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Form 12666*03: Application for daily parental allowance (DSA)

National Fund for Family Allowances (Cnaf) - Cerfa n° 12666*03
Autre numéro : S7152b

Allows a person who wishes to temporarily stop working to care for his seriously ill, injured or disabled child to receive an allowance.

To download the form, click first to select your place of residence.

FYI  

this form also gives you access to cerfa form no. 11423*06 of declaration of situation (to be filled in to complete the application).

Go to the online administrative form

Verified 16 September 2019 - 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 :