Accident at work CHSCT investigation of a serious

Ministry of Labor - Cerfa n° 12758*01
Autre numéro : 61-2256

Sheet to be sent within 15 days to the labor inspector, in duplicate

Go to the online administrative form

Verified 11 April 2022 - Directorate for Legal and Administrative Information (Prime Minister)

To whom shall I send this form ?

  • Departmental Directorate for Employment, Labor and Solidarity (DDETS or DDETS-PP)

    https://dreets.gouv.fr/

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