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Talib Hussain

The document is an application form for leave submitted by Talib Hussain, a Postal Assistant, requesting six days of Earned Leave from July 28 to August 2, 2025, due to domestic exigencies. It includes details such as the applicant's name, post, department, pay, and the leave rules applicable. The form also contains undertakings regarding the refund of leave salary under certain conditions and requires a certification of admissibility from the controlling officer.

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Mehtab Sabri
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99 views1 page

Talib Hussain

The document is an application form for leave submitted by Talib Hussain, a Postal Assistant, requesting six days of Earned Leave from July 28 to August 2, 2025, due to domestic exigencies. It includes details such as the applicant's name, post, department, pay, and the leave rules applicable. The form also contains undertakings regarding the refund of leave salary under certain conditions and requires a certification of admissibility from the controlling officer.

Uploaded by

Mehtab Sabri
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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FORM FOR APPLICATION FOR LEAVE S.R.

-1
(See Supplementary Rule 216)
Note : Items 1 to 11 must be filled in by all applicants whether gazetted or non-gazetted

1. Name of the Applicant​ ​ ​ ​ : Talib Hussain


2. Leave Rules Applicable​​ ​ : CCS (Leave) Rules 1972
3. Post Held​ ​ ​ ​ ​ : Postal Assistant
4. Department, Office and Section​ ​ : Postal, PG College So
5. Pay​ ​ ​ ​ ​ ​ : ₹.Basic Pay 26300+Allowances
6. House rent allowance, conveyance​ ​ :
allowance or other compensatory
allowances drawn in the present post.
7. Nature and period of leave applied for​ ​ : Earned Leave for six days w.e.f 28-07-2025 To 2 August 2025
and date from which required
8. Sunday and holidays, if any proposed​ ​ : 27 July(Sunday)
to be prefixed/suffixed to leave.
9. Ground on which leave is applied for​ ​ : Domestic Exigencies
10. Date of return from last leave and the​ ​ :
nature and period of that leave
11. I proposed / do not propose to avail myself of leave travel concession in the block years ………………….. during
the ensuing leave.
12. (a) I undertake to refund the difference between the leave salary drawn during leave on average pay/commuted leave
and that admissible leave on half average pay half leave, which would not have been admissible had the provision to
F.R.81(b)(II) Rule II(c) (III) of the revised Leave Rules, 1933 not been applied in the event of my retirement from service at
end or during the currency of the leave.
12. (b) I undertake to refund leave salary drawn during leave not due which would not have been admissible had F.R.81 (c)
Rule 11(d) of the Revised Leave Rule 1933 not been applied, in the event of my voluntary retirement or resignation from
service at any time I until earn half pay leave not less than the amount of leave not due availed of by me.

Date : 28/07/2025 Signature of Applicant

13. Remarks and-or recommendation of the controlling Officer.

Signature with Designation


Date ………………….​

​ ​ ​ ​ ​ ​ ​

CERTIFICATE REGARDING ADMISSIBILITY OF LEAVE


(By Accountant General to the case of gazetted Officers)

14. Certified that ………………………………………………….. [Nature of leave] for ………................ from [period] ………….…………… to
…………………………...is admissible under rule ……………………… of the …………………... Rules.

Date …………………​ ​ ​ ​ ​ ​ ​ ​ ​ Signature with Designation ​


​ ​ ​ ​ ​ ​

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