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FORM NO.

SUBJECT

RELEVANT REGULATION

TO BE USED BY

FORM-01 Employer's Registration Form 10 B Employer
FORM-01(A) Form of annual information on factory/establishment covered under ESI Act 10 C Employer
FORM-1 Declaration Form 11 & 12 Employer
FORM-1(A) Family Declaration Form 15-A Employer
FORM-2 Addition/Deletion in Family Declaration Form 15-B Employer
FORM-3 Return of Declaration Form 14 Employer
FORM-5 Return of Contribution 26 Employer
FORM-5(A) Advance payment of contribution 31 Employer
FORM-5 (New) Return of Contribution (New) 31 Employer
FORM-6 Register of Employees 32 Employer
FORM-9 Claim for Sickness/ Temporary Disablement Benefit/Maternity Benefit 63 & 89(B) IP/Beneficiary
FORM-11 Accident Book 66 Employer
FORM-12 Accident Report from Employer 68 Employer
FORM-14 Claim for Permanent Disablement Benefit 76(a) IP/Beneficiary
FORM-15 Claim for Dependent Benefit 80 IP/Beneficiary
FORM-16 Claim for periodical payment of Dependent Benefits 83(A) IP/Beneficiary
FORM-19 Claim for Maternity Benefit and notice of work 88, 89 & 91 IP/Beneficiary
FORM-20 Claim for Maternity Benefit after the death of an Insured Women leaving behind the child 89(A) IP/Beneficiary          
FORM-22 Funeral Expenses Claim 95(E) Beneficiary
FORM-23 Life Certificate for Permanent Disablement Benefit 107 IP/Beneficiary
FORM-24 Declaration and Certificate for Dependents Benefit 107(A) IP/Beneficiary   

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