esi general amdmt regulations 1.5.2011 (1)

8/3/2019 ESI General Amdmt Regulations 1.5.2011 (1)

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3W6 THE GAZETTE OF INDJ -, APRIL 30, 2011 (VAISAKHA 10, J ; ;3)======PARTm-SEC. 4New Del.i, the 30th March 2011

No. N-, J13j2j2010-P&D: Whereas cert. draft regulations further to .smend the Employees'State Ii', .urance (General) Regulations, 1)50, were published as requlre.; under sub-section (1)of section 97 of the Employees' State Insurance Act, 1948 (34 of 1948), in the Gazette of India,Part Ill, Section 4, dated the 26th February, 2011 for inviting objections and suggestions fromall persons likely to be affected thereby till the expiry of the period of thirty days from the dateon which the copies of the Gazette of India in which the said notification was published, weremade available to the public;

And whereas, the copies of the sad Gazette were made available to the public on the26th February, 2011;

And whereas no objection or suggestion has been received from any person in thisregard; . ,

Now, therefore, in exercise of the powers conferred by section 97 of the Employees'State Insurance Act, 1948, the Employees' State Insurance Corporation, hereby makes the.following regulations further to amend the Employees' State Insurance (General) Regulations,1950, namely: -

1) These Regulations may be called the Employees' State Insurance (General)(Amendment) Regulations, 2011.

2) They shall come into force from 1st May, 2011.3) In the Employees' State Insurance (General) Regulations, 1950;


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I',,, i iJ ')lx.4J THE GAZETTE OF INDIA, APRIL 30, 2011 (VAISAKHA 10,1933)====== 3 C E 7factory/establishment to which tnis Act applies and to whom a code number has alreadybeen allotted, shall intimate to the appropriate Regional Office, Sub-Regional Office,Divisional Office or Branch Office, any change in the particulars furnished in Form 01 atthe time of registration of the factory/establishment within two weeks of such change."2. The existing form-01 shall be substituted with the following form.-

"FORM-011. Name of the Unit (Factory / Establishment):

i::~~-add-ress along with Pin Code I 1-1 J_u_r-,is_d_ict_io_n_a_l_No., Municipality Ward No. (if in a I Phone Nos./Mobile No 'I

' Rev. Village, Name of the Village, & e-mail address Police StationHobf and all other details of I' Fax No 'Ldemarcation) I ---------~-------~---------

2. Exact nature of activity(work / business carried on)

3. Date of commencement of the Unit:4. a) Whether the i ) building/premises of the unit

are hired / owned/ leased.ii) Machinery & Fixtures of theunit are hired / owned/ leased.

b) Date of purchase / lease


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THE GAZETT: OF INDIA,APRIL 30,2011 (Vt\lSA},.; lA 10, 1933)================ =================

[ P A R T Ill-SEC. 4

Names &Designations

Permane;"-;: AddressI.elephone Nos.I

including mobilenumbers & e-maili address_L

Names & addresses of the preser.:Principal employers

.e., Proprietor/Partners/ Managjnf~ I.xecutive Directors / Chairman/ Lcretarv and the manager of the U .)'---9. Addresses of Registered offices/Head Office/ Branch Office/Sales.Offices/Administrative offices andNo. of employees employed therei=

Full Addresses No,of employees employed Tel. Nos.

10. Total No. of persons emploved and No. ofEmployees whose wages does not exceedRs.15000/- P.M.i)ii)iii)

By Principal employerThrough Immediate Employer (Without ESICode No)Through Immediate Employer (Having ESICode No)

As on ................. . .Signature of the Principal Employer.

(along with date)DECLARATION

I have read the instructions and hereby declare that all the particulars given above are trueand correct to the best of my knowledge and belief. In case of any change at any time In theinformation given above, I undertake to intimate those Changes, to the RO/SRO/Branch OffIce within15days.


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J'/l1(T lil--SEC 4} THi: GAZeTTE OF INDIA , A . PR IL 30, 2011 ( VA I SAKHA 10, 19~3)--------------------I. The address of the location of work, administration office, Branch Office, Sales

Office etc.b. The change of management i i K E - Proprietorship to Partnershio etc.

Any change in the existing incumbents along with list ~.,fnew incumbents anr:their pe rman en t nddresses c lod phone numbers.

,. Transfer of the unit bv sale/p,ift/lease en.., along with t"p cQ:;ie~of connect.;documents.

c. ,11,ny change in/ addition to the existing activities, closure of / crt:atlol~ (if O( ".'Sales offices/ Broach office etc.

2. In case of permanent closure, the sa/ne shall be duly intimated along with copies o r thi'connected documents to the Regional Office and the concerned Branch office immediately anthe returns sha ll b e submitted in accordance with Regulation 26 (b) ot ESI(General) Regulations1950."

3. The existing form-1 shall be substituted with the foilowing form.IJF ORM -1

DECLARATION FORM(To be submitted in respect of employee who is not already registered under ES!Act~

1 .

:----~'i~ME-oF-TnEEMPLOYEE ----- -- r-DATE OF BJRTIDAG): -!-'svi--! -~ iARlTA{ --I i I I STATUSj (IN BLOCK LETTERS): ! i


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3100 THE GAZETTE OF IND' '"APRIL 30, 2011 (VAISAKHA 10,'33)==== ==============

[P ART III--SEc. 4

3, Fa1:herIHusband's Name : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 . D:~ of appointment ESIDispensar LChosen for Tr .tment -------'l ],---5, N'::ne &Address ofthe Employer&ne Branch Office to which attact-d (Affix the Seal) :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . , .

.... , ~~ ~ ~ ~ .

. . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6, Details of the Nominee for payment of Cash Benefits after death:Relatlo-n-s-h-ip-&-a-ge-o-r-th-e-- ----P~-rm-a-ne-n-t-A-d-d-res-s--~I

nominee ,I- - ' - - 1I

. I~ ~I ~ JName

~------------+--------!.----------+--- ....-_.-.._--_._._-_.

7, Family Particulars:11 SI,No. I Name & RelatioDship withth I.P If Residing elsewhere.Add I ithDate of Birth&Ag WbetberR 'd' ith, I eason esi lng Wl I ress a ong WlI I

I Name .flhe Slate Idate the I.P,I :j


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,)'(i ill SI-(.4J H1E GAZETTE OF INDIA, APRiL 30, 20]] (VAISAKHA 10,1933)-.~~:=.:~-::::.::::==-----.--.----------. - - 31\

9. In case of person with disability, please specify the nature of Disability and its percentage(Please enclose relevant documents).

DECLARATION1 I undertake to intimate any change in the membership of my family within 15 days of such

change.2. I hereby certify that particulars furnished above are true to the best of my knowledge.

Signature of the l.P .

Countersignature of Principal EmployerOr Authorised Signatory (along with Name & Date) .1

4. The existing form-12 shall be substituted with the following form.-

"Form-12ACC IDEN T REPORT FROM EM PLOYER UN DER REGULAT ION 6 8

D AT E O F A CC IDE NT :1 . N AM E , IN SURAN CE N O . OF IN JURED P ERSON


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-3102 THE AZETTE OF INDIA, APRIL 30,2011 :\.lSAKHA 10, 1933) [ P . - . & T I-SEC, 4

====== ==============

8) iF A C CID EN T OC C l, 'RED O UTS ID E TH E P R EM IS ES OF T, FACTORY OR ESTABLISHMENT

A ) EXA CT ssor 0 H E A C C IDEN TB) W H ER E H E VIlli. "RAVEttlNG TO A T T HA 7 liME

C } TH E DETA ILS o r TH E VEH IC LE H E W A S TRA VELLIN G. [TH E TIM E OF A CC IDEN T,REG ISTRA ION N O., M AK E, W H ETH ER IT IS H IS OWt:,.':TC)

D) W HETH ER H E W AS ON OFF IC IA L DUTY OR COM IN G ro W ORK PLA CE ORR ETU RN IN G H OM E

E ) IS F IR LODG ED A ND A NY POSTM ORTEM CON DUCTP '

D ATE OF A CC IDEN T R EP OR T N Ji./: ;iE , C OD E N O. A N D A D DR ES SO F TH E fA C TO RY lE ST A BLlS HM EN T(S EA L)

S IG NA TUR E OF TH E EM PLOYER I AU THOR IS E D S !G N A TORY". .(B.K.SAHU)

Insurance Commissioner.

esi general amdmt regulations 1.5.2011 (1)

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