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Ltcadvance

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Government of India

MiNISTRY OF STATISTICS AND PROGRAMME IMPLEMENTATION

APPLICATION FOR GRANT OF L.T.C. ADVANCE

1. Name of the Government Servant :


2. Designation :
3. Emp. Code No. :
4. Telephone / Intercom No. :
5. E-Mail address :
6. Date of entering the Central :
Government service
7. Pay :
8. Whether Permanent or Temporary :
9. (a) Home Town as Recorded in the :
Service Book
(b) Nearest Railway Station :
10. Whether wife / husband is employed : YES / NO
& if so whether entitled to L.T.C. : YES / NO
11. Whether the concession is to be : YES / NO
availed for visiting home town, Block Year ________________
and if so Block Year for which
L.T.C. is to be availed.
12. If the concession is to visit : Place ________________
"ANYWHERE IN INDIA", name the place
to be visited and Block Year for Block Year ________________
which L.T.C. is to be availed. :
13. Nature of leave ................ from ............ to ............
OR
* Proposed date for onward journey & :
Proposed date for return journey :
14. Single Rail/Bus fare from the :
Headquarter to Home Town/place
of visit by shortest route.
15. Persons in respect of whom L.T.C. is proposed to be availed :-
--------------------------------------------------------------------
Sl. No Name Age Relationship
--------------------------------------------------------------------

--------------------------------------------------------------------

16. Amount of advance required Rs. ...........


17. 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
outward journey within ten days of receipt of the advance.

In the event of cancellation of the journey or if I fail to produce the


tickets within 10 days of the receipt of the advance, I undertake to refund
the entire advance in one lumpsum.

Dated : (Signature of the applicant)

* Applicable in case of advance required for family members only.


CHECK LIST (Cash and Accounts Section)

1. Amount entitled for : Fare Rs. ......X 2 X (No. of tickets)


Reimbursement

2. Advance admissible ( 90% of the amount i.e. Rs. ...........)

Advance of Rs. ...............................................


may be sanctioned.

Dealing Hand. Signature of D.D.O.

=========================================================================

CHECK LIST FOR ADMINISTRATION

L.T.C. advance to __________________________________________________

1. Block Year / Calendar Year :

2. Home Town / A place anywhere in India :

3. a) For whom advance is applied for :

b) Total number of persons :

4. Specific grounds waranting sanction : for both/ onwards/ return


journey of advance under Rule G.F. 235 (2) (iii) (a)

5. Leave application received : Yes / No

6. Amount of advance : Rs.

7. Temporary / Permanent :

8. If temporary (Surety bond produced) : Yes / No

Necessary entry has been made in the L.T.C. Advance Register.

He/She is eligible for L.T.C. for the Block/Calender Year ...............

We may sanction the advance as per fair sanction letter placed below for
approval & signatures of D.D. (Admn) please.

Dealing Hand (Section Officer)

D.D. (Admn)

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