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Formulaire

Declaration of employment of a family job

Cerfa 11469*03

Individual employer who wishes to declare the hiring of a au pair, an intern family caregiver foreigner, of a au pair employee or a casual construction worker
Service free
4 steps
Language French
To be addressed within 8 days after the date of employment

Fill out the form

To whom shall I send this form ?

Urssaf

Comment faire ?

Download the form
Complete the form, sign and date
Print the form
The transmit atUrssaf

Information about theemployer (surname, first name and civil status in particular)
Information about the employee (surname, first name and civil status in particular)

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Verified 24 April 2026 - Public Service / Directorate of Legal and Administrative Information (Prime Minister)