Form No: CPIS - 8: Please Fill Up The Form According To The Instructions Given at The End)
Form No: CPIS - 8: Please Fill Up The Form According To The Instructions Given at The End)
3 . Gender (M/F):
SC
ST
10 .PRAN* No. *Note: For those Employees appointed on or after 1st January, 2005
15.Name of Service (Please tick the appropriate one): IAS / IPS / IFS / MCS / MPS / MFS / Jr.MCS / MSS / MHS / MJS / MVS / Manipur Forest Service / Lecturer (UGC Scale) 16. Current Designation/Post: 17. Permanent/Temporary Employee: 18. Present Place of Posting:
20. Date of Retirement: 21. Fathers / Husbands Name (in BLOCK Letters):
NO 22. Dependants (Tick the Appropiate Box only): YES If YES, Mention as per Service Book Record:
Relat Nam ions Sl. e hip Age 1 2 3
1S
PB1
PB2
PB3
PB4
HA G
Fix ed
25. Gra de Pay: 24. Basic Pay: AC AC P-I P-II 26. ACP (Tick one):
NO
29. Hou se Rent Allo wan ce (HR A): 28. Dearness Allowance (DA):
31. Tran spor t Allo wan ce(T A): 30. Special Compensatory Allowance (SCA): 32. Allowance**:
a)
Non-Practicing Allowance:
b)
Special Allowance:
**Note: Insert other Allowance by concerned Dept. if not mentioned. 33. Total Emoluments:
34. Date of Next Increment (D.N.I): (DD/MM/YYYY) 35. Name of the Bank in which Salary account is Opened:
Signature by DDO/HOO Name: Name: (in Block letters) Designation EIN: Date:
Seal:
Seal