Notice of job loss
Tell the voivode within 15 working days that you lost the job covered by your temporary residence and work permit. Not needed if you applied to change the permit within that time.
You get the official PDF with your answers in its boxes, ready to print and sign by hand.
About the form
- Official name
- Informacja o utracie pracy przez cudzoziemca posiadającego ważne zezwolenie na pobyt czasowy i pracę
- Published by
- Urząd do Spraw Cudzoziemców
- Form and legal basis
- F-03/KIU-230 (29.01.2022)
- Pages
- 2
- Official source
- www.gov.pl
- Copy used here
- taken on 4 October 2026, checked against the source every day
The official blank
The same file as on the official source, to print and fill in by hand.
How to file it
What the law says about filing, each point with the passage it rests on. These sources are checked every day.
- If you hold a temporary residence and work permit, report in writing within 15 working days that you lost work with any employer named in the permit.art. 121 ust. 1 ustawy o cudzoziemcach
- Send the notice to the voivode who granted the permit. If the Head of the Office for Foreigners granted it on appeal, send it to the voivode who decided the case first.art. 121 ust. 2 ustawy o cudzoziemcach
- You need not send the notice if within those 15 working days you apply to change the temporary residence and work permit.art. 121 ust. 3 ustawy o cudzoziemcach
- If you report in time, for 30 days after losing the job the permit is not withdrawn because the purpose of your stay ended. This works only once while the permit is valid.art. 123 ust. 1, art. 123 ust. 1 pkt 1, art. 123 ust. 2, art. 101 pkt 1 ustawy o cudzoziemcach
Updated on 7 November 2026. Rules and office practice change: check with your office yourself before you go.
What the form asks for
The questions in your language, as the site asks them. The printed form stays in Polish.
- Full name
- Place of writing
- Date of writing
- Date of birth
- Residence card number
- Phone number
- Date of job loss
- Employer where the job was lost
- Address for correspondence: street and number
- Address for correspondence: postal code
- Address for correspondence: town
- Additional information
Example situations
Fictional people. When filling in the form, pick one to see a completed example, then replace the answers with yours.
Fixed-term contract ended
A man's fixed-term contract simply ended; the optional note is left empty.
Ended by mutual agreement
A man ended his employment contract by mutual agreement and is looking for work as an accountant.
Dismissed, new offer found
A woman was dismissed by her employer and already has an offer from a new one.
Employer closed the business
A man lost his job because his employer closed down, and he is looking for work in the same trade.
Dismissed during probation
A woman's employer ended her probation period contract early, and she is looking for a new job.
This site is not connected to any office. The office decides on your case, so check with it which documents and attachments it needs before you go.
Other forms
- PESEL number application
- PESEL with the UKR status
- Temporary residence registration
- Permanent residence registration
- Temporary residence deregistration
- Permanent residence deregistration
- Residence card: new card or replacement
- Report a lost or damaged document
- Schengen visa extension
- National visa extension
- Register your stay as an EU citizen
- Notice of leaving Poland
- Notice of return to Poland
- Driving licence: apply or exchange
- Change of temporary residence and work permit
- Polish travel document for a foreigner
- Invitation register application
- Temporary identity certificate for a foreigner (TZTC)