APPLICATION FOR LEAVE.

1.

Name of applicant

______________________________

2.

Leave Rules applicable

______________________________

3.

Post held

______________________________

4.

Department

______________________________

5.

Pay

______________________________

6.

House Rent Allowance conveyance allowance or other compensatory allowance

drawn in the present post.

______________________________

7.

a)
b)

Nature of leave applied for

Period of leave in days

______________________________
______________________________

c)

Date of commencement

______________________________

8.

Particular Rules/ Rules under which

leave is admissible.

______________________________

9.

a)

Date of return from last leave.

______________________________

b)

Nature of Leave

______________________________

c)

Period of leave in days.

______________________________

Name of applicant

______________________________

Signature

______________________________

Dated

______________________________

10.

Remarks and Recommendation of controlling officer.

11.

Certificate that leave applied for is admissible under Rule

and necessary condition are fulfilled.

Signature

______________________________

Stamp

______________________________

Date ______________
12.

Report Audit Officer.

Signature

______________________________

Stamp

______________________________

Date ______________
13.
Orders of the sanctioning authority certifying that on the expiry of leave the
applicant is likely to return to the same post or another post carrying the compensatory
allowance being drawn by him.
Jerjees Haider Shah