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<h2 style="text-align: center;"><u><strong><span style="font-size:18px;"><span
style="font-family: arial,helvetica,sans-serif;">BULLETIN DE PENSION
RETRAITE</span></span></strong></u></h2>

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<p><strong><span style="font-size:12px;"><span style="font-
family: arial,helvetica,sans-
serif;">Nom&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span></strong></p>

<p><strong><span style="font-size:12px;"><span style="font-


family: arial,helvetica,sans-serif;">Identifiant</span></span></strong></p>

<p><strong><span style="font-size:12px;"><span style="font-


family: arial,helvetica,sans-serif;">Situation Familiale</span></span></strong></p>

<p><strong><span style="font-size:12px;"><span style="font-


family: arial,helvetica,sans-serif;">Statut</span></span></strong></p>

<p><strong><span style="font-size:12px;"><span style="font-


family: arial,helvetica,sans-
serif;">Grade&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span></strong></p>

<p><strong><span style="font-size:12px;"><span style="font-


family: arial,helvetica,sans-serif;">Date derni&egrave;re
promotion</span></span></strong></p>

<p><strong><span style="font-size:12px;"><span style="font-


family: arial,helvetica,sans-serif;">Echelon</span></span></strong></p>

<p><strong><span style="font-size:12px;"><span style="font-


family: arial,helvetica,sans-serif;">Date d&#39;entr&eacute;e en
service</span></span></strong></p>

<p><strong><span style="font-size:12px;"><span style="font-


family: arial,helvetica,sans-serif;">Date de
d&eacute;part</span></span></strong></p>
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<td>
<p><strong><span style="font-size:12px;"><span style="font-
family: arial,helvetica,sans-
serif;">Nom&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp
;&nbsp;&nbsp; </span></span></strong></p>

<p><strong><span style="font-size:12px;"><span style="font-


family: arial,helvetica,sans-serif;">Identifiant</span></span></strong></p>

<p><strong><span style="font-size:12px;"><span style="font-


family: arial,helvetica,sans-serif;">Situation Familiale</span></span></strong></p>

<p><strong><span style="font-size:12px;"><span style="font-


family: arial,helvetica,sans-serif;">Statut</span></span></strong></p>

<p><strong><span style="font-size:12px;"><span style="font-


family: arial,helvetica,sans-
serif;">Grade&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span></strong></p>

<p><strong><span style="font-size:12px;"><span style="font-


family: arial,helvetica,sans-serif;">Date derni&egrave;re
promotion</span></span></strong></p>

<p><strong><span style="font-size:12px;"><span style="font-


family: arial,helvetica,sans-serif;">Echelon</span></span></strong></p>

<p><strong><span style="font-size:12px;"><span style="font-


family: arial,helvetica,sans-serif;">Date d&#39;entr&eacute;e en
service</span></span></strong></p>

<p><strong><span style="font-size:12px;"><span style="font-


family: arial,helvetica,sans-serif;">Date de
d&eacute;part</span></span></strong></p>
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<p style="text-align: center;"><span style="font-
size:12px;"><span style="font-family: arial,helvetica,sans-serif;">REPUBLIQUE DE
DJIBOUTI</span></span></p>

<p><span style="font-size:12px;"><span style="font-family:


arial,helvetica,sans-serif;">MINISTERE DE LA DEFENSE</span></span></p>

<p style="text-align: center;"><span style="font-


size:12px;"><span style="font-family: arial,helvetica,sans-serif;">CAISSE MILITAIRE
DE RETRAITE</span></span></p>

<p style="text-align: center;">&nbsp;</p>

<p style="text-align: center;">&nbsp;</p>

<p style="text-align: center;"><span style="font-


size:12px;"><span style="font-family: arial,helvetica,sans-serif;">&nbsp;&nbsp;
Boulevard de la R&eacute;publique &nbsp;&nbsp;&nbsp;&nbsp; </span></span></p>

<p style="text-align: center;"><span style="font-


size:12px;"><span style="font-family: arial,helvetica,sans-serif;">Tel : (253) 21
35 88 08</span></span></p>

<p style="text-align: center;"><span style="font-


size:12px;"><span style="font-family: arial,helvetica,sans-serif;">&nbsp;Fax :
(253) 21 35 88 09</span></span></p>

<p style="text-align: center;"><span style="font-


size:12px;"><span style="font-family: arial,helvetica,sans-serif;">BP : 1875 -
Djibouti RDD</span></span></p>

<p style="text-align: center;"><span style="font-size:12px;">Site


web :&nbsp; www.cmr.dj</span></p>
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<td colspan="3" style="text-align: center; height: 35px;"><span
style="font-family:arial,helvetica,sans-serif;"><span style="font-size:
14px;"><span style="font-size:16px;"><strong>PENSION DE RETRAITE
AU</strong></span></span></span></td>
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<td style="text-align: center; height: 40px;"><span style="font-
family:arial,helvetica,sans-serif;"><span style="font-size:
14px;"><strong>&nbsp;MODALITE DE PAIEMENT</strong></span></span></td>
<td style="text-align: center;"><span style="font-
family:arial,helvetica,sans-serif;"><span style="font-size:
14px;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs
p;&nbsp; &nbsp;
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span></sp
an></td>
<td style="text-align:
center;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&
nbsp;</td>
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<td style="text-align: center; height: 35px;"><span style="font-
size:16px;"><span style="font-family: arial,helvetica,sans-
serif;"><strong>LIBELLES</strong></span></span></td>
<td colspan="2" rowspan="1" style="text-align: center;"><span
style="font-size:16px;"><span style="font-family: arial,helvetica,sans-
serif;"><strong>MONTANT</strong></span></span></td>
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<td style="height: 20px;"><span style="font-
family:arial,helvetica,sans-serif;"><span style="font-size: 14px;">1. Pension de
retraites + Pension de r&eacute;forme</span></span></td>
<td colspan="2" style="text-align: center; height:
20px;">&nbsp;</td>
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<td style="height: 20px;"><span style="font-
family:arial,helvetica,sans-serif;"><span style="font-size: 14px;">2. Pension
d&#39;invalidit&eacute; en %</span></span></td>
<td colspan="2" style="text-align: center; height:
20px;">&nbsp;</td>
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<td style="height: 20px;"><span style="font-
family:arial,helvetica,sans-serif;"><span style="font-size: 14px;">Total de Pension
trimestriel brute</span></span></td>
<td colspan="2" style="text-align: center; height:
20px;">&nbsp;</td>
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<td style="height: 20px;"><span style="font-
family:arial,helvetica,sans-serif;"><span style="font-size: 14px;">Retenue 1%
Caisse Pr&eacute;-m&eacute;dicament</span></span></td>
<td colspan="2" style="text-align: center; height:
20px;">&nbsp;</td>
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<td bgcolor="#B3B2B1" style="height: 40px;"><span style="font-
family:arial,helvetica,sans-serif;"><span style="font-size: 14px;"><strong>Montant
Pension Trimestrielle</strong></span></span></td>
<td bgcolor="#B3B2B1" colspan="2" style="text-align: center;
height: 10px; width: 50px;"><span style="font-family:arial,helvetica,sans-
serif;"><span style="font-size: 14px;"><strong>2</strong></span></span></td>
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<td colspan="3" style="text-align: center; height: 35px;"><span
style="font-size:16px;"><span style="font-family: arial,helvetica,sans-
serif;"><strong>PRESTATION FAMILIALE</strong></span></span></td>
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<td style="height: 20px;"><span style="font-
family:arial,helvetica,sans-serif;"><span style="font-size: 14px;">Allocation
conjointe</span></span></td>
<td colspan="2" style="text-align: center; height:
20px;">&nbsp;</td>
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<td style="height: 20px;"><span style="font-
family:arial,helvetica,sans-serif;"><span style="font-size: 14px;">Allocation
enfants</span></span></td>
<td colspan="2" style="text-align: center; height:
20px;">&nbsp;</td>
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<td bgcolor="#B3B2B1" style="height: 40px;"><span style="font-
family:arial,helvetica,sans-serif;"><span style="font-size:
14px;"><strong>Allocation Familiale Net</strong></span></span></td>
<td bgcolor="#B3B2B1" colspan="2" style="text-align:
center;">&nbsp;</td>
</tr>
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<td colspan="3" style="text-align: center; height: 35px;"><span
style="font-size:16px;"><span style="font-family: arial,helvetica,sans-
serif;"><strong>RETENUES DIVERS</strong></span></span></td>
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<td style="height: 20px;"><span style="font-
family:arial,helvetica,sans-serif;"><span style="font-size: 14px;">Retenues (Saisie
Arret, Pension Alimentaire,..)</span></span></td>
<td colspan="2" style="text-align: center; height:
30px;">&nbsp;</td>
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<td bgcolor="#B3B2B1" style="height: 40px;"><span style="font-
family:arial,helvetica,sans-serif;"><span style="font-size: 14px;"><strong>Pension
Trimestrielle net &agrave; payer</strong></span></span></td>
<td bgcolor="#B3B2B1" colspan="2" style="text-align:
center;">&nbsp;</td>
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