APPLICATION
FOR LEAVE TRAVEL CONCESSION ADVANCE
FOR THE BLOCK
YEAR ………… TO …………………..
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1
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Name of Official
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2
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Designation
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3
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Pay
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4
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Office to which attached
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5
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Whether permanent or temporary
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6
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Period and nature of leave taken
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7
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Place of visit
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8
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Date of commencement of journey
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9
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Date of returned journey
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10
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Place and date of visit on way and mode of journey
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(a)
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Bus No.
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(b)
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Train No./Class
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11
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Name of persons who will perform journey
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S.No
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Name of Person
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Age
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Relationship with
the official
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1
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2
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3
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4
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5
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6
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7
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8
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12
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Distance
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13
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Rate of Railway fare admissible
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14
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Amount of advance required
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Rs.
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Signature of the
applicant
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Declaration
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1
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I……………………………………………………………..
hereby declare that my father/mother wife/son/daughter/brother/sister are
wholly dependant upon me. All children mentioned above are
unemployed/unmarried.
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2
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I hereby declare that I desire
to avail of the concession as noted above proceed on the journey immediate
after from advance on proposed date. Failing which I may be proceeded against
besides recovery of the entire advance from my pay bill in one lump sum.
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3
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I also undertake to produce all
documentary evidence i.e. each receipts ,money receipts as proof of LTC
journey.
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Date
Signature
of the applicant
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कोई टिप्पणी नहीं:
एक टिप्पणी भेजें