Form 1 – Declaration Form

Employees must fill out the form, attach two postcard-size photographs, and submit it to their employer. The employer must ensure the completed form reaches the concerned Branch Office within 10 days of the employee’s appointment — delays can trigger penal action against the employer under Section 85 of the Act.

Employees must also inform the ESI Corporation of any changes in their family membership within 15 days of the change.

Download Form 1