Service Accident Report - Trip Accident - Public Service (Document Template)

Ministry of Public Service

Model form for the declaration of an accident at work or a journey accident, intended for the titular official or trainee, to be transmitted to your HRD dwithin 15 days of the date of the accident.

The reporting form must be accompanied by a medical certificate indicating the nature and location of the injuries resulting from the accident and, where appropriate, the duration of the resulting incapacity for work.

If the accident results in a work stoppage, you must transmit this work stoppage within 48 hours according to its establishment.

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The form is accessible at the bottom of the page.

Go to the letter template

Verified 02 August 2024 - Directorate for Legal and Administrative Information (Prime Minister)

For details, please use the practical information sheets :

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