ESIC Vadodara

Other Information

		How to reach
		Branch Offices
		Dispensaries & Hospitals
		Super Specialty Treatment
		Implemented Areas
		Medical Board
		Regional Board
		Local Committee
		Notifications
		SRO Statistics
		Penal Provisions
		EI Court & MAT
		Revenue Recovery
		Tender / Quotations
		Advertisements / Notices
		Circular / Office Orders
		Recruitment / Results
		List of Banks
		List Of Prosecution Casese
		Holiday Lists
		Right to Information (RTI)
		Grievance Redressal
		Vigilance
		Rajiv Gandhi Sramik Kalyan Yojana
		Scheme for the Disabled persons- 1, 2
		Self Certification Scheme
		New Inspection Pollcy-2008

Forms

Forms for employer

SI.No.		Description
Form - 01		Employers' Registration Form
Form - 01A		Annual information of factory/estt 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 - 37		Certificate of Employment

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