11135*04)

National Health Insurance Fund (Cnam) - Cerfa n° 11135*04
Autre numéro : S3201p

Go to the online administrative form

Verified 30 November 2018 - Legal and Administrative Information Directorate (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 :