Life certificate

In order to receive your benefits abroad, a life certificate must be filled in by the local authority, the embassy or the consulate of your place of residence.

We kindly ask you to send us the completed form (no duplicate) within 2 months per mail to Agence fédérale des risques professionnels, avenue de l'Astronomie 1, 1210 Bruxelles (Belgium).

Please carefully read the GDPR appendix (96,02 KB) that informs you about the use of your personal information by Fedris and about your rights regarding those data.

If you print this form for another person, also print the GDPR appendix so that they are informed of their rights.

PDF icon Life certificate141.73 KB