Formulaire

Distressed Contributors Assistance Form (DFAA) (Form)

To apply for the CDTA, you must complete the following form and attach the following supporting documents:

· Last tax or non-tax notice for all household members;

· A justification that can shed light on the difficulties.

The form is to be sent to the Urssaf via the Urssaf personal space by sending the request via the section: messaging.

After verification of all administrative criteria and supporting documents, the application shall be submitted to the Health and Social Action Commission of the CPSTI of the place of professional activity.

The sole trader shall be informed in writing when the CPSTI has taken a decision.

    Fill out the form

    To whom shall I send this form ?

    For details, please use the practical information sheets :

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    Émetteur du formulaire administratif : Urssaf

    Verified 27 November 2024 - Directorate for Legal and Administrative Information (Prime Minister)