Form 105 Word Format: Esic

[HEADER: EMPLOYEES' STATE INSURANCE CORPORATION] Form 105 (Revised) Month/Year of Contribution: _____________ Employer Code: _____________

For each employee covered under ESIC:

Example: Gross wages ₹10,000 → Employee: ₹75, Employer: ₹325 → Total ₹400. esic form 105 word format