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Form of Application For Leave

This document is a leave application form that contains 14 items requesting information from the applicant such as their name, pay, type of leave being requested, and certification from controlling officers. If approved, the applicant agrees to refund any excess leave salary drawn if their employment ends before the leave is earned. The form collects essential details to process requests for leave according to the applicable leave rules.

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Alvin
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Download as PDF, TXT or read online on Scribd
664 views

Form of Application For Leave

This document is a leave application form that contains 14 items requesting information from the applicant such as their name, pay, type of leave being requested, and certification from controlling officers. If approved, the applicant agrees to refund any excess leave salary drawn if their employment ends before the leave is earned. The form collects essential details to process requests for leave according to the applicable leave rules.

Uploaded by

Alvin
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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S.R.

-1
FORM FOR APPLICATION FOR LEAVE
(See Supplementary Rule 216)

Note : Items 1 to 11 must be filled in by all applicants whether gazetted or non-gazetted

1. Name of the applicant

2. Leave rules applicable

3. Post held

4. Department, Office and Section

5. Pay

6. House rent allowance, conveyance


allowance or other compensatory
allowances drawn in the present post.

7. Nature and period of leave applied for


and date from which required

8. Sunday and holidays, if any proposed


to be prefixed/suffixed to leave.

9. Ground on which leave is applied for

10. Date of return from last leave and the


nature and period of that leave

11. I proposed / do not proposed to avail myself of leave travel concession in the block years
………………….. during the ensuing leave.

12. (a) I undertake to refund the difference between the leave salary drawn during leave on
average pay/commuted leave and that admissible leave on half average pay half leave,
which would not have been admissible had the provision to F.R.81(b)(II) Rule II(c) (III)
of the revised Leave Rules, 1933 not been applied in the event of my retirement from
service at end or during the currency of the leave.

(b) I undertake to refund leave salary drawn during leave not due which would not have
been admissible had F.R.81 (c) Rule 11(d) of the Revised Leave Rule 1933 not been
applied, in the event of my voluntary retirement or resignation from service at any time
I until earn half pay leave not less than the amount of leave not due availed of by me.

Date ……………………. Signature of applicant ……………………….


13. Remarks and-or recommendation of the
controlling Officer.

Signature ……………………………….

Date …………………. Designation …………………………….

_____________________________________________________________________________________________________________________

CERTIFICATE REGARDING ADMISSIBILTY OF LEAVE


(By Accountant General to the case of gazetted Officers)

14. Certified that ……………………………………………..…………………..…………………….. [Nature of leave]


for………..............................from [period] …………………….…………… to ………………….………………
is admissible under rule ……………………………………… of the …………………………………... Rules.

Signature ……………………………….

Date …………………. Designation …………………………….


______________________________________________________________________________________________________

I the applicant is drawing any compensatory allowance the sanctioning authority should
state whether on the expiry of leave he is likely to return the same post or to another
post carrying a similar allowance.

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