अर्जित अवकाश आवेदन
Earned Leave Application
PROFARMA -1 (Sec S. R.S. below PF 74)
अर्जित अवकाश के लिये प्रार्थना पत्र
Form of Application for Leave
Note – Item 1 to 11 must be filled in by all applicants whether Gazetted or Non Gazetted item 12 may to be filled in only where it is applicable to the Government-Servant concerned. I propose / do not propose to avail myself of leave travel concession for the block years …………………… during the ensuing leave.
| 1 | Name of the Applicant प्रार्थी का नाम | __________________________________________ |
| 2 | Leave of Rules applicable छुट्टी के नियम जो लागू हो | __________________________________________ |
| 3 | Post held पद | __________________________________________ |
| 4 | Department, Office and Section. विभाग एवं कार्यालय | __________________________________________ |
| 5 | Pay वेतन | __________________________________________ |
| 6 | House rent allowance conveyance allowance or other compensatory allowance drawing on the present post. मकान किराया, भत्ता सवारी या वर्तमान वेतन के अनुसार और कोई भत्ता जो मिलता है। | __________________________________________ |
| 7 | Nature and period of leave applied for and date from which required. जिस तारीख़ से छुट्टी मांगी गई उसका स्वरुप एवं पूर्ण स्वरुप | __________________________________________ |
| 8 | Sundays and holidays if and proposed to be prefixed / suffixed to leave रविवार और अन्य छुट्टियाँ जोड़ी या न जोड़ी जाती हो। | __________________________________________ |
| 9 | Ground on which leave as applied for छुट्टी लेने का कारण | __________________________________________ |
| 10 | Date of return from last leave and the nature and period of that leave. पिछली ली छुट्टी का स्वरुप एवं उस छुट्टी से लौटने की अवधि | __________________________________________ |
| 11 | Leave address if Granted मंजूर होने की दशा, छुट्टी के समय आवेदक का पता | __________________________________________ |
| 12 | (a) I undertake to refund difference between the leave salary drawn during leave on average pay i.e. commuted leave & that admissible during leave on half average pay leave, which would not have been admissible had the provision to F.R. 88(b) (ii) M. B. E. R. 79 (C) Rule 11 (e) of the Revised Leave-Rules 14(c) of the Madhya Pradesh Revised Leave Rules 1934/Rule 93(c) of the Rajasthan Service Rules not been applied in the event of my retirement from at the end of during currency of the leave. | |
| (b) | I undertake to refund the leave salary drawn during leave not due which would not have been adminassion had F.R. 81 (C) Rule 11 (d) of the Reversed leave Rules 1993 / Rules 15 of the Madhya Pradesh revised leave 1934 / Rule 79 -A of M.B.F. rule 93 (d) of the Rajasthan service rule not been applied in the event of my voluntary retirement from service at the or during the currency of leave. | |
Signature of Applicant
(with date)
13. Remarks and recommendation of the controlling officer.
Singnature
(with date and Designation)
Certified Regarding Admissibility of leave
(By Accountant General Gazetted Officer)
14. Certified that ……………………………….. (Name of leave)…………………….. for period………………
………. From……………………. .To………………………… . is admissible rule ………………. Of the
Signature
(with date) and Designation
15. Order of sanctioning authority
Signature
(with date and Designation)
*If the applicant is drawing and compensatory allowance the sanctioning authority should state whether on the expiry of leave this is like to refuse in the same post or to another.
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