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LTCIntimationForm

This document is an application form for Leave Travel Concession (LTC) intimation/advance for employees of Indira Gandhi National Open University. It requires personal details, travel information, and family member information, along with a certification of the accuracy of the provided details. Employees must apply for the advance at least 30 days before the journey or submit an intimation otherwise.

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rohitahirwar2
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4 views

LTCIntimationForm

This document is an application form for Leave Travel Concession (LTC) intimation/advance for employees of Indira Gandhi National Open University. It requires personal details, travel information, and family member information, along with a certification of the accuracy of the provided details. Employees must apply for the advance at least 30 days before the journey or submit an intimation otherwise.

Uploaded by

rohitahirwar2
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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INDIRA GANDHI NATIONAL OPEN UNIVERSITY

IGNOU-SAMARTH PROJECT
APPLICATION FOR L.T.C. INTIMATION/ADVANCE

1. Employee ID
2. Name
3. Post Held
4. Grade Pay and Level as per 7th CPC
5. School/Department
6. Date of Birth
7. Date of entering the service
8. Date of Retirement
9. Place of Visit with District and State
10. Nearest Airport/Railway Station
11. Details of Family Members:
S.No. Name Age Date of Birth Relationship
1.
2.
3.
4.
5.
12. Nature and period of leave sanctioned with dates
13. Leave Reference No.
14. Whether intention to avail of the LTC given on the
leave application
Whether LTC required for Home Town under the two years LTC
15. scheme or any where scheme or to some other place.
16. Block of year of the LTC
Sub-block year
17. Whether Advance required for self/family both
18. Proposed date(s) of Journey Outward Return
Self
Family
19. Mode of Journey
Class as per entitlement
Total Kilometer (by shortest Route)
Total Fare (Attach Proof)
20. Advance required (Yes/No)
21. 90% of the Total Fare (in Rs.)
22. Leave Encashment Required
I hereby certify that the above particulars furnished by me are true and correct.

(Signature of Employee)

Note : Apply advance atleast minimum 30 days before performing the journey, otherwise submit intimation

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