Formulaire

Application for daily parental attendance allowance (AJPP) - MSA (Form 12666*05)

Cerfa 12666*05 (S7152d)

Allows a person who wishes to temporarily stop working to care for a child who is seriously ill, injured or disabled to receive an allowance.

    Fill out the form

    To whom shall I send this form ?

    For details, please use the practical information sheets :

    J'ai réalisé une démarche administrative

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    Émetteur du formulaire administratif : Central Fund of Agricultural Social Mutual Society (MSA)

    Verified 28 February 2024 - Directorate for Legal and Administrative Information (Prime Minister)