ESI Form 1- Details And Easy Guide To Fill It | UBS
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What Is Form 1? – Definition And Easy Guide To Form 1 Filling

November 7, 2022
HR Toolkit
Form 1

The employee has got to fill out Form 1 with two postcard-size photographs, and fork them over to the employer.

The Employees’ State Insurance Act 1948, a.k.a. ESI Act, of which the Central Form1 Declaration Form is a part. This form1 is a social insurance scheme for employees working in Indian companies.

What Is The Objective Of ESI Form 1?

The main objective of the Employees’ State Insurance Scheme is to protect employees from disablement, sickness, maternity, and death during employment. It specifies the principles governing the Employees’ State Insurance Scheme. Under the scheme, medical treatment and care are provided to employees and their family members.

Form1 duly filled, must reach the concerned Branch Office within 10 days of the appointment of an Employee. If there is a delay, it attracts penal action against the employer under Section 85 of the Act.

ESI Form 1

Note: This letter will be useful to you! You can edit it, as your needs and requirements.

What Is The Form 1 Declaration Form?

The Form1 Declaration Form is a component of the Employees’ State Insurance Act 1948 in general and the Employees’ State Insurance (General) Regulations 1950 in particular.

Form1 refers to the declaration an employee has got to fill and submit to their employer, and therefore the employer has to fill and submit to the ESI Corporation. The employee must attach 2 passport- sized photographs along with Form1.

  • Along with the filled Central Form 1 Declaration Form, together with the supporting documents, must be submitted to the ESI Branch Office under whose jurisdiction the company falls within 10 days of the concerned employee’s appointment.
  • If the employee makes any false statement in the Form 1 Declaration Form, they could be punished with a fine of INR 2,000 and/or six months imprisonment.
  • If there’s any change in the employee’s family member, the employer must inform the ESI Corporation within fifteen (15) days of the change.

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Which Details Should Be Entered In Form 1 Declaration Form?

After filling out the Form 1 Declaration Form, the employer has to verify the details of the employee and issue a Temporary Identity Card. The Temporary card is signed by the T.I. of I.P. and therefore the Branch Manager with a seal. In Form 1 Declaration Form, with a temporary identity card the employee and employer of the company need to enter the following details:

  • Insurance Number
  • Insured Name In Block Letter
  • Father Or Husband’s Name Of The Insured Person
  • Date Of Birth Of The Insured Person
  • Permanent Address Of The Insured Person
  • Present Address Of The Insured Person
  • Employer’s Code No
  • Details Of Nominee
  • Date Of Appointment Of The Insured Person
  • Employer’s Name And Address
  • Previous Employment Details Of The Insured Person
  • Previous Insurance Number Of Insured Person
  • Previous Employer’s Code No
  • Previous Employer’s Telephone Number And Email Address
  • Data Of The Family Of The Insured, Such As The Name, Relationship With The Employee, Date Of Birth, And Residential Status

The form 1 declaration form applies to all or any Indian states except for Sikkim, Manipur, Arunachal Pradesh, Mizoram, and Nagaland. The Employees’ State Insurance Act 1948, of which the Form 1 Declaration Form is a part applies to all or any non-seasonal establishments, such as hotels, factories, restaurants, cinemas, shops, educational institutions, private medical institutions,  newspaper establishments, road-motor transport undertakings employing quite ten (10) workers.

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How To Download Form 1 Declaration Form?

You can find the Form 1 Declaration form to be used by the employer as provided by the Employees’ State Insurance Corporation, Ministry of Labour and Employment, Government of India. You can download the form from https://www.india.gov.in/esi-declaration-form-employer portal, or you can download Form16 from here

The Procedure To Download Form 1 PDF From The Official Website Is:

  • Visit the official Employees’ State Insurance Corporation, Ministry of Labour and Employment, Government of India website: https://www.india.gov.in/esi-declaration-form-employer
  • You will find the ‘ESI Declaration form for employer’ option just click on it.
  • You will find the ‘PDF’ option.
  • You have to select the relevant option at your convenience. 
  • You will be able to download the form on the next page.

OR 

You can download the Form1 from UBS HR Toolkit.

ESI Form 1

Note: This letter will be useful to you! You can edit it, as your needs and requirements.

Who Need To Submit Form 1 Declaration Form?

According to the Employees’ State Insurance (General) Regulations 1950, the Central Form 1 Declaration Form must be filled and submitted by employees and employers.

  • Category 1: According to Regulation No. 11 of the Employees’ State Insurance  Regulations 1950, the Central Form 1 Declaration Form must be filled by every employee of the company on or before the appointed day.

After issuing the Certificate, the employer must obtain the employee’s signature or thumb impression before filling in the remaining sections of the Form.

  • Category 2: According to Regulation No. 11 of the Employees’ State Insurance Regulations 1950, the Central Form 1 Declaration Form must be filled by the employee and submitted along with the photographs of themselves and their family members before the appointed day.

After the employee fills out the Central Form 1 Declaration Form, the employer must enter the Temporary Identification Certificate details.

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Which Other Compliance Forms Does The Employer Have To Submit For ESI?

According to the Employees’ State Insurance Act 1948, all employers must submit the subsequent compliance forms. 

  • Employee Registration
  • Employer Registration
  • Form 1 Declaration form
  • Form 01(A) – Annual Information
  • Form 2- Change In Family Declaration
  • Form 3- Declaration Form Return
  • Form 6- Employee Registration
  • Form 9- Claim for maternity, sickness, and disablement benefit
  • Form 11- Accident Book
  • Form 12 A- Claim of maternity benefit for sickness
  • Form 12- Accident Report
  • Form 13 – claim for Sickness or Maternity or Temporary disablement
  • Form 14 – Sickness or disablement or maternity benefit
  • Form 15 – Dependent Benefit Claim
  • Form 16 – Periodical Payment of Dependent Benefits Claim
  • Form 19 – Maternity Benefit and see of work Claim
  • Form 20 – Maternity Benefit by a Nominee Claim
  • Form 21 – Certificate of Expected Confinement- Maternity Benefit
  • Form 22 – Claim Of Funeral Expense
  • Form 23 – Permanent Disablement Benefit Life Certificate
  • Form 24 – Dependent’s Benefit Declaration & Certificate

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How UBS Payroll Software Can Help?

Taxation & Compliance management are important factors of payroll management. To manage them you may need an automated tool. UBS payroll software has everything automated that can easily make your operations easy by eliminating extra efforts to find and submit government forms. 

Moreover, you can easily get the form 1 PDF from the HR toolkit of UBS. Check the HR toolkit to get any necessary doc for employees and HR.

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Alpesh Vaghasiya

Alpesh Vaghasiya

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