Formulaire

Application for the retirement of a public official, a magistrate or a member of the military, on grounds of disability

Cerfa 15684*01

This form applies to the following persons:

  • Civil servant or magistrate permanently unable to perform his or her duties or any other reclassification function because of a disability attributable or not to service, resulting from injuries or illnesses acquired or aggravated during a period of service valid for retirement or with at least 15 years of service to the State and suffering, when he no longer acquires pension rights, from an incurable infirmity or illness rendering him unable to pursue any profession
  • Military suffering from disabilities attributable or not to the service, making them permanently unable to perform their service
  • Civil servant, magistrate or military with at least 15 years of service and whose spouse is suffering from an incurable disability or illness making it impossible for him to practice any profession.
  • Service free
  • 4 steps
  • Language French

Fill out the form

Comment faire ?

  1. Print the form
  2. The fill by hand
  3. The sign
  4. THEsend through the hierarchy to your managing administration with the necessary supporting documents

  • Medical documents from your attending physician attesting to your inability to practice any profession or medical documents from your spouse's attending physician attesting to his inability to practice any profession
  • Copy of your current family record book or document certifying that you have had a dependent child (photocopy of the guardianship act for example)

Ce formulaire concerne :

J'ai réalisé une démarche administrative

Je donne mon avis sur Services Publics +. L'administration concernée me répondra.

Je donne mon avis

Verified 06 May 2026 - Public Service / Directorate of Legal and Administrative Information (Prime Minister)