APPLICATION FORM FOR TRANSFER
1. Name and Designation of the Applicant :
2. Office / Institution in which working at :
present
3. Date from which serving in the present :
office / Institution
4. Date of Superannuation :
5. Region to which he / she belongs :
6. Permanent Residential Address :
7. Present Residential Address :
8. Details of previous service rendered in various offices / Institutions from the date of his / her
initial appointment
Sl. Designation Office / Institution From To
No.
9. Whether working for the present on service placement. If so, furnish the details
Sl. Name of the institution to which Date from which working
No. service placed presently
1
Sl. Name of the institution to which Date from which To
No. service placed earlier working
1.
2.
3.
…2/
-:2:
10. Whether his / her spouse is a :
Government Servant, if so, present
place of posting of the spouse
11. Place / Office / Region to which transfer : Puducherry / Karaikal / Mahe / Yanam
applied for in the order of preference
1.
(Mention atleast three places)
2.
3.
12. Reasons for transfer applied for :
13. Details of all kinds of leave (other than CL and RH) taken during the period of present posting
(for the past three years / two years / one year wherever applicable)
Sl. Details of Leave Total No. of Whether sanctioned
No. day(s) by the Competent
Authority
1. Earned Leave
2. Commutted Leave
3. Maternity Leave
4. EOL with Medical Certificate
5. EOL without Medical Certificate
6. Child Care Leave
7. Unauthorized Absence
8. Study Leave
9. Other Kinds of Leave, if any
Place :
Date :
NAME & SIGNATURE OF APPLICANT
Recommended & Forwarded. The service particulars furnished by the applicant against Sl.Nos. 8, 9
& 13 have been verified and found correct.
SIGNATURE OF HEAD OF OFFICE /
INSTITUTION WITH DATE
Recommendations of DHFWS
SIGNATURE OF HEAD OF
DEPARTMENT WITH DATE