FORM 5

RETURN OF CONTRIBUTIONS
EMPLOYEES' STATE INSURANCE CORPORATION

(Regulation 26)

Name of Branch Office : BO - Kalkaji Employer's Code No. 20001281580001018

Name and Address of the factory or establishment :ABHINAV IMMIGRATION SERVICES PRIVATE LIMITED - 307-A, 3RD FLOOR, DEVIKA TOWER, 6 NEHRU
PLACE, ,
Particulars of the Principal employer(s)
(a) Name :AJAY SHARMA

(b) Designation :Director

(c) Residential Address:Flat No.301, 3rd Floor, CAT-HIG Saraswati, Block K-1 Pocket
-6 Sec-D,VasantKunj New Delhi-110070
Contribution Period from : Apr 2021 to Sep 2021

I furnish below the details of the Employer's and Employee's share of contribution in respect of the under mentioned insured persons. I hereby declare that the return

includes each and every employee, employed directly or through an immediate employer or in connection with the work of the factory / establishment or any

work...............................connected with the administration of the factory / establishment or purchase of raw materials, sale or distribution of finished products etc. to

whom the ESI Act, 1948 applies, in the contribution period to which this return relates and that the contributions in respect of employer's and employee's

share have been correctly paid in accordance with the provisions of the Act and Regulations.

Employees's Share 6,495.00

Employer's Share 28,065.00
Total Contribution 34,560.00

S.No. Month Challan Number Date of Challan Amount Name of the Bank and Branch
1 Apr-2021 02021115170936 5/12/2021 4032.00 State Bank of India

2 May-2021 02021118429262 6/14/2021 5428.00 State Bank of India

3 Jun-2021 02021121392311 7/13/2021 6226.00 State Bank of India

4 jul-2021 02021125325748 8/14/2021 6226.00 State Bank of India

5 Aug-2021 02021127567377 9/10/2021 6628.00 State Bank of India

6 Sep-2021 02021131962742 10/13/2021 6020.00 State Bank of India

Printed By: Page 1 of 3 Print Date: 19-Jun-2024 02:34:33 PM

 Place: Total amount paid: 34560.00

Date: Signature and Designation of the Employer

(with Rubber Stamp)
Important Instructions : Information to be given in 'Remarks Column (No. 9)

(i) If any I.P. is appointed for the first time and / or leaves during the contribution period indicate
"A__________________(date)"and /or"L__________________(date)"

(ii) Please indicate Insurance Nos. in ascending order.

(iii) Figures in Columns 4,5 & 6 shall be in respect of wage periods ended during
the contribution period.

(iv) Invariably strike totals of Columns 4, 5 and 6 of the Return.

For *CP ending 31st March, due date is 12th May

For CP ending 30th September, due date is 11th November

EMPLOYEES' STATE INSURANCE CORPORATION

Employer's Name and Address ABHINAV IMMIGRATION SERVICES PRIVATE LIMITED - 307-A, 3RD FLOOR, DEVIKA TOWER, 6
NEHRU PLACE, ,
Employer's Code No period from Apr 2021 to Sep 2021

Sl.No. Insurance Name of Insured No. of days for Total amount of Employee's Average Whether
Remarks
Number Person which wages wages paid (Rs.) contribution Daily still continues
paid deducted Wages(Rs.) working

1 2017177695 RAKESH 176 95,025.00 713.00 540.00 N

2 2017179621 HARI KARAN MAURYA 176 105,272.00 793.00 599.00 Y

3 2017513757 MANOJ KUMAR 176 102,833.00 776.00 585.00 N

4 2017800421 RYNA RAJAN 0 0.00 0.00 N

5 2017826567 NISHANT VASHIST 127 82,821.00 623.00 653.00 N

6 2017826628 HARSHIT VIRMANI 176 97,144.00 730.00 552.00 N

7 2017841661 JATIN SHARMA 176 114,707.00 863.00 652.00 N

8 2017891194 AMIT 176 74,946.00 564.00 426.00 Y

Printed By: Page 2 of 3 Print Date: 19-Jun-2024 02:34:33 PM

 9 2018248809 YOGESH VITTHAL 176 76,636.00 575.00 436.00 Y
NIKADE

10 2018309317 HIMANSHU 122 79,804.00 600.00 655.00 N

11 2018388943 R UMME SALMA 16 8,054.00 61.00 504.00 N

12 5346740919 ARUN 60 26,230.00 197.00 438.00 Y

*Date of appointment and leaving the job

Signature of the Employer
may be given in remarks column.

(FOR OFFICIAL USE)

1.Entitlement position marked.

2.Total of Col. 5 of Return checked and Found correct/correct amount is indicated

3.Checked the amount of Employer's/Employee's contribution paid which is in order / observation memo enclosed.

Countersignature____________________

U.D.C. Head Clerk Branch Officer

-- End of Report ---

Printed By: Page 3 of 3 Print Date: 19-Jun-2024 02:34:33 PM

 FORM 5

RETURN OF CONTRIBUTIONS
EMPLOYEES' STATE INSURANCE CORPORATION

(Regulation 26)

Name of Branch Office : BO - Kalkaji Employer's Code No. 20001281580001018

Name and Address of the factory or establishment :ABHINAV IMMIGRATION SERVICES PRIVATE LIMITED - 307-A, 3RD FLOOR, DEVIKA TOWER, 6 NEHRU
PLACE, ,
Particulars of the Principal employer(s)
(a) Name :AJAY SHARMA

(b) Designation :Director

(c) Residential Address:Flat No.301, 3rd Floor, CAT-HIG Saraswati, Block K-1 Pocket
-6 Sec-D,VasantKunj New Delhi-110070
Contribution Period from : Oct 2021 to Mar 2022

I furnish below the details of the Employer's and Employee's share of contribution in respect of the under mentioned insured persons. I hereby declare that the return

includes each and every employee, employed directly or through an immediate employer or in connection with the work of the factory / establishment or any

work...............................connected with the administration of the factory / establishment or purchase of raw materials, sale or distribution of finished products etc. to

whom the ESI Act, 1948 applies, in the contribution period to which this return relates and that the contributions in respect of employer's and employee's

share have been correctly paid in accordance with the provisions of the Act and Regulations.

Employees's Share 7,441.00

Employer's Share 32,153.00
Total Contribution 39,594.00

S.No. Month Challan Number Date of Challan Amount Name of the Bank and Branch
1 Oct-2021 02021133907620 11/9/2021 6020.00 State Bank of India

2 Nov-2021 02021137599384 12/9/2021 6020.00 State Bank of India

3 Dec-2021 02022101812665 1/12/2022 6917.00 State Bank of India

4 Jan-2022 02022105430665 2/12/2022 6917.00 State Bank of India

5 Feb-2022 02022109328700 3/14/2022 6119.00 State Bank of India

6 Mar-2022 02022111941333 4/12/2022 7601.00 State Bank of India

Printed By: Page 1 of 3 Print Date: 19-Jun-2024 02:35:43 PM

 Place: Total amount paid: 39594.00

Date: Signature and Designation of the Employer

(with Rubber Stamp)
Important Instructions : Information to be given in 'Remarks Column (No. 9)

(i) If any I.P. is appointed for the first time and / or leaves during the contribution period indicate
"A__________________(date)"and /or"L__________________(date)"

(ii) Please indicate Insurance Nos. in ascending order.

(iii) Figures in Columns 4,5 & 6 shall be in respect of wage periods ended during
the contribution period.

(iv) Invariably strike totals of Columns 4, 5 and 6 of the Return.

For *CP ending 31st March, due date is 12th May

For CP ending 30th September, due date is 11th November

EMPLOYEES' STATE INSURANCE CORPORATION

Employer's Name and Address ABHINAV IMMIGRATION SERVICES PRIVATE LIMITED - 307-A, 3RD FLOOR, DEVIKA TOWER, 6
NEHRU PLACE, ,
Employer's Code No period from Oct 2021 to Mar 2022

Sl.No. Insurance Name of Insured No. of days for Total amount of Employee's Average Whether
Remarks
Number Person which wages wages paid (Rs.) contribution Daily still continues
paid deducted Wages(Rs.) working

1 2017147966 RAMESH 121 66,560.00 500.00 551.00 N

2 2017177695 RAKESH 182 99,156.00 744.00 545.00 N

3 2017179621 HARI KARAN MAURYA 182 109,848.00 828.00 604.00 Y

4 2017513757 MANOJ KUMAR 182 107,304.00 810.00 590.00 N

5 2017826628 HARSHIT VIRMANI 182 116,040.00 872.00 638.00 N

6 2017841661 JATIN SHARMA 123 79,796.00 600.00 649.00 N

7 2017891194 AMIT 182 84,816.00 640.00 467.00 Y

8 2018248809 YOGESH VITTHAL 182 89,032.00 668.00 490.00 Y

NIKADE

Printed By: Page 2 of 3 Print Date: 19-Jun-2024 02:35:43 PM

 9 2018309317 HIMANSHU 182 119,706.00 900.00 658.00 N

10 2018585185 SUNIL SARSWAL 31 16,862.00 127.00 544.00 N

11 2018601193 SRISHTI ARORA 31 20,156.00 152.00 651.00 N

12 5346740919 ARUN 182 79,980.00 600.00 440.00 Y

*Date of appointment and leaving the job

Signature of the Employer
may be given in remarks column.

(FOR OFFICIAL USE)

1.Entitlement position marked.

2.Total of Col. 5 of Return checked and Found correct/correct amount is indicated

3.Checked the amount of Employer's/Employee's contribution paid which is in order / observation memo enclosed.

Countersignature____________________

U.D.C. Head Clerk Branch Officer

-- End of Report ---

Printed By: Page 3 of 3 Print Date: 19-Jun-2024 02:35:43 PM

 FORM 5

RETURN OF CONTRIBUTIONS
EMPLOYEES' STATE INSURANCE CORPORATION

(Regulation 26)

Name of Branch Office : BO - Kalkaji Employer's Code No. 20001281580001018

Name and Address of the factory or establishment :ABHINAV IMMIGRATION SERVICES PRIVATE LIMITED - 307-A, 3RD FLOOR, DEVIKA TOWER, 6 NEHRU
PLACE, ,
Particulars of the Principal employer(s)
(a) Name :AJAY SHARMA

(b) Designation :Director

(c) Residential Address:Flat No.301, 3rd Floor, CAT-HIG Saraswati, Block K-1 Pocket
-6 Sec-D,VasantKunj New Delhi-110070
Contribution Period from : Apr 2022 to Sep 2022

I furnish below the details of the Employer's and Employee's share of contribution in respect of the under mentioned insured persons. I hereby declare that the return

includes each and every employee, employed directly or through an immediate employer or in connection with the work of the factory / establishment or any

work...............................connected with the administration of the factory / establishment or purchase of raw materials, sale or distribution of finished products etc. to

whom the ESI Act, 1948 applies, in the contribution period to which this return relates and that the contributions in respect of employer's and employee's

share have been correctly paid in accordance with the provisions of the Act and Regulations.

Employees's Share 8,544.00

Employer's Share 36,862.00
Total Contribution 45,406.00

S.No. Month Challan Number Date of Challan Amount Name of the Bank and Branch
1 Apr-2022 02022116585567 5/14/2022 8135.00 State Bank of India

2 May-2022 02022119862153 6/14/2022 7370.00 State Bank of India

3 Jun-2022 02022123286530 7/13/2022 6546.00 State Bank of India

4 jul-2022 02022126797675 8/12/2022 7061.00 State Bank of India

5 Aug-2022 02022130916246 9/15/2022 8197.00 State Bank of India

6 Sep-2022 02022134245335 10/13/2022 8097.00 State Bank of India

Printed By: Page 1 of 3 Print Date: 19-Jun-2024 02:36:19 PM

 Place: Total amount paid: 45406.00

Date: Signature and Designation of the Employer

(with Rubber Stamp)
Important Instructions : Information to be given in 'Remarks Column (No. 9)

(i) If any I.P. is appointed for the first time and / or leaves during the contribution period indicate
"A__________________(date)"and /or"L__________________(date)"

(ii) Please indicate Insurance Nos. in ascending order.

(iii) Figures in Columns 4,5 & 6 shall be in respect of wage periods ended during
the contribution period.

(iv) Invariably strike totals of Columns 4, 5 and 6 of the Return.

For *CP ending 31st March, due date is 12th May

For CP ending 30th September, due date is 11th November

EMPLOYEES' STATE INSURANCE CORPORATION

Employer's Name and Address ABHINAV IMMIGRATION SERVICES PRIVATE LIMITED - 307-A, 3RD FLOOR, DEVIKA TOWER, 6
NEHRU PLACE, ,
Employer's Code No period from Apr 2022 to Sep 2022

Sl.No. Insurance Name of Insured No. of days for Total amount of Employee's Average Whether
Remarks
Number Person which wages wages paid (Rs.) contribution Daily still continues
paid deducted Wages(Rs.) working

1 2017147966 RAMESH 183 105,114.00 792.00 575.00 N

2 2017177695 RAKESH 183 115,665.00 873.00 633.00 N

3 2017179621 HARI KARAN MAURYA 183 123,318.00 930.00 674.00 Y

4 2017513757 MANOJ KUMAR 153 102,425.00 770.00 670.00 N

5 2017826628 HARSHIT VIRMANI 30 20,573.00 155.00 686.00 N

6 2017891194 AMIT 183 95,690.00 722.00 523.00 Y

7 2018248809 YOGESH VITTHAL 183 105,831.00 799.00 579.00 Y

NIKADE

8 2018309317 HIMANSHU 61 41,132.00 310.00 675.00 N

Printed By: Page 2 of 3 Print Date: 19-Jun-2024 02:36:19 PM

 9 2018585185 SUNIL SARSWAL 183 106,488.00 804.00 582.00 N

10 2018601193 SRISHTI ARORA 183 124,668.00 936.00 682.00 N

11 2018752478 ABHAY KUMAR 81 52,770.00 397.00 652.00 N

12 2018782825 AKASH KUMAR 61 39,900.00 300.00 655.00 N

13 2018815895 KHUSHI 22 14,521.00 109.00 661.00 Y

14 5346740919 ARUN 183 86,033.00 647.00 471.00 Y

*Date of appointment and leaving the job

Signature of the Employer
may be given in remarks column.

(FOR OFFICIAL USE)

1.Entitlement position marked.

2.Total of Col. 5 of Return checked and Found correct/correct amount is indicated

3.Checked the amount of Employer's/Employee's contribution paid which is in order / observation memo enclosed.

Countersignature____________________

U.D.C. Head Clerk Branch Officer

-- End of Report ---

Printed By: Page 3 of 3 Print Date: 19-Jun-2024 02:36:19 PM

 FORM 5

RETURN OF CONTRIBUTIONS
EMPLOYEES' STATE INSURANCE CORPORATION

(Regulation 26)

Name of Branch Office : BO - Kalkaji Employer's Code No. 20001281580001018

Name and Address of the factory or establishment :ABHINAV IMMIGRATION SERVICES PRIVATE LIMITED - 307-A, 3RD FLOOR, DEVIKA TOWER, 6 NEHRU
PLACE, ,
Particulars of the Principal employer(s)
(a) Name :AJAY SHARMA

(b) Designation :Director

(c) Residential Address:Flat No.301, 3rd Floor, CAT-HIG Saraswati, Block K-1 Pocket
-6 Sec-D,VasantKunj New Delhi-110070
Contribution Period from : Oct 2022 to Mar 2023

I furnish below the details of the Employer's and Employee's share of contribution in respect of the under mentioned insured persons. I hereby declare that the return

includes each and every employee, employed directly or through an immediate employer or in connection with the work of the factory / establishment or any

work...............................connected with the administration of the factory / establishment or purchase of raw materials, sale or distribution of finished products etc. to

whom the ESI Act, 1948 applies, in the contribution period to which this return relates and that the contributions in respect of employer's and employee's

share have been correctly paid in accordance with the provisions of the Act and Regulations.

Employees's Share 10,971.00

Employer's Share 47,329.00
Total Contribution 58,300.00

S.No. Month Challan Number Date of Challan Amount Name of the Bank and Branch
1 Oct-2022 02022137419577 11/11/2022 8309.00 State Bank of India

2 Nov-2022 02022141369004 12/13/2022 9472.00 State Bank of India

3 Dec-2022 02023102744616 1/14/2023 9391.00 State Bank of India

4 Jan-2023 02023106189219 2/14/2023 10647.00 State Bank of India

5 Feb-2023 02023109883415 3/14/2023 10223.00 State Bank of India

6 Mar-2023 02023113276764 4/13/2023 10258.00 State Bank of India

Printed By: Page 1 of 3 Print Date: 19-Jun-2024 02:36:54 PM

 Place: Total amount paid: 58300.00

Date: Signature and Designation of the Employer

(with Rubber Stamp)
Important Instructions : Information to be given in 'Remarks Column (No. 9)

(i) If any I.P. is appointed for the first time and / or leaves during the contribution period indicate
"A__________________(date)"and /or"L__________________(date)"

(ii) Please indicate Insurance Nos. in ascending order.

(iii) Figures in Columns 4,5 & 6 shall be in respect of wage periods ended during
the contribution period.

(iv) Invariably strike totals of Columns 4, 5 and 6 of the Return.

For *CP ending 31st March, due date is 12th May

For CP ending 30th September, due date is 11th November

EMPLOYEES' STATE INSURANCE CORPORATION

Employer's Name and Address ABHINAV IMMIGRATION SERVICES PRIVATE LIMITED - 307-A, 3RD FLOOR, DEVIKA TOWER, 6
NEHRU PLACE, ,
Employer's Code No period from Oct 2022 to Mar 2023

Sl.No. Insurance Name of Insured No. of days for Total amount of Employee's Average Whether
Remarks
Number Person which wages wages paid (Rs.) contribution Daily still continues
paid deducted Wages(Rs.) working

1 2017147966 RAMESH 182 112,570.00 848.00 619.00 N

2 2017177695 RAKESH 182 125,820.00 948.00 692.00 N

3 2017179621 HARI KARAN MAURYA 182 132,218.00 994.00 727.00 Y

4 2017513757 MANOJ KUMAR 0 0.00 0.00 N

5 2017891194 AMIT 182 101,082.00 762.00 556.00 Y

6 2018248809 YOGESH VITTHAL 182 107,274.00 810.00 590.00 Y

NIKADE

7 2018585185 SUNIL SARSWAL 182 110,036.00 830.00 605.00 N

8 2018601193 SRISHTI ARORA 61 41,556.00 312.00 682.00 N

Printed By: Page 2 of 3 Print Date: 19-Jun-2024 02:36:54 PM

 9 2018752478 ABHAY KUMAR 182 119,700.00 900.00 658.00 N

10 2018782825 AKASH KUMAR 182 128,680.00 970.00 708.00 N

11 2018815895 KHUSHI 182 118,800.00 894.00 653.00 Y

12 2018867789 TANISHKA 136 94,361.00 711.00 694.00 N

13 2018867844 AAKRITI KUMARI 87 59,503.00 449.00 684.00 N

14 2018924485 DEEPAK NARESH 90 48,018.00 363.00 534.00 N

GOSAVI

15 2018924513 ANUSHKA SARRAF 89 47,501.00 359.00 534.00 Y

16 2018949484 AMARJOT KAUR 24 15,742.00 119.00 656.00 N

17 5346740919 ARUN 182 93,318.00 702.00 513.00 Y

*Date of appointment and leaving the job

Signature of the Employer
may be given in remarks column.

(FOR OFFICIAL USE)

1.Entitlement position marked.

2.Total of Col. 5 of Return checked and Found correct/correct amount is indicated

3.Checked the amount of Employer's/Employee's contribution paid which is in order / observation memo enclosed.

Countersignature____________________

U.D.C. Head Clerk Branch Officer

-- End of Report ---

Printed By: Page 3 of 3 Print Date: 19-Jun-2024 02:36:54 PM

 FORM 5

RETURN OF CONTRIBUTIONS
EMPLOYEES' STATE INSURANCE CORPORATION

(Regulation 26)

Name of Branch Office : BO - Kalkaji Employer's Code No. 20001281580001018

Name and Address of the factory or establishment :ABHINAV IMMIGRATION SERVICES PRIVATE LIMITED - 307-A, 3RD FLOOR, DEVIKA TOWER, 6 NEHRU
PLACE, ,
Particulars of the Principal employer(s)
(a) Name :AJAY SHARMA

(b) Designation :Director

(c) Residential Address:Flat No.301, 3rd Floor, CAT-HIG Saraswati, Block K-1 Pocket
-6 Sec-D,VasantKunj New Delhi-110070
Contribution Period from : Apr 2023 to Sep 2023

I furnish below the details of the Employer's and Employee's share of contribution in respect of the under mentioned insured persons. I hereby declare that the return

includes each and every employee, employed directly or through an immediate employer or in connection with the work of the factory / establishment or any

work...............................connected with the administration of the factory / establishment or purchase of raw materials, sale or distribution of finished products etc. to

whom the ESI Act, 1948 applies, in the contribution period to which this return relates and that the contributions in respect of employer's and employee's

share have been correctly paid in accordance with the provisions of the Act and Regulations.

Employees's Share 6,988.00

Employer's Share 30,159.00
Total Contribution 37,147.00

S.No. Month Challan Number Date of Challan Amount Name of the Bank and Branch
1 Apr-2023 02023116828894 5/12/2023 7561.00 State Bank of India

2 May-2023 02023119711281 6/9/2023 7347.00 State Bank of India

3 Jun-2023 02023124603737 7/14/2023 6568.00 State Bank of India

4 jul-2023 02023128368032 8/14/2023 5205.00 State Bank of India

5 Aug-2023 02023131804479 9/13/2023 5233.00 State Bank of India

6 Sep-2023 02023135590688 10/12/2023 5233.00 State Bank of India

Printed By: Page 1 of 3 Print Date: 19-Jun-2024 02:37:41 PM

 Place: Total amount paid: 37147.00

Date: Signature and Designation of the Employer

(with Rubber Stamp)
Important Instructions : Information to be given in 'Remarks Column (No. 9)

(i) If any I.P. is appointed for the first time and / or leaves during the contribution period indicate
"A__________________(date)"and /or"L__________________(date)"

(ii) Please indicate Insurance Nos. in ascending order.

(iii) Figures in Columns 4,5 & 6 shall be in respect of wage periods ended during
the contribution period.

(iv) Invariably strike totals of Columns 4, 5 and 6 of the Return.

For *CP ending 31st March, due date is 12th May

For CP ending 30th September, due date is 11th November

EMPLOYEES' STATE INSURANCE CORPORATION

Employer's Name and Address ABHINAV IMMIGRATION SERVICES PRIVATE LIMITED - 307-A, 3RD FLOOR, DEVIKA TOWER, 6
NEHRU PLACE, ,
Employer's Code No period from Apr 2023 to Sep 2023

Sl.No. Insurance Name of Insured No. of days for Total amount of Employee's Average Whether
Remarks
Number Person which wages wages paid (Rs.) contribution Daily still continues
paid deducted Wages(Rs.) working

1 2017147966 RAMESH 91 58,149.00 438.00 639.00 N

2 2017177695 RAKESH 8 5,591.00 42.00 699.00 N

3 2017179621 HARI KARAN MAURYA 0 0.00 0.00 Y

4 2017891194 AMIT 183 109,681.00 826.00 600.00 Y

5 2018248809 YOGESH VITTHAL 183 116,471.00 877.00 637.00 Y

NIKADE

6 2018585185 SUNIL SARSWAL 183 117,132.00 882.00 641.00 N

7 2018752478 ABHAY KUMAR 8 5,320.00 40.00 665.00 N

8 2018782825 AKASH KUMAR 0 0.00 0.00 N

Printed By: Page 2 of 3 Print Date: 19-Jun-2024 02:37:41 PM

 9 2018815895 KHUSHI 61 39,600.00 298.00 650.00 Y

10 2018867789 TANISHKA 91 62,907.00 474.00 692.00 N

11 2018924485 DEEPAK NARESH 183 102,990.00 777.00 563.00 N

GOSAVI

12 2018924513 ANUSHKA SARRAF 183 96,036.00 726.00 525.00 Y

13 2018949484 AMARJOT KAUR 0 0.00 0.00 N

14 2019022724 SUKKA HYMAVATHI 177 115,820.00 870.00 655.00 N

15 5346740919 ARUN 183 98,175.00 738.00 537.00 Y

*Date of appointment and leaving the job

Signature of the Employer
may be given in remarks column.

(FOR OFFICIAL USE)

1.Entitlement position marked.

2.Total of Col. 5 of Return checked and Found correct/correct amount is indicated

3.Checked the amount of Employer's/Employee's contribution paid which is in order / observation memo enclosed.

Countersignature____________________

U.D.C. Head Clerk Branch Officer

-- End of Report ---

Printed By: Page 3 of 3 Print Date: 19-Jun-2024 02:37:41 PM

 FORM 5

RETURN OF CONTRIBUTIONS
EMPLOYEES' STATE INSURANCE CORPORATION

(Regulation 26)

Name of Branch Office : BO - Kalkaji Employer's Code No. 20001281580001018

Name and Address of the factory or establishment :ABHINAV IMMIGRATION SERVICES PRIVATE LIMITED - 307-A, 3RD FLOOR, DEVIKA TOWER, 6 NEHRU
PLACE, ,
Particulars of the Principal employer(s)
(a) Name :AJAY SHARMA

(b) Designation :Director

(c) Residential Address:Flat No.301, 3rd Floor, CAT-HIG Saraswati, Block K-1 Pocket
-6 Sec-D,VasantKunj New Delhi-110070
Contribution Period from : Oct 2023 to Mar 2024

I furnish below the details of the Employer's and Employee's share of contribution in respect of the under mentioned insured persons. I hereby declare that the return

includes each and every employee, employed directly or through an immediate employer or in connection with the work of the factory / establishment or any

work...............................connected with the administration of the factory / establishment or purchase of raw materials, sale or distribution of finished products etc. to

whom the ESI Act, 1948 applies, in the contribution period to which this return relates and that the contributions in respect of employer's and employee's

share have been correctly paid in accordance with the provisions of the Act and Regulations.

Employees's Share 5,026.00

Employer's Share 21,697.00
Total Contribution 26,723.00

S.No. Month Challan Number Date of Challan Amount Name of the Bank and Branch
1 Oct-2023 02023139432610 11/11/2023 4222.00 State Bank of India

2 Nov-2023 02023142515010 12/9/2023 4098.00 State Bank of India

3 Dec-2023 02024101878445 1/11/2024 4098.00 State Bank of India

4 Jan-2024 02024105350130 2/10/2024 3993.00 State Bank of India

5 Feb-2024 02024110195807 3/13/2024 5156.00 State Bank of India

6 Mar-2024 02024114661551 4/15/2024 5156.00 State Bank of India

Printed By: Page 1 of 3 Print Date: 19-Jun-2024 02:38:13 PM

 Place: Total amount paid: 26723.00

Date: Signature and Designation of the Employer

(with Rubber Stamp)
Important Instructions : Information to be given in 'Remarks Column (No. 9)

(i) If any I.P. is appointed for the first time and / or leaves during the contribution period indicate
"A__________________(date)"and /or"L__________________(date)"

(ii) Please indicate Insurance Nos. in ascending order.

(iii) Figures in Columns 4,5 & 6 shall be in respect of wage periods ended during
the contribution period.

(iv) Invariably strike totals of Columns 4, 5 and 6 of the Return.

For *CP ending 31st March, due date is 12th May

For CP ending 30th September, due date is 11th November

EMPLOYEES' STATE INSURANCE CORPORATION

Employer's Name and Address ABHINAV IMMIGRATION SERVICES PRIVATE LIMITED - 307-A, 3RD FLOOR, DEVIKA TOWER, 6
NEHRU PLACE, ,
Employer's Code No period from Oct 2023 to Mar 2024

Sl.No. Insurance Name of Insured No. of days for Total amount of Employee's Average Whether
Remarks
Number Person which wages wages paid (Rs.) contribution Daily still continues
paid deducted Wages(Rs.) working

1 2017179621 HARI KARAN MAURYA 60 41,750.00 314.00 696.00 Y

2 2017891194 AMIT 183 119,700.00 900.00 655.00 Y

3 2018248809 YOGESH VITTHAL 183 118,692.00 894.00 649.00 Y

NIKADE

4 2018585185 SUNIL SARSWAL 10 6,297.00 48.00 630.00 N

5 2018815895 KHUSHI 70 46,337.00 349.00 662.00 Y

6 2018924485 DEEPAK NARESH 101 60,292.00 454.00 597.00 N

GOSAVI

7 2018924513 ANUSHKA SARRAF 183 107,868.00 813.00 590.00 Y

8 2019022724 SUKKA HYMAVATHI 0 0.00 0.00 N

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 9 2019198831 VICKY SHARMA 174 63,537.00 480.00 366.00 N

10 5346740919 ARUN 183 103,032.00 774.00 564.00 Y

*Date of appointment and leaving the job

Signature of the Employer
may be given in remarks column.

(FOR OFFICIAL USE)

1.Entitlement position marked.

2.Total of Col. 5 of Return checked and Found correct/correct amount is indicated

3.Checked the amount of Employer's/Employee's contribution paid which is in order / observation memo enclosed.

Countersignature____________________

U.D.C. Head Clerk Branch Officer

-- End of Report ---

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