Formulaire

Application for Asi by the holder of an invalidity pension paid by the Social Security (Form 11175*06)

Cerfa 11175*06 (S4151f)

Allows the holder of a disability pension paid by the Social Security to apply for a supplementary disability allowance (Asi).

This form contains the package leaflet n°51646*03.

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

    Verified 31 January 2025 - Directorate for Legal and Administrative Information (Prime Minister)