The form shall be filled with due care and the instructions given in the Annexure A may please

be read carefully before filling up this form. For any

doubts/clarifications please contact Paybill/Admin section.
DDO Code & Name: Date:

A SNo Particulars Details

1. Pensionable Employee NPS (Joined service on

Type (Pensionable/ NPS)
or after 01.01.2004)
2. Name (Shri/Mr/Smt/Ms./Km/Dr/Dr(Smt) First Middle Last

3. Gender Male Female

4. D D M M Y Y Y Y
Personal Details

Date Of Birth
5. PAN No. P

6. Aadhaar No.
7. Date of Entry in Govt. service D D M M Y Y Y Y

8. Date of Regularization in Govt. Service D D M M Y Y Y Y

9. Employee's Controller TELECOMMUNICATIONS

10. Date of joining above Controller D D M M Y Y Y Y

11. Current Office

12. Date of Joining above Office D D M M Y Y Y Y Forenoon/Afternoon
Posting Details

13. City Class (where employee is working) ( City Class ‘X’, ‘Y’, ‘Z’)

14. Current Post in the Office (Designation)

15. City Class for TA ( City Class ‘X’, ‘Y’, ‘Z’)

16. Date from which working in Current Post D D M M Y Y Y Y

17. Current Posting Mode( If Deputation fill Annexure ‘B’)

18. Pay Commission 7th Pay Commission

19. Pay Level LEVEL

Pay Details

20. Basic Pay

21. Pay w.e.f. Date D D M M Y Y Y Y

22. Next Increment Date D D M M Y Y Y Y

23. N.P.S
PF Type G.P.F
PF / NPSDetails

(If NPS fill only PRAN No.)

24. A/c Maintained By (PF Agency) PAO -

25. PF Series
26. PF / PRAN No.
27. CGEGIS Applicable? Central Government
CGEGIS/CGHS/ Category

28. Current CGEGIS Group ( Group ‘A, ‘B, ‘C’)

29. Membership Date (in this Group) 0 1 0 1 Y Y Y Y

Details

30. CGHS Deduction Applicable (Y / N) YES NO

31. CGHS Card No #

32. Category (General, OBC, SC, ST)

33. Ex-Serviceman(Y / N) YES NO

34. Employee code by employer#

ID/ Contact Details

35. Mobile No.

36. E-Mail @

37. Physically Disabled? YES NO If Yes fill Annexure ‘C’

38. PLI No.

39. IFSC Code
40. Bank Name
Bank Details

41. Bank Branch

42.
Bank Saving A/c No (Attach a copy of cancelled
cheque/passbook)

B. Have taken Govt. Quarter? YES NO C. Have Loan details? YES NO

 (If YES, please fill Form: EIS/Q/2) (If YES, please fill Form: EIS/L/3)

Form: EIS/Q/2
Quarter Allotment Details

Name: PAN: Date:

SNo. A. Quarter Location GPRA CITY LOCATION:-

1. (AAN) Allotee Account No

2. Address 1

3. # Address 2

B. Allotment Details

4. Allotted to (Self/Spouse/Relative/Others) Date Occupied D D M M Y Y Y Y

5. # Allotment Letter No. # Date D D M M Y Y Y Y

C. Rent details

6. Quarter Owned by (Directorate of Estate/Departmental Pool/Other Pool)

7. Custodian

8. Quarter Type (Type-I/II/III/IV/V/VI/VII/VIII etc.)

9. Rent Status (Rented/Rent Free) Licence Fee/Rent (Rs.)

#Additional Rent-1 (Rs.)

10. # Water Charge (Rs.)
(Electrical Charges)
11. # Garage Rent (Rs.) # Service Charge (Rs.)

Form: EIS/L/3
Loan/Advance already taken by employee

Name: PAN: Date:

SNo. A. Disbursement Details

1. Loan / Advance

(Additional HBA / Car Advance/Computer Advance/GPF Adv Group ABC/ HBA Extension/HBA for Construction/House Building Advances/Scooter
Advance)

2. Sanction Order No. # San. Order Date# D D M M Y Y Y Y

3. Loan Amount Disbursed (Rs)

B. Recovery Schedule for

4. Principal Interest

Total Loan Taken (Rs.).

5. OR
Total Interest Amount (Rs.)

6. Instalment Amount No. of Instalment including Odd instalment

7. Odd Instalment Amount Odd Instalment No.

8. Last Instalment No. paid

Form: EIS/L/3
Loan/Advance already taken by employee

Name: PAN: Date:

SNo. A. Disbursement Details

 1. Loan / Advance

(Additional HBA / Car Advance/Computer Advance/GPF Adv Group ABC/ HBA Extension/HBA for Construction/House Building Advances/Scooter
Advance)

2. Sanction Order No. # San. Order Date# D D M M Y Y Y Y

3. Loan Amount Disbursed (Rs)

B. Recovery Schedule for

4. Principal Interest

Total Loan Taken (Rs.).

5. OR
Total Interest Amount (Rs.)

6. Instalment Amount No. of Instalment including Odd instalment

7. Odd Instalment Amount Odd Instalment No.

8. Last Instalment No. paid

Form: EIS/L/3
Loan/Advance already taken by employee

Name: PAN: Date:

SNo. A. Disbursement Details

1. Loan / Advance

(Additional HBA / Car Advance/Computer Advance/GPF Adv Group ABC/ HBA Extension/HBA for Construction/House Building Advances/Scooter
Advance)

2. Sanction Order No. # San. Order Date# D D M M Y Y Y Y

3. Loan Amount Disbursed (Rs)

B. Recovery Schedule for

4. Principal Interest

Total Loan Taken (Rs.).

5. OR
Total Interest Amount (Rs.)

6. Instalment Amount No. of Instalment including Odd instalment

7. Odd Instalment Amount Odd Instalment No.

8. Last Instalment No. paid

Disclaimer: I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief. In case any information
given in this form proves to be false or incorrect, I shall be held responsible.

Signature of the Officer/Official

For Office(Admin) Use Only

The information provided by the officer/official is verified as per available records.

Signature of the verifying authority

 Annexure ‘A’

Details filled by the Officials may be entered in the PFMS-EIS System only after verification by DDO

Instruction for filling forms (for selected points):

Form: EIS/B/1 (Personal & Other Basic Details of Employee)

1. Tick () before applicable type of Employee
2. Select Salutation out of the available option and Name as per Service Book. (First Name, Middle Name & Last Name)
4. Write Date of Birth as per Service Book in the DD/MM/YYYY format.
5. PAN No. – Enter valid PAN of the Employee.
Note: Above details are very important for creation of Employee Code in the System. As such, correct details should be filled, once
filled it cannot be changed further.
7. Date of joining / entry in the Government Service (Date of First entry in Govt. Service).
8. Date of regularisation in Government service
9. Three-digit Controller Code in which EIS is being implemented. It should be selected from the list populated during data being saved online.
10. Date of joining in the above Controller where EIS is being implemented.
Personal details cannot be changed so information should be given and filled with due diligence.in case of error here, profile will have to be deleted
and fresh entry made)

11. Name of the DDO as available in PFMS/E-Lekha (Current Office – Select from the list)
12. This is date of joining in the above DDO (Current Office). This date should be same as joining Controller Code date or after it.
16. Date from which working in Current Post (Designation).
17. Current Posting Mode [“As per Transfer Act”/ “Compassionate Ground”/ “Deployment Of Service”/ “Deputation In (From
CG/SG/IPS/Other)”/ “Deputation Out (To SG/Corpn)”/ “General Transfer”/ “Join New Services”/ “Merger”/ “One Step Promotion”/ “Open
Selection”/ “Promotion (With Transfer)”/ “Promotion (Without Transfer)”/ “Re-appointment”/ “Reversion (With Transfer)”/ “Reversion
(Without Transfer)”/ “Transfer (Ex Cadre Posting)”]
21. This is the date from which pay has been drawn till dateIt must be date of joining/fixation, 1st Jan or 1st July.
22. Next increment date- It must be 1st June or 1st Jan.
24. Name of the PAO for GPF Employee. Not applicable in case of NPS.
25. PF Series as maintained by PAO for GPF Employee. Not applicable in case of NPS.
26. PF No. in case of GPF Employee. PRAN No (Exact 12 digit) in case of NPS Employee.
27. Central Govt.(CGEGIS) OR CGEIS (Old Scheme) as applicable.
28. Group ‘A, ‘B, ‘C’ as applicable.
29. Membership Date should be 1st Jan and (YYYY) applicable year as per point 28 above. For those Employees who have Joined Govt. Service
on or after 2nd January of current year, Membership Date should be left blank. For all such Employees, the Membership date will be reset by
DDO during Jan of next year before salary processing.
34. This is numeric Employee Code allotted by DDO internally.
35. & 36. Mobile No. and E-Mail. It is mandatorily required for generation of USER ID & PASSWORD for Employee Login in EIS
Module/System for accessibility of report like. Pay Slip, GPF Status, Income Tax Calculation, etc.
37. Physically Disabled. If chosen Yes, fill Annexure C.

Form: EIS/Q/2 (Quarter Allotment Details of Employee)

4. Allotted to: Please choose one out of (Self/Spouse/Relative/Others). Only in case of “Self” HRA is not admissible and Licence Fee/ Rent will
be required to fill. In all other cases only HRA will be not admissible as per rule.
6. & 7. Quarter Owned by and Custodian (Online filling of Details): There is one default value created in the System “Directorate of Estate”. In
case of “Departmental Pool” multiple Custodians can be created by the PAO office as applicable in the concerned Department/Ministry. The
DDO may approach its PAO office for creation of Departmental Pool Custodians.

Form: EIS/L/3 (Loan / Advance Details of Employee)

Note: In case of more than one Loan/Advance please fill Separate form for each type.
1. Select the Loan/Advance Type as per the details given.
3. Loan Amount Disbursed (Rs.): It is total amount of Loan/Advance taken by the employee.
4. If the repayment of Principal amount is still due the details of the “Principal” will be given in the columns No. 5 to 8. If the principal amount is
fully recovered, the details of “Interest” will be appear in the columns no. 5 to 8.
5. Auto generated field equal to amount at Sl.No.3.
6. Instalment Amount: This is required to be filled. Other Details at point no. 6 to 7 will be calculated by the System.
8. Last Instalment No. paid. : It is the number of instalment up to which repayment has deducted in the Last Paid Salary.
 Annexure ‘B’

Deputation Details

SNo.

1. Deputed To Central Govt./ State Govt./ Autonomous or Private

Deputation Order
2.
No.
3. Order Date

4. Deputed to Office

5. On Designation

6. Date of Deputation

7. Relieved on Date Forenoon | Afternoon

(tick one)

8. Date of Repatriation

Annexure ‘C’

Disability Details

SNo.

1. Disability Type Orthopaedic/ Deaf and Dumb/ Visually Disable(Blind)/ Spastic/ Hearing Impaired

2. % Disability

3. Severe YES | NO

4. Certificate No.

5. Certificate Date

6. Issuing Authority

7. Administrative
Order No.
8. Administrative
Order Date
9. Entitled for Double YES | NO
TA?
10. Remarks