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I hereby declare that the particulars furnished in the above L.T.A. form are true and correct and confirm that the
period of leave mentioned above has been sanctioned by my Department Head and debited to my Privilege Leave
Place:
Date: Signature of Employee
Total -
Notes : -
1. LTA exemption should be claimed for only one journey during the financial year
2. If the journey is performed by Airways, e-ticket or boarding pass for both sides of travel issued by the airlines
should be enclosed.
3. If the journey is performed by Railways, e-ticket or copy of rail ticket for both sides of travel should be enclosed.
4. If the journey is performed by Roadways, the original bill of the transport agency should clearly
mention whether the journey was by AC / Non-AC car, the kilometers travelled and the rate per kilometer.
6. Proofs submitted for foreign travel will not be considered for exemption