Application for a daily parental attendance allowance (AJPP) (Form 12666*03)

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 a child who is seriously ill, injured or disabled to receive an allowance.

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


this form also gives you access to the cerfa no. 11423 status declaration form (which must be completed to make the request).

Go to the online administrative form

Verified 09 March 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.