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Independent Verification Worksheet Ind V1 20142015 Please read the entire form, complete ALL sections, attach the requested documentation, sign the form, and return to the Financial Aid Office. By

How to fill out form 10 esic

How to fill out form 10 ESIC:

1. Gather the necessary information: Before filling out form 10 ESIC, make sure you have all the required information at hand. This includes details like your employer's name and address, your personal details, such as name, date of birth, and contact information, as well as your employment details.
2. Download or obtain the form: You can find form 10 ESIC on the official website of the Employees' State Insurance Corporation (ESIC). Alternatively, you can also visit an ESIC office to obtain a physical copy of the form.
3. Fill in your personal details: Begin by filling in your personal information accurately. This includes your name, date of birth, gender, marital status, and contact details. Ensure that you provide all the required information in the designated spaces.
4. Provide your employment details: In the next section of the form, fill in your employment information. This includes details like your employer's name, address, employee code number, and whether you are employed on a regular or temporary basis. Fill in all the requested information accurately.
5. Complete the family particulars section: In this section, provide details about your family members who are dependent on you. This may include your spouse, children, parents, or any other eligible dependents. Fill in their names, dates of birth, and relationship with you.
6. Declare your previous insurance coverage: If you were previously covered under any insurance scheme, disclose the same in this section. Provide information about the scheme, the organization, the period of coverage, and the policy number, if applicable.
7. Signature and submission: Once you have carefully filled out all the sections of form 10 ESIC, review the information for accuracy. Sign the form in the specified space and date it. Keep a photocopy of the form for your records, and submit the original form to the relevant ESIC office or your employer, as instructed.

Who needs form 10 ESIC?

1. Employees covered under the Employees' State Insurance (ESI) scheme: Form 10 ESIC is primarily required by employees who are covered under the Employees' State Insurance (ESI) scheme. This scheme provides various social security benefits to employees and their dependents.
2. Employees seeking medical benefits: Form 10 ESIC is specifically required when an employee seeks medical benefits under the ESI scheme. By filling out this form, employees can apply for medical treatment, reimbursement of medical expenses, or cash benefits during sickness, maternity, or any other eligible event.
3. Employees applying for permanent disablement benefit: If an employee suffers permanent disablement due to an employment injury, they may be eligible for permanent disablement benefits under the ESI scheme. In such cases, form 10 ESIC is necessary to initiate the process of claiming these benefits.

Note: The specific requirements and eligibility criteria for form 10 ESIC may vary based on the applicable laws and regulations in your country or jurisdiction. It is advisable to refer to the official guidelines and consult with the relevant authorities for accurate and up-to-date information.

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What is form 10 esic?

Form 10 esic is a declaration form issued by the Employees' State Insurance Corporation (ESIC) for the registration of employees.

Who is required to file form 10 esic?

Employers are required to file form 10 esic for all their eligible employees.

How to fill out form 10 esic?

Employers can fill out form 10 esic online on the ESIC portal by providing the necessary information about their employees.

What is the purpose of form 10 esic?

The purpose of form 10 esic is to register eligible employees for the ESIC scheme, which provides them with benefits such as medical, sickness, maternity, and disablement benefits.

What information must be reported on form 10 esic?

Employers must report information such as the employee's name, address, date of birth, salary details, and family details on form 10 esic.