Introduction
Employees’ State Insurance Corporation (ESIC) is a social security organization that provides medical and financial benefits to employees and their families. It is mandatory for all employers to register their employees with ESIC and submit the required documents. One of the documents required is the ESIC Declaration Form 1, which is used to declare the details of the employee and the employer. This article will provide a step-by-step guide on how to fill the ESIC Declaration Form 1, as well as a sample filled form.
How To Fill ESI Form 1 Or Sample Filled ESIC Declaration Form 1
ESI Form 1 or ESIC Declaration Form 1 is a form that is used to register an employee for the Employees’ State Insurance Corporation (ESIC). This form is used to declare the details of the employee, employer, and the wages of the employee.
Instructions for Filling ESI Form 1
1. Enter the name of the employee in the first box.
2. Enter the date of birth of the employee in the second box.
3. Enter the address of the employee in the third box.
4. Enter the name of the employer in the fourth box.
5. Enter the address of the employer in the fifth box.
6. Enter the nature of the employment in the sixth box.
7. Enter the wages of the employee in the seventh box.
8. Enter the date of commencement of employment in the eighth box.
9. Enter the date of termination of employment in the ninth box.
10. Enter the name of the family members of the employee in the tenth box.
11. Enter the date of submission of the form in the eleventh box.
12. Sign the form in the twelfth box.
Sample Filled ESI Form 1
Name of the Employee: John Smith
Date of Birth: 01/01/1990
Address of the Employee: 123 Main Street, Anytown, USA
Name of the Employer: ABC Corporation
Address of the Employer: 456 Main Street, Anytown, USA
Nature of Employment: Full-time
Wages: $2,000 per month
Date of Commencement of Employment: 01/01/2020
Date of Termination of Employment: N/A
Name of Family Members: Jane Smith, Mary Smith
Date of Submission of Form: 01/02/2020
Signature: _________________________
ESIC Form 1 is also known as ESIC declaration form, issued by employer to their employees during their joining team. Simply ESI form 1 is declaration from employee to include him or her in Employee State Insurance Corporation Scheme. Here you are going to learn how to fill ESI form 1 and you can also download ESI declaration form 1. But before that we have to know some important points about ESI form 1.
What is ESIC Form 1
ESIC Form is a declaration form to be submitted to the nearest ESIC office by employer. ESIC declaration form has to filled by insured person i.e employee.
↓ Download ESIC Form 1 Or ESIC Declaration Form 1
Note : After implementation of online system , every thing became online. Employers are now filling this form in online in their ESIC portal. But all the fields present in ESIC form 1 physical format and ESI Form 1 online format are similar. So this post is to just give some information about previously used ESIC Form 1 and how to fill ESI Form 1.
Online ESIC form 1 is available at esic.in i.e esic employer portal. After login to esic portal with employer user id and password, there is an option called register new employee, when we click on that option then we will get ESIC online declaration form 1. Here take this sample filled ESI Form 1 as reference to fill online ESIC form 1.
Also Read : What To Do If Employee Got Two UAN Numbers
How To Make Online ESIC Payment
How To Fill ESI Form 1 / Sample Filled ESIC Form 1
↓ Download Sample Filled ESI Form 1
In this physical format of ESI form 1, temporary id ( now we are calling it as print counter foil) card is also present. You can get print counter foil in online just after submitting employee details. In earlier days employer need to submit this filled ESI form 1 to the ESIC office with in 10 days from the date of appointment of employee. Now there is no need to submit any physical forms to ESIC office.
How To Fill ESI Form 1 Or Sample Filled ESIC Declaration Form 1
ESI Form 1 or ESIC Declaration Form 1 is a form that is used to register an employee under the Employees’ State Insurance Corporation (ESIC). This form is used to provide the employee with medical and other benefits under the ESIC scheme. It is important to fill out this form correctly and accurately to ensure that the employee is eligible for the benefits.
Steps to Fill ESI Form 1
- The first step is to fill in the personal details of the employee. This includes the name, address, date of birth, gender, marital status, and contact details.
- The next step is to fill in the details of the employer. This includes the name, address, contact details, and the date of commencement of employment.
- The third step is to fill in the details of the employee’s salary. This includes the gross salary, deductions, and allowances.
- The fourth step is to fill in the details of the employee’s bank account. This includes the name of the bank, account number, and IFSC code.
- The fifth step is to fill in the details of the employee’s family members. This includes the name, date of birth, and relationship of each family member.
- The sixth step is to fill in the details of the employee’s medical history. This includes any pre-existing medical conditions, allergies, and any other medical information.
- The seventh step is to sign the form. This is done by the employee and the employer.
Sample Filled ESIC Declaration Form 1
The following is a sample filled ESIC Declaration Form 1:
Name of Employee: John Doe
Address: 123 Main Street, Anytown, USA
Date of Birth: 01/01/1980
Gender: Male
Marital Status: Married
Contact Details: 123-456-7890
Name of Employer: ABC Corporation
Address: 456 Main Street, Anytown, USA
Contact Details: 987-654-3210
Date of Commencement of Employment: 01/01/2020
Gross Salary: $50,000
Deductions: $2,000
Allowances: $1,000
Name of Bank: XYZ Bank
Account Number: 1234567890
IFSC Code: XYZ12345
Name of Family Member 1: Jane Doe
Date of Birth: 01/01/1985
Relationship: Wife
Name of Family Member 2: Joe Doe
Date of Birth: 01/01/2010
Relationship: Son
Medical History: None
Signature of Employee: ___________________
Signature of Employer: ___________________
