APPLICATION FOR GRANT OF LTC ADVANCE 1. Name of the Govt. servant : 2. Designation : 3. Date of entering the central Govt servant : 4. Pay :...
APPLICATION FOR GRANT OF LTC ADVANCE
1. Name of the Govt. servant :
2. Designation :
3. Date of entering the central Govt servant :
4. Pay :
5. Whether permanent or temporary :
6. Home town as recorded in the service book :
7. Whether wife/husband is employed and if so
whether entitled to LTC :
8. Whether the concession is to be availed for :
visiting home town, and if so block for which
LTC is to be availed. :
9. (a) If the concession is to visit ‘anywhere in
(b) BLOCK for which to be availed :
10. Single railfare/ bus fare from the headquarters
to home town/ place of visit by shortest route:
11. Persons in respect of whom LTC is proposed
to be availed :
Sl Name and Age Relationship
12. Period of leave applied. :
13. Amount of Advance Required :
I declare that the particulars furnished above are true and correct to the best of my knowledge. I undertake to produce the tickets for the out ward journey within ten days of receipt of the advance. In the event of cancellation of the journey or if I fail to produce within ten days of receipt of advance, I undertake to refund the entire advance in one
lump sum.
PART II
(To be filled by the Head of office)
Certified that the particulars furnished by the applicant against item2,3,and 5 of part I are correct.
Signature of Postmaster.
PART III
(To be filled by HPO)
1. Particulars of previous 4 years LTC/ advance :
Taken since block period.
2. Whether advance was used for performing
Journey :
3. If not, how the advance was adjusted :
4. Any amount of previous advance remaining
to be adjusted. :
Signature of Postmaster.
PART IV
(ORDERS OF THE SANCTIONING AUTHORITY)
COMMENTS