Downloadable Forms

FORM NO. SUBJECT RELEVANT REGULATION TO BE USED BY
       
FORM-9 Claim for Sickness/ Temporary Disablement Benefit/Maternity Benefit 63 & 89(B) IP/Beneficiary
FORM-11 Accident Book 66 Employer
FORM-12 Accident Report from Employer 68 Employer
FORM-14 Claim for Permanent Disablement Benefit 76(A) IP/Beneficiary
FORM-15 Claim for Dependent Benefit 80 IP/Beneficiary
FORM-16 Claim for periodical payment of Dependent Benefits 83(A) IP/Beneficiary
FORM-19 Claim for Maternity Benefit and notice of work 88, 89 & 91 IP/Beneficiary
FORM-20 Claim for Maternity Benefit after the death of an Insured Women leaving behind the child 89(A) IP/Beneficiary
FORM-22 Funeral Expenses Claim 95(E) Beneficiary
FORM-23 Life Certificate for Permanent Disablement Benefit 107 IP/Beneficiary
FORM-24 Declaration and Certificate for Dependents Benefit 107(A) IP/Beneficiary