< > | < >
 
Form to be completed by employee only:
 
Name *
 
Surname *
 
PESEL *
 
 
 
 
Sex *
 
 
Date of birth *
--
 
Place of birth *
 
E-mail *
 
Telephone No. *
 
Branch - select the one where you have signed your employment contract *
 
WYBRANE POLISY
Polisa1
Polisa2
Polisa3
Polisa4
Polisa5
Polisa6
 
Value1
Polisa_1
Polisa_2
Polisa_3
Polisa_4
Polisa_5
Polisa_6
 
Value2
Polisa_x1
Polisa_x2
Polisa_x3
Polisa_x4
Polisa_x5
Polisa_x6
 
Value3
Polisa_y1
Polisa_y2
Polisa_y3
Polisa_y4
Polisa_y5
Polisa_y6
 
 
 
 
 
 
 
 
 
 
 

To the extent that the processing of your personal data is based on consent, you have the right to withdraw this consent. You can withdraw your consent at any time in the branch or by sending an e-mail to: kontakt@pzu.pl or a letter to PZU, ul. Postępu 18a, 02-676 Warszawa, Poland. The withdrawal of consent does not affect the legality of the processing carried out on the basis of consent before its withdrawal.


 
 
 
 
 
 
 
 
 
 
 

 
 
 
 
SEND
 
 
 

Wystąpił błąd podczas generowania wydruku. Proszę spróbuj ponownie.

Nie można wygenerować wydruku - element został usunięty.