Zakład Ubezpieczeń Społecznych — Social Insurance Institution of Poland (ZUS) Edition Z-3, ZUS file of February 2026 (printing order 561/26(E)) 8 pages

ZUS Z-3 — Employer's certificate for sickness and maternity benefits (Poland)

The certificate a Polish employer gives ZUS so it can decide and calculate an employee's sickness benefit, care allowance, maternity benefit or rehabilitation benefit.

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ZUS Z-3 employer's certificate for sickness and maternity benefits · Zaświadczenie płatnika składek (Z-3)
The official Zakład Ubezpieczeń Społecznych — Social Insurance Institution of Poland (ZUS) form, edition Z-3, ZUS file of February 2026 (printing order 561/26(E)) — blank
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ZUS Z-3 employer's certificate for sickness and maternity benefits (2026) Zaświadczenie płatnika składek (Z-3) — page 1 of 8
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ZUS Z-3 employer's certificate for sickness and maternity benefits (2026) Zaświadczenie płatnika składek (Z-3) — page 2 of 8
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ZUS Z-3 employer's certificate for sickness and maternity benefits (2026) Zaświadczenie płatnika składek (Z-3) — page 5 of 8
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ZUS Z-3 employer's certificate for sickness and maternity benefits (2026) Zaświadczenie płatnika składek (Z-3) — page 6 of 8
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What is ZUS Z-3 employer's certificate for sickness and maternity benefits?

Z-3 (Zaświadczenie płatnika składek) is the certificate an employer fills in when ZUS has to establish an employee's right to sickness benefit, care allowance, maternity benefit, a benefit equal to maternity benefit, compensatory benefit or rehabilitation benefit. The form's instructions say that during employment the employer submits the benefit claim for the employee, and for the first medical certificate the Z-3 is itself that claim.

It covers your business, the employee and their address and bank account, the benefits claimed and for which periods, employment details (working time, temporary work, work abroad, accidents at work, unpaid or parental leave), benefits you have already paid, and the pay tables: monthly pay for the 12 calendar months before the incapacity began, plus quarterly, yearly and other-period components, which set the benefit's basis.

FileIt guides you through each part, checks PESEL, NIP, REGON and account numbers, checks that the days worked don't exceed the days due, and prints your answers into ZUS's own PDF, in capitals where the form asks. The certificate is saved in your FileIt vault. FileIt never submits anything to ZUS.

Who fills it
The employer (payer of contributions)
Sent to
ZUS
Deadline
7 days from receiving the medical certificate on PUE/eZUS, or from receiving an alternative-mode paper certificate from the employee
Signatures
An authorised person, with a stamp giving name, surname and position
Edition
ZUS file of February 2026 (printing order 561/26)
Continuation claim
Point 1 and point 5 of 'About the employee' only, or form ZAS-12

Who needs to fill out ZUS Z-3 employer's certificate for sickness and maternity benefits?

  • Employers that reported 20 or fewer people for sickness insurance, whose employees' benefits ZUS pays.
  • Any employer when a benefit is claimed after the employee's job has ended.
  • Payroll and HR staff preparing sick-leave, care-allowance or maternity claims for ZUS.

When to use ZUS Z-3 employer's certificate for sickness and maternity benefits

  • When ZUS has to establish an employee's right to a sickness, care, maternity, compensatory or rehabilitation benefit.
  • For a further uninterrupted period of illness or care (a shorter continuation certificate, or ZAS-12).
  • Again when the kind of benefit the employee receives changes, except rehabilitation benefit after a sickness-benefit Z-3.

What you need before you start

  • Your NIP (or REGON, PESEL or identity document), name and address.
  • The employee's PESEL, name, address and, optionally, bank account.
  • The benefit periods and the medical certificates' series and numbers.
  • The employment start date, working time and the date that working time began.
  • Details of any accident at work or occupational disease, unpaid or parental leave, and maternity or parental leave granted.
  • Sick pay and benefits you paid this year, and the number of people you report for sickness insurance.
  • Payroll records: gross pay for each of the last 12 months, days worked and due, and the percentage of contributions deducted.

What’s on ZUS Z-3 employer's certificate for sickness and maternity benefits

The 2026 edition has 8 pages. FileIt asks for it in 13 parts, and it is signed by Employer:

  1. Type of certificateEmployer
  2. Your business — payer of contributions (Dane płatnika składek)Employer
  3. The employee (Dane osoby ubezpieczonej)Employer
  4. The employee claims (Pracownik występuje o)Employer
  5. About the employee (Informacje o pracowniku)Employer
  6. Maternity and parental leave (points 6 and 7)Employer
  7. Benefits you have paid (Informacje o wypłaconych świadczeniach)Employer
  8. Pay for monthly periods (Składniki wynagrodzenia za okresy miesięczne)Employer
  9. Pay for quarterly periods (Składniki wynagrodzenia za okresy kwartalne)Employer
  10. Pay for yearly periods (Składniki wynagrodzenia za okresy roczne)Employer
  11. Pay for other periods (Składniki wynagrodzenia za inne okresy)Employer
  12. Civil contracts and time-limited pay (point 5)Employer
  13. Remarks and signature (Uwagi, Podpis)Employer

How to fill out ZUS Z-3 employer's certificate for sickness and maternity benefits, step by step

1 Type of certificate and your business

Tick a first claim or a continuation, then give your NIP (or REGON, PESEL or identity document), name, address and phone.

2 The employee and the claim

The employee's PESEL, name, address and optional bank account, then each benefit claimed with its period and, for sickness or care, the medical certificate's series and number.

3 About the employee

Employment start (or period), working time and since when, temporary work, work abroad, whether the incapacity comes from an occupational disease or an accident (with the document), and whether the employee is on unpaid, parental or carer's leave, in detention or in prison during the incapacity. For maternity benefit, the leave granted and any work during parental leave.

4 Benefits paid and other information

Sick pay (art. 92 of the Labour Code), sickness or rehabilitation benefit and maternity benefit you paid, with periods and codes, and whether you report up to 20 or more than 20 insured people.

5 Pay tables

Monthly pay for the 12 months before the incapacity, split into fixed pay (column 6), variable pay reduced proportionally (column 7) and components paid in the actual amount (column 8), with days worked and due and the percentage of contributions deducted. Add quarterly, yearly and other-period components if there are any.

6 Civil contracts, remarks and signature

Any contract of mandate or similar with the employee (or a time-limited pay component) with monthly amounts, remarks such as a previous working time, then the date and the authorised person's signature and stamp.

Common mistakes to avoid

  • Giving pay after deducting social insurance contributions. The tables need amounts before those deductions.
  • Including components the employee keeps during the benefit, or one-off payments that don't count towards the basis.
  • Not using full calendar months after a change of working time, or not noting the previous working time in the remarks.
  • Missing the 7-day deadline after receiving the medical certificate.
  • Filling in the whole form for a continuation, when point 1 and point 5 (or ZAS-12) are enough.

After you fill it out

Print the certificate, have an authorised person sign it and add your stamp with their name, surname and position. Send it to ZUS with the documents you received from the employee. FileIt does not submit anything; ZUS's electronic route is its PUE/eZUS platform.

Tell ZUS about changes that affect the benefit, especially the end of employment, or an employee on parental leave taking up work of no more than half-time.

A copy stays in your FileIt vault, so the pay tables are easy to reuse for the next claim.

Fill out ZUS Z-3 employer's certificate for sickness and maternity benefits online with FileIt

  1. Pick the person. Choose someone from People and FileIt fills in their name, date of birth, address and other details it already knows.
  2. Answer plain-language questions. One part of the form at a time, with the official help text beside each question — 263 fields in all. Your answers save as you go.
  3. Check the live preview. Watch your answers land on the real Zakład Ubezpieczeń Społecznych — Social Insurance Institution of Poland (ZUS) form, and let FileIt do any worksheet arithmetic.
  4. Generate the official PDF. FileIt prints your answers into the agency’s own PDF and files it in that person’s folder in your vault. Sign it, or send it for e-signature.

FileIt fills the form — it never files or submits anything for you. Deliver the finished form to whoever asked for it, the way the form’s instructions say.

Start ZUS Z-3 employer's certificate for sickness and maternity benefits now — it’s free

ZUS Z-3 employer's certificate for sickness and maternity benefits: frequently asked questions

Who counts the 20 insured people?

The form's instructions say the number of insured is taken as on 30 November of the previous calendar year, or, if you reported nobody for sickness insurance then, in the first month you did.

Which 12 months go in the monthly table?

According to the instructions, the 12 calendar months before the month in which the uninterrupted incapacity began. If the employee received a benefit or sick pay with a break of less than one calendar month, use the months before the earliest incapacity.

What percentage of contributions do I enter?

The percentage of social insurance contributions deducted from the employee. The instructions explain how to calculate an average rate for a month in which pay passed the yearly cap on pension and disability contributions.

Is there a shorter version for further sick leave?

Yes. For a further uninterrupted period, the Z-3 filled in up to point 1 and point 5 of 'About the employee', or form ZAS-12, is the claim.

Does FileIt calculate the benefit?

No. FileIt checks the identifiers and that the tables are consistent. ZUS calculates the benefit.

Official sources

FileIt is not affiliated with or endorsed by Zakład Ubezpieczeń Społecznych — Social Insurance Institution of Poland (ZUS) or any government. This page explains the form in general terms and is not legal, tax or immigration advice. Always read the official instructions, and check that you are using the edition the recipient accepts. Page last reviewed 2026-09-28.

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