The Zonal Manager,

Punjab & Sind Bank,

Zonal Office,
AMRITSAR
Dear Sir,
REG: LFC / LFC ENCASHMENT
I am
to inform
you
that
I am proceeding
to
avail
LFC with effect
from_______________to__________________along with the following members of my family who
are dependent upon me.
SNo. Name of the member
1
2
3
4
5
6

Relation

Age

I have also applied for__________days earned leave w.e.f.______________ to _______________,

therefore, request you to allow me an advance of Rs._____________(Rupees_______________
_____________________________________)from Sundry Debtors (O.D. Suspense Account of my
Branch to enable me to meet the anticipated fare expenses for availment of said LFC. I am giving
below the detail of desired information regarding myself for your perusal and reference please:
1. Date of joining the regular service of the bank

2. Date of Month/year when previous LFC availed by

me and at which Branch
:
3. Previous Block of LFC availed.

4. Proposed touring places

5. Place of Domicile

I hereby undertake that I will submit the LFC Bill along with the money
receipt/ relative/
certificate in terms of the staff Circulatory letter No.117 dated 15.04.80 for release of sanction within
a period of one week I resume my duties after availment of LFC in terms of Zonal Office Circulatory
LFC Bill within the above said said period I shall have no objection if the amount so advanced to
me is deducted from my salary due next. I also undertake that if the LFC is released for the amount
lesser than the amount advanced the balance may be deducted from my salary.
Yours faithfully,
(_________________________)

PF Code

:________________________

Designation

Branch

:________________________

:________________________

/var/www/apps/conversion/tmp/scratch_5/317466421.doc 1

Dated

:________________________

LFC Block

:________________________

/var/www/apps/conversion/tmp/scratch_5/317466421.doc 2

DECLARATION OF DEPENDENTS
I,____________________________S/o _______________________, Clerk/Peon/Officer of Punjab
& Sind Bank presently posted at ______________________________________________
hereby declare as under:1. That following members of my family are usually residing with me and are wholly dependent upon
me.
2. Details in respect of my dependent family members are given below:SNo. Name

Relation

Age

Occupation

Annual
Income from
all
sources
(Incl.Pension)

I hereby undertake that the fare does not exceed the economy tickets fares offered by NACIL (AIR
INDIA) and shall also that no cash benefit, has been received as a part of any package offered by
airline.
Further, I confirm that I have thoroughly read the Staff Circular No.1646 dated 16.2.87, Staff
Circular No.1712 dated 10.9.87 and all the information stated above is true to the best of my
knowledge and belief.

Signature

:________________________

Name

:________________________

PF Code

:________________________

Designation

:________________________

Branch Office

:________________________

LFC Block

:________________________

Dated

:________________________

/var/www/apps/conversion/tmp/scratch_5/317466421.doc 3

Zonal Manager,
Punjab & Sind Bank,
Zonal Office,
Amritsar.
Dear Sir,
REG: ENCASHMENT OF EARNED LEAVE.
I am pleased to inform you that I am proceeding to avail Leave Fare Concession w.e.f.
____________to ______________. I have been sanctioned/have applied for ______________days
earned leave w.e.f. __________to _____________ to avail LFC.
You are requested to encash me one month/15 days earned leave by debiting the same to my earned
leave account. I have already given my option to avail LFC once in four years/once in two years and
understand that the option given is irrevocable. I also understand that I cannot encash my earned
leave again before _________. My desired particulars are as under:1. Date of joining as regular service

:_____________

2. Date when previous LFC availed

:_____________

3. Branch where previous LFC availed :_____________

Signature

:________________________

Name

:________________________

PF Code

:________________________

Designation

:________________________

Branch Office

:________________________

Leave Encashment Block:_________________________

Dated

:________________________

/var/www/apps/conversion/tmp/scratch_5/317466421.doc 4

The Zonal Manager,

Punjab & Sind Bank,
Zonal Office,
AMRITSAR
Dear Sir,
REG: LFC dt.________________
I hereby undertake that the fare does not exceed the economy tickets fares offered by NACIL (AIR
INDIA) and shall also that no cash benefit, has been received as a part of any package offered by
airline.
Further, I confirm that I have thoroughly read the Staff Circular No.1646 dated 16.2.87, Staff
Circular No.1712 dated 10.9.87 and all the information stated above is true to the best of my
knowledge and belief.

Signature

:________________________

Name

:________________________

PF Code

:________________________

Designation

:________________________

Branch Office

:________________________

LFC Block

:________________________

Dated

:________________________

/var/www/apps/conversion/tmp/scratch_5/317466421.doc 5

iatkc
cSad

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fla/k

PUNJAB & SIND BANK

(A Govt.of India Undertaking)

Zonal Office,
Hall Bazar, Amritsar.

( Hkkjr ljdkj dk midze )

vkapfyd dk;Zky;,
, ve`rlj

-0183-5057504-05-14 -0183-2553904 e-mail [email protected]

Date: ______________

OFFICE NOTE
SIR,
REG: Leave application and LFC advance / LFC encashment of Sh. _______________________
Designation_______________ PF Code- ___________ , BO ________________________
We have received the leave application for encashment of ________ days earned leave and LFC
advance/LFC encashment application of above named official for availing LFC during Block
_______________ to _______________. We may sanction __________ days earned leave for
encashment and advance of Rs._____________ against tickets for touring __________________
______________ / LFC encashment (75% of admissible fare).
Further

we

sanction___________days

earned/casual/sick

leave

w.e.f.

______________to

______________avail LFC.
We have been debited the above leave in leave record of captioned employee and his next LFC Block
due is ______________ to ______________ .

OFFICER

MANAGER

SR.MANAGER

ASSTT.GENERAL MANAGER

/var/www/apps/conversion/tmp/scratch_5/317466421.doc 6

iatkc
cSad

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fla/k

PUNJAB & SIND BANK

(A Govt.of India Undertaking)

Zonal Office,
Hall Bazar, Amritsar.

( Hkkjr ljdkj dk midze )

vkapfyd dk;Zky;,
, ve`rlj

-0183-5057504-05-14 -0183-2553904 e-mail [email protected]

Date: ______________

OFFICE NOTE
REG: Advance against TA/Transfer TA Bill of Sh. _______________________ PF Code- _________
Designation___________________, BO _____________________________
We have received the application for advance against TA/Transfer TA Bill of above named official for
__________________________________________________________________________________.
The details of estimated TA Bills claimed and for which he is entitled in terms of Staff Circulars No.
2805 and 2810 dated 24.05.2010 are given hereunder:Particular

Claim

Entitlement

Fare (By ________) to & fro Rs.______________

Rs. ______________

Transport Charges

Rs.______________

Rs.______________(Distance _____Kms.)

Other Charges

Rs.______________

Rs.______________

Total

Rs.______________

Rs.______________

We may sanction advance of Rs._____________ against tickets/transportation Charges for visiting

________________________________.
Further we sanction___________days
______________.

MANAGER

Joining

period

SR.MANAGER

1) Transportation rate (Staff Circular 2833 dt.19.05.2011)

Upto 1000 Km. 2.80 x Distance x Entitlement
Above 1000 Km. 2.00 x Distance x Entitlement
(The above rates apply on a slab basis)

leave

w.e.f.

______________to

ASSTT.GENERAL MANAGER
Entitlement
IBA approved transport - 12.0 Ton
Unapproved transport
- 6.0 Ton
Without family
- 2.5 Ton

(MINIMUM REIMBURSEMENT PERMITTED UPTO 300 KM X WEIGHT X RS.2.80)

2) Mode of Travel-An officer in Middle Management Grade is entitled to travel by 1st Class or AC 2-tier Sleeper by train.
He may, however, travel by air (economy class) if the distance to be traveled is more than 1000 kms. He may, however,
travel by air (economy class) even for a shorter distance if so permitted by the Competent Authority, having regard to the
exigencies of business or public interest
/var/www/apps/conversion/tmp/scratch_5/317466421.doc 7

/var/www/apps/conversion/tmp/scratch_5/317466421.doc 8