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FORM OF APPLICATION FOR EARNED LEAVE (SEE SUPPLEMENTARY RULE 216) Note: Items 1 to 12 must be filed in by all applicants whether Gazetted or Non-Gazetted. 01 02 03 04
Name of the applicant Leave rules applicable Post held Department, office and section
05 06
Basic pay House rent allowance, conveyance allowance, or other compensatory allowance drawn in the present post Nature and period of leave applied for and date from which required Sundays and Holidays, if any, proposed to be prefixed/suffixed Ground on which leave is applied for Date of return from last leave and the nature and period of leave Address during the leave I propose to avail myself to Leave Travel Concession for the Block Year during the ensuing leave
07 08 09 10 11 12
Priya. As per revised rules. Multi Tasking Staff. O/o. Commissioner of Income Tax (Appeals)-2, Aurangabad. Rs 18000/As per revised rules.
Earned Leave of 04 days:05/03/2019 to 08/03/2019 Prefixed: 02/03/2019, 03/03/2019, 04/03/2019 Suffixed: 09/03/2019 and 10/03/2019 Domestic. As per record. Shillong, Meghalaya. No.
13(a) I undertake to refund the difference between the leave salary drawn during leave on average pay/commuted leave and that admissible during leave on half average pay/half pay leave which should not have been admissible had the provision to FR 81(b)(ii) rule II c(iii)of the Revised Leave Rules, 1993, not been applied in the vent of my retirement from service at the end or during the currency of the leave.
(b) I undertake to refund the leave salary drawn during leave not due, which would not have been admissible had FR 81(c) Rule- 11 of the Revised Leave Rules, 1993, not been applied in the event of my voluntary retirement or resignation from service at any time until I earn half pay leave not less than the amount of leave not due availed of by me.
Date: 14. Remarks and/or recommendation of the Controlling Officer:
(Priya) (Sign of the applicant)
CERTIFICATE REGARDING ADMISSIBILITY OF LEAVE Certified that the leave applied for is admissible to the official as mentioned above.
Date:Signature: Designation:
15. Order of the sanctioning authority :
Date:-
Signature: Designation:
Name of the applicant Leave rules applicable Post held Department, office and section
05 06
Basic pay House rent allowance, conveyance allowance, or other compensatory allowance drawn in the present post Nature and period of leave applied for and date from which required Sundays and Holidays, if any, proposed to be prefixed/suffixed Ground on which leave is applied for Date of return from last leave and the nature and period of leave Address during the leave I propose to avail myself to Leave Travel Concession for the Block Year during the ensuing leave
07 08 09 10 11 12
Priya. As per revised rules. Multi Tasking Staff. O/o. Commissioner of Income Tax (Appeals)-2, Aurangabad. Rs 18000/As per revised rules.
Earned Leave of 04 days:05/03/2019 to 08/03/2019 Prefixed: 02/03/2019, 03/03/2019, 04/03/2019 Suffixed: 09/03/2019 and 10/03/2019 Domestic. As per record. Shillong, Meghalaya. No.
13(a) I undertake to refund the difference between the leave salary drawn during leave on average pay/commuted leave and that admissible during leave on half average pay/half pay leave which should not have been admissible had the provision to FR 81(b)(ii) rule II c(iii)of the Revised Leave Rules, 1993, not been applied in the vent of my retirement from service at the end or during the currency of the leave.
(b) I undertake to refund the leave salary drawn during leave not due, which would not have been admissible had FR 81(c) Rule- 11 of the Revised Leave Rules, 1993, not been applied in the event of my voluntary retirement or resignation from service at any time until I earn half pay leave not less than the amount of leave not due availed of by me.
Date: 14. Remarks and/or recommendation of the Controlling Officer:
(Priya) (Sign of the applicant)
CERTIFICATE REGARDING ADMISSIBILITY OF LEAVE Certified that the leave applied for is admissible to the official as mentioned above.
Date:Signature: Designation:
15. Order of the sanctioning authority :
Date:-
Signature: Designation:
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