APPLICATION FOR LEAVE

Item No. 1 to 9 must be filled in by all the applicants.

Item No. 12 applicant in the case of Government servants of Grade-16 and above.

1. Name of Applicant. ___________________________________________________________________________

2. Leave Rules Applicabel. ____REAVISED LEAVE RULES 1981. 3. Post held.______________________________

4. Department or Office. (Education) ___________________________________________________________

5. Basic Pay___________________ 6. Allowances Drawn in the present Post.__________________________

7. (a) Nature of Leave applied for__________________________________________________________________

(b) Period of Leave in days _______________________ To_______________________ Days________________

(C Date of commencement ____________________________________________________________________

8. Particulars of Rules under which leave is admissible __Revised Leave Rules 1981_________________________

9. (a) Date of Return from last Leave _______________________________________________________________

(b) Nature of Leave___________________________________________________________________________

(c Period of leave in days. ____________________ To _______________________ Days___________________

Dated_______________________________ Signature of Applicant.________________________________________

10. Remarks and recommendation of the controlling Officer _____________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

11. Certified that leave applied for is admissible under rule_______Revised Leave Rules 1981_______________and

Necessary conditions are fulfilled.

Dated______________________________ Sginature and Designation._______________________________________

12. Report of Audit Officer.________________________________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

Dated___________________________ Signature and Designation.________________________________________

13. Orders of the sanctioning authority certifying that on the expiry of leave the applicant in likely to return to the
same post or another post carrying the compensatory allowances being drawn by him.

Dated.___________________________ Signature___________________________________________

Designation__________________________________________
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 FORM OF LEAVE ACCOUNT UNDER THE REVISED LEAVE RULES 1981
(Approved Vide Finance Division’s letter No.F.I (3) –Rev.1978, dated.18.01.1979)

Leave Account of Mr. /Miss/ Mrs.___________________________________________________________________________ Date of Commencement of

Service______________________________
Date of attaining the age of superannuation.__________________________________________________________________

Leave earned on full pay 4 days

LEAVE TAKEN

Leave at credit (Column 21+6)

Government/ Department

for each calendar month.

LEAVE ON LEAVE NOT

to mazimum of 120 days and 305 days

maximum of365 days in entre service.

ABSENCE

Leave on full pay without M.C subject

Leave on full pay on M.C subject to a

10+11+12+14+15+17+19)
Recreation leave of 15 days in a
year but 10 days to be debited.
Leave on full pay on M.C subject ot

Balance on 1-7-1978 /
HALF PAY DUE
served under

Total Leave (Column

return form leave

maximum of 180 days.

(column 7-20)
In Term of Half Pay
ATTESTATI

In term of half pay

In term of full pay

In term of full pay

debitable(double the
Actual No. of days
PERIOD OF DUTY REMARKS

in case of L.P.R
ON

No. of days

actual No.)
PERIOD

Full Days Days From To Days Days Days Days Days Days Days Days Days Days Days Days
From To Y.M.D Calendar
Months
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
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