DPAE Checklist (Déclaration préalable à l'embauche)

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.