Payment of Gratuity Act,1972

Forms as per norm of Payment of Gratuity Act,1972

Form No. A- Notice of Opening
Form No. B- Notice of Change
Form No. C- Notice of Closure
Form No. D- Notice for Excluding Husband from Family
Form No. E- Notice of Withdrawal of Notice for excluding Husband from family
Form No. F- Nomination
Form No. G- Fresh Nomination
Form No. H- Modification of Nomination
Form No. I- Application for Gratuity by an Employee
Form No. J- Application for Gratuity by a Nominee
Form No. K- Application for Gratuity by a Legal Heir
Form No. L- Notice for Payment of Gratuity
Form No. M- Notice Rejecting Claim for Payment of Gratuity
Form No. N- Application for Direction
Form No. O- Notice for Appearance before the Controlling Authority
Form No. P- Summons
Form No. Q- Particulars of Application under Section 7
Form No. R- Notice for Payment of Gratuity
Form No. S- Notice for Payment of Gratuity as Determined by Appellate Authority
Form No. T- Application for Recovery of Gratuity
Form No. U- Abstract of the Act and Rules

REGISTERS TO BE MAINTAINED UNDER FACTORIES ACT,1948

Forms Purpose

Form 5 - Certificate of fitness.
Form 10 - Over Time.
Form 11 - (Notice of periods of workers for adult worker
And children)
Form 29 - Particulars of rooms in the factory
Form 12 - Register of Adult Workers.
Form 15 - Register of Leaves.
Form 18 - Accident report / ESI
Form 26 - Accident Book.
Form 7I - Record of white washing & paintings.
Form 35 - Register of trained workers.
Form 36 - Register of lifting fitting clothes.
Form 37 - Register of lifting materials.
Form 38 - Report of examination of lifts and hoists.

Important Norms of E.S.I. Act,1948

Wages ceiling up to Rs. 15000/- Gross P.M.
Employee Contribution - 1.75%
Employer Contribution - 4.75%
Monthly Challans along with amount shall be paid on or before 21st of every month.


Some Important Forms:

Form-01 Employers Register Form

Form-1 Declaration Form

Form-3 Return of declaration form

Form-1B Change in the family particulars

Form-6 Return of Contributions.

Form-16 Accident Reports.

ESIC-37 Certificate of re-employment/
Continuing employment.

Form-53 Application for change of dispensary.

ESIC-71 Wages/Contributory Record.

Form-72 Application for duplicate
Identity card.

Form-86 Certificate of employment
Issued to I.P.(Insured Person) by employer.

Form-105 Certificate of entitlement for
Medical treatment.


Form-7 List of employees (A separate Register should be maintained)
Form-15 Accident Book. (A separate Register should be maintained)

Provident Fund To Be Filed

Annual Return

Form 3A (Member's annual Contribution Form showing month wise contribution, Before 30th April)
Form 6A (annual contributions of each member of the establishment, before 30th April)

Monthly Return

Form 5 (For New Joined Employees, to be submitted along with Form-12A every month)
Form 10 (For Exit Employees, to be submitted along with Form-12A every month)
Form 2 (Nomination Form, to be attached with Form 5)
Form 12A (Monthly Return, before 25th of the following month)

ESI And PF Combined Challan

Central Government has approved common challan for depositing ESI and PF monthly contribution with effect from April 2010.