Mehal Consultancy

S.No	Form No.	Purpose
1	Form-01	Employer's Registration Form
2	Form-01(A)	Form of Annual Information on Factory / Establishment covered under ESI Act
3	Form - 1	Declaration Form
4	Form - 1(A)	Family Declaration Form
5	Form - 1 (B)	Changes in Family Declaration Form
6	Form-2	Addition / Deletion in Family Declaration Form
7	Form - 3	Return of Declaration Forms
8	Form - 5	Return of Contributions
9	Form-9	Claim for Sickness/Temporary Disablement Benefit/Maternity Benefit
10	Form-11	Accident Book
11	Form - 12	Accident Report filled by Employer
12	Form - 14	Claim for Permanent Disablement Benefit
13	Form-15	Claim for Dependent Benefit
14	Form - 16	Claim for Periodical Payment of Dependent Benefit
15	Form - 19	Claim for Maternity Benefit & Notice of Work
16	Form - 20	Claim for Maternity Benefit after the death of an Insured women leaving behind the child
17	Form - 22	Funeral Expenses Claim
18	Form - 23	Life Certificate for Permanent Disablement Benefit
19	Form - 24	Declaration and Certificate for Dependents Benefit
20	Form - 32	Wage / Contribution record for disablement Benefit
21	Form - 37	Certificate of Re-employment / continuous Employment
22	Form - 53	Application for change in particulars of IP regarding change of Branch office/Dispensary
23	Form - 63	Declaration form regarding payment to the legal heir/representative of the deceased IP
24	Form - 71	Particulars of contribution in case Return of Contribution in respect of IP not sent
25	Form - 72	Application for Duplicate Identity Card
26	Form - 86	Certificate of Employment
27	Form - 105	Certificate of Entitlement
28	Form - 126	Certificate of Continuous Employment for Extended Medical / Sickness Benefit
29	Form - 142	Claim for conveyance allowance and/or compensation for loss of wages for an IP appeared before the medical board

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ESIC Atc, 1948

Employee's state insurance corporation (ESIC)