Formulaire

Application for a widow's or widow's disability pension - person covered by the agricultural scheme (MSA) (Form 14837*01)

Cerfa 14837*01

Please fill in if you are a widow, disabled and under 55 years of age and are covered by the Agricultural Scheme (ASM).

    Fill out the form

    To whom shall I send this form ?

    For details, please use the practical information sheets :

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    Émetteur du formulaire administratif : Ministry of Health

    Verified 31 August 2022 - Directorate for Legal and Administrative Information (Prime Minister)