{"id":1117,"date":"2026-03-07T09:07:19","date_gmt":"2026-03-07T08:07:19","guid":{"rendered":"https:\/\/aw.hr.sos.pl\/?page_id=1117"},"modified":"2026-03-07T09:31:59","modified_gmt":"2026-03-07T08:31:59","slug":"1117-2","status":"publish","type":"page","link":"https:\/\/aw.hr.sos.pl\/?page_id=1117","title":{"rendered":"Formularz UoP"},"content":{"rendered":"\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1116-o1\" lang=\"pl-PL\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F1117#wpcf7-f1116-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formularz kontaktowy\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"1116\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.9.6\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"pl_PL\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1116-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<p>I.\tInformacje Podstawowe\n<\/p>\n<p><label> imi\u0119*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span> <\/label><br \/>\n<label> drugie imi\u0119<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-name2\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-name2\" \/><\/span> <\/label><br \/>\n<label> nazwisko*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-surname\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-surname\" \/><\/span> <\/label><br \/>\n<label> nr i seria dowodu osobistego<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ID\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"ID\" \/><\/span> <\/label><br \/>\n<label> obywatelstwo*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"citizen\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"citizen\" \/><\/span> <\/label><br \/>\n<label> PESEL*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"PESEL\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"PESEL\" \/><\/span> <\/label><br \/>\n<label> data urodzenia*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"birth_date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"birth_date\" \/><\/span> <\/label><br \/>\n<label> Miejsce urodzenia*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"birth_city\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"birth_city\" \/><\/span> <\/label><br \/>\n______________<br \/>\n<label> nr rachunku bankowego*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"IBAN\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"IBAN\" \/><\/span> <\/label><br \/>\n______________\n<\/p>\n<p>II.\tAdres zamieszkania\n<\/p>\n<p><label> ulica<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"street\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"street\" \/><\/span> <\/label><br \/>\n<label>nr domu *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"house\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"house\" \/><\/span> <\/label><br \/>\n<label> nr mieszkania<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"flat\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"flat\" \/><\/span> <\/label><br \/>\n<label> kod pocztowy*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"zpi-code\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zpi-code\" \/><\/span> <\/label><br \/>\n<label> miejscowo\u015b\u0107*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"city\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"city\" \/><\/span> <\/label><br \/>\n<label> poczta*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"poczta\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"poczta\" \/><\/span> <\/label><br \/>\n<label> gmina\/dzielnica*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"gmina\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"gmina\" \/><\/span> <\/label><br \/>\n<label> powiat*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"powiat\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"powiat\" \/><\/span> <\/label><br \/>\n<label> wojew\u00f3dztwo*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"wojewodztwo\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"wojewodztwo\" \/><\/span> <\/label><br \/>\n<label> Tw\u00f3j adres e-mail*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span> <\/label><br \/>\n<label> Tw\u00f3j nr telefonu<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"tel\" \/><\/span> <\/label><br \/>\n______________<br \/>\nIII.\tUrz\u0105d skarbowy\n<\/p>\n<p><label> Urz\u0105d skarbowy podatnika*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"US\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"US\" \/><\/span> <\/label><br \/>\n______________<br \/>\nIV.\tubezpieczenia<br \/>\n<label> Przynale\u017cno\u015b\u0107 do NFZ*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"NFZ\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"NFZ\"><option value=\"01 \u2013 Dolno\u015bl\u0105ski\">01 \u2013 Dolno\u015bl\u0105ski<\/option><option value=\"02 - Kujawsko-Pomorski\">02 - Kujawsko-Pomorski<\/option><option value=\"03 \u2013 Lubelski\">03 \u2013 Lubelski<\/option><option value=\"04 \u2013 Lubuski\">04 \u2013 Lubuski<\/option><option value=\"05 \u2013 \u0141\u00f3dzki\">05 \u2013 \u0141\u00f3dzki<\/option><option value=\"06 \u2013 Ma\u0142opolski\">06 \u2013 Ma\u0142opolski<\/option><option value=\"07 \u2013 Mazowiecki\">07 \u2013 Mazowiecki<\/option><option value=\"08 \u2013 Opolski\">08 \u2013 Opolski<\/option><option value=\"09 \u2013 Podkarpacki\">09 \u2013 Podkarpacki<\/option><option value=\"10 \u2013 Podlaski\">10 \u2013 Podlaski<\/option><option value=\"11 \u2013 Pomorski\">11 \u2013 Pomorski<\/option><option value=\"12 \u2013 \u015al\u0105ski\">12 \u2013 \u015al\u0105ski<\/option><option value=\"13 \u2013 \u015awi\u0119tokrzyski\">13 \u2013 \u015awi\u0119tokrzyski<\/option><option value=\"14 - Warmi\u0144sko-Mazurski\">14 - Warmi\u0144sko-Mazurski<\/option><option value=\"15 \u2013 Wielkopolski\">15 \u2013 Wielkopolski<\/option><option value=\"16 \u2013 Zachodniopomorski\">16 \u2013 Zachodniopomorski<\/option><\/select><\/span><br \/>\n<label> czy jeste\u015b emerytem?*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"emeryt\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"emeryt\"><option value=\"nie\">nie<\/option><option value=\"tak\">tak<\/option><\/select><\/span><br \/>\n<label> czy jeste\u015b rencist\u0105?*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"renta\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"renta\"><option value=\"nie\">nie<\/option><option value=\"tak\">tak<\/option><\/select><\/span><br \/>\n______________\n<\/p>\n<p>V.\tOsoba, kt\u00f3r\u0105 nale\u017cy powiadomi\u0107 w razie wypadku\n<\/p>\n<p><label> imi\u0119 i nazwisko<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"pomoc_kontakt\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"pomoc_kontakt\" \/><\/span> <\/label><br \/>\n<label> adres<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"pomic_adres\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"pomic_adres\" \/><\/span> <\/label><br \/>\n<label> telefon<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"pomoc_telefon\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"pomoc_telefon\" \/><\/span> <\/label><br \/>\n______________\n<\/p>\n<p>VI. Rodzina<br \/>\n<label> czy sprawujesz opiek\u0119 nad dzie\u0107mi do lat 4?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"opieka\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"opieka\"><option value=\"nie\">nie<\/option><option value=\"tak\">tak<\/option><\/select><\/span><br \/>\n<label> 1.1.Czy wyra\u017ca Pan\/Pani zgod\u0119 na prac\u0119 w rozk\u0142adzie czasu pracy przewiduj\u0105cym przed\u0142u\u017cenie normy czasu pracy powy\u017cej 8 godzin na dob\u0119 (art. 148 pkt 3 Kodeksu pracy)?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"opieka_zgoda1\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"opieka_zgoda1\"><option value=\"nie dotyczy\">nie dotyczy<\/option><option value=\"nie\">nie<\/option><option value=\"tak\">tak<\/option><\/select><\/span><br \/>\n<label> 1.2. Czy wyra\u017ca Pan\/Pani zgod\u0119 na prac\u0119 w godzinach nadliczbowych, w porze nocnej, w przerywanym systemie czasu pracy (art. 139 Kodeksu pracy) a tak\u017ce na delegowanie poza sta\u0142e miejsce pracy (art. 178 \u00a7 2 kodeksu pracy)?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"opieka_zgoda2\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"opieka_zgoda2\"><option value=\"nie dotyczy\">nie dotyczy<\/option><option value=\"nie\">nie<\/option><option value=\"tak\">tak<\/option><\/select><\/span><br \/>\n<label> dzieci pod opiek\u0105 :imi\u0119, nazwisko i data urodzenia<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"dzieci\"><textarea cols=\"40\" rows=\"10\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"dzieci\"><\/textarea><\/span> <\/label><br \/>\n<label>1.3. Sprawuj\u0105c opiek\u0119 nad dzieckiem do lat czternastu:<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"opieka_zgoda3\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"opieka_zgoda3\"><option value=\"nie dotyczy\">nie dotyczy<\/option><option value=\"b\u0119d\u0119 korzysta\u0107 z 2 dni p\u0142atnego zwolnienia od pracy w roku kalendarzowym z zachowaniem prawa do wynagrodzenia (art. 188 Kodeksu pracy)\">b\u0119d\u0119 korzysta\u0107 z 2 dni p\u0142atnego zwolnienia od pracy w roku kalendarzowym z zachowaniem prawa do wynagrodzenia (art. 188 Kodeksu pracy)<\/option><option value=\"b\u0119d\u0119 korzysta\u0107 z 1 dni p\u0142atnego zwolnienia od pracy w roku kalendarzowym z zachowaniem prawa do wynagrodzenia (art. 188 Kodeksu pracy)\">b\u0119d\u0119 korzysta\u0107 z 1 dni p\u0142atnego zwolnienia od pracy w roku kalendarzowym z zachowaniem prawa do wynagrodzenia (art. 188 Kodeksu pracy)<\/option><\/select><\/span>\n<\/p>\n<p>______________\n<\/p>\n<p>VII. Zg\u0142oszenie cz\u0142onk\u00f3w rodziny do NFZ<br \/>\n___<br \/>\nOsoba 1:<br \/>\n<label> Imi\u0119 i nazwisko<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"czlonek1\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"czlonek1\" \/><\/span> <\/label><br \/>\n<label> PESEL<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"PESEL1\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"PESEL1\" \/><\/span> <\/label><br \/>\n<label> Stopie\u0144 pokrewie\u0144stwa<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"pokrewienstwo1\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"pokrewienstwo1\"><option value=\"\"><\/option><option value=\"ma\u0142\u017conek\">ma\u0142\u017conek<\/option><option value=\"dziecko\">dziecko<\/option><option value=\"wnuk\">wnuk<\/option><option value=\"matka\">matka<\/option><option value=\"ojciec\">ojciec<\/option><option value=\"macocha\">macocha<\/option><option value=\"ojczym\">ojczym<\/option><option value=\"babka\">babka<\/option><option value=\"dziadek\">dziadek<\/option><option value=\"osoba przysposabiaj\u0105ca\">osoba przysposabiaj\u0105ca<\/option><option value=\"inni krewni\">inni krewni<\/option><\/select><\/span><br \/>\n<label> Stopie\u0144 niepe\u0142nosprawno\u015bci <\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"niepelnosprawnosc1\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"niepelnosprawnosc1\"><option value=\"\"><\/option><option value=\"brak\">brak<\/option><option value=\"lekki\">lekki<\/option><option value=\"umiarkowany\">umiarkowany<\/option><option value=\"znaczny\">znaczny<\/option><option value=\"osoba niepe\u0142nosprawna do 16 roku \u017cycia\">osoba niepe\u0142nosprawna do 16 roku \u017cycia<\/option><\/select><\/span>\n<\/p>\n<p>___<br \/>\nOsoba 2:<br \/>\n<label> Imi\u0119 i nazwisko<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"czlonek2\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"czlonek2\" \/><\/span> <\/label><br \/>\n<label> PESEL<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"PESEL2\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"PESEL2\" \/><\/span> <\/label><br \/>\n<label> Stopie\u0144 pokrewie\u0144stwa<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"pokrewienstwo2\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"pokrewienstwo2\"><option value=\"\"><\/option><option value=\"ma\u0142\u017conek\">ma\u0142\u017conek<\/option><option value=\"dziecko\">dziecko<\/option><option value=\"wnuk\">wnuk<\/option><option value=\"matka\">matka<\/option><option value=\"ojciec\">ojciec<\/option><option value=\"macocha\">macocha<\/option><option value=\"ojczym\">ojczym<\/option><option value=\"babka\">babka<\/option><option value=\"dziadek\">dziadek<\/option><option value=\"osoba przysposabiaj\u0105ca\">osoba przysposabiaj\u0105ca<\/option><option value=\"inni krewni\">inni krewni<\/option><\/select><\/span><br \/>\n<label> Stopie\u0144 niepe\u0142nosprawno\u015bci <\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"niepelnosprawnosc2\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"niepelnosprawnosc2\"><option value=\"\"><\/option><option value=\"brak\">brak<\/option><option value=\"lekki\">lekki<\/option><option value=\"umiarkowany\">umiarkowany<\/option><option value=\"znaczny\">znaczny<\/option><option value=\"osoba niepe\u0142nosprawna do 16 roku \u017cycia\">osoba niepe\u0142nosprawna do 16 roku \u017cycia<\/option><\/select><\/span><br \/>\n___<br \/>\nOsoba 3:<br \/>\n<label> Imi\u0119 i nazwisko<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"czlonek3\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"czlonek3\" \/><\/span> <\/label><br \/>\n<label> PESEL<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"PESEL3\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"PESEL3\" \/><\/span> <\/label><br \/>\n<label> Stopie\u0144 pokrewie\u0144stwa<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"pokrewienstwo3\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"pokrewienstwo3\"><option value=\"\"><\/option><option value=\"ma\u0142\u017conek\">ma\u0142\u017conek<\/option><option value=\"dziecko\">dziecko<\/option><option value=\"wnuk\">wnuk<\/option><option value=\"matka\">matka<\/option><option value=\"ojciec\">ojciec<\/option><option value=\"macocha\">macocha<\/option><option value=\"ojczym\">ojczym<\/option><option value=\"babka\">babka<\/option><option value=\"dziadek\">dziadek<\/option><option value=\"osoba przysposabiaj\u0105ca\">osoba przysposabiaj\u0105ca<\/option><option value=\"inni krewni\">inni krewni<\/option><\/select><\/span><br \/>\n<label> Stopie\u0144 niepe\u0142nosprawno\u015bci <\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"niepelnosprawnosc3\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"niepelnosprawnosc3\"><option value=\"\"><\/option><option value=\"brak\">brak<\/option><option value=\"lekki\">lekki<\/option><option value=\"umiarkowany\">umiarkowany<\/option><option value=\"znaczny\">znaczny<\/option><option value=\"osoba niepe\u0142nosprawna do 16 roku \u017cycia\">osoba niepe\u0142nosprawna do 16 roku \u017cycia<\/option><\/select><\/span><br \/>\n___<br \/>\nOsoba 4:<br \/>\n<label> Imi\u0119 i nazwisko<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"czlonek4\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"czlonek4\" \/><\/span> <\/label><br \/>\n<label> PESEL<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"PESEL4\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"PESEL4\" \/><\/span> <\/label><br \/>\n<label> Stopie\u0144 pokrewie\u0144stwa<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"pokrewienstwo4\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"pokrewienstwo4\"><option value=\"\"><\/option><option value=\"ma\u0142\u017conek\">ma\u0142\u017conek<\/option><option value=\"dziecko\">dziecko<\/option><option value=\"wnuk\">wnuk<\/option><option value=\"matka\">matka<\/option><option value=\"ojciec\">ojciec<\/option><option value=\"macocha\">macocha<\/option><option value=\"ojczym\">ojczym<\/option><option value=\"babka\">babka<\/option><option value=\"dziadek\">dziadek<\/option><option value=\"osoba przysposabiaj\u0105ca\">osoba przysposabiaj\u0105ca<\/option><option value=\"inni krewni\">inni krewni<\/option><\/select><\/span><br \/>\n<label> Stopie\u0144 niepe\u0142nosprawno\u015bci <\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"niepelnosprawnosc4\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"niepelnosprawnosc4\"><option value=\"\"><\/option><option value=\"brak\">brak<\/option><option value=\"lekki\">lekki<\/option><option value=\"umiarkowany\">umiarkowany<\/option><option value=\"znaczny\">znaczny<\/option><option value=\"osoba niepe\u0142nosprawna do 16 roku \u017cycia\">osoba niepe\u0142nosprawna do 16 roku \u017cycia<\/option><\/select><\/span><br \/>\n___<br \/>\nOsoba 5:<br \/>\n<label> Imi\u0119 i nazwisko<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"czlonek5\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"czlonek5\" \/><\/span> <\/label><br \/>\n<label> PESEL<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"PESEL5\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"PESEL5\" \/><\/span> <\/label><br \/>\n<label> Stopie\u0144 pokrewie\u0144stwa<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"pokrewienstwo5\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"pokrewienstwo5\"><option value=\"\"><\/option><option value=\"ma\u0142\u017conek\">ma\u0142\u017conek<\/option><option value=\"dziecko\">dziecko<\/option><option value=\"wnuk\">wnuk<\/option><option value=\"matka\">matka<\/option><option value=\"ojciec\">ojciec<\/option><option value=\"macocha\">macocha<\/option><option value=\"ojczym\">ojczym<\/option><option value=\"babka\">babka<\/option><option value=\"dziadek\">dziadek<\/option><option value=\"osoba przysposabiaj\u0105ca\">osoba przysposabiaj\u0105ca<\/option><option value=\"inni krewni\">inni krewni<\/option><\/select><\/span><br \/>\n<label> Stopie\u0144 niepe\u0142nosprawno\u015bci <\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"niepelnosprawnosc5\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"niepelnosprawnosc5\"><option value=\"\"><\/option><option value=\"brak\">brak<\/option><option value=\"lekki\">lekki<\/option><option value=\"umiarkowany\">umiarkowany<\/option><option value=\"znaczny\">znaczny<\/option><option value=\"osoba niepe\u0142nosprawna do 16 roku \u017cycia\">osoba niepe\u0142nosprawna do 16 roku \u017cycia<\/option><\/select><\/span>\n<\/p>\n<p>______________<br \/>\nVIII.\tZgody*\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-285\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"checkbox-285[]\" value=\"Wyra\u017cam zgod\u0119 na przetwarzanie powy\u017cszych danych \u2013 obecnie i w przysz\u0142o\u015bci w celach podatkowych, ubezpieczeniowych i ewidencyjnych przez zleceniodawc\u0119\/zamawiaj\u0105cego.\" \/><span class=\"wpcf7-list-item-label\">Wyra\u017cam zgod\u0119 na przetwarzanie powy\u017cszych danych \u2013 obecnie i w przysz\u0142o\u015bci w celach podatkowych, ubezpieczeniowych i ewidencyjnych przez zleceniodawc\u0119\/zamawiaj\u0105cego.<\/span><\/label><\/span><\/span><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-286\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"checkbox-286[]\" value=\"Wyra\u017cam zgod\u0119, na kontaktowanie si\u0119 ze mn\u0105 drog\u0105 telefoniczn\u0105 oraz\/lub mailow\u0105 w sprawach zwi\u0105zanych za umow\u0105, rozliczeniami oraz podatkami.\" \/><span class=\"wpcf7-list-item-label\">Wyra\u017cam zgod\u0119, na kontaktowanie si\u0119 ze mn\u0105 drog\u0105 telefoniczn\u0105 oraz\/lub mailow\u0105 w sprawach zwi\u0105zanych za umow\u0105, rozliczeniami oraz podatkami.<\/span><\/label><\/span><\/span><\/span><br \/>\n______________<br \/>\nIX.\tDodatkowe<br \/>\n<label> uwagi (opcjonalne)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"your-message\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> za\u0142\u0105czniki (\u015bwiadectwa pracy, dyplomy itp.)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"file-77\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" accept=\"audio\/*,video\/*,image\/*\" aria-invalid=\"false\" type=\"file\" name=\"file-77\" \/><\/span> <\/label>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Wy\u015blij\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1117","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/aw.hr.sos.pl\/index.php?rest_route=\/wp\/v2\/pages\/1117","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/aw.hr.sos.pl\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/aw.hr.sos.pl\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/aw.hr.sos.pl\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/aw.hr.sos.pl\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1117"}],"version-history":[{"count":2,"href":"https:\/\/aw.hr.sos.pl\/index.php?rest_route=\/wp\/v2\/pages\/1117\/revisions"}],"predecessor-version":[{"id":1123,"href":"https:\/\/aw.hr.sos.pl\/index.php?rest_route=\/wp\/v2\/pages\/1117\/revisions\/1123"}],"wp:attachment":[{"href":"https:\/\/aw.hr.sos.pl\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1117"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}