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Employee's State Insurance Corporation (ESIC)

    The object of the Act is to secure sickness, maternity, disablement and medical benefits to employees of factories and establishmens and dependents benefits to the dependents of such employees.

    Applicability of the Act

    • To all Factories & establishments employing 20 or more employees.
    • Every employee drawing wages (Gross Salary) upto Rs.15,000/- Per month.

    Wages for ESI Contributions
    Registers/files to be maintained by the employer

    To be deemed as Wages

    • Basic Pay
    • Dearness allowance
    • House rent allowance
    • City compensatory allowance
    • Overtime wages (but not to be taken into account for determining the coverage of an employee)
    • Payment for day of rest
    • Production incentive
    • Bonus other than statutory bonus
    • Night Shift allowance
    • Heat, Gas & Dust allowance
    • Payment for unsubstitued holidays
    • Meal /Food allowance
    • Suspension allowance
    • Lay off Compensation
    • Children education allowance (not being reimbursement for actual tuition fee)

    Not to be deemed as Wages

    • Contribution paid by the employerto any pension/ provident fund or under ESI Act.
    • Sum paid to defray special expenses entailed by the nature of employement- Daily Allowance paid for the period spent on tour.
    • Gratuity payable on discharge
    • Pay in lieu of notice of retrenchment compensation
    • Benefits paid under the ESI Scheme
    • Encashment of Leave
    • Payment of Inam which does not form part of the terms of Employment
    • Washing allowance for livery
    • Conveyance Amount towards reimbursement for duty related journey

    Rates of Contribution 


    Employee's Contribution

    Employer Contribution

    Employee State Insurance (ESI)



    Contribution Period 
    • 1st April to 30th September.
    • 1st October to 31st March.

    Forms for Employer

    Form 01

    Employer's Registration Form

    Form- 01A

    Annual information of factory/establishment submission form

    Form 3

    Return of Declaration forms

    Form 5

    Return of contributions

    Form 5a

    Statement of advance payment of contributions

    Form 6

    Register of employees

    Form 10

    Abstention verification

    Form 11

    Accident Register

    Forms for Employees

    Form 1

    Declaration Form

    Form 2

    Addition / Deletion in Family declaration form

    Form 9

    Claim form  for sickness /TDB/ Maternity

    Form 14

    Claim form for Permanent disablement benefit (PDB)

    Form 15

    Claim form for Dependant Benefit (DB)

    Form 16

    Claim form for periodical payments of DB

    Form 19

    Claim for Maternity benefit

    Form 20

    Claim form for  Maternity benefit after death of child

    Form 22

    Claim form for Funeral Expenses

    Form 23

    Life certificate

    Form 24

    Dependant benefits declaration


Form Downloads


  • Medical Benefit
  • Sickness Benefit
  • Maternity Benefit
  • Dependent Benefit
  • Disablement Benefit
  • Funeral Expenses