Posted on 02nd Aug 2018 | 3980 views

4 avg. rating (80% score) - 1 votes

Esic Forms

Employee state insurance corporation(ESIC) is a body under the ministry of labor and employment, the government of India.ESIC has implemented ESI employee state insurance scheme for Indian workers/ employees this scheme provides various benefits for the working class in India such as medical and monetary.other benefits. Any establishment having 10 or more employees or 20 in some state with their wage more than 1000rs must register itself with ESIC. Under the employee insurance scheme the employee, as well as the employer, need to contribute a certain percentage to ESIC to avail the benefits.

ESIC card form

Contributions towards the ESI

● In case of an employer, 4.75% must be contributed by the employer out of total monthly salary payable to the employee

● In case of an employee, 1.75 % must be contributed from his/her monthly salary or wage

These contributions will be deposited by the employer towards ESI my 21st day of the next month and the Benefits covered by ESi are:

a. Sickness benefit of 70% in case any officially certified illness

b. Medical benefits to employees family

c. Maternity benefit to the female employee (paid leaves)

d. In the event of death employee while in service 90% of his/her salary will be given to a dependent on the employee

e. Funeral expenses

f. Old age care medical expenses

Type of companies come under ESi are

● Shops

● Private education institutes

● Cinemas

● Road transports

● Newspaper companies

The documents required for the registration are

● registration certificate provided under Factories Act, Shops, and Establishment Act

● Certificate of Registration Company

● Association of the Company Memorandum

● employees list working in the organization


● details of all the employee's salary record

● canceled cheque

● Bank Account of the establishment

● Directors of the Company names

● Shareholders list

● register with attendance of the employees

All documents are mandatory

Form No – 1 (Employers Registration Form) for registering to ESI

It is available in ESIC website and it should be downloaded and filled must be submitted through the website

after verification, the registered member will provide with providing 17 digits unique number

an employee under ESI scheme must provide this filled form and passport photos of his/her family as part of the registration to the employer

if any changes are needed it should intimate by the company to the ESIC

ESIC Forms

Esic forms under The Employees’ State Insurance Act, 1948

● FORM72

● Form-23 Life Certificate for Permanent Disablement Benefit

● Form-24 Declaration and Certificate for DB

● Form-22 Funeral Expenses Claim

● Form-20 Claim for Maternity Benefit after the death of an IP

● Form-19 Claim for Maternity Benefit and Notice of Work

● Form-16 Claim for Periodical Payment of DB

● Form-15 Claim for Dependent Benefit

● Form-14 Claim for Permanent Disablement Benefit

● Form-12 Accident Report from Employer

● Form-11 Accident Book

● Form-9 Claim for Sickness-TDB-MB

● Form-6 Register of Employees

● Form-5(A) Advance Payment of Contribution

● Form-5 Return of Contributions

● Form-3 Return of Declaration Form

● Form-2 Addition-Deletion in Family Declaration Form

● Form-1 Declaration Form

● Form-01 Employer’s Registration Form

● Form 1(A) Family Declaration Form


● ESIC-142 Claim for Conveyance Allowance and Compensation for loss of wages

● ESIC-105 Certificate of Entitlement

● ESIC-86 Certificate of Employment

● ESIC-71 Particulars of contribution in case of RC in respect of an IP

● ESIC-63 Declaration form regarding payment to the legal heir

● ESIC-53 Application for change in particulars of IPs

● ESIC-37 Certificate of Re-employment-Continuous employment

● ESIC-32 Wage-Contributory Record for DB

ESIC Downloadable Forms

1.FORM-1 - Declaration Forms

2.FORM NO. 3 Return of Declaration Form (Regulation 14)

3.FORM NO. ESIC-MED 37 Certificate of Re-employment, Continuing employment


5.FORM NO. 12 (Regulation 68) Accident Report Form

These forms can be downloaded www.labourlawindia.com

ESIC card form

ESIC card form

ESIC card form

0 Comments on WHAT IS ESI FORM?

Comment as a guest:

All rights reserved © 2020 Wisdom IT Services India Pvt. Ltd DMCA.com Protection Status