Regulation Of The Minister Of Labour And Social Policy Of 23 October 2009 On The Determination Of Patterns Leads To Social Insurance And Health Insurance, Registered Monthly Reports And Monthly Reports Of Registered Notes,

Original Language Title: ROZPORZĄDZENIE MINISTRA PRACY I POLITYKI SPOŁECZNEJ z dnia 23 października 2009 r. w sprawie określenia wzorów zgłoszeń do ubezpieczeń społecznych i ubezpieczenia zdrowotnego, imiennych raportów miesięcznych i imiennych raportów miesięcznych korygujących,

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On the basis of article. 49 paragraphs 1 and 2. 2 and 4 of the Act of 13 October 1998 on the social insurance system (Journal of laws of 2007. # 11, item 74, as amended. 2)) are managed as follows: § 1. 1. Specifies the patterns: 1) reporting to the insurance/notification of changes to the data of the insured person is a symbol of SOCIAL SECURITY, which are the AET annex 1 to the regulation;

2) reporting data about family members, for the purpose of health insurance is a symbol of SOCIAL SECURITY ZCNA FORM, constituting Annex 2 to the regulation;

3) reporting to health insurance/notification of changes to the data-with the symbol of SOCIAL SECURITY FROM BEHIND, forming annex 3 to Regulation;

4) notification of a change of identification of an insured person is a symbol of the ZUS ZIUA, constituting Annex # 4 to the regulation;

5) UN Security-symbol ZUS ZWUA, constituting Annex 5 to the regulation;

6) application/change data of the payer contributions – legal person or organizational unit without legal personality-symbol ZUS ZPA, constituting Annex No 6 to the regulation;

7) reporting/data of the payer contributions – a natural person – symbol ZUS ZFA, constituting Annex # 7 to the regulation;

8) notification of a change of identification the payer contributions-symbol ZUS ZIP, constituting Annex 8 to Regulation: 9) UN-payer contributions-symbol ZUS ZWPA, constituting Annex 9 to Regulation;

10) information about the numbers of bank accounts the payer contributions-symbol ZUS ZBA, annex 10 to the regulation;

11) business addresses by the payer contributions-symbol ZUS ZAA, constituting Annex 11 to Regulation;

12) personal monthly report on outstanding contributions and paid benefits-symbol ZUS RCA, Appendix 12 to the regulation;

13) personal monthly report on outstanding contributions for health insurance – symbol ZUS RZA, annexed # 13 to Regulation;

14) registered monthly report of paid benefits and breaks in contributions-symbol ZUS RSA, annexed to Regulation No 14;

15) Declaration of account-symbol ZUS DRA, annex 15 to the regulation;

16) (repealed);

16A) monthly for the insured person – Appendix 16a of regulation;

16B) annual information for the insured person – Annex No. 16b of regulation;

17) application/correction of data about work in special conditions, or of a special nature-symbol of SOCIAL SECURITY ZSWA, annexed to Regulation No 17.

2. For registered monthly reports of remediation is determined by reference to the same designs, referred to in paragraph 1. 1 paragraphs 12 to 14, for the Declaration of account credit note-the same pattern, referred to in paragraph 1. 1 paragraph 15, for a monthly credit note information for the insured person – the same pattern, referred to in paragraph 1. 1, point 16a, and for the information of the annual credit note for an insured person-the same pattern, referred to in paragraph 1. 1 paragraph 16b.

§ 2. Documents are filled in using codes, the list of which is set out in annex 18 to the regulation.

§ 3. 1. For the documents referred to in § 1 paragraph 1. 1 paragraph 1 – 11 and 17 shall be pantone color # 224, paragraphs 12-14-pantone color # 158, paragraphs 15 to pantone color # 172 and paragraph 16a and 16b-pantone color # 340.

2. the documents, in the form of a document written in the form of copies or printed from the website of the social insurance institution or print the software interface can be passed without the colors, referred to in paragraph 1. 1. § 4. 1. Payers of contributions may to stocks to use designs documents set out in annexes 1 to 13 and 16 to the regulation, referred to in paragraph 5, if the documents are submitted in the form of a written record.

2. in the case of a transfer document for the period up to the date of entry into force of this Regulation shall apply to insurance codes set out in the regulation referred to in paragraph 5, in the period for which this document was made.

§ 5. Repealed the Ordinance of the Minister of labour and social policy of 24 June 2008 on determining patterns leads to social insurance and health insurance, registered monthly reports and monthly reports of registered notes, reports, billing statement and statements of account credit notes and other documents (Journal of laws No. 112, item. 717).

§ 6. The regulation shall enter into force on 1 January 2010.



 

1) Minister of labour and social policy directs Government Administration Department-social security, on the basis of § 1 para. 2 paragraph 2 of the regulation of the Prime Minister of 16 November 2007 on the detailed scope of the Minister of labour and social policy (OJ No 216, 1598).

2) Changes the consolidated text of the said Act were announced in the journal of laws of 2007. # 17, item. 95, no. 21, item. 125, no. 112, item. 769, no. 115, item. 791, 792 and 793 and # 176, item. 1243, 2008 No. 63, item. 394, no. 67, item. 411, no. 141, item. 888, # 171, poz. 1056, no. 209, item. 1318, # 220, item. 1417 and 1418, no. 227. 1505, No 228, item. 1507 and # 237. 1654 and 1656, and 2009 # 6, item. 33, no. 8, item. 38, no. 14, item. 75, no. 18, item. 97, no. 22, item. 120, no. 68, item. 574, # 71, item. 609, no. 111, item. 918, # 131, poz. 1075, No 157, item. 1241 and # 161. 1278. Annex 1. [MODEL-ZUS AET]

The annexes to regulation of the Minister of labour and social policy of 23 October 2009 (item 1444) Annex # 1 pattern-ZUS AET annex 2. [MODEL-ZUS ZCNA FORM]

Appendix 2 MODEL-ZUS ZCNA FORM in annex 3. [MODEL-ZUS ZZA]

Annex 3 MODEL-ZUS ZZA annex 4. [MODEL-ZUS ZIUA]

Appendix 4 MODEL-ZUS ZIUA annex 5. [MODEL-ZUS ZWUA]

Appendix 5 MODEL-ZUS ZWUA annex 6. [MODEL-ZUS ZPA]

Annex No. 6 MODEL-ZUS ZPA annex 7. [MODEL-ZUS ZFA]

Annex No. 7 PATTERN-ZUS ZFA Annex 8. [MODEL-ZUS ZIP]

Annex No. 8 MODEL-ZUS ZIP Attachment 9. [MODEL-ZUS ZWPA]

Annex No. 9 PATTERN-ZUS ZWPA annex 10. [MODEL-ZUS ZBA]

Annex No. 10 MODEL-ZUS ZBA Annex 11. [MODEL-ZUS ZAA]

Annex No. 11 PATTERN-ZUS ZAA annex 12. [MODEL-ZUS RCA]

Annex # 12 PATTERN-ZUS RCA annex 13. [MODEL-ZUS RZA]

Annex No. 13 DESIGN-ZUS RZA annex 14. [MODEL-ZUS RSA]

Annex No. 14 MODEL-ZUS RSA Annex 15. [MODEL-ZUS DRA]

Appendix No 15 MODEL-ZUS DRA Annex 16. [(repealed)]

Annex 16 (repealed) Appendix 16a. [MODEL – INFORMATION MONTHLY FOR THE INSURED PERSON]

Appendix 16a model – INFORMATION MONTHLY for the INSURED PERSON Appendix 16b. [MODEL – ANNUAL INFORMATION FOR THE INSURED PERSON]

Annex No. 16b model – ANNUAL INFORMATION for the INSURED PERSON Annex 17. [MODEL-ZUS ZSWA]

Annex No. 17 MODEL-ZUS ZSWA Annex 18. [CODES USED FOR THE FILLING IN OF THE DOCUMENTS]

Annex No. 18 CODES USED for the FILLING in of the DOCUMENTS [1] and insurance code-consists of 6 characters, representing: 1) the base along with the file extension (4 characters) 2) established or not established right to retirement or disability pension (1 character) 3) degree of disability (1 character) 1. The basic entity with extension: 01 10-employee subject to social insurance and health insurance 01 11-employee subject to social insurance and under special regulations not subject to health insurance 01 12 – a person that takes a training benefit paid on termination of employment, worker-01 13 payer contributions has benefited from the funding of social security contributions with funds from the State budget and the State Fund for rehabilitation of disabled persons on the basis of article. 25 paragraph 2. 2, 3 or 3a of the Act of 27 August 1997 on the professional and social rehabilitation and employment of persons with disabilities (Journal of laws 2008 No. 14, item 92, as amended), as in force until 1 January 2008, and currently has the obligation to aid contributions and passes after 30 June 2008. billing documents for the period up to December 2007.

01 20-employee juvenile 01 24-former employee appointed or were a civil servant to which is fixed the employment relationship, that takes cash benefit for the period after termination of employment


01 25-employee subject to social insurance and health insurance, paying premiums on their own insurance in the case referred to in article. 109 of Council Regulation (EEC) No 574/72 of 21 March 1972 on the implementation of Council Regulation (EEC) No 1408/71 on the application of social security schemes to employed persons, to self-employed persons and to members of their families moving within the Community (OJ. EC-L 74 of 27.03.1972, p. 1, as amended. d.; Oj. EU Polish Special Edition, chapter. 05, vol. 1, p. 35), hereinafter referred to as "Council Regulation (EEC) No 574/72" or in the article. 21(1). 2 regulation of the European Parliament and of the Council (EC) no 987/2009 of 16 September 2009 on the implementation of Regulation (EC) No 883/2004 on the coordination of social security systems (OJ. EU L 284 of 30.10.2009, p. 1), hereinafter referred to as "Council Regulation (EC) no 987/2009 01 26-employee subject to social insurance and under special regulations not subject to health insurance, paying premiums on their own insurance in the case referred to in article. 109 of Council Regulation (EEC) No 574/72 or article. 21(1). 2 of Council Regulation (EC) no 987/2009 02 00-person implementing tolling 02 13-person performing job-processing, for which the payer of the contributions has benefited from the funding of social security contributions with funds from the State budget and the State Fund for rehabilitation of disabled persons on the basis of article. 25 paragraph 2. 2, 3 or 3a of the Act of 27 August 1997 on the vocational rehabilitation and social and employment of persons with disabilities, in the version in force to date and January 2008, and currently has the obligation to aid contributions and passes after 30 June 2008. billing documents for the period up to December 2007.

03 10-Member agricultural production cooperatives, cooperatives of the machinery rings or other cooperatives engaged in agricultural production 03 20-person performing work in the cooperative or agricultural holding cooperative on a different basis than the employment relationship, other than his Member and remunerated according to the rules applicable to members of the cooperative, including the candidate as a member of the cooperative 04 11-an agency agreement, contract or agreement for the provision of services 04 17-an agency agreement , contract or agreement for the provision of services pursuant to the provisions of specific non-regulated health insurance 04 21-collaborator with the person implementing the agency agreement, contract or agreement for the provision of services 04 24-person is matched with the person implementing the agency agreement, contract or agreement for the provision of services pursuant to the provisions of specific non-health insurance 04 26-an agency agreement, contract or agreement for the provision of services , who pays the contributions on their own insurance in the case referred to in article. 109 of Council Regulation (EEC) No 574/72 or article. 21(1). 2 of Council Regulation (EC) no 987/2009 04 28-an agency agreement, contract or agreement for the provision of services, by specific provisions of non-health insurance, who pays the contributions on their own insurance in the case referred to in article. 109 of Council Regulation (EEC) No 574/72 or article. 21(1). 2 of Council Regulation (EC) no 987/2009 04 30-the person who has custody of the children on the basis of a contract that triggers within the meaning of the Act of 4 February 2011 on the care of children up to the age of 3 years (Journal of laws No. 45, item 235), for which the base dimension of the social contributions is not higher than the height of the minimum remuneration for work 04 31 – the person who has custody of the children on the basis of a contract that triggers within the meaning of the Act of 4 February 2011. caring for children aged up to 3 years, for which the base dimension of the social contributions is the excess over the amount of the minimum remuneration for work 05 10-person non-agricultural economic activity on the basis of the provisions of the business or other specific provisions of non-established rights to a pension for incapacity for work, for which the base dimension of the social insurance contributions is declared the amount of not less than 60% of the amount of the average monthly salary , and the person leading non-public school, base or their team, on the basis of the provisions of the education system 05 11-person with person non-agricultural activities 05 12-person non-agricultural economic activity on the basis of the provisions of the business or other specific provisions which established the right to a survivor's pension for incapacity for work, for which the base dimension of the social insurance contributions is declared the amount of not less than 60% of the amount of the average monthly wage 05 13-disabled person that first time undertook conducting non-agricultural economic activities and benefited from the funding of social security contributions with funds from the State Fund for rehabilitation of disabled persons on the basis of article. 25 paragraph 2. 3B of the Act of 27 August 1997 on the vocational rehabilitation and social and employment of persons with disabilities, in the version in force to date and January 2008, and currently has the obligation to aid contributions and passes after 30 June 2008. billing documents for the period up to December 2007.

05 20 – 05 30-artist 05 40-person non-agricultural activities in the field of professional services 05 43-partner sole proprietorship limited liability company and partners general partnership, limited partnership or partnership 05 44-person non-agricultural activities, pursuant to the provisions of specific non-health insurance 05 45-person with person non-agricultural activities, pursuant to the provisions of specific non-health insurance 05 70-person non-agricultural economic activity without a fixed right to a pension for incapacity for work for which the base dimension of the social insurance contributions is declared the amount of not less than 30% of the amount of the minimum wage 05 72-person non-agricultural economic activities with established the right to a survivor's pension for incapacity for work, for which the base dimension of the social insurance contributions is declared the amount of not less than 30% of the amount of the minimum wage 06 10-member or senator in receipt of emoluments of the 07 10-sports scholarship that takes a scholarship under the social insurance and health insurance or only health insurance 07 20-sports scholarship that gets a scholarship to be the only social insurance 08 00 – a person who performs work for a consideration based on referral to work, at the time of imprisonment or detention 09 10-unemployed person receives unemployment benefits, a person that takes performance integrative 09 11-unemployed person unemployment benefit or a scholarship niepobierająca 09 20-person that takes a scholarship during the period of training , placement or vocational training of adults, which was addressed by the emplyment or emplyment steering entity and a person that takes a scholarship during the period of studies postgraduate 09 40-person resident in the Republic of Poland that takes pension bridging allowance or pre-retirement 09 41 – a person that takes a pension bridging allowance or pre-retirement, residing in other than the Republic of Poland a Member State of the European Union or a Member State of the European free trade agreement (EFTA) 10 10-Cardinal non-agricultural economic activities stating, who pays the premium from the minimum assessment base 10 11-Cardinal, stating non-agricultural economic activities, who pays the fee of a minimum basis and declared surplus over the minimum base dimension, for the period to 31 March 2004.

10 12 – Cardinal, stating non-agricultural economic activities, who pays the contribution declared surplus over the minimum base dimension 10 20-Cardinal, stating non-agricultural economic activity, who is a member of the order of the contemplative-klauzurowego or missionary, who pays the premium from the minimum assessment base 10 40-(deleted) 10 50-student Seminary, a newcomer, a postulant and juniorysta, subject to the health insurance 11 10-soldier lay in active service 11 11 11 12 held replacement service person – a person that takes place nadterminową the essential military service 11 13-person held periodic military service 11 14- an officer in the service of the candidate, and a candidate for the professional soldier 11 20-soldier professional 11 30 – a police officer 11 31-officer of the internal security agency and foreign intelligence agency 11 32-border guard 11 33-officer State Fire 11 34-Customs officer


11 35-officer of the central anti-corruption Bureau, the Military Counterintelligence, Military Intelligence Service or the Government Protection Bureau 11 40-officer of the prison service 11 50-person at rest that takes the emoluments of 11 51-person that takes a family salary 11 52 – a person that takes a salary after his release from service or cash benefits of the same nature 11 53-soldier or officer, for which he is obliged to pay contributions to the pension scheme in connection with the release of service or loss of the right to a pension or annuity

12 11-person on parental leave 12 50-person who has personal custody of the child, which directly before taking care subject to the pensions insurance and pension system as a person non-agricultural activities of 12 60-person who has personal custody of the child, which is directly in front of the caregiving insurance subject to the pensions and insurance as the contractor 12 70-person who has personal custody of the child, which directly before taking care subject to the pensions insurance and pension system as a collaborator with the person conducting non-agricultural activity or from the contractor 12 80 – the person who has personal custody of the child, which directly before taking care subject to the pensions insurance and pension system as a clerical person who has-12 90 personal custody of the child, subject to the pensions insurance only 12 40-person that takes maternity 13 10 – a person who on the basis of separate provisions or collective gets social benefit paid during maternity leave other than railway 13 20-person that takes a social allowance for the duration of the retraining and seek new employment 13 21-person that on the basis of separate provisions or collective gets social benefit paid during maternity leave 13 22 train – a person that takes social benefit during the period of exemption from the obligation to perform work 14 22-person, organizational unit of social assistance or mayor, Mayor or city President is obliged to pay contributions 15 00-(deleted) 16 10-(deleted) 17 00-(deleted) 18 10-(deleted) 18 11-student or participant of doctoral which school or organizational unit of the leading PhD is required to pay health insurance premiums 18 30-listener National School of public administration 19 00-person who is the subject of voluntary insurance and pensions scheme, based on art. 7 of the Act of 13 October 1998 on the social insurance system 19 10-person who is the subject of voluntarily insurance pensions and insurance during the period of suspension of establishment 20 10 20 20 judge-Prosecutor, magistrate court, trainee national school of judiciary and public prosecution 20 30-judge or Prosecutor, which is obliged to pay social insurance contributions, in connection with the termination or expiry of a work relationship 21 10-child or student not subject to health insurance with another title 21 20-listener the establishment of teacher education not subject to health insurance with another title 22 10-war veteran, whose contributions to the health insurance is required to pay the Office for war veterans and Repressed Persons 22 30-person who is the subject of health insurance in respect of entitlement to maintenance payments based on a court settlement or final judgment of the Court of 22 40 – member of the Supervisory Board, which is subject to the health insurance 24 10-person covered by a voluntary health insurance or volunteer , not subject to health insurance with another title, for which the contribution for health insurance on a voluntary basis using funds, referred to in the provisions on the activities of public benefit and about volunteering 25 00-pensioner residing in the Republic of Poland, whose contribution to the health insurance is financed by recipient 25 01-pensioner residing in other than the Republic of Poland a Member State of the European Union or a Member State of the European free trade agreement (EFTA) , whose contribution to the health insurance is financed by recipient 25 10-a pensioner residing in the Republic of Poland, whose contribution to the health insurance is financed from the State budget 25 11-pensioner residing in other than the Republic of Poland a Member State of the European Union or a Member State of the European free trade agreement (EFTA), whose contribution to the health insurance is financed from the State budget 26 00 – a person that takes teachers to provide compensating residing in the Republic of Poland 26 01 – a person that takes teachers to provide compensatory She lives in other than the Republic of Poland a Member State of the European Union or a Member State of the European free trade agreement (EFTA) 27 00 – a person that takes a bridging pension resident in the Republic of Poland 27 01 – a person that takes a bridging pension resident in other than the Republic of Poland a Member State of the European Union or a Member State of the European free trade agreement (EFTA) 30 00-person, which must be cleared and paid contributions or payable benefits in settlement documents submitted no earlier than next month After termination of title insurance 50 00-other title insurance 2. Established or not established right to retirement or disability pension: 0 – a person who has not established the right to pensions 1 – a person who has established the right to old-age pension 2 – a person who has established the right to a survivor's pension 3. Degree of disability: 0 – a person having a decision on disability or the person who has the judgment and did not submit it to the payer contributions 1 – a person who has submitted to the payer contributions judgment with a slight disability 2 – a person who has submitted to the payer contributions judgment to moderate disabilities 3 – a person who has submitted to the payer of the contributions the decision severely disabled 4 – a person who has submitted to the payer decision on disability issued to persons up to 16. year of life II. Code degree/affinity-consists of 2 characters: 01-11-spouse child their own, adopted child or spouse 21-grandson or a child, for whose care has been established, or a child in the foster family 30 – 31 mother – father 32-33 stepmother-stepfather 40-41 grandmother-grandfather 50-person adopters insured persons 60-other dependent relatives in the insured persons in the common household III. Code work in special conditions, consists of 3 signs in accordance with Annex 1 to this Act of 19 December 2008 on pensions bridging (Journal of laws No. 237, 1656), of which: – in the first box, type the number of the annex (1)-in the second and third type of number: 01 – work directly on the conversion of mechanical coal and metal ores or their enrichment 02 – works that provide or supplies related to extrac minerals rock 03 – work under the ground directly drill down tunnels in subsurface 04 – work directly with flooding the molds, transporting blood casting with liquid, hot material (cast iron, cast steel, non-ferrous metals and their alloys) 05 – work directly on the manual finishing castings: remove the filler elements, shear, grinding the surface of the casting and painting on hot 06 – work directly with blast furnaces and furnaces stalowniczych or casting 07-bricklaying directly blast furnaces Foundry Coke, batteries, and in the production of ceramic materials 08-works directly with manual compiling materials or manual formation of glass products in glass industry 09 – work directly with forging manual forging 10-works directly for the handling of aggregates and equipment for the production of non-ferrous metals 11 – work directly with roll strings: preparation, supervision of work rolls or roller table, interference with hair loss and zaklinowaniu materials 12-work on the crane when rendered directly handling pig iron , iron alloys or non-ferrous metals 13 – work directly in the manufacture of coke in coke batteries 14 – work directly with Coke coke battery with push, extinguishing or sorting Coke 15 – work directly in the manufacture of moulding materials or izolacyjnoegzotermicznych used in the foundry and metallurgy 16 – work directly with manual loading or unloading Chamber kilns in refractory 17 – work directly with manual loading or unloading hot ceramic products


18 – the work directly on the formation of refractory products of large-scale using of manual vibration tools 19-work on the manual forming, casting, cleaning or szkliwieniu ceramic products 20-work Diver or kesoniarza, work in hyperbaric chambers 21 – manual heavy directly on the transhipment in the holds of the vessel 22-works marine fishermen 23-work on vessels shipping 24-work on offshore oil rigs 25 – works in the air performed on the aircraft by attendants 26 – work directly with support for drilling and mining on the search for oil or natural gas 27 – work directly in mining drilling hole flange: oil or natural gas 28 – works directly on the welding arc or thermal cutting in areas with very low in volume, with limited ventilation (double bottom ships, tanks, pipes, etc.)

29-works directly on the painting, nitowaniu or assembling pieces of equipment in a very small room with limited ventilation (double bottom ships, tanks, pipes, etc.)

30 – the works inside the tanks, boilers and tanks with very low volume when hazardous substances 31 – works on manual laying on hot pavement with mixtures of mineral-bituminous 32-works directly with the processing of asbestos-containing materials or demolition related to their disposal 33-tannery work directly on wet skin 34 – work directly at zrywce or manual harvest of trees portable chainsaw chainsaw 35-work in the areas of technology imposed by air temperature below 0 ° c 36 heavy physical work in the underground sewers 37 – professional dancers work associated with very heavy exercise 38-works for the export of solid and liquid waste and landfill and wylewiskach impurity associated with very heavy exercise 39-works by forging manual forging industrial and mechanical hammers 40-work in the production of cemented carbide, electrodes, ores and drums and ferro-alloys (IV). Labour Code of a special nature-consists of 3 signs in accordance with Annex 2 to the Act of 19 December 2008 on pensions bridging, of which: – in the first box, type the number of the annex (2)-in the second and third type of number: 01-work aircraft pilots (pilot, instructor) 02 – the work of air traffic controllers 03-air mechanics works relating to direct support for confirming the safety of the aircraft on the tarmac 04 – navigators on ships and marine pilots 05-works drivers traction (traction vehicle driver, the driver instructor, share wieloczynnościowych driver driver and heavy machines to railway construction and railway catenary, the driver of the locomotive smoke up to 300 KM, the driver's helper locomotives) and managers trains 06 – work directly when setting the road course trains and vehicles (on-call traffic, Signalman, shunting, positioner, switchman, auditor of the rolling stock directly attesting to the safety of the train Metro traffic, the dispatcher, the on-call traffic and Metro) 07-work protection guards turn 08-work bus drivers, trolley buses and trams motorniczych in public transport 09-works drivers of emergency vehicles 10 – the works drivers of vehicles carrying dangerous goods that require marking of the vehicle an array of warning colours of Orange, in accordance with the provisions of the European Agreement concerning the international carriage of dangerous goods by road (ADR), done at Geneva on 30 September 1957.

11 – nuclear reactor operators work 12-tower cranes operators work to support that that category permissions are required or equivalent, and cranes port or shipyard 13 – works in direct control of technological processes which may pose a threat of a major industrial accident with consequences for public safety 14 – works in direct control of technical processes which could cause a crash with serious consequences for public safety 15-work directly in the manufacture of explosives the measures of blasting, pyrotechnic articles and their confection of 16 – work directly with energy blocks producing electricity or heat 17 – work directly and removal and installation electricians operation overhead electricity networks in conditions of work under voltage 18-work team members emergency medical professional rescue teams members work 19 (chemical, mountain, sea, downhole mining) 20-work employees fire protection units referred to in article 1. 15 paragraph 1a-5 and 8 of the Act of 24 August 1991 on fire protection (OJ of 2009 # 178, item 1380), participating directly in the rescue 21 – the work of teachers, educators and other pedagogical workers employed in educational centres, youth, youth centres socjoterapii, centres szkolno-educational, shelters for minors and correctional facilities, in accordance with the provisions of the law of 26 October 1982 on proceedings in cases of minors (Journal of laws of 2002 No. 11 , item. 109, as amended. d.)

22-the work of the staff having the care of the inhabitants of the houses of social assistance for the chronically mentally ill, mentally handicapped children and adolescents or adults, in accordance with the provisions of the Act of 12 March 2004 on social assistance (Journal of laws of 2009 # 175, item 1362) 23-work medical affiliates of psychiatric and addiction treatment in direct contact with patients, in accordance with the provisions of the law of 19 August 1994 on the protection of mental health (Journal of laws No. 111 , item. 535, as amended. d.)

24-the work of medical personnel in treatment disciplines under anesthesia 1 operating er V. Branch Code provincial National Health Fund – consists of three characters: 01R-Lower Silesian Regional Branch of the national health fund in Wrocław 02R – Kuyavian-Pomeranian Regional Branch of the national health fund in Bydgoszcz 03R – Lublin branch of the Provincial national health fund in Lublin 04R-Lubusz Regional Branch of the national health fund in Zielona Góra 05R-Łódź branch of the Provincial national health fund in Łódź 06R-Malopolska Regional Branch of the national health fund in Krakow, 07R-Mazowiecki Regional Branch of the national health fund in Warsaw 08R-Opole Regional Branch of the national health fund in Opole 09R-Podkarpacki Regional Branch of the national health fund in Rzeszow, 10R-Podlaski Regional Branch of the national health fund in Białystok 11R-Pomeranian Regional Branch of the national health fund in Gdansk 12R-Silesian Regional Branch of the national health fund in Katowice, 13R – the Świętokrzyski branch of the Provincial national health fund in Kielce, 14R – of Warmia and Mazury in Olsztyn, the national health fund Regional Branch 15R-greater Poland branch of the Provincial National Fund Health in Poznań 16R – West Pomeranian Regional Branch of the national health fund in Szczecin. Disability code 0 is a person having a decision on disability 1-person ruling with a slight disability 2-person who has the judgment to moderate disabilities 3-person ruling severely disabled 4-person with a disability ruling issued to persons up to 16. year of life. Reason code to unregister the insured – consists of 3 characters: 100-stopping title insurance/insurance 500-death of the insured person 600 – another cause clock-700-suspend execution of non-agricultural economic activities on the basis of the provisions of the freedom of economic activity. Code type of permissions-consists of 2 characters: 11 – entry in the register, the list or register 31 – France 32-34 authorization-decision 40-permission other than those mentioned above. Reason code to unregister the payer-consists of 3 characters: 111-cessation business innovation 115 – order of the Court for the closure of insolvency proceedings 117 – death of payer contributions 210 – suspend execution of non-agricultural economic activities on the basis of the provisions of the freedom of economic activity 211-deletion from the register, register or deletion from the list of 311-the decision of the competent authority for the liquidation of the payer contributions which is a unit of the public finance sector 350-UN-Security the last person for which the payer was obliged to submit insurance documents 600 – another cause clock-out


X. ID type: P-PESEL N-D & C R-NUMBER 1-ID card 2 – passport or other document proving the identity of the EU citizen. Code provision/break-consists of 3 characters: 1. A break in paying your contributions: 111-121 unpaid leave-parental leave granted on the basis of article. 186 section 1 of the Act of 26 June 1974-labour code (Journal of laws 1998, No 21, item 94., as amended.)

122 – parental leave granted on the basis of article. 186 section 2 of the Act of 26 June 1974-labour code 151-a period of justified absence from work, without the right to remuneration or allowance 152 – Unexcused absence 2. Type: 212 – compensatory allowance from sickness insurance 214-compensatory allowance from accident insurance 215 – alignment of compensatory benefit from sickness insurance 216 – alignment of compensatory allowance from accident insurance 3. Type of benefits and breaks: 311-maternity benefit from sickness insurance for the period as a period of maternity leave or leave under the conditions of maternity 313-sickness benefit from sickness insurance 314-sickness benefit from accident insurance 315-the alignment of the maternity benefit from sickness insurance for the period as a period of maternity leave or leave under the conditions of maternity 316 – alignment of care allowance from sickness insurance 317-the alignment of the sickness benefits from sickness insurance 318-the alignment of the sickness allowance from accident insurance 319 – maternity allowance from the sickness insurance for a period fixed as the period of parental leave 320-the alignment of the maternity benefit from sickness insurance for a period fixed as the period of parental leave 321 – provision of rehabilitation from sickness insurance 322-rehabilitation benefit accident insurance 323 – alignment of rehabilitation benefits from sickness insurance 324-the alignment of the rehabilitation benefits from accident insurance 325-maternity benefit from sickness insurance for the period as a period of additional maternity leave or additional leave under the conditions of maternity 326-the alignment of the maternity benefit from sickness insurance for the period as a period of additional maternity leave or additional leave under the conditions of maternity 327-maternity benefit from sickness insurance for the period as a period of paternity leave 328-the alignment of the maternity benefit from sickness insurance for a period fixed as the period of parental leave 331-remuneration for the time incapacity for work due to illness, the employer-funded 332-remuneration for the time incapacity for work due to illness financed from the Fund of guaranteed employee benefits 335 – alignment of remuneration for the time incapacity for work due to illness, the employer-funded 336-alignment of remuneration for the time incapacity for work due to illness, financed from the Fund of guaranteed employee benefits 350-other benefits/break. The term code transmission of declarations and reports: 1-for the Declaration submitted to the 5. day of the following month for the previous month 2 – for the Declaration submitted to 10. day of the following month for the previous month 3 – for the Declaration submitted to the 15. day of the following month for the previous month (code do not use agents, for which the code "4") 4-for the Declaration submitted to the 15. day of the following month for the previous month by shareholders of companies (single-Member limited liability company, civil, express, limited partnerships, partnerships), who pay contributions only for themselves, but the company has employees or other persons, subject to the insurance, and by persons subject to the voluntary health insurance 5-for the Declaration made by judges, prosecutors, soldiers or officers, for which it is required to pay social security contributions. Code information about the annual calculation basis of contributions to the pension scheme: 1-in the case when information on exceeding the annual contribution base donated insured 2-in the case when information on exceeding the annual contribution base gave the payer contributions 3-in the case when information on exceeding the annual contribution base gave the social insurance. Codes of clearing and Declaration identifiers numbers roll monthly report: 1) 01-for the Declaration of account and personal monthly report 02-39 inclusive-for declaration of account credit memo and roll report monthly correction 2) in the case of: (a)) district labour offices, for the unemployed and recipients of the scholarship during the period of training, placement or vocational training in the workplace, which have been addressed by the district Labour Office , b) military pension offices. The establishment of the pension scheme of the Ministry of Internal Affairs and administration and the pension Office of the prison service, for retirees and pensioners, c) social assistance organizational units or mayors, mayors and mayors, for persons receiving family benefits and for persons benefiting from social assistance benefits for which contributions are paid, d) settlement banks health insurance contributions when making the payment of pensions abroad , e) other entities unless health insurance contributions in the case of payment of the pension from abroad, f) rozliczającej institutions health insurance contributions, making the payment of annuities structured in accordance with the provisions of the Veterans of the structural and rural development funds from the guarantee section of the European agricultural guidance guarantee fund and the provisions to promote rural development with the participation of the European agricultural fund for rural development , g) social inclusion for recipients to provide integrative, 51-for the Declaration of account and roll report monthly 52-69 including – for the Declaration of account credit memo and roll report monthly healing 3) in the case of SOCIAL SECURITY for retirees and pensioners and persons receiving pension bridging allowance or pre-retirement: 51-for the Declaration of account and roll report monthly 52-89 including – for the Declaration of account credit memo and roll report monthly correction 4) in the case of judges , public prosecutors, soldiers or officers, which was required to pay social security contributions: 70 – for the Declaration of account and personal monthly report 71-79 including – for the Declaration of account credit memo and roll report monthly correction 5) in the case of the Declaration of the account and the personal monthly report for the calendar month, the bankruptcy trustee for the period from the Declaration of bankruptcy: 80 – for the Declaration of account and personal monthly report 81-89 including – for the Declaration of account credit memo and roll report monthly healing 6) in the case of payers contributions from contributors at your own insurance, making up for the month more than one billing statement with different insurance codes: 01 – for the first statement of account spline for the month 02-39 inclusive-for statement of account credit note folded to the Declaration marked with number 01 40-for the second statement of account spline for the month 41-49 including – for the Declaration of account credit note folded to the Declaration marked the number 40 51-for the third statement of account spline for the month 52 – 69 inclusive-for statement of account credit note folded to the Declaration marked the number 51 7) in the case of payers of contributions required to draw up and billing documents and person exercising custody of the children on the basis of a contract that triggers within the meaning of the Act of 4 February 2011 on the care of children up to the age of 3 years: 40 – for the Declaration of account and personal monthly report 41-49 including – for the Declaration of account credit memo and a report of the corrective roll Number monthly roll monthly report should be the number of the statement of account to which it is attached [1] Annex 18 as amended stipulated by § 1 paragraph 9 of the regulation of the Minister of labour and social policy dated September 9, 2013. amending the regulation on the determination of patterns leads to social insurance and health insurance, registered monthly reports and monthly reports of registered notes, reports, billing statement and Declaration of the corrective work data applications billing in specific conditions or of a special nature and other documents (OJ item 1101). The change came into force on April 1, 2014.

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