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ACCIDENT REPORT dwV la ;k Code No. chek r O;fDr dk uke o irk dk;Z ;k O;olk; dk Lo:i Name & Address of insured person Nature of Industry/ business 'kk kk dk;kZy; Branch Office chekad fyax ifjlj dk irk tgka nq?kZVuk gqbZA Insurance No. Sex Address of premises where accident happened vk;q fiNyk tUe fnu foHkkx O;olk; Age (Last birthday) Deparment Occupation ikjh le; Shift Hour nq?kZVuk dh rkjh k o le; nq?kZVuk dgk gqbZ Date and hour of Accident Exact place of acc.

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How it works Open the esic form 16 download and follow the instructions. Easily sign the form 16 esi accident report with your finger. Send filled & signed esic accident report form 16 pdf or save.

The rates are revised from time to time. Currently, the employee's contribution rate (w.e.f. 01.07.2019) is 0.75% of the wages and that of employer's is 3.25% of the wages paid/payable in respect of the employees in every wage period.

Registered users can login directly using their CPGRAM user ID and password. Login into CPGRAM. In section "Grievance Detail" select "Others/Not Listed/Not Known" In the "Ministry/Department" Drop Down Select ESIC. In "Subordinate Department/Office" select the Regional Office. Provide details of the complaint. Proceed.

Form 86 - Certificate of employment. Form 63 - Declaration form with regards to payment to the legal heir. Form 53 - Application form for change in particulars of insured person. Form 37 - Certificate of re-employment or continuous employment.

Below are the steps mentioned to check the ESI claim status online: Open the UMANG App or you can download it on your smartphone. Enter the IP number or the ESIC Insurance Number and click on 'Get OTP'. Enter the OTP that will be sent to the reference phone number and click on 'Submit'.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232