Scribd Logo
Upload

Welcome to Scribd!

  • Esic New Form3

    Uploaded by

    Vidhya Prabu
    7 views1 page
    1. The document is a return of declaration forms submitted by an employer to the Employees' State Insurance Corporation regarding newly employed workers. 2. It lists the names, identification numbers, and family details of new employees who earn less than Rs. 6,500 per month. 3. The employer declares that every eligible employee has been included in the list and encloses declaration forms for each one to be processed by the local ESIC office.

    Original Description:

    Original Title

    esic-new-form3

    Copyright

    © Attribution Non-Commercial (BY-NC)

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    1. The document is a return of declaration forms submitted by an employer to the Employees' State Insurance Corporation regarding newly employed workers. 2. It lists the names, identification numbers, and family details of new employees who earn less than Rs. 6,500 per month. 3. The employer declares that every eligible employee has been included in the list and encloses declaration forms for each one to be processed by the local ESIC office.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    7 views1 page

    Esic New Form3

    Uploaded by

    Vidhya Prabu
    1. The document is a return of declaration forms submitted by an employer to the Employees' State Insurance Corporation regarding newly employed workers. 2. It lists the names, identification numbers, and family details of new employees who earn less than Rs. 6,500 per month. 3. The employer declares that every eligible employee has been included in the list and encloses declaration forms for each one to be processed by the local ESIC office.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    www.esicoimbatore.

    org

    EMPLOYEES’ STATE INSURANCE CORPORATION


    (To be submitted in Duplicate) REG. FORM – 3

    RETURN OF DECLARATION FORMS


    (Regulation 14)

    Name and Address of the Factory or Establishment ……………………………………………………


    …………………………………………………………………………………………………………………………
    …………………………………………………………………………………………………………………………..
    Employer’s Code No.

    I am enclosing the Declaration Forms in respect of following employees. I hereby declare that
    each and every person, employed as an ‘employee’ within the meaning of Section 2(9) of the Employees’
    State Insurance Act’ 1948 on ……………… in this factory or establishment and in receipt of a
    remuneration not exceeding Rs.6500/- (excluding remuneration for overtime work) per month have been
    included in this list (excepting those in respect of whom declaration forms have already been sent to the
    Corporation in the past).

    Date ……………… Signature ……………………………………………

    Name in Block letters………………………………

    Place ………………

    Designation & Seal………………………………

    Serial Name of the employee Distinguishing Father’s or Insurance No. allotted


    No. No. with the Husband’s by the Corporation (to
    Employer, if any Name be entered at the
    Local Office)
    1. 2. 3. 4. 5.
    1
    2
    3
    4

    Signature………………………………
    Enclosures:
    1- Declaration forms in respect of
    the above named employees
    2- Continuation sheet(s)

    You might also like