EMPLOYEES’ STATE INSURANCE CORPORATION · 2020. 10. 29. · certificate’ for 2020-21 from the...

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कर्मचारी राज्य बीर्ा निगर् EMPLOYEES’ STATE INSURANCE CORPORATION

श्रर् और रोजगार रं्त्रालय, (भारत सरकार) MINISTRY OF LABOUR & EMPLOYMENT, (GOVERNMENT OF INDIA)

ईरे्ल-:[email protected]@esic.nic.in ;;वेबसाइट: https://www.esic.nic.in/

No: L-11/12/3/UG-Admission/2020-21/MEC Date: 29.10.2020

ADMISSION NOTICE

ADMISSION OF ‘WARDS OF INSURED PERSONS’ (IPs) IN UG COURSE

(MBBS/BDS) IN ESIC MEDICAL/DENTAL & SOME GOVERNMENT MEDICAL

COLLEGES under ‘INSURED PERSONS (IPs) QUOTA’ FOR ACADEMIC

SESSION 2020-21.

1. ESI Corporation, a statutory body established by an Act of Parliament, i.e. ESI Act [Act

No. 34] of 1948 subsumed in Social Security Code 2020, under the administrative control

of Ministry of Labour & Employment, Govt. of India, has started Medical Education

Institutions in the country at large.

2. The approved provisional policy and procedure (Annexure-1) for admission to under

graduate (MBBS/BDS) Courses in ESIC Medical Education Institutions, provides for

‘Insured Persons (IPs) Quota’ after allocation to “All India Quota” and the

“State Government Quota”.

3. ‘Wards of Insured persons’ under ESI Scheme who meet the laid down

eligibility criteria and have qualified in National Eligibility cum Entrance Test

(UG)-2020 [NEET (UG) - 2020] can apply for admission to UG course

(MBBS/BDS) in ESIC Medical/Dental Colleges and some Government Medical

Colleges under ‘Insured Persons Quota’ for academic session 2020-21 as per

admission policy and procedure approved by the Government of India / ESI

Corporation.

रु्ख्यालय, क. रा. बी. निगर्, HEADQUARTERS, E.S.I.C.

नचनकत्सा निक्षा प्रकोष्ठ, MEDICAL EDUCATION CELL

पंचदीप भवि : सी.आई.जी.र्ागम, PANCHEEP BHAWAN: C.I.G. MARG

िईनदल्ली-110002 NEW DELHI-110002

mailto:[email protected]:[email protected]://www.esic.nic.in/

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4. Provisional number of MBBS/BDS seats under ‘Insured person Quota’ is as under.

Name - Medical College (125) annual MBBS seats) Insured Person (IP) Quota –

No. of Seats

1. ESIC Medical College Faridabad, Haryana 43

2. ESIC Medical College Joka, Kolkata, WB 65

3. ESIC Medical College K.K.Nagar, Chennai, TN 25

4. ESIC Medical College Rajajinagar, Bengaluru, Karnataka 56

5. ESIC Medical College Gulbarga, Karnataka 56

6. ESIC Medical College Sanathnagar, Hyderabad 43

7. Government Medical College, Coimbatore, Tamil Nadu* 20

8. Shri Lal Bahadur Shastri Medical College, Ner Chowk ,Mandi, Himachal Pradesh*

36

9. Government Medical College, Kollam, at Paripally* 39

TOTAL 383

*Infrastructure of erstwhile proposed ESIC Colleges at serial No.(7) to (9) has been

transferred to respective State Governments to establish and run these colleges. These

colleges contribute seats to the ESIC ‘pool’ of seats for ‘Insured Persons (IPs) Quota’

as per terms of MoU for transfer of these colleges. The numbers are as conveyed by

the colleges.

ESIC Dental College (62 annual BDS seats)

Insured Persons (IPs) Quota – No. of Seats

1. Gulbarga, Karnataka 28

TOTAL 28

The reservation in r/o of the above seats would be as per extant Central Government

guidelines in the matter.

5. Mechanism for filling up of ‘Insured Persons Quota’ (erstwhile ESIC

Management Quota)

5.1 Available seats of ‘Insured Persons Quota’ in various States will be pooled on ‘All

India Basis’ and allotted, amongst the wards of Insured persons (IPs).

5.2 The ‘guiding principles’ for filling up of ‘Insured Persons Quota’ will be as

under:-

5.2.1 Reservation policy of Central Government for SC/ST/OBC/PH/EWS etc. will

be followed for allotment of seats

5.2.2 Candidates seeking admission under ‘Insured Persons Quota’ will have to fulfill

the following eligibility criteria:

a) Minimum eligibility criteria for admission will be as per MCI/NMC

regulations.

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b) Applicant must have a valid “Ward of Insured Person” Certificate,

issued by concerned Regional Director/SRO I/C. [Annexure –

3(A); or 3(B) for PDB/DB cases].

c) The selection and admission to MBBS seats in any Medical Institution

recognized for running MBBS Courses as per Indian Medical Council Act

1956 subsumed into The National Medical Commission Act, 2019, is

subject to fulfilling the admission criteria, eligibility, medical fitness and

such other criteria as may be prescribed by the Universities etc. In event

of any difference in criteria of MCI/NMC and Affiliating University etc., the

higher criteria will prevail.

d) Applicants are advised to refer to the websites of the Affiliating

Universities, i.e. Rajiv Gandhi University of Health Sciences (RGUHS) for

ESIC colleges in Karnataka; West Bengal University of Health Sciences

(WBUHS) for ESIC college in West Bengal; The Tamil Nadu Dr. MGR

Medical University (TNMGRMU) for ESIC / (State) Government Medical

college in Tamil Nadu; and Pt. BD Sharma University of Health Sciences

for ESIC college in Haryana, Kaloji Narayana Rao University of Health

Sciences (KNRUHS), for ESIC college in Telangana; and Himachal

Pradesh University, Shimla; Kerala University of Health Sciences (KUHS)

for Government medical colleges in Mandi, Himachal Pradesh and

Paripally, Kollam, Kerala respectively, for further information.

5.2.3 Methodology for filling up of Insured Persons (IPs) Quota for 2020-

21 – (ref. Para[4] of Annexure-1) - Candidates will be allotted seats,

based on their ‘merit cum preference of Institution, through a

centralized ‘on-line’ counseling to be conducted by Directorate

General of Health Services (DGHS) for the ‘Insured Persons Quota’ as

per schedule provided on their website www.mcc.nic.in

5.2.4 Candidates are requested to check the ESIC (www.esic.nic.in) and

DGHS (www.mcc.nic.in) web-site regularly for further details.

6. HOW TO APPLY

6.1 Issue of ward of IP Certificate – All candidates must have valid ‘Ward of IP

certificate’ for 2020-21 from the concerned Regional Office (RO) / Sub-regional

Office (SRO) of the ESI Corporation (ESIC). The procedure for obtaining the same

is as under:

6.1.1 Candidates are to apply on-line and click in on the ‘link’ to be provided

on the ESIC website www.esic.nic.in , when a page would be displayed

for registration.

http://www.mcc.nic.in/http://www.esic.nic.in/http://www.esic.nic.in/

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6.1.2 Following the registration, applicant is required to complete the form

(page) filling up the details asked for.

Only candidates who are in receipt of Dependents Benefit (IP is no longer

alive); or where the parent is receiving Permanent Disablement Benefit

(hence an IP for ESIC) may fill ‘Yes’ at serial No. 18 & 19 of the form.

6.1.3 After the form is complete, the applicant is to take a printout, sign it (both

IP and candidate) and submit it to the concerned Branch Office of ESIC

along with all required documents, for issue of ‘Ward of IP certificate’. It

may be ensured that the correct information is filled up as the system will

allow generation of only one application against an e-mail ID and mobile

number.

6.1.4 Candidate should enclose self attested copies with the application and

carry originals for verification at the time of submitting the application, as

under:

Relevant under ESI

▪ Two (2) Passport size photographs of the IP

▪ Copy of - ESI Card

▪ Copy of documents in r/o employee/IP

‾ Wage Slip for September 2019

‾ Certificate of Attendance r/o the IP for 01 year from

cut-off date (30.09.19), i.e. from 01/10/2018 or from

date of entering employment, whichever is later, to

30.09.2019.

‾ Detail of EPFO payment in r/o the employee, if

available.

Note: Not required in cases of (i) IPs not working in

establishment/factory covered under ESI Act but in

receipt of PDB as on 30.09.19; (ii) candidates in

receipt of Dependents’ Benefit

▪ Copy of proof of

‾ Candidate in receipt of Dependents’ Benefit.

‾ IP in receipt of PDB

▪ Copy of Affidavits for female candidates as Annexure – 4 & 5

Relevant to Candidate (Ward of IP)

▪ Two (2) Passport size photographs of the ‘Ward of IP’ (candidate)

▪ Copy of NEET Admit Card containing NEET Roll No. of 2020 Exam.

(It may be ensured that the NEET 2020 Roll Number is filled up

and not the NEET Application number)

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▪ Copy of – Proof of Residence

▪ Copy of - School Certificate for proof of Date of Birth / Birth

Certificate

▪ Copy of - Senior Secondary School certificate (+2).

‾ Final / Provisional / Not Available [in case ‘ward of IP’ certificate is

applied for, before declaration of result of (+2)]

▪ Copy of SC/ST/OBC/PH Certificate from the ‘Appropriate Authority’ as

specified in the NEET Brochure

▪ Copy of EWS Certificate from the ‘Appropriate Authority’

6.1.5 A system generated ‘Acknowledgement Slip’, duly signed and stamped by

the Branch Office manager would be given to the candidate. The system

would allow generation of only one Acknowledgement slip against a given

Insurance Number and Name of candidate.

6.1.6 The candidate can track the progress of the certificate by logging in with

the username and password, i.e. as (i) Issued; or (ii) Rejected. In event

of issue, the certificate in PDF format would be visible to the candidate

who can take a printout after downloading the certificate. In event of

rejection, the reason would be displayed as well.

6.1.7 The original certificate, as issued by the relevant RO/SRO, would be

collected from the Branch Office by the candidate.

6.2 The Student link for applying on-line for issue ‘Ward of IP Certificate’

would tentatively activated on 06/11/2020 and deactivated (closed) at

23:59 hrs on 09/11/2020.

6.3 The last date for submitting physical copy of application to the

concerned Branch Office, for issue of ‘Ward of IP Certificate’ is

10/11/2020, by close of office hours.

6.4 Registration at DGHS website for participating in counseling - Candidates

may log on to the DGHS website (www.mcc.nic.in) and register themselves for

the MBBS/BDS seats under ‘Insured Persons (IPs) Quota’ in ESIC Medical/Dental

Colleges as per Instructions given on the website.

6.5 Candidates are requested to check the DGHS (www.mcc.nic.in) web-site

regularly for further details.

http://www.mcc.nic.in/

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7. OTHER IMPORTANT INSTRUCTIONS

7.2 Fee structure Stipulation on annual basis:

Tuition Fee Rs 24,000/-(Rs. Twenty four thousand only) per annum

University Charges As per Actual

College Security Deposit

(Refundable)

Rs 5000/- (Five thousand only) per annum i.e. chargeable

annually

Hostel Charges To be decided separately

Hostel and Mess Security To be decided separately

Mess Charges As per actual

Note: As the MBBS Course is 4 ½ years Course, The tuition fee to be charged for the

final year will be half of the Annual Tuition Fee.

7.3 Demand Draft (DD) of Rs. 24000/- drawn in favor of ‘ESI Fund Account No. 2’,

payable at city where the college is located, shall have to be deposited at

the time of completing the admission process at the ESIC Medical / Dental College,

after allotment of seat. There will be no capitation fee or profiteering in any

form.

7.4 The above at Para (7.3) would not be applicable to students allotted MBBS seat

at Shri Lal Bahadur Shastri Government Medical College, Ner Chowk, Mandi (HP)

and Government Medical College, Paripally, Kollam, Kerala. The student will have

to deposit the annual tuition fee of Rs. 24,000/- in the form specified by the

college.

7.5 Completion of Admission process at the concerned Medical College, ESIC

or otherwise, after allotment of seat.

7.5.1 Candidate should also bring the following documents in original along with

self-attested copies for verification failing which they will not be allowed to

complete the admission process

a) ESIC Pehchan card

b) Secondary School Certificate which must bear Date of Birth or Birth

Certificate.

c) Senior Secondary School certificate (+2). Provisional if final has not

been issued.

d) Admit card for National Eligibility cum Entrance Test-2020 [NEET (UG)

- 2020]

e) Score card [NEET - 2020] with Rank Position i.e. All India Rank

f) ‘Ward of Insured Person’ Certificate from Competent Authority

(Annexure – 3(A), 3(B) as applicable).

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g) SC/ST/OBC/PH Certificate as applicable; and in the format as per

NEET-2019 brochure. The PH certificate would be subject to verification

by Competent ESIC Board, if required.

h) EWS Certificate by Appropriate Authority

i) For FEMALE CANDIDATES ONLY

Affidavit by candidate as per Annexure - 4

Affidavit by IP as per Annexure – 5

7.5.2 Candidates are also requested to check the DGHS

(www.mcc.nic.in) web-site regularly for further details in this

regard.

7.6 ‘Insured Persons Quota’ - Ref: Para (3) of Annexure - 1. The seats shall be

filled up, inter-alia, as may be specified by ESIC from time to time.

7.7 Execution of Bond for Service – Ref Para (7) of Annexure – 1 – Format of

UG Bond is enclosed as Annexure – 6A & 6B

7.8 Insured person for the purpose of availing benefit under ‘Insured Persons

Quota’- ref Para (8) of Annexure – 1

7.9 ‘Ward of Insured Person’ for the purpose of availing benefit under ‘Insured

Persons Quota’- ref Para (9) of Annexure – 1

7.10 The critical cut-off date for determining;

7.10.1 Eligibility of Insured person for availing benefit under the ‘Insured

Persons’ Quota for his/her child/children would be 30th September,

2019, i.e. only a person who is ‘Insured Person’ as per the Act, as on

30/09/2019 would be eligible for availing benefit under the ‘Insured

Persons’ Quota for his/her child/children.

7.10.2 The age of dependent male ‘Ward of IP’ for eligibility under the

‘Insured Persons Quota’ should not be more than 21 years as on 31st

December, 2020 (31.12.2020). The said date would not apply to

dependent unmarried female Ward of IP as per provisions of the ESI Act,

1948. [Only for 2020-21]

8. All processes / actions undertaken regarding admissions under IP Quota for

2020-21 would be subject to final outcome in WA 2274 & 2304 of 2019.

Medical Education Cell, HQ (For Director General)

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ANNEXURE-1

ADMISSION POLICY FOR UNDER GRADUATE (MBBS/BDS) ADMISSIONS FOR

ACADEMIC SESSION 2020-21

Admission procedure for under graduate courses (MBBS and BDS) in ESIC

Medical Education institutions shall be as follows:

1. All India Quota: ‘All India Quota’ will be 15% of total available seats in each of its

Medical Institutions, Or, All India Quota will be as per the prevailing Central

Government’s [i.e. Ministry of H & FW] directives for the said quota, from time to time.

It will be filled up as per policy, including reservation policy, and procedures of the

Central Government.

2. State Government Quota: Based on the location of the ESI’s Medical Education

Institution, a ‘State Government Quota’ will be as per the policy of respective States

applicable to un-aided non-minority Institutions, or in the absence thereof, as may be

mutually agreed to, between the respective State Government and the ESI Corporation

from time to time. The Admissions to these seats will be made according to the policy,

including reservation policy, and procedures of the State Government concerned, and

these seats will be filled up accordingly.

3. Insured Persons (IPs) Quota: The remaining seats after allocation to All India

Quota and the State Govt. Quota shall be treated as “Insured Persons (IPs) Quota”. It

shall comprise of seats ‘pooled’ together on All India basis from various ESIC

Medical/Dental Colleges, as the case may be. The seats shall be allotted to the ‘Wards

of Insured Persons’ (IPs) on All India basis and shall be filled-up through merit cum

preference basis, following due process specified below or as may be specified by ESIC

from time to time.

4. Methodology for filling up of Insured Persons (IPs) Quota: Available seats of

"Insured Persons (IPs) Quota” in various States will be pooled on ‘All India Basis’ and

allotted, among the wards of Insured persons (IPs). The ‘guiding principles’ for filling

up of ‘Insured Persons Quota’ will be as under:-

4.1 The Insured Persons (IPs) Quota seats will be filled through merit cum

preference basis.

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4.2 Reservation policy of the Central Government will be followed, within the

Insured Persons (IPs) Quota enumerated above.

4.3 Candidates seeking admission under ‘Insured Persons (IPs) Quota’ will have to

fulfill the following eligibility criteria:

4.3.1 Minimum eligibility criteria for admission will be as per MCI/NMC

regulations

4.3.2 Submit “Ward of Insured Person” certificate issued by Competent/

designated Authority for the purpose by ESIC.

4.4 Prospective/desirous and eligible candidates will be required to appear in an All

India competitive examinations in force or any other similar equivalent approved

Central entrance test as may be specified from time to time by ESIC.

4.5 After qualifying in such Centralized test, candidates have to respond to the

advertisement by the ESIC and, apply for admission under the Insured Persons

(IPs) Quota.

4.6 Merit list would be prepared based on the All India rank of eligible applicants in

the specified test/merit list for the year, consistent with the reservation policy

of the Central Government for preparation of category-wise inter-se merit.

4.7 Candidates will be allotted the seats, based on their merit cum preference of

Institution and category, through a centralized counseling for the Insured

Persons (IPs) Quota

4.8 Mop-up Counselling – Mop-up counseling would be conducted as per

feasibility. Seats falling vacant / remaining unfilled/leftover, due to any

reason, would be offered to balance candidates as per the guidelines of the

counseling Authority.

5. Unfilled/leftover seats, if any, after conclusion of all counsellings will be

surrendered to the respective State Government for inclusion in the State

Government Quota, to be filled up as per policy, including reservation policy, and

procedures of the State Government in a manner so as to comply with the laid

down time schedule for completion of admission process.

6. Fee structure Stipulation:

Fee structure (Tuition fee & other approved fee) in ESIC Medical Education

Institutions will be as may be approved by ESIC from time to time. There will be

no capitation fee or profiteering in any form.

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7. Execution of Bond for Service

All Candidates seeking admission to any ESIC Medical Education Institution will

have to execute a bond for ₹ 5 lakh, to serve any ESIC / ESI Scheme (ESIS

institution run by State Government) for a period of 01 years, as may be

specified, from time to time. Further, the candidate would have to submit a Bank

Guarantee for ₹ 05 lakh within three months of start of internship year. The

original documents of the student would be retained by the Corporation pending

the submission of Bank Guarantee. Period of rural service, if any, as per policy of

the Central or State Government, will be inclusive in the one year period of the

bond.

8. Insured person for availing the benefit of MBBS/BDS seats for his/her wards

shall be ‘as defined under Section (2), subsection (14) of the ESI Act, 1948’, as

on the last day of the contribution period immediately preceding the date of

notification for NEET-UG for the relevant year. Definition under Section (2),

subsection (14) of the ESI Act, 1948 ’is reproduced as under;

“Insured person” means a person who is or was an employee in respect

of whom contributions are or were payable under this Act and who is

by reason thereof, entitled to any of the benefits provided under this

Act”.

Note: The critical date for eligibility under ‘IP Quota’ for 2020-21 would be

30/09/2019, i.e. only a person who is ‘Insured Person’ as per the Act, as on

30/09/2019 would be eligible for availing benefit under the ‘Insured Persons’

Quota for his/her child/children.

9. ‘Ward of Insured Person’ will be children/child of an Insured person who

are/is eligible for benefit under the ESI Act as on 31st December, 2020, for

admission to MBBS/BDS course (only for 2020-21).

Note: The critical date for determining age of the Ward of the IP as per Section

2 (11) (iii) of the ESI Act, 1948, for the benefit of admission to MBBS/BDS course

under Insured Person Quota, would be 31/12/2020.

10. Regional Director/Other Officer/Authority/Committee under ESIC as may be

specified by ESIC from time to time shall be the Competent Authority to issue the

“Ward of Insured Person” certificate. The specified Competent Authority of ESIC

will issue the certificate.

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ANNEXURE - 2

List of Enclosures to be carried along-with, with self attested photocopies,

for Completion of Admission process at the concerned Medical College, ESIC

or otherwise, after allotment of seat

i) ESIC Pehchan card

ii) Secondary School Certificate which must bear Date of Birth or Birth Certificate.

iii) Senior Secondary School certificate (+2). Provisional if final has not been

issued.

iv) Admit card for in National Eligibility cum Entrance Test-2020 [NEET (UG) -

2020]

v) Score card [NEET - 2020] with Rank Position i.e. All India Rank

vi) ‘Ward of Insured Person’ Certificate from Competent Authority in original.

vii) SC/ST/OBC/PH Certificate as applicable; and in the format as per NEET-2020

brochure. The PH certificate would be subject to verification by Competent ESIC

Board, if required.

viii) EWS Certificate by Appropriate Authority

ix) For FEMALE CANDIDATES ONLY

Affidavit by candidate as per Annexure - 4

Affidavit by IP as per Annexure – 5

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ANNEXURE-3(A)

‘WARD of IP’ CERTIFICATE (2020-21) Certificate No…………………………………. NEET Roll No. …………………………………

‘Ward of Insured Person’ (IP) – CERTIFICATE (To be issued on OFFICIAL LETTERHEAD)

1. This is to certify that ____________________________________ Son /Daughter/Ward of

Shri/Smt _____________________________ Insurance No: __________________ is ‘Ward

of Insured person’ as per records; and satisfies the eligibility criteria as in the Admission

Policy (2020-21) for admission to MBBS/BDS course under ‘Insured persons’ Quota’ in ESIC

Medical / Dental Colleges and some other Govt. Medical Colleges.

2. This certificate is being issued on the basis of Verification of records by Shri/Smt.

____________________________________ (designation)…….___________________at

Regional/SRO Office __________________________ for eligibility under “Insured Persons

Quota” for admission to Undergraduate course, i.e. MBBS/BDS in ESIC Medical / Dental

Colleges and some other Govt. Medical Colleges for the Academic Session 2020-21

DATE REGIONAL DIRECTOR/SRO I/c

PLACE (Duly stamped)

Photo of IP

(As

Uploaded)

Photo of

‘Ward of IP’

(As

Uploaded)

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ANNEXURE-3(B)

‘WARD of IP CERTIFICATE’ (2020-21) Certificate No…………………………………. NEET Roll No. ………………………………… (To be issued on OFFICIAL LETTERHEAD) ‘Ward of Insured Person’ (IP) – CERTIFICATE for (Delete whatever is not applicable)

i. Ward of IPs in receipt of Dependents’ Benefit

OR

ii. IPs in receipt of PDB for

1. *This is to certify that ____________________________Son /Daughter/Ward of Late

Shri/Smt. ___________________________ Insurance No: _______________________ is in

receipt of Dependents’ Benefit and is eligible ‘Ward of IP’ for the benefit of admissions under

‘Insured persons’ Quota’ to MBBS/BDS course in ESIC Medical/dental Colleges and some other

Govt. medical Colleges.

OR

2. *Shri/Smt ______________________________Insurance No: _______________________ is

in receipt of Permanent Disablement Benefit (PDB) w.e.f.______________. His / Her ward;

Name_______________________ satisfies the eligibility criteria as in the Admission

Policy (2020-21) for admission to MBBS/BDS course under ‘Insured persons’ Quota’ in ESIC

Medical / Dental Colleges and some other Govt. Medical Colleges.

*Strike out (1) or (2) as applicable

3. This certificate is being issued on the basis of Verification of records by Shri/Smt.

____________________________________ (designation) ___________________at Regional/SRO

Office __________________________ for eligibility under “Insured Persons Quota” for admission

to Undergraduate course, i.e. MBBS/BDS in ESIC Medical / Dental Colleges and some other Govt.

Medical Colleges for the Academic Session 2020-21

DATE REGIONAL DIRECTOR /SRO I/c

PLACE (Duly stamped)

Photo of IP

(As

Uploaded)

Photo of

‘Ward of IP’

(As

Uploaded)

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ANNEXURE - 4

AFFIDAVIT (By Female Candidate only)

1. That deponent Ms……………………., aged………years is the Daughter of

Shri/Smt…………………….

2. Shri/Smt……………………. is employed with the factory / establishment,

viz…………………………….. covered under ESI Act vide Code No……………

3. The father/mother of the deponent is beneficiary under the ESI Act having Insurance no

…………………..

4. The deponent is unmarried and wholly dependent on the earnings of Insured Person.

5. The deponent hereby declares that aforesaid facts are correct on the basis of the record

and if the aforesaid declaration is found to be incorrect and contrary to the records, the

admission sought shall be declared illegal and liable to be cancelled.

6. The deponent further declares that if the information submitted by the deponent is found

to be incorrect the deponent would be liable to be prosecuted in accordance with law.

DEPONENT

VERIFICATION:

I swear by this Affidavit that the contents of my above affidavit are true and correct to my

knowledge and belief. No part of it is false and nothing relevant has been concealed therein.

Verified at …………………… on this ……………day of …………………….., 2020.

DEPONENT

[To be duly Notarized]

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ANNEXURE – 5

AFFIDAVIT

(By IP – only in case of female candidate)

1. That deponent is an employee with the factory/establishment,

viz.……………………..………. covered under ESI Act vide Code No………………………The

deponent is a beneficiary under ESI Act. having Insurance

No………………………………………

2. The deponent has got Daughter (Name:……………………….) is………years of age.

3. The Daughter (Name :……………………………………) of the deponent is unmarried and

wholly dependent on the earnings of Insured Person.

4. The deponent hereby declares that aforesaid facts are correct on the basis of the

record and if the aforesaid declaration are found to be incorrect and contrary to the

records, the admission sought shall be declared illegal and liable to be cancelled.

5. The deponent further declares that if the information submitted with the deponent is

found to be incorrect the deponent would be liable to be prosecuted and face the

consequential action which the ESI Corporation may deem fit and proper.

DEPONENT

VERIFICATION

I swear by this Affidavit that the contents of my above affidavit are true and correct to

my knowledge and belief. No part of it is false and nothing relevant has been concealed

therein.

Verified at ………………………… on this…………………………………..day of …………………… 2020

DEPONENT

[To be duly Notarized]

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ANNEXURE – 6A

FORMAT OF BOND

(FOR UG –MEDICAL/DENTAL STUDENTS in ESIC Colleges)

(To be executed on Stamp Paper of value as applicable under Stamp Duty Act.

Duly Notarized) KNOW ALL MEN BY THESE PRESENTS THAT We (1)

(Mr./Mrs./Ms.)______________________________(herein-after called the Bounden)

son/daughter/wife of _______________________________________ residing at (Residential

Address………………………………………….) and (2) Shri /

Smt.____________________________________________ (hereinafter called ‘the

Surety/Sureties’) son/daughter/wife of _______________________________

residing at (Here enter address) _____________________________________________do

hereby bind ourselves and each of us & our respective heirs, executors & administrators jointly

and severally to pay to the Employees’ State Insurance Corporation (hereinafter referred to as

‘the Corporation’) on demand the total amount of Rs 5,00,000 (Rupees Five Lakh only) with

interest @ 12% towards failure to fulfill the obligation/ for violation of the condition here-in-after

mentioned. The bounden and sureties shall furnish Bank Guarantee** amounting to Rs 5,00,000

(Rupees Five lakh only) in favour of the Dean of the ESIC Institution in lieu of the amount within

03 months of internship year. The total obligation amount would not exceed Rs. 05 lakh at any

stage. The original documents of the student would be retained by the Corporation pending the

submission of Bank Guarantee.

Signed this ................ Day of ...............in the year................ by the bounden

(Mr./Mrs./Ms.)..................... and Surety/Sureties Shri / Smt…………………………………….

Signature In the presence of Witness*:

1. Signature

(Name & Address with official seal)

1. Signature of BOUNDEN (Name & Address**; Photo ID No.)

2. Signature (Name & Address)

2. Signature of SURETY/SURETIES (Name & Address**; Photo ID No.)

**The provision of Bank Guarantee is subject to final outcome in various Writ Petitions pending in the Hon’ble High Courts.

WHEREAS the Bounden (Mr./Mrs./Ms.) ….............. has been selected to

undergo...................................................... (here enter the name of the course of study) on

the basis of merit Central/State/Stake Holder in ESIC Medical Education Institution (Name of the

Institution) ______________________ for a period of ________(duration of Course).

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AND WHEREAS the Corporation have agreed to incur the expenses on condition that after

successful completion of the course of study the bounden shall serve any of the institution, of the

Corporation or of ESI Scheme of the State Government, as the case may be, for a period of one

year anywhere in India and also subject to the terms and conditions hereinafter appearing and

the bounden and the surety/sureties have agreed to the same.

NOW the condition of the above written obligation is that in the event the Bounden

discontinues the study or after completion of the MBBS/BDS Course of study to which he/she was

selected, fails to serve the Corporation for period of one year, the Corporation shall have the right

to invoke the Bank Guarantee so furnished by the Bounden and sureties.

The bond is legally binding on the bounden and the sureties. The above written

obligation shall be void and of no effect in event of invocation of Bank Guarantee; otherwise this

shall remain in full force and effect.

PROVIDED further that the bounden and the surety/sureties do hereby agree that all

sums found due to the Corporation under or by virtue of this bond shall be recovered jointly and

severally from them and their properties movable and immovable as if such dues were arrears of

land revenue under the provisions of the Revenue Recovery Act for the time being in force or in

such other manner as the Corporation may deem fit.

PROVIDED further that during the tenure of study the Bounden shall be paid stipend in

the internship year as per guidelines of Ministry of Health & Family Welfare, GoI, or as decided by

the Corporation from time to time.

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29.10.2020

Provided further that it is not necessary for the Corporation to sue the bond holder before

taking action on the surety/sureties, under this bond and the liabilities of the surety/sureties is

Co-extensive with that of the Bounden and shall not be affected by the Corporation giving time or

any other indigence to the bounden or by the Corporation varying of the terms and conditions

herein contained,


(Mr./Mrs./Ms.)..................... and surety/sureties Shri / Smt…………………………………….

Signature

In the presence of Witness*:

1. Signature (Name & Address with official seal)

1. Signature of BOUNDEN (Name & Address**; Photo ID No.)


2. Signature of SURETY/SURETIES (Name & Address**; Photo ID No.)

Vetted and is formally in order.27-04-10

K.N.Chaturvedi, Advocate

*Dean/Administrative Officer of ESIC Medical Education Institution will sign as witness.

**Proof of Residential Address of Bounden and Surety/Sureties is to be obtained.

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ANNEXURE – 6B

FORMAT OF BOND

(FOR UG –MEDICAL STUDENTS in State Govt. Colleges with IP Quota seats)

(To be executed on Stamp Paper of value as applicable under Stamp Duty Act. Duly Notarized)

KNOW ALL MEN BY THESE PRESENTS THAT We (1)

(Mr./Mrs./Ms.)______________________________(herein-after called the

Bounden)son/daughter/wife of _______________________________________ residing at

(Residential Address………………………………………….) and (2) Shri /

Smt.____________________________________________ (hereinafter called ‘the

Surety/Sureties’)son/daughter/wife of _______________________________residing

at (Here enter address) _____________________________________________do hereby bind

ourselves and each of us & our respective heirs, executors & administrators jointly and

severally to pay to the Employees’ State Insurance Corporation (hereinafter referred to as ‘the

Corporation’) on demand the total amount of Rs 5,00,000 (Rupees Five Lakh only) with interest

@ 12% towards failure to fulfill the obligation/ for violation of the condition here-in-after

mentioned. The bounden and sureties shall furnish Bank Guarantee** amounting to Rs 5,00,000

(Rupees Five lakh only) in favour of the Regional Director, ESIC, in lieu of the amount within

03 months of internship year. The total obligation amount would not exceed Rs. 05 lakh at any

stage. The original documents of the student would be retained by the Corporation pending the

submission of Bank Guarantee.


(Mr./Mrs./Ms.).....................and Surety/Sureties Shri/Smt…………………………………….

Signature In the presence of Witness*:

3. Signature

(Name & Address with official seal)

3. Signature of BOUNDEN (Name & Address**; Photo IDNo.)


4. Signature of SURETY/SURETIES (Name & Address**; Photo IDNo.)

**The provision of Bank Guarantee is subject to final outcome in various Writ Petitions pending in the Hon’ble High Courts.

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WHEREAS the Bounden (Mr./Mrs./Ms.) ….............. has been selected to

undergo...................................................... (here enter the name of the course of study) on

the basis of merit Central/State/Stake Holder in (Name of the Institution)

______________________ for a period of ________(duration of Course).

AND WHEREAS after successful completion of the course of study the bounden shall serve

any of the institution, of the Corporation or of ESI Scheme of the State Government, as the case

may be, for a period of one year anywhere in India and also subject to the terms and conditions

hereinafter appearing and the bounden and the surety/sureties have agreed to the same.

NOW the condition of the above written obligation is that in the event the Bounden

discontinues the study or after completion of the MBBS/BDS Course of study to which he/she was

selected, fails to serve the Corporation for period of one year, the Corporation shall have the right

to invoke the Bank Guarantee so furnished by the Bounden and sureties.

The bond is legally binding on the bounden and the sureties. The above written obligation

shall be void and of no effect in event of invocation of Bank Guarantee; otherwise this shall

remain in full force and effect.

PROVIDED further that the bounden and the surety/sureties do hereby agree that all

sums found due to the Corporation under or by virtue of this bond shall be recovered jointly and

severally from them and their properties movable and immovable as if such dues were arrears of

land revenue under the provisions of the Revenue Recovery Act for the time being in force or in

such other manner as the Corporation may deem fit.

PROVIDED further that during the tenure of study the Bounden shall be paid stipend in

the internship year as per guidelines of Ministry of Health & Family Welfare, GoI, or as decided by

the Corporation from time to time.

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29.10.2020

Provided further that it is not necessary for the Corporation to sue the bond holder before

taking action on the surety/sureties, under this bond and the liabilities of the surety/sureties is

Co-extensive with that of the Bounden and shall not be affected by the Corporation giving time or

any other indigence to the bounden or by the Corporation varying of the terms and conditions

herein contained,


(Mr./Mrs./Ms.)..................... and surety/sureties Shri/Smt…………………………………….

Signature

In the presence of Witness*:

3. Signature (Name & Address with official seal)

3. Signature of BOUNDEN (Name & Address**; Photo IDNo.)


4. Signature of SURETY/SURETIES (Name & Address**; Photo IDNo.)

Vetted and is formally in order.27-04-10

K.N.Chaturvedi, Advocate

*Dean/Administrative Officer of ESIC Medical Education Institution will sign as witness.

**Proof of Residential Address of Bounden and Surety/Sureties is to be obtained.

EMPLOYEES’ STATE INSURANCE CORPORATION · 2020. 10. 29. · certificate’ for 2020-21 from the...

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Transcript of EMPLOYEES’ STATE INSURANCE CORPORATION · 2020. 10. 29. · certificate’ for 2020-21 from the...