Accident at work Wage certificate for agricultural worker (Form 11450*04)

Central Fund of Agricultural Social Mutual Society (MSA) - Cerfa n° 11450*04

Certificate to be sent to the fund of the Agricultural Social Mutual Society (MSA) to which you report. The daily allowances due to the victim are calculated on the basis of the information provided.

Go to the online administrative form

Verified 23 September 2016 - Directorate for Legal and Administrative Information (Prime Minister)

To whom shall I send this form ?

J'ai réalisé une démarche administrative

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