Formulaire

Declaration of an accident caused by a third party

Cerfa 15263

Allows you to report an accident caused by an individual, company or administration.

For example:

  • Blows and injuries,
  • Bites of an animal,
  • Traffic accident
  • Injury following a sporting activity,
  • Injury from an object belonging to a neighbor...

To be done within 15 days of the accident.

    Fill out the form

    For details, please use the practical information sheets :

    J'ai réalisé une démarche administrative

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

    Je donne mon avis

    Émetteur du formulaire administratif : National Health Insurance Fund (Cnam)

    Verified 27 January 2026 - Public Service / Directorate of Legal and Administrative Information (Prime Minister)