Formulaire

Application for the use of earned points for an increase in pension insurance period (Form 15511*04)

Cerfa 15511*04 (S5117c)

You can choose to use some or all of the earned points in your prevention work account to get a free increase in your pension insurance term.

This will give you the allocation of additional quarter(s).

    Fill out the form

    To whom shall I send this form ?

    • Prevention Business Account - 3682

      For any question on the establishment of the Prevention Professional Account (C2P) for employees of the general scheme and the agricultural scheme exposed to occupational risk factors

      By telephone

      3682

      Free service + call price

      Open from Monday to Friday from 8am to 5pm

      If you are unable to reach this number or from the foreigner, call 0033 97110 3682 (call not surcharged).

      By mail

      Preventive Business Account

      Free answer 86057

      35099 Rennes Cedex 9

    For details, please use the practical information sheets :

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    Émetteur du formulaire administratif : Prevention Business Account

    Verified 08 October 2024 - Directorate for Legal and Administrative Information (Prime Minister)