Get Remplissable Declaration D'accident Du Travail - Cnps

Filling out the Remplissable Declaration D'accident Du Travail is an essential process for reporting workplace accidents. This guide provides clear instructions on how to complete the declaration effectively online, ensuring all necessary details are accurately recorded.

Follow the steps to complete the declaration accurately.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Begin by filling out the information for the employer section, including the CNPS number, taxpayer number, company name or reason for incorporation, postal address, phone numbers, professional activity, and number of employees at the time of the accident.
3. Next, move to the victim section. Enter the victim's CNPS number, full name, sex, date and place of birth, nationality, parents' names, and personal contact information. Also, provide details such as the victim’s position in the company, profession, qualifications, seniority in the profession, hiring date, and notice period.
4. In the accident section, specify the date and time of the accident, location, material involved, nature of the injuries, and the location of the injuries. Ensure to provide detailed circumstances surrounding the accident.
5. Document the victim's work schedule, including precise working hours for the morning, afternoon, and evening shifts.
6. Include medical certificate data, such as the date of work stoppage, duration of temporary incapacity, and date of return to work.
7. List witnesses by including their names, professions, cities, and contact information.
8. In the emergency contacts section, provide names and contact information for individuals to reach out in case of emergencies.
9. After completing all sections, review the form for accuracy and completeness before saving your changes. Users can then choose to download, print, or share the form as required.

Complete the Remplissable Declaration D'accident Du Travail online to ensure timely processing of your claim.