FORM OF APPLICATION FOR LEAVE

 

FORM OF APPLICATION FOR LEAVE

Note : Item 1 to 10 must be filled by all the

Government servant whether Gazetted or Non-Gazetted

-oOo-

           

1. Name of the Applicant                                           :

 

2. Leave rules applicable                                            : AP.Leave Rules 1933

 

3. Department                                                                         : Animal Husbandry Department

 

            Office                                                              : 

                                                                                      

4. Post held                                                                 : 

 

5. House Rent Allowance                                           Pay      :  Rs.      

    Conveyance allowance other                                              DA      :  Rs.

    Compensatory allowance                                       HRA    :  Rs

    Drawing the present post                                      

 

6. Nature and period of Leave                                               :          

    Applied for and date from                                                  

    Which required                                                                                                                                                                   

7. Sunday and Holidays if any                                               :   -- 

    Proposed to be prefixed suffixed to leave                  

 

8. Ground on which leave is                                       :  

    Applied for

 

9. Date of return of last leave and the                                    :  --      

    Nature and period of that leave

 

10. (a) I undertake to refund the difference between the leave salary drawn during the leave on   

      Average pay and that admissible during leave on half average pay would no have been applied in

      the event of my retirement from service at the end of during the currency of leave.

 

      (b) I undertake to refund the leave salary drawn during the leave not due which would has been

      Admissible under FR.81 not been applicable in the event of my voluntary retirement from service   

      The time and of during the currency of the leave.

 

 

                                                                        Signature of the Applicant

 

11. Remarks/Recommendations of the

    controlling officer.

 

                                                                        Signature:

                                                                        Designation:

                                                                        Office Seal: