are RTE Government of India adhe aa fers dar NATIONAL INFORMATION CENTRE aa an Rare & afte at igi & fay ater _ APPLICATION FOR GRANT OF L.T.C. ADVANCE 4. werd alent ar ar Name of the Government Servant 2 Designation 3 whadhste der Emp. Code No 4 BETUatafter geaTN zo ‘Telephone / interrcom No. 5 few — E-Mail address 6 deta wet dort Rafer a ata Date of entering the central Government service 7. an pay a sar vert $a seem Whether Permanent or Temporary 9. (m) Bar gerd René fea ogee TE TR we (3) wy 8 ee Vem wa (a) Home Town as Recorded in ‘The Service Book (b) Nearest Railway Station 10, rar aRtyeh ark fac sate tata aa 2 ged am fares & weer f Whether Wife/husbandis employed: YES/NO & if so whether entitled to L:T.C ‘YES/No Ww RES 2 andl fry Pear FR on? aie of ay wera 8 der ae tar Sah alle af Tore fre ged ar Rrra fear oon & ‘Whether the comcession is to be availed: YES/ No For visiting home town, : YES/ No And if so Block year for which L.T-C. is to be availed. 12, ae" aa Ff ah 2aere oh ain ah fey fae @ at ory re OTE TH eT aie at if the concession is to visit * ANYWHERE IN INDIA" name the place to be visited and Block Year for which L.T.C. is to be availed. 13 aap ‘Nature of leave sear OR a ao wees arts sar a oh ses ter ‘© proposed date for onward joumey & proposed date for return jaourney 140 gene a ys yer re age oh ay ag ATH a Fe te) ee oy fa Single Rail/Bus fare from the Headquarter to Home Town/place 18. es aya Raa wry awe aa URE @ weet oy Rae Persons in respect of whon L.T.C, is proposed to be availed :- RET a omy Bea et a | SI. No, Name Age Relationship 16, arte afte Amount of advance required RS... we 47, 24 Sheen ae & Po auf RA ae Rae SA adios ara & org wey 2 Shs B (A oH bo Ee can rer arch oh ether & 10 Pett ob ae ar oe oT a Read weg ET | 1 declare that the particulars furnishrd above are true and correct to the best of my Knowledge. | undertake to produce the tickets for the outward joumney within ten days of receipt of the advance. carat ee ah wy RUA A orm aR ae rg wey Ht arte 8 10 A wt a eh a ‘femme mage wet ary ret at Hees Sor § fee ote a art air eagee A afte we Ge | (artes # eae) (Signature of the applicant) ate: Sra Rees werd 8 2 afte Sam A ary ee | Dated = ‘© Applicable in case of advance required for family members only.