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    Leave Application

    Uploaded by

    ajith KN
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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Leave Application

    Uploaded by

    ajith KN
    28 views2 pages
    none

    Copyright

    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
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    28 views2 pages

    Leave Application

    Uploaded by

    ajith KN
    none

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    PEN No: Mob No :

    Form No 13
    APPLICATION FOR LEAVE
    (Rule 113, Part I)
    (Note:-Items 1 to 16 must be filled in by all applicants whether
    Gazetted or Non-Gazetted)
    1. Name of Applicant :
    2. Date of Birth :
    3. Post held :
    4. Department, Office and section :
    5. Pay and scale of Pay :
    6. Date of entry in service :
    7. Date of commencement of
    Continuous service :
    8. Whether the applicant has got
    confirmation in any post, if so from
    which date and in which post :
    9. Address during leave :
    10. House rent allowance, Conveyance
    allowance or other compensatory
    allowance drawn in the present post:
    11. Nature and period of leave applied
    and date from which required :
    12. Sundays/holidays, if any, proposed
    to be prefixed/suffixed to leave : :
    13. Ground on which leave is applied for:
    14. Date of return from last leave and
    nature and period of that leave :
    15. (a) I undertake to refund the difference between the leave salary drawn
    during commuted and that admissible during half pay leave which
    would not have been admissible in the event of my retirement from
    service at the end of or during the currency of leave.
    (b) I undertake to refund the leave salary drawn during ‘leave not due’
    which would not have been admissible had rule 85, Part I ,not been
    applied in the event of my voluntary retirement or resignation from
    service at any time until I earn half pay leave not less than the amount of
    leave not due availed of by me.

    16. Place: Signature of applicant


    (with date) [P.T.O]
    17. Remarks and or recommendation of the controlling officer.

    Signature (with date) and


    designation.

    Note:- In the case of a Government servant who is mentally unsound and or physically
    unable to fill in the columns of this form and sign it, the guardian of his
    appointment under the Indian Lunacy Act,. 1912(Central Act IV of 1912) or any
    person authorised by t
    he column and sign the application for and on behalf of the Government servant.

    Certificate Regarding Admissibility of Leave


    (By Account General in the case of Gazatted officers)

    18. “Certified that . . . . .. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . .


    (Nature of leave) for . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .
    from . . . . . . . . . . . . . . . .. . . . . . to. . . . . . . . . . . . . . . . . . . . .is admissible under
    Rule . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . of Kerala
    Service Rules.”

    Signature (with date)


    Designation.

    19. *Orders of the sanctioning authority:

    Signature (with date)


    Designation.

    *If the applicant is drawing any compensatory allowance the sanctioning authority should
    state whether on the expiry of leave he is likely to return to the same post or to another
    post carrying a similar allowance.

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