Application

ESI Registration Application

A covering application for ESIC registration under the ESI Act, 1948.

Covering Letter for ESI Registration

Date: [DD/MM/YYYY]

To,
The Regional Director,
Employees State Insurance Corporation (ESIC),
[City, State]

Subject: Application for Registration under the ESI Act, 1948 – [Establishment Name]

Respected Sir/Madam,

We, [Establishment Name] situated at [Full Address], hereby apply for registration under the Employees State Insurance Act. The establishment employs [No.] persons drawing wages within the coverable limit and became liable for coverage with effect from [Date]. The principal activity is [Nature of Business].

The following documents are enclosed:

  • Registration/incorporation proof
  • PAN and address proof of the establishment
  • List of employees with wages and Aadhaar
  • Bank details and authorisation of the employer

Kindly grant the ESI registration and allot the establishment code.

Yours faithfully,
[Name]
[Designation], [Establishment Name]
[Mobile] | [Email]

Before you use it — fill in / check

  • Applicant/business
  • To/Authority
  • Detail
  • Date

How to use this template

  1. Read through and replace every [bracketed] or blank placeholder with your actual details.
  2. Delete any clause that doesn't apply and add anything specific to your situation.
  3. Click Print / Save as PDF to download, or Copy text to paste into your letterhead.
  4. Get it signed / stamped / notarised as required, and keep a copy for your records.

This is a general, editable template for convenience only — not legal advice. For anything material, have a professional review it. TaxClue isn't liable for how it's used.