Computerisation of Personnel Information System (CPIS)

for Government of Manipur

Form No: CPIS 3

(Termination from Service)
(Revised w.e.f. 01-08-2010)

Sl.
No
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8

Particulars

To be filled in

EIN (Employee Identification Number)

Name (in Block Letters)
Designation
Department
Pay Scale
Basic Pay
Present Place of Posting (Office)
DDO Code (7 digit Code)

After Termination
9
10
11
12

Termination Order No.

Termination Order Date (DD/MM/YYYY)
Effective date of termination (DD/MM/YYYY)
Reason for termination (Superannuation/
Death/Resignation/Punishment/Others)
Note 1: All fields are mandatory
Note 2: Use A4 size JK bond paper
Note 3: Fields are to be computer typed neatly
Note 4: Enclose relevant documents

Signature
Name of the Authorised Signatory:
(in Block letters)
Designation:
EIN:
Date:
Seal
To,
The Special Officer
Directorate of MIS
Room No. 307, 308, 309
3rd floor, North Block, New Secretariat
Imphal 795001