Introduction

Sample Filled ESIC Form 53 | How To Fill ESIC Form 53

1. Enter the name of the employer and the address of the establishment.

2. Enter the name of the employee and the employee’s address.

3. Enter the employee’s date of birth, gender, and marital status.

4. Enter the employee’s designation and the date of joining the establishment.

5. Enter the employee’s salary details, including the gross salary, the deductions, and the net salary.

6. Enter the employee’s bank account details, including the bank name, account number, and IFSC code.

7. Enter the employee’s ESIC number, if available.

8. Enter the employee’s PAN number, if available.

9. Enter the employee’s Aadhar number, if available.

10. Enter the employee’s contact details, including the phone number and email address.

11. Enter the name of the employer’s representative and the date of signing the form.

12. Sign the form and submit it to the ESIC office.

ESIC form 53 is also known as the application for change in particulars of insured person. These particulars are like ESIC dispensary, employee name, employee father’s name, DOB, and address. ESI form 53 has to be submitted to the respective medical officer of ESIC corporation and at the same time, ESIC form 53 needs both employee and employer signatures. Here you can find sample filled ESIC form 53 and instructions on how to fill ESIC form 53.

Generally, ESI form 53 is required when insured person transfers from one job location to another job location or when insured person finds any incorrect details mentioned in ESIC employee portal. It is always a good idea to correct any incorrect details in ESIC portal, so that insured person and his or her family members won’t get any problems during ESIC treatment.

↓ Download ESIC Form 53

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Sample Filled ESIC Form 53 Or How To Fill ESIC From 53

This form consists two sections one section is to change ESIC local office and ESIC Dispensary and here we need to write the reason for the change. The second section is to change employee name, employee relation ship details, date of birth and address.

Sample Filled ESIC Form 53

↓ Download Sample Filled ESIC Form 53

The changes may take with in 30days. But recently employee state insurance corporation has made every thing online, insured persons can able to change their dispensaries online but it is not possible to change employee name and date of birth in online, so in this cases, insured persons need to submit ESIC Form 53 to their regional ESIC office.

Sample Filled ESIC Form 53 | How To Fill ESIC Form 53

ESIC Form 53 is an important form for employees of the Employees’ State Insurance Corporation (ESIC). It is used to register the employee for the ESIC scheme and to provide the necessary information about the employee. This form is also used to update the employee’s details in the ESIC database. In this article, we will discuss how to fill ESIC Form 53 and provide a sample filled ESIC Form 53.

What is ESIC Form 53?

ESIC Form 53 is a form used by the Employees’ State Insurance Corporation (ESIC) to register the employee for the ESIC scheme. This form is also used to update the employee’s details in the ESIC database. It is important to fill out this form accurately and completely to ensure that the employee is registered correctly.

How to Fill ESIC Form 53?

Filling out ESIC Form 53 is a simple process. The form consists of two parts: Part A and Part B. Part A is for the employee’s personal information, such as name, address, date of birth, etc. Part B is for the employer’s information, such as name, address, etc. The following steps will help you fill out ESIC Form 53:

Step 1: Fill out Part A of the form with the employee’s personal information.
Step 2: Fill out Part B of the form with the employer’s information.
Step 3: Sign and date the form.
Step 4: Submit the form to the ESIC office.