Form 5

ESI Form 5 is a Return of Contribution form to be submitted half yearly with details of employee wise ESI contribution made on a monthly basis.

To view the ESI Form 5,

Go to Gateway of Tally > Display > Payroll Reports >Statutory Reports > Employee State Insurance>Form 5

Go to Gateway of Tally > Display > Statutory Reports > Payroll Reports >Employee State Insurance>Form 5

The required period can be specified in the From and To fields. By default the values are pre-filled with the Contribution Period based on the last data entry date.
Employee Category: You can select the required Cost Category when there is more than one Payroll/Cost categories.
Employee/Group: You can print the report for a specific group or All Items.
Sorting Method: Select the required Sorting Method from the list.
Appearance of Employee Names: Select the required display Name style name
Place: The name of the place where the organisation is located has to be provided against this field to print the same in the Form 5.
Date of Printing: The user can specify the desired date of printing, by default the actual date of printing will be selected.
Authorised Signatory: Name of the signing authority should be entered in this field.
Designation: The designation of the authorised signatory in Form 3 needs to be entered in this field.
Residential Address: Enter the residential address of the authorised signatory in this field.

The printed Form 5 – page 1 is displayed as shown:

Name of Branch Office: This displays the ESI branch office for the Company as specified in the F11: Statutory & Taxation screen while enabling Payroll Statutory features.
Employer’s Code No.: This displays the ESI Code of Employer as specified in F11: Statutory & Taxation screen while enabling Payroll Statutory features.
Name & Address of the Factory/Establishment: This displays the Company name & address.
Employer’s Code: This displays the ESI Code allotted to Employer as specified in the F11: Statutory & Taxation screen while enabling ESI.
Particulars of Principal Employers (Name, Designation and Residential Address) are printed as specified in the Print Configuration screen.
Period From and To is printed as specified in the Print Configuration screen.
Total ESI amount contributed with the break-up of Employer’s share and Employees’ share is displayed based on the calculations.

Column Details in table

Column Name	Description
Sl. No.	Displays the serial no.
Month	Displays the Month name for which the ESI payment is made.
Challan Dates	Displays the Challan dates for the ESI payments.
Amount	Displays the Challan amount for ESI Payments.
Name of the Bank and Branch	Displays the name of the bank and branch code as specified in the Challan details screen.

Place: The Name of the place as specified in the Print Configuration screen is displayed in this field.

Date: The Date of Printing as specified in the Print Configuration screen is displayed in this field.

Designation: The Designation of the signing authority is displayed in this field.

The printed Form 5 – page 2 is displayed as shown:

The Page 2 contains the required instructions and CA Form.

Column 2: Insurance number (ESI number) assigned to each employee as entered in the Employee Master is displayed in this column.

Column 3: The name of Insured person (Employee) appears is displayed in this column.

Column 4: The total number of days for which the wages/salary is paid during the selected period to each employee is displayed in this column.

Column 5: The amount of wages (regular income considered for ESI calculation) for the selected period is displayed in this column for each employee.

Column 6: The Employee’s contribution towards ESI during the given period for each employee is printed in this column.

Column 7: The average daily wages calculated based on the total wages divided by the number of working days, is printed in this column.

Column 7(A): Shows whether the employee is still working with the company and still eligible for the ESI benefits,

Column 8: Name of the ESI dispensary as entered in the Employee Master to which the each employee is associated is printed in this column.

Column 9: The remarks needs to be entered manually in this column.

Column Name	Description
Sl. No.	Displays the serial no.
Insurance No.	Displays the ESI number for each employee as entered in the Employee Master.
Name of the Insured Person	Displays the name of the Employees who are eligible for ESI.
No. of days for which wages paid/payable	Displays total number of working days for which wages (salary) is paid/payable during the Contribution period for each employee.
Total amount of wages paid/payable	Displays total wages (salary) paid/payable for the given Contribution period for each employee.
Employees' contribution deducted	Displays the Employee share of ESI contribution for the given contribution period each employee.
Average Daily wages 5/4	Displays average daily wages the amount of ESI contribution for the selected Contribution period for each employee.
Whether still continue working and drawing wages within the insurable wages ceiling	Displays the status as Yes or No showing whether the employee is still working with the company and still eligible for the ESI benefits based on Gross wages drawn during the last month of Contribution period.
Name of the Dispensary of IP.	Displays the name of the ESI dispensary as entered in the Employee Master to which the each employee is associated.
Remarks	Remarks if any should be entered in this column manually.

Note: Facility is provided to print only the duplicate copies of ESI Form 3, Form 5 and Challan.