Change of temporary residence and work permit
Official application to change the permit. File it on paper with the voivode, in person or by post. Check your voivode office's page first.
You get the official PDF with your answers in its boxes, ready to print and sign by hand.
About the form
- Official name
- Wniosek o zmianę zezwolenia na pobyt czasowy i pracę
- Published by
- Minister Spraw Wewnętrznych i Administracji
- Form and legal basis
- Dz.U. 2026 poz. 464
- Pages
- 10
- Official source
- api.sejm.gov.pl
- Copy used here
- taken on 4 November 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.
- You can ask for a change at any time when you plan to work for another employer, another user employer or on terms other than those in the permit.art. 120 ust. 1, art. 120 ust. 1 pkt 1-3 ustawy o cudzoziemcach
- Apply to the voivode of the place where you stay now.art. 120 ust. 1 ustawy o cudzoziemcach
- Attach the annex filled in by the new employer and documents that confirm the data in the application and the reason for the change.art. 120a ust. 2 ustawy o cudzoziemcach
- A change does not extend the permit. With a new employer the voivode refuses if you did not report the job loss in time or the new job is shorter than the permit.art. 120 ust. 3, art. 120 ust. 4 pkt 5-6 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.
- Date of submission
- Authority the application is addressed to
- Surname
- Previous surnames
- Family name at birth
- Given name(s)
- Previous given name(s)
- Date of birth
- Sex
- Place of birth
- Country of birth
- Citizenship(s)
Show 90 more
- Education
- PESEL number (if issued)
- Phone number
- E-mail address
- Address in the country of origin: country
- Address in the country of origin: voivodeship / region / province / state
- Address in the country of origin: district / county / region
- Address in the country of origin: municipality (gmina)
- Address in the country of origin: town
- Address in the country of origin: street
- Address in the country of origin: house number
- Address in the country of origin: flat number
- Address in the country of origin: postal code
- Address in the previous country of residence: country
- Address in the previous country of residence: voivodeship / region / province / state
- Address in the previous country of residence: district / county / region
- Address in the previous country of residence: municipality (gmina)
- Address in the previous country of residence: town
- Address in the previous country of residence: street
- Address in the previous country of residence: house number
- Address in the previous country of residence: flat number
- Address in the previous country of residence: postal code
- Decision number (permit being amended)
- Permit being amended: issue date
- Permit being amended: expiry date
- Entity entrusting the work named in the permit being amended
- End of work for the previous entity
- Which voivode was notified
- Place of residence in Poland: voivodeship
- Place of residence in Poland: district / county / region
- Place of residence in Poland: municipality (gmina)
- Place of residence in Poland: town
- Place of residence in Poland: street
- Place of residence in Poland: house number
- Place of residence in Poland: flat number
- Place of residence in Poland: postal code
- Family member 1: name and surname
- Family member 1: sex
- Family member 1: date of birth (DD.MM.YYYY)
- Family member 1: degree of kinship
- Family member 1: citizenship
- Family member 1: place of residence
- Family member 1: applying for a temporary residence permit
- Family member 1: dependent on the foreigner
- Family member 2: name and surname
- Family member 2: sex
- Family member 2: date of birth (DD.MM.YYYY)
- Family member 2: degree of kinship
- Family member 2: citizenship
- Family member 2: place of residence
- Family member 2: applying for a temporary residence permit
- Family member 2: dependent on the foreigner
- Family member 3: name and surname
- Family member 3: sex
- Family member 3: date of birth (DD.MM.YYYY)
- Family member 3: degree of kinship
- Family member 3: citizenship
- Family member 3: place of residence
- Family member 3: applying for a temporary residence permit
- Family member 3: dependent on the foreigner
- Family member 4: name and surname
- Family member 4: sex
- Family member 4: date of birth (DD.MM.YYYY)
- Family member 4: degree of kinship
- Family member 4: citizenship
- Family member 4: place of residence
- Family member 4: applying for a temporary residence permit
- Family member 4: dependent on the foreigner
- Family member 5: name and surname
- Family member 5: sex
- Family member 5: date of birth (DD.MM.YYYY)
- Family member 5: degree of kinship
- Family member 5: citizenship
- Family member 5: place of residence
- Family member 5: applying for a temporary residence permit
- Family member 5: dependent on the foreigner
- Health insurance
- When, for what act, what sentence and whether it was executed
- Which proceedings
- Signing date
- Attachment 1
- Attachment 2
- Attachment 3
- Attachment 4
- Attachment 5
- Attachment 6
- Attachment 7
- Attachment 8
- Attachment 9
- Attachment 10
Example situations
Fictional people. When filling in the form, pick one to see a completed example, then replace the answers with yours.
New employer, notice in this application
The applicant has left his previous employer and uses this application to notify the voivode of the job loss.
New position, same employer
The applicant stays with the same employer and is promoted to shift leader.
New employer, voivode notified earlier
The applicant moves to a new employer after notifying the voivode of the job loss separately; his wife lives with him in Poland.
Same employer, new terms
The applicant stays with her employer but changes working hours and the type of contract; her two children live with her.
Agency worker, new user employer
A temporary-agency worker moves to a different user employer, and no job-loss notice is due when he applies.
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
- Notice of job loss
- Polish travel document for a foreigner
- Invitation register application
- Temporary identity certificate for a foreigner (TZTC)