Central Form 1 Declaration Form - Ways to Fill the Form

The Employees’ State Insurance Act 1948, a.k.a. ESI Act, of which the Central Form 1 Declaration Form is a part, is a social insurance scheme for employees working in Indian companies or the Indian offices of foreign companies. The Act specifies the rules governing the Employees’ State Insurance Scheme. The primary objective of the Employees’ State Insurance Scheme is to protect employees against the effects of sickness, disablement, maternity, and death during employment. The scheme also provides medical treatment and care to the employees possessing ESI cards and their dependent family members.

The Employees’ State Insurance Act 1948, of which the Central Form 1 Declaration Form is a part, is also referred to as Act No. 34 of 1948 or XXXIV of 1948. It was promulgated on 19th April 1948. The Central Form 1 Declaration Form rules are contained in the Employees’ State Insurance (General) Regulations 1950. The Indian Government published the Employees’ State Insurance (General) Regulations on 17th October 1950.

The Employees’ State Insurance Act 1948, of which the Central Form 1 Declaration Form is a part, applies to all Indian states except for Arunachal Pradesh, Sikkim, Manipur, Mizoram, and Nagaland. The Act applies to all non-seasonal establishments, including factories, hotels, cinemas, restaurants, shops, newspaper establishments, educational institutions, private medical institutions, and road-motor transport undertakings employing more than ten (10) workers. Since 01.01.2017, the wage limit for including an employee in the ESI Scheme is INR 21,000 per month.

This article explains the Central Form 1 Declaration Form’s various provisions and enlists the best way to fill the Form. Besides explaining every section of the Central Form 1 Declaration Form in detail, the following sections also contain information about the compliance forms every Factory/ Human Resource/ Personnel Manager needs to fill and submit to the appropriate authority every year.

For easy understanding, this article on Central Form 1 Declaration Form has been divided into the following subsections:

What is the Central Form 1 Declaration Form?

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

Central Form 1 Declaration Form refers to the declaration an employee has to fill and submit to their employer, and the employer has to fill and submit to the ESI Corporation. Besides filling up the Central Form 1 Declaration Form, the employee must attach two (2) recent passport-sized photographs.

According to the Employees’ State Insurance (General) Regulations 1950, the filled Central Form 1 Declaration Form, along with the supporting documents, must be submitted to the ESI Branch Office under whose jurisdiction the factory or company falls within ten (10) days of the concerned employee’s appointment. It is also good to note that any delay by the employer might expose them to penal actions under Section 85 of the Employees’ State Insurance Act 1948. And if the employee makes any false statement in the Central Form 1 Declaration Form, they might be punished with a fine of INR 2,000 and/or six months’ imprisonment. Also, if there is any change in the employee’s family member, the employee must inform the ESI Corporation of such a change within fifteen (15) days of the change.

In the Central Form 1 Declaration Form, the employee and employer of a registered factory or company need to enter the following details:

  • Insurance number of the insured person
  • Name of the insured person in block letters
  • The insured person’s father’s/husband’s name
  • The insured person’s date of birth
  • The insured person’s present address
  • The insured person’s permanent address
  • Details of Nominee u/s 71 of ESI Act 1948/Rule-56(2) of ESI (Central) Rules, 1950
  • Employer’s Code No.
  • The insured person’s date of appointment
  • Name & Address of the Employer
  • The insured person’s previous employment details
  • The insured person’s previous insurance number
  • The Employer’s Code No. of the previous employer
  • Telephone number and email address of the previous employer
  • Family Particulars of the insured person, including the name, date of birth, relationship with the employee, and residential status

While filling the Central Form 1 Declaration Form, the employer needs to verify the particulars of the employee and issue a Temporary Identity Card. The Temporary Identity Card contains details like the insured person's name, Insurance number, and date of appointment: Branch Office, Dispensary, the Employer’s Code No. & address, and validity. The Temporary Identity Card is signed by the T.I. of I.P. and the Branch Manager with a seal.

Who Needs to Submit the Central Form 1 Declaration Form?

According to Regulation Nos. 11 and 12 of the Employees’ State Insurance (General) Regulations 1950, the Central Form 1 Declaration Form must be filled and submitted by the following two categories of employees and employers:

Category 1 - Employed Persons on the Appointed Day

According to Regulation No. 11 of the Employees’ State Insurance (General) Regulations 1950, the Central Form 1 Declaration Form must be filled by every employee of an establishment or factory on or before the appointed day. The law mandates both the employee and employer to furnish the Central Form 1 Declaration Form details. After the employee fills out the Central Form 1 Declaration Form and the photograph, the employer must provide them with a Temporary Identification Certificate. After issuing the Certificate, the employer needs to obtain the employee’s thumb impression or signature before filling the remaining sections of the Form.

Category 2 - Employed Persons After the Appointed Day

According to Regulation No. 11 of the Employees’ State Insurance (General) Regulations 1950, the Central Form 1 Declaration Form must be filled by the employee and submitted along with the photographs of themselves and their family members before the appointed day. After the employee fills out the Central Form 1 Declaration Form, the employer must enter the Temporary Identification Certificate details. After entering the Certificate details, the employer needs to obtain the employee’s thumb impression or signature before filling the remaining sections of the Form.

Which Compliance Forms Does the Employer Need to Submit?

According to the Employees’ State Insurance Act 1948, all employers must submit the following compliance forms, besides the Central Form 1 Declaration Form, to appropriate authorities:

  • Employer Registration
  • Employee Registration
  • Form 1 - Declaration Form
  • Form 01(A) - Form of Annual Information
  • Form 2 - Addition/Deletion in Family Declaration
  • Form 3 - Return of Declaration Form
  • Form 6 - Register of Employees
  • Form 9 - Claim for Sickness/ Temporary Disablement Benefit/Maternity Benefit
  • Form 11 - Accident Book
  • Form 12 - Accident Report
  • Form 12A - claim for Maternity benefit for sickness
  • Form 13 - claim for Sickness or Temporary disablement or Maternity
  • Form 14 - Sickness or Temporary disablement or maternity benefit for sickness
  • Form 15 - Claim Dependent Benefit
  • Form 16 - Claim for Periodical Payment of Dependent Benefits
  • Form 19 - Claim for Maternity Benefit and notice of work
  • Form 20 - Claim for Maternity Benefit by a Nominee
  • Form 21 - Maternity Benefit - Certificate of Expected Confinement
  • Form 22 - Funeral Expense Claim
  • Form 23 - Life Certificate for Permanent Disablement Benefit
  • Form 24 - Declaration & Certificate for Dependent’s Benefit

Central Form 1 Declaration Form - How to Fill The Form?

This section explains all the Central Form 1 Declaration Form subsections to help you fill the form correctly. The employer and the employee may fill the form in English or Hindi.

Here are the subsections of the Central Form 1 Declaration Form the employee and employer need to fill before submitting it to the ESI Corporation’s Branch Office:

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  • Insurance number of the insured person - The insurance number refers to a unique number alloted to an employee by the ESI Branch Office.
  • Name of the insured person in block letters - The employee must enter their name in capital letters in this subsection of the Central Form 1 Declaration Form.
  • The insured person’s father’s/husband’s name - The employee must provide his or her father’s name in this box. If the employee is a married woman, she must provide her husband’s name.
  • The insured person’s date of birth - Here, the employee needs to enter their date of birth. The date of birth must be mentioned in appropriate documentary evidence.
  • The insured person’s present address - The employer must enter their present residential address in this section.
  • The insured person’s permanent address - The employer must enter their permanent residential address in this section. The permanent address must be mentioned in appropriate documentary evidence.
  • Details of Nominee u/s 71 of ESI Act 1948/Rule-56(2) of ESI (Central) Rules, 1950 - The employee needs to furnish the details of the nominee in this subsection of the Central Form 1 Declaration Form. The nominee details must contain the name of the nominee, relationship status with the insured person, and the nominee’s address.
  • Employer’s Code No. - The employer needs to enter the Code No. or Registration Number allotted to the establishment or factory as per the provisions of the Employees’ State Insurance Act 1948, of which the Central Form 1 Declaration Form is a part.
  • The insured person’s date of appointment - The employer must enter the date on which the employee was appointed in the establishment or factory.
  • Name & Address of the Employer - The manager filling this subsection of the Central Form 1 Declaration Form needs to enter the establishment name and address.
  • The insured person’s previous employment details - The employee must enter their previous employment details in this box.
  • The insured person’s previous insurance number - The employee needs to mention the insurance number (if applicable).
  • The Employer’s Code No. of the previous employer - The employee must write the Employer’s Code No. of their previous employer.
  • Telephone number and email address of the previous employer - Enter the official telephone number and email address of the employee’s previous employer.
  • Family Particulars of the insured person - In this subsection of the Central Form 1 Declaration Form, the employee must mention the name, date of birth, relationship with the employee, and residential status of all beneficiaries (dependent family members).

Conclusion

The Central Form 1 Declaration Form is a mandatory requirement for employers and employees of establishments and factories operating within the territory of India. The Form is freely available and serves as the gateway to quality healthcare. An insured person and their dependent family members get various benefits, including total medical care, sickness, permanent and temporary disability, and maternity. However, the advantages mentioned above are subject to contributory conditions specified in the Employees’ State Insurance Act 1948, of which the Central Form 1 Declaration Form is a part.

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Key Takeaways

  • The Employees’ State Insurance Act 1948, a.k.a. ESI Act, of which the Central Form 1 Declaration Form is a part, is a social insurance scheme for employees working in Indian companies or the Indian offices of foreign companies
  • Central Form 1 Declaration Form refers to the declaration an employee has to fill and submit to their employer, and the employer has to fill and submit to the ESI Corporation
  • According to the Employees’ State Insurance (General) Regulations 1950, the fully filled Central Form 1 Declaration Form, along with the supporting documents, must be submitted to the ESI Branch Office under whose jurisdiction the factory or company falls within ten (10) days of the concerned employee’s appointment
  • If the employee makes any false statement in the Central Form 1 Declaration Form, they might be punished with a fine of INR 2,000 and/or six months’ imprisonment.
  • While filling the Central Form 1 Declaration Form, the employer needs to verify the particulars of the employee and issue a Temporary Identity Card
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