CURRENTLY APPLICABLE LEGAL & OTHER Rev.

00
REQUIREMENTS FOR INTEGRATED MANAGEMENT Date :
Page
SYSTEM AT GPL, Chatrapur
Document No. IMSL/ GPL /1

SECTION – 1
TABLE OF CONTENTS

Section Title Page no (s)

No.
- Title page 1
1 Table of contents 1
2 Preface 1
3 Factory acts & rules 13
4 Petroleum act & rules 3
5 The Gas cylinder rules 1
6 Employees state insurance act & rules 2
7 Indian Motor vehicle act & rules 2
8 The Electricity act & rules 4
9 The Environmental (protection) act & rules 3
 The Noise pollution ( Regulation & control ) rules
 Hazardous waste ( Management & Handling ) rules
 Manufacture, Storage & Import of Hazardous Chemical rules
 Batteries ( Management & Handling ) rules
 Ozone depletion rules
 E-Waste (management & Handling) rules
 EIA Notifications
10 The Water ( Prevention & Control of pollution) Act & rules 1
11 The Air ( Prevention & Control of pollution act ) & rules 1
12 Odisha Fire prevention & Fire safety rules 2017 1
13 Odisha Irrigation act & rules 1
14 Other requirements 1
 Energy conservation act & rules
 The Private Security Agencies (Regulation) Act 2005
15 List of abbreviation 1
16 Distribution list 1
17 Revision history 1
 3 Odisha Factory acts & rules 13

EMPLOYEES ODISHA STATE INSURANCE ACT, 1948 & EMPLOYEES STATE INSURANCE REGULATIONS, 1950
             
S.No Type & Description Of the Relevant Schedule Of Submitting Authority Remarks
Nature Of Form Clause Submission/
Document Maintenance

1 Form I Declaration Form Regulation 11 to be filled in by the employee with his  

& 12 signature or thumb impression and
submit it to the employer

2 Form I-A Family Declaration Regulation to be filled in by the employee and  

Form 15-A submitted back to the employer , who
shall forward the same to the appropriate
office within 10 days from the date of
submission by the employee
3 Form I-B Changes in family Regulation to be submitted by the insured person to  
declaration form 15-B the employer within 15 days of such
changes occurring and the employer in
turn would forward the same to the
appropriate office within 10 days of
receipt.
4 Form 3 Return of Regulation 14 to be sent by the employer to the  
declaration forms appropriate office within 10 days of
receipt of the filled up forms

5 Form 4 Identity Card Regulation 17 to be issued by the appropriate office in  

respect of all insured employees, and
send the same to the employer, who shall
issue the same to the concerned
employee after obtaining the signature in
the card
6 Form 4-A Family Identity Regulation to be arranged by the appropriate office  
Card 95-A and necessary family particulars added in
Form 4

7 Form 6 ESIC-Return of Regulation 26 to be sent by the employer in  

Contributions quadruplicatealongwith receipt copies of
challans to the appropriate office within
42 days of termination of related
contribution period; within 21 days of
permanent closure of the factory; within 7
days of the date of receipt of requisition
from the appropriate office
8 Form 7 Register Of Regulation 32 to be maintained by the employer in  
Employees respect of every employee of his factory
or establishment

9 Form 8 First Certificate Regulation 57 this medical certificate is to be issued by  

& 89-B the insurance medical officer during the
first examination in respect of a spell of
sickness or a spell of temporary
disablement
10 Form 9 Final Certificate Regulation 58 to be issued by the insurance meddical  
& 89-B officer, when he feels that not later than 3
days of the date of examination(other
than a first certificate) the insured
 employee would be fit to resume duties
11 Form 10 Intermediate Regulation 59 to be submitted by the insured person  
Certificate & 89-B within 7 days (commencing from the date
of first certificate) in cases wherein the
final certificate is not issued within 7 days
of issue of first certificate
12 Form 11 Special Regulation 61 to be furnished by the insured person in  
Intermediate & 89-B cases wherein the insurance medical
Certificate officer feels that temporary disablement
has continued for not less than 28 days
and such disablement is likely to continue
for a longer period
13 Form 12 Sickness or Regulation 63 to be submitted by the insured person  
Temporary desirous of claiming sickness or
Disablement temporary disablement benefit to the
Benefit appropriate local office by post or
otherwise alongwith appropriate medical
certificates
14 Form 12- Maternity Benefit Regulation to be submitted by every insured woman  
A for sickness 89-B claiming maternity benefit in case of
sickness arising out of pregnancy,
confinement, premature birth of child or
miscarriage to the local appropriate office
by post or otherwise
15 Form 13 Sickness or Regulation 63 to be submitted by the insured person or  
Temporary & 89-B insured woman desirous of claiming
Disablement sickness or temporary disablement
Benefit or benefit to the appropriate local office by
Maternity Benefit post or otherwise alongwith appropriate
for sickness medical certificates
16 Form 13- Maternity Benefit Regulation to be submitted by every insured woman  
A for sickness 89-B claiming maternity benefit in case of
sickness arising out of pregnancy,
confinement, premature birth of child or
miscarriage to the local appropriate office
by post or otherwise
17 Form 14 Sickness or Regulation 63 to be submitted by the insured person or  
Temporary insured woman desirous of claiming
Disablement sickness or temporary disablement
Benefit or benefit to the appropriate local office by
Maternity Benefit post or otherwise alongwith appropriate
for sickness medical certificates
18 Form 14- Maternity Benefit Regulation to be submitted by every insured woman  
A for sickness 89-B claiming maternity benefit in case of
sickness arising out of pregnancy,
confinement, premature birth of child or
miscarriage to the local appropriate office
by post or otherwise
19 Form 15 Accident Book Regulation 66 To be maintained by the employer in  
which appropriate particulars of any
accident causing personal injury to an
insured person may be entered and
preserved every such book for a period of
five years.
20 Form 16 Accident Report Regulation 68 to be furnished by the employer to the  
from Employer nearest local office and to the nearest
insurance medical officer immediately if
the injury is serious

21 Form 17 Dependant's Regulations To be issued free of charge by the  

benefit - Death 79 & 95-C Insurance Medical Officer attending the
Certificate disabled person at the time of his death
22 Form 18 Dependant's Regulation 80 To be submitted by the dependant or  
benefit - Claim dependants concerned or by the legal
Form representative of the insured member
with all supporting documents to the
appropriate local office by post or
otherwise
23 Form 18- Dependant's Regulation To be submitted by the dependant whose  
A Benefit - Claim 83-A claim for dependent’s benefit is admitted,
Form for to the local appropriate office except in
periodical the case of first and final payments
Payments
24 Form 19 Maternity Benefit - Regulation - To be submitted by an insured woman  
Notice of 87 before confinement to the local
Pregnancy appropriate office

25 Form 20 Maternity Benefit - Regulation - To be submitted by an insured woman  

Certificate of 87 before confinement to the local
Pregnancy appropriate office

26 Form 21 Maternity Benefit - Regulation - To be submitted by every insured woman  

Certificate of 88 claiming maternity benefit before
Expected confinement not earlier than 15 days
Confinement before the expected date of confinement

27 Form 22 Maternity Benefit - Regulation 88 To be submitted by every insured woman  

Claim Form & 89 to the local appropriate office stating
therein the date on which she ceases to
work for remuneration and if the insured
woman is claiming maternity benefit for
miscarriage the claim form ought to be
submitted within 30 days of the date of
miscarriage.
28 Form 23 Maternity Benefit - Regulation 88 To be submitted by every insured  
Certificate of & 89 womanwothin 30 days of the date on
Confinement or which her confinement takes place to the
Miscarriage local appropriate office

29 Form 24 Maternity Benefit - Regulation 91 To be furnished by an insured woman  

Notice Of Work who has claimed maternity benefit, if she
does work for remuneration on any day
during the period for which maternity
benefit would be payable to her.
30 Form 24- Maternity Benefit Regulation To be submitted by the nominee or legal  
A & 24-B after the death of 89-A representative of the insured woman to
an insured woman the local appropriate office, a claim for
leaving behind the maternity benefit within 30 days of the
child / Maternity death of the insured woman, together
Benefit- Death with a death certificate in 24-B
Certificate
31 Form 25 Claim for Regulation To be submitted by an insured person  
Permanent 76-A declared as permanently disabled by a
Disablement Medical Board to the local appropriate
Benefit office by post or otherwise

32 Form 25- Funeral Expenses Regulation To be submitted by the claimant entitled,  

A Claim Form 95-E to the local appropriate office and in case
of a minor, by his guardian and the form
ought to be submitted with all supporting
documents
33 Form 26 Certificate for Regulation To be submitted by every person whose  
permanent 107 claim for permanent disablement has
disablement been admitted at six monthly intervals, a
benefit certificate attested by such authority as
may be specified by the director general
34 Form 27 Declaration & Regulation To be submitted by every person whose  
Certificate for 107-A claim for dependent’s benefit has been
Dependant's admitted at six monthly intervals , duly
Benefit attested by such authority as may be
specified by the director general
35 Form 28 Abstention Regulation To be furnished by every employer to the  
Verification 52-A appropriate office, such particulars &
information in respect of abstention of an
insured person from work for which
sickness benefit or disablement benefit
for temporary disablement have been
claimed or paid
36 Form 28- Abstention Regulation To be furnished by every employer to the  
A Verification 52-A appropriate office, such particulars &
information in respect of abstention of an
insured woman from work for which
maternity benefit has been claimed or
paid