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ESIC Form 1


ESIC Form 1 Download

ESIC Form 1 is also known as the ESIC declaration form and is provided by employers to new employees. 

Also, ESI Form 1 is an employee's declaration to be included in the Employee State Insurance Corporation scheme.

Here you will learn how to complete ESI Form 1, and you can also download the ESI Form 1 declaration. But, before that, ESI Form 1 details must be cleared.

Part of the Workers' State Insurance Act of 1948, sometimes known as the ESI Act, is the Central Form 1 Disclosure Form.

This form is a social insurance programme for employees of Indian companies.

The employee must complete the form, attach two photographs at postcard size, and hand it over to the company.

This form, carefully filled out, must reach the relevant Branch Office within 10 days after an Employee's appointment.

Section 85 of the Act provides for disciplinary action against the employer in the case of a delay.

The employee is required to notify ESIC within 15 days of any changes to his family's structure.

What is the objective of the ESI Form 1?

The main objective of the ESIC Scheme is to safeguard employees against disability, illness, maternity, and death during their employment.

It provides the guiding principles for the Employees' State Insurance Scheme.

Medical treatment and care and other benefits are provided to employees and their dependent family members under the scheme.

Form 1 must be submitted to the relevant Branch Office within 10 days of an employee's recruitment.

Section 85 of the Act provides for disciplinary action against the employer in the event of a delay.

As the digital framework was set up, everything became online. Employers are currently completing this form online using their ESIC website.

In contrast, the ESIC Form 1 physical format and the ESI Form 1 online format have identical fields.

The purpose of this page is to provide information on Form 1 and how to fill it out.

  • ESIC Form 1 is accessible online at, the ESIC employer portal. 
  • After logging in to the ESIC portal with the employer user id and password,
  • there is an option called "register a new employee, When we click on that option, we will get ESIC Online Declaration Form 1.
  • Here, take this sample filled ESI Form 1 as a reference to fill out the online ESIC Form 1.

What is the Form 1 Declaration Form?

The Form 1 Declaration Form is a part of the Employees’ State Insurance Act 1948 in general and the Employees’ State Insurance (General) Regulations 1950 in particular.

Form 1 is the declaration that employees must complete and submit to their employers, and employers must complete and submit to the ESI Corporation.. Form 1 must be accompanied by two pictures in passport format.

  • The filled-out ESIC Form 1 Declaration Form and any other paperwork that goes with it must be sent to the ESI Branch Office that covers the company within 10 days of the employee's start date.
  • If the employee makes any false declarations 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 contact the ESI Corporation within fifteen (15) days of the change.

What details must be included on the Form 1 Declaration Form?

After completing Form 1, the employer must verify the employee's information and provide a temporary identity card.

The T.I. of I.P. signs the temporary card, and then the Branch Manager provides a seal/stamp.

With a temporary identity card, the employee and employer of the company must submit the following information on Form 1 Declaration:

  • Employer's Code No.
  • Details of the Nominee
  • Date of employment or Appointment of the Insured Person
  • Employer's Name And Address;
  • Previous job (Employment) Details of the Insured Person (if he was registered with ESIC earlier)
  • Previous Insurance Number of Insured Person
  • Previous Employer's Code No.

Except for Sikkim, Manipur, Arunachal Pradesh, Mizoram, and Nagaland, the form 1 declaration applies to all or any Indian states.

The Employees' State Insurance Act of 1948, of which the Form 1 Declaration Form is a part, applies to all non-seasonal establishments, including :






educational institutions

private medical institutions

newspaper establishments

road-motor transport


If these Companies/ firms/ organisations/ undertakings employing more than ten (10) workers, ESIC registration is compulsory.

How Can I Get Declaration Form 1?

The Employer Form 1 Declaration provided by the ESIC, Ministry of Labour and Employment, Government of India can be downloaded on this page.

You can get the form at webpage or from this page.

The method for downloading Form 1 PDF from the official website is as follows:

  • Visit the official ESIC website at
  • Click on the option titled "ESI Declaration form for the employer."
  • You'll find the PDF option.
  • You should select the appropriate option at your convenience.
  • Form 1 will be displayed for download on the following page.


You can download the ESIC Form 1 from Here

Who Should File Form 1 Declaration Form?

According to the ESI (General) Regulations of 1950, employees and employers must complete and submit the Central Form 1 Declaration Form.

• Category 1:

According to Regulation No. 11 of the Workers' State Insurance Regulations of 1950, every employee of the company must submit the ESIC Form 1 Declaration Form on or before the due date.

Before completing the next sections of the Form, the employer must take the employee's signature or thumb impression after issuing the Certificate.

• Category 2:

According to Regulation No. 11 of the Employees' State Insurance Regulations of 1950, the employee must fill out the ESIC Form 1 Declaration Form and submit it with photographs of themselves and their family before the due date.

After the employee has completed the Central Form 1 Declaration Form, the employer must submit the data for the temporary identification certificate.

Which Additional Compliance Forms Must An Employer Submit For ESI?

The Workers' State Insurance Act of 1948 requires all employers to submit the following compliance forms according to requirements and conditions.

  • 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- for the Claim of maternity, sickness, and disablement claim benefit
  • Form 11- Accident Book
  • Form 12 A- applied for the Claim of maternity benefit and for sickness
  • Form 12- Accident Report
  • Form 13 - Claim for Sickness, Maternity, or Temporary Disablement
  • Form 14 - Sickness, disablement, or maternity benefit
  • Form 15 - Dependent Benefit Claim
  • Form 16 - used for Periodical Payment of Dependent family members' Benefits Claim
  • Form 19: used for Maternity Benefit and Seek of Work Claim
  • Form 20: used for Maternity Benefit claim by a Nominee
  • Form 21: Certificate of Expected Conception-Maternity Benefit
  • Form 22: Claim of Funeral Expense
  • Form 23: Permanent Disability Benefit Life Certificate
  • Form 24: Dependent's Benefit Declaration & Certificate
  • Form 19 - Maternity Benefit and

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