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SR 1 Form

This document is an application form for earned leave or extension of leave, requiring details such as the applicant's name, post, department, pay, nature and period of leave, and grounds for the leave request. It includes sections for the applicant's declaration, remarks from the controlling officer, and certification of leave admissibility. Additionally, it outlines the need for orders from the competent authority to grant the leave.

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Topesh Sahu
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698 views2 pages

SR 1 Form

This document is an application form for earned leave or extension of leave, requiring details such as the applicant's name, post, department, pay, nature and period of leave, and grounds for the leave request. It includes sections for the applicant's declaration, remarks from the controlling officer, and certification of leave admissibility. Additionally, it outlines the need for orders from the competent authority to grant the leave.

Uploaded by

Topesh Sahu
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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APPLICATION FORM FOR EARNED LEAVE OR EXTENSION OF LEAVE

1. Name of applicant :

2. Post held :

3. Department, Office and Section :

4. Pay : BASIC PAY=Rs. + G. P.=Rs.

5. House Rent and other Compensatory :


allowances drawn in the present post

6. Nature and period of leave : Earned Leave/Commuted Leave

7. Number of Days & date from which the leave Number of Days:
required
FROM TO

8. Sunday, and holidays, if any proposed to be : PREFIX:


prefixed/suffixed to leave
SUFFIX :

9. Grounds on which leave is applied for :

10. Date of return from last leave and the nature :


and period of that leave
N/A

11. I propose/do not propose to avail myself of :


leave travel concession for the block
years___________________________

12. Address during the leave period : I, hereby, declare that I will obey the rules regarding
earned leave.

Signature of applicant

(With date)

Phone No.

13. Remarks and or recommendation of the Controlling Officer.

Signature/Designation

(With date)
CERTIFICATE REGARDING ADMISSIBILITY OF LEAVE
14. Certified that Earned leave for (Nature of Leave) ___________________
(period/days) from________ to______________ is admissible under Leave
Rule.

Signature/Designation

(With date)

15. Orders of the competent authority to grant leave

Signature/Designation

(With date)

-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-
.-.-.-.-.-.
#If the applicant is drawing any compensatory allowance, it should also be indicated in the orders
on the expiry of leave, the Government serving similar allowance.

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