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Bolt Food
Deligoo
Glovo
Jedz co chcesz
Stuart
Uber
Bolt Food
1. Application location
Voivodeship
City
2.Essential data
Personal details
Name
Middle name
Surname
Mother's name
Father's name
Family name
Date of birth
Birth place
Series and number of the ID / passport / residence card
PESEL (Personal Identity Number)
Telephone number
E-mail address
Place of residence
Voivodeship
District
Municipality
Location
Street
Building number
Flat number
Postal code
Post office
My place of residence is different from my home address
Place of living
Voivodeship
District
Municipality
Location
Street
Building number
Flat number
Postal code
Post office
My mailing address is different from my registered address
Mailing address
Voivodeship
District
Municipality
Location
Street
Building number
Flat number
Postal code
Post office
3.Bank account information
Name of the bank
Account number (IBAN)
Account holder name
4. Details of the tax office where you settled your finances
Name of the tax office
Tax office address
Voivodeship
District
Municipality
Location
Street
Building number
Flat number
Postal code
Post office
5. Details required for the contract
1) Polish tax resident
is a natural person (residing in Poland) who:
has a centre of personal or economic interests in the territory of the Republic of Poland, i.e. centre of life interests
or
resides in Poland for more than 183 days in the tax year, if 183 days have passed in a given year.
A natural person must meet only one of the two criteria listed above in order to be considered a Polish tax resident.
2) A non-resident
is a person who, within the meaning of the tax legislation, does not have a place of residence in Poland. In other words, a non-resident is a natural person who has a centre of personal interest abroad and is resides abroad.
Tax residency status
Choose your tax residency status
I have unlimited tax liability (I am a Polish tax resident)
I have limited tax liability (I am a Polish tax non-resident)
I am a resident of Poland because I stay in Poland more than 183 days in 2020)
I am a student up to 26 years old and have a valid student ID card
University's name
School card number
Scan of the certificate from the university (a scan of both sides of the student ID card is sufficient for the time of the epidemic)
Select a file from your computer
I am a student up to 26 years old and have a valid school card
School name
School card number
Scan of the certificate from the school (for the time of the epidemic, a scan of both sides of the school ID card is sufficient)
Select a file from your computer
I am employed under a contract of employment
Name of the company
For work, my gross monthly salary is
Select one
Lower than the amount of 2600 PLN
Equal or higher than 2600 PLN
Workplace address
Voivodeship
District
Municipality
Location
Street
Building number
Flat number
Postal code
Post office
I perform work on the basis of a contract of mandate covered by compulsory social insurance with another Principal
Name of the prinicipal
For work, my gross monthly salary is
Select one
Lower than the amount of 2600 PLN
Equal or higher than 2600 PLN
Date of social security coverage
I run a business
Type of business
Select one
Agricultural
Non-agricultural
I pay contributions on preferential terms as a New Enterpreneur
The subject of the civil-law contract concluded with the Principal falls within the scope of the conducted business activity
I'm currently on leave
Type of leave
Select one
Maternal education
Unpaid
I am a retiree based on the decision of the Social Insurance Institution (ZUS)
ZUS decision number (Social insurance number)
Date of the decision
I am a pensioner on the basis of the decision of the Social Insurance Institution (ZUS)
ZUS decision number (Social insurance number)
Date of the decision
I get a survivor's pension
Decision number
Date of the decision
I have a disability certificate
Type of disability
Select one
Mild
Moderate
Severe
Decision number
Date of the decision
6. Sign here
Remember!
To make your signature clear on the contract, use as much space as possible below. If the signature did not come out the first time, clear the pad with the button below.
Clear PAD
I declare that the signature signed above is authentic
If you want to make an order with Mivado sp. z o.o. cover you with voluntary sickness insurance, contact us to verify whether you can apply for voluntary sickness insurance.
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