*Notice: this assumes by default the Great Rift occurred on (9)999999.M41 on the local Imperial Calendar.
0.0previo.M1
40,000.0previo
40,000.0-
Addendum
Some sources say, for the year fragment, that "year 000" should come after "year 999". It makes no sense, and there cannot be something like "X 1000 1000.M12". So I made both the year fraction and the year fragment go from 000 to 999. See the "Year 0 Problem" discussion on the Lexicanum for further references.
I added hours and minutes mainly because hours impact the year fraction.
For the check number, I based it on the classification found on the Warhammer 40k Wiki .
Splitting a year into 1000 parts does not allow the backward conversion (from Imperial System to Gregorian) to be accurate to the hour (but to about ~8 hours).
The explanations for the Era Indomitus dating system are limited, notably for the initials to use for the planet it is relative to. It also does not specify if the chronosegments should be counted backward when it is used for a date prior to the Great Rift, so I decided to make them go backward (so it reads "2 years and 345 chronosegments prior to the Great Rift" for example, not"345 segments into the third year that preceded the Great Rift".)
I spent an ungodly amount of time trying to get an input of type datetime-local to work instead of these fields for the Gregorian date, but it simply refuses to work correctly beyond year 9999 on Chrome.