Scribd
Upload
113 views1 page

Application Commuted Leave

Application for commutted leave application

Uploaded by

anchalblockpanchayath
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
113 views1 page

Application Commuted Leave

Application for commutted leave application

Uploaded by

anchalblockpanchayath
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

Form No.

13
Application For Leave
Rule 113 Part I
Note:- Item 1 to 16 must be filled in by all applicants whether gazetted or non gazetted
1. Name of applicant :
2. Date of birth :
3. Post held :
4. Department, Office and section :
5. Pay and Scale of Pay :
6. Date of entry into service :
7. Date of commencement of continuous service :
8. Whether the applicant has got confirmation in any post,
If so, from which date and in which post :
9. Address during Leave :
10. HRA, PCA or other compensatory allowances drawn in the pre-post :
11. Nature and period of leave applied for and date from which Required:
12. Sundays and Holidays if any proposed to be prefixed/suffixed :
13. Ground on which leave applied for :
14. Date of return from last leave and the nature and period of leave :

15.a) I undertake to refund the difference between the leave salary drawn during commuted leave and
the admissible during half pay leave which would not have been admissible in the event of my
retirement from service at the end or during the currency of leave.
b) I undertake to refund the leave salary drawn during leave not due which would not have been
admissible had rule 85 Part I not be applied in the event of my voluntary retirement or
resignation from service at any time until earned half pay leave not less the amount of leave not
due availed of by me.

Signature of applicant with date


16. Place :
17. Remarks and recommendation of controlling Officer
Signature (with date) & Designation

Note:- In the case Government servant who is mentally unsound and or physically unable to fill in the
columns of this form and sign in it, the guardian or his appointed under the India lunacy Act 1912
Central Act IV of 1912 of any person authorized by the authority competent to grant the leave may fill in
the column and sign the application for and on behalf of the Government servant.
CERTIFICATE REGARDING ADMISSIBILITY OF LEAVE
(By Accountant General in the case of Gazetted Officers)
18. Certified that ……………………………………. (Nature of Leave) for …………. days from
………………… to ………………… is admissible under rule …………………… of KSR,
Part I.

Signature (with date) & Designation


19. Order of the Sanctioning Authority

ORDER No. …………………., dated, …………………………………….

Signature (with date) & Designation

If the applicant is drawing any compensatory allowance, the sanctioning authority should state be on the expiry of
leave is likely to return to the post or to another post carrying a similar advance.

You might also like