Checklist for the déclaration préalable à l'embauche (DPAE), the mandatory pre-hiring declaration to URSSAF — this is a CHECKLIST, not the official government form itself (the DPAE is filed online via urssaf.fr / net-entreprises); it must be submitted BEFORE the employee's actual start of work, in the 8 days preceding it.
⚠️ This is a blank template, not legal advice: check the wording with a lawyer and adapt it to your jurisdiction and your case.
This template has no optional clauses: the text is the same for everyone. Field placeholders are shown as labels — on the site the template is read-only, values are entered inside the system.
DPAE CHECKLIST (DÉCLARATION PRÉALABLE À L'EMBAUCHE)
Employer: Employer name (SIRET Employer SIRET) Employee: Employee name, born Employee date of birth
⚠️ This is an internal CHECKLIST, not the official government declaration itself. The DPAE must be filed electronically with URSSAF (urssaf.fr or net-entreprises.fr) — no separate form is generated by this platform.
1. TIMING — MANDATORY BEFORE THE START OF WORK 1.1. Hire date/time: Date and time of hire 1.2. The DPAE may be filed no earlier than 8 days before this date/time, but MUST be filed before the employee actually starts working — even a few minutes' delay after the employee has begun work exposes the employer to the sanctions in section 3.
2. CONTENT TO DECLARE 2.1. Employee identity: Employee name, date of birth Employee date of birth, social security number Employee social security number. 2.2. Contract type: Contract type
3. ⚠️ CONSEQUENCES OF A MISSING OR LATE DPAE 3.1. Working without a DPAE constitutes travail dissimulé (undeclared work) — a criminal offence — exposing the employer to a civil penalty of up to 300 times the minimum garanti (approx. €1,270) and criminal penalties of up to €1,500–€7,500 (higher for repeat offences or legal entities), in addition to URSSAF reassessments and loss of certain social-contribution exemptions.
4. SUBMISSION 4.1. Status: URSSAF submission status 4.2. Submission date/time: Submission date/time 4.3. Confirmation (accusé de réception) obtained: Accusé de réception (confirmation) obtained
5. FOLLOW-UP 5.1. Occupational medical visit (visite d'information et de prévention) scheduled: Occupational medical visit scheduled 5.2. Notes: Notes
Checklist completed by: ______________ Date: ______________
— — — ⚠️ This is a boilerplate template, not legal advice. French employment, consumer-protection and data-protection law (Code du travail, Convention collective HCR "CCN HCR", Code de la consommation, RGPD/CNIL, Regulation (EU) No 1169/2011 "INCO") is highly procedural, includes fixed statutory calendars (e.g. the entretien préalable and rupture conventionnelle timelines) and changes frequently — statutory figures (SMIC, grille HCR, sanction amounts) are re-indexed periodically. Have this document reviewed and adapted by a French employment/legal advisor (avocat en droit du travail / expert-comptable) and verified against the current rates before use. Under the loi Toubon (Law No. 94-665 of 4 August 1994), documents intended for use in France — employment contracts, consumer information, mandatory workplace notices — must be available in French; where a French-language version of this document is also used, that version prevails in case of conflict.
Fields that belong to a switched-off clause are dimmed — they are not asked for.
DPAE must be filed no earlier than 8 days before this exact date/time, and always before actual work begins
Visite d'information et de prévention (VIP), generally due within 3 months of hire
2 of 12 fields are taken from the company, employee or counterparty record, the questionnaire can be dictated to the AI, and the finished document comes with a number, a PDF and an acknowledgement record.