



What information is needed to issue an L-4 exemption?
May 9, 2015
If it is necessary to justify an employee's temporary incapacity to work (caused by illness or the need to provide care to a sick family member), a certificate will be issued on the ZUS ZLA form.
In order for such a certificate, i.e. sick leave, to be valid, it is necessary to provide the following data on the ZUS ZLA form:
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by the person issuing the ZLA:
– name and surname of the insured person,
– the address where he/she will stay during the period of sick leave,
– date of discharge, medical indications and discharge letter code,
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by patient:
– PESEL number of the insured person (or passport series and number if no PESEL number has been assigned),
– Tax Identification Number of the employer.
If you are employed by more than one company, it will be necessary to issue a separate certificate for each employer, i.e. provide the Tax Identification Number (NIP) of each contribution payer.
The ZUS ZLA form is intended for employees in an employment relationship. Individuals employed under other forms of employment do not receive such a form. Those insured with the Agricultural Social Insurance Fund (KRUS) may apply for sickness benefits based on a medical certificate of temporary incapacity for work due to illness, issued on the ZUS ZLA form. This benefit is payable for each day of incapacity for work lasting at least 30 consecutive days, but no longer than 180 days.
Residents of Kiełczów and the entire Długołęka Commune will soon have access to a new clinic in the NZOZ Twój Lekarz network. The facility at 11/18 Mleczna Street will open on Wednesday, April 22nd, and from that date, it will accept patients under the National Health Fund's Primary Health Care and Coordinated Care programs.
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In our work, we are guided by the idea of a family doctor who provides the patient with comprehensive care at all times, not only when they are ill. Our mission is to take care of the health of residents on a daily basis. We provide health education and promote prevention.
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