ESIC Form 37 Download – Filled Sample

ESIC Form 37 has to be submitted by employer to local ESI office that comes under its jurisdiction. In this post i will explain the purpose of the ESI Form 37 and include links to download form 37. You can also find filled sample form to easily understand the fields in application form.

ESI Form 37 (Employee State Insurance Corporation Forms)

This form is known as Certificate of Re-employment or Continuing Employment.

Form 37 is a declaration by employer with respect to employee’s reemployment or continuity of the employment during insurable contribution period to be submitted on demand by local ESI office.

ESI Form 37 is also applicable when an employee resign and joins a new company. The new employer is required submit form 37 to carry forward the employee’s ESI Number. So, whenever your new employer ask you to fill form 37, you must enter old ESI Number in order to carry forward the contributions you already made to your ESI account.

The employer must submit this form to ESIC local office to continue the ESIC old account.

ESIC Form 37 Filled Sample

You need to provide the following details in form 37 before submitting it to your employer. So that your employer can forward it to ESI local office. I have provided sample esic form 37 here under. If you need detailed information regarding the fields in sample form, you can refer the detailed explanation provided below.

1. Write your current employer company name in this field
2. Write your current employer Address in this field
3. Write current employer ESI Code. You may contact your HR manager / personnel dept. for this information.
4. Write employee name as it appears on Id proofs.
5. Write employee father name as per ID proof.
6. Write the employee ESI IP Number. If you don’t provide this number, ESI will assign a new number. If you have changed your company, be sure to enter old ESI IP number without fail in this field.
7. Write the date on which you started contributing to ESI account after joining the new company or current company.
8. Write the date on which you joined new company or current company.
9. Write the last date on which you contributed to ESIC account when working with old employer.
10. Write the date of submitting this form
11. Your current Employer should sign and write the designation along with office seal before forwarding the ESIC Form 37 to ESI office.

I have provided ESIC Form 37 Filled sample here. Refer to it, if you have problem in filling the application.

Click Here for ESIC Form 37 Pdf Download