Employee State Insurance Forms
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Employee State Insurance Forms

In this post we discuss the ESI forms for employer and employee.

The Employee State Insurance (ESI) Act, 1948 consists of certain health related eventualities of employment such as sickness, temporary or permanent disablement, maternity, occupational diseases and death due to the employment injury which may lead to partial or total earning capacity. 

The Act has made provisions to counterbalance such financial distress or physical distress by providing medical and financial support to insured persons and their families. 

The ESI scheme is administered by Employees State Insurance Corporation (ESIC), an autonomous body under the Central Government of India, and is governed by the Ministry of Labour and Employment, Government of India. 

There are several forms for employer and employee for several purposes. We will look at them in this post.

If you want to know more details about ESI, Visit – ESI (Employee State Insurance)

For employers

There are the various forms for employers –  

Form 01Employers’ Registration Form
Form01AAnnual information of factory/establishment submission form
Form3Return of Declaration forms
Form 5Return of contributions
Form 5aStatement of advance payment of contributions
Form 6Register of employees
Form 10Abstention verification

Form 12

Accident Register

Accident Report

For employees

There are various forms for employee –

FORM-1Declaration Form
Form-2Addition / Deletion in Family declaration form
Form 9Claim form for sickness /TDB/ Maternity
Form 14Claim form for Permanent disablement benefit (PDB)
Form 15Claim form for Permanent disablement benefit (PDB)
Form 16Claim form for periodical payments of DB
Form 19Claim for Maternity benefit and notice of work
Form 20Claim form for Maternity benefit after death of child
Form 22Claim form for Funeral Expenses
Form 23Life certificate
Form 24Dependent benefits declaration

Related Post:

ESI registration procedure

PF ESI Deductions Rules

ESI Insurance Scheme

ESI Rules and Obligation for Employer

Required documents

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