ESIC Form 5 Download
 

Can anyone provide me ESIC Form 5 of Return Of Contributions?

Re: ESIC Form 5 Download
 

You want ESIC Form 5 of Return Of Contributions so I have this form and I am giving it to you:

Name of Branch Office .................................
Name and Address of the factory or establishment :
Particulars of the Principal employer(s)
(a) Name :
(b) Designation :
(c) Residential Address
Employer's Code No. ...................
..........................
..........................
..........................
..........................
Contribution Period from ............................... to ..........................
D I furnish below the details of the Employer's and Employee's share of contribution in respect of the under mentioned insured persons. I hereby declare that the return includes each and every employee, employed directly or through an immediate employer or in connection with the work of the factory / establishment or any work...............................
connected with the administration of the factory / establishment or purchase of raw materials, sale or distribution of finished products etc. to whom the ESI Act, 1948 applies, in the contribution period to which this return relates and that the contributions in respect of employer's and employee's share have been correctly paid in accordance with the provisions of the Act and Regulations.

I am uploading file of form and you are free to download it.