Single application for a basic pension for permanent incapacity of occupational origin (Form)
National old-age insurance fundAutre numéro : S5130b
This form allows you to apply for your basic permanent disability pension if you have a permanent disability of at least 10% accident at work as a result of an occupational disease or illness for all the activities you have carried out as:
- Employee, head of company, collaborating partner, craftsman, merchant and industrialist, etc. (Pension insurance)
- Agricultural worker, farm manager or farm company, worker and family helper (MSA: titleContent)
- Minister of Worship or Religion (Cavimac).
Go to the online administrative form
Verified 08 March 2022 - 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 :
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