ESI Forms

Relevant Forms under the ESI Act

  1. Form-01 – Employer’s Registration Form
  2. Form-1 – Declaration Form
  3. Form 1(A) – Family Declaration Form
  4. Application for duplicate ID Card
  5. Form-3 Return of Declaration Form
  6. Form-5 Return of Contributions (Half Yearly)
  7. Form-11 Accident Book
  8. Form-12 Accident Report from Employer
  9. Form-14 Claim for Permanent Disablement Benefit
  10. Form-15 Claim for Dependent Benefit
  11. Form-16 Claim for Periodical Payment of DB
  12. Form-19 Claim for Maternity Benefit and Notice of Work
  13. Form-22 Funeral Expenses Claim
  14. Form-24 Declaration and Certificate for Dependent Benefit
  15. ESIC-32 Wage-Contributory Record for DB
  16. ESIC-37 Certificate of Re-employment-Continuous employment
  17. ESIC-53 Application for change in particulars of IPs
  18. ESIC-63 Declaration form regarding payment to the legal heir
  19. ESIC-71 Particulars of contribution in case RC in respect of an IP
  20. ESIC-86 Certificate of Employment

9 Responses to “ESI Forms”

  1. saranyaa 29. Jun, 2011 at 3:22 pm

    i need ESIC half yearly return form immediately

  2. praveen13ad 29. Jun, 2011 at 11:09 pm

    Hi Saranya,

    U have the forms available in the section you have checked

  3. thiagaraju 21. Oct, 2011 at 6:20 am

    thank u

  4. sathya 15. Nov, 2011 at 2:39 pm

    form 52,form 72(a) is available in esi.except the above 20 forms,will u send me the other forms of esi

  5. praveen13ad 16. Nov, 2011 at 11:50 pm

    Hi Sathya,

    You may wish to download the form at this following link – http://esic.nic.in/downloadsnew.htm

  6. Chinnarasu 02. Apr, 2012 at 10:12 pm

    thank you

  7. Name (required) 21. Dec, 2012 at 12:53 pm

    adiga k n

    ISIC DISPENSARY ASKING FOR BORM 7B, WHICH IS NOT IN THE LIST PLEASE LET ME KNOW, FOR WHAT IT IS , WHERE IT CAN BE AVAILABLE.

  8. Krishna Kant Pateriya 25. Jan, 2013 at 11:14 am

    U have available of ESIC FOrm which is very important for everyone.

  9. Bhagwan Mahaveer Jain hospital 13. May, 2013 at 1:13 pm

    Hello Sir/ Madam

    CAN I GET THE FORM OF 7B WHICH IS NOT IN THE LIST, PLEASE LET ME KNOW WHERE IT CAN BE AVAILABLE.

    Thanks,
    Kalai