Formulaire

Declaration of occupational disease or application for recognition of occupational disease (Form 16130*01)

Cerfa 16130*01

The user leaflet n°50562#03 is attached to the form.

    Fill out the form

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    For details, please use the practical information sheets :

    J'ai réalisé une démarche administrative

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    Émetteur du formulaire administratif : National Health Insurance Fund (Cnam)

    Verified 11 April 2022 - Directorate for Legal and Administrative Information (Prime Minister)