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Filling in the fields marked with "*" is mandatory.

The application, duly executed and filed under the established procedure, is subject to compulsory acceptance and review. Application made without observing the above requirements and/or filed in violation of the procedure established by the law shall be returned to the applicant with the relevant explanations no later than ten days after the day of receiving it.

Written application not signed by the author (authors), as well as the application from which it is impossible to establish the authorship (including electronic application), is recognized as anonymous and is not subject to review.

We would like to draw your attention to the fact that filing the accurate information in the Application form is a necessary condition for the proper processing of your application by UNIQA IC, PjSC/UNIQA Life IC, PjSC in accordance with the current legislation.

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