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    Leave Application Form

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    জেত বন
    FORM NO-2 (Subsidiary Rule 73) Application for leave

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    © All Rights Reserved
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    Leave Application Form

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    FORM NO-2 (Subsidiary Rule 73) Application for leave

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    Leave Application form

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    FORM NO-2 (Subsidiary Rule 73) Application for leave

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    63 views2 pages

    Leave Application Form

    Uploaded by

    জেত বন
    FORM NO-2 (Subsidiary Rule 73) Application for leave

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    FORM NO-2

    (Subsidiary Rule 73)


    Application for leave
    Note: Items 1 to 9 must be filled in by all applicants whether gazetted or non-gazetted. Item 12 applies
    only in the case of gazetted officers. Items 13 and 14 apply only in the case of non-gazetted officers.

    1. Name of the applicant:

    2. Leave Rules applicable:

    3. Post held:

    4. Department of Office:

    5. Pay:

    6. House rent allowance, conveyance allowance or other compensatory


    allowances drawn in the present post:

    7. Nature and period of leave applied for and date from which required:

    8. Ground on which leave is applied for:

    9. Date of return from last leave and the nature and period of that leave:

    10. I undertake to refund the difference between the leave-salary drawn during
    leave on average pay commuted leave and that admissible during leave on half
    average pay/half pay leave, which would not have been admissible had the
    proviso to FR18 (b) (ii)/Rule 13 (c) (iii) of the Revised Leave Rules, 1934 not
    been applied in the event of my retirement from service at the end or during
    the currency of the leave.

    Date …………. Signature of the applicant


    Leave address:.

    11. Remarks and/or recommendation of the controlling officer.

    Date …………. Signature


    Designation

    12. Report of the Audit Officer

    Date …………. Signature


    Designation
    13. Statement of leave granted to applicant previous to this application.
    Nature of leave In current year During past year Total
    Privilege/on average pay/earned
    On average pay Medical
    Certificate/Commuted
    On half average pay/half pay
    Not due
    On quarter average pay
    Extraordinary
    Maternity
    Total

    14. Certified that leave on average pay/earned leave ……………….. for ………
    months and ……………….. days from………………… to ……………is
    admissible ……………………… under…………………. of the
    ………………………
    15. Orders of the sanctioning authority

    Date …………. Signature


    Designation

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