To be sent to Personnel Department,Kolkata

Office, after Sanction

BRIDGE & ROOF CO. (INDIA) LTD.

(A Govt. of India Enterprise)
APPLICATION FORM FOR

(1) LEAVE
(2) LEAVE ENCASHMENT
(3) CANCELLATION / EXTENSION / REDUCTION OF LEAVE
(4) LEAVE / LEAVE ENCASHMENT EARLIER APPROVED

PERSONNEL DETAILS

EMPLOYEE JOB PLACE OF POSTING/

FULL NAME ( IN BLOCK LETTERS ) GRADE
No. ORDER NO. DEPARTMENT
CIVIL DESIGN
101386 ARINDAM MUKHERJEE E1 -
(KOLKATA OFFICE)

CONTACT E-MAIL FAX NO.

PLACE / ADDRESS WHILST ON LEAVE
NO. * *
ODISHA 9163297389

* If available
APPLIED FOR

(A) LEAVE (B) LEAVE ENCASHMENT

NUMBER OF DAYS TOTAL

FROM TO DAYS NUMBER OF DAYS (P.L.)
P.L. S.L. C.L.
28.01.2015 31.01.2015 4 4

SIGNATURE DATE : 24.01.2015

FOR USE BY
SITE INCHARGE / HOD / SANCTIONING AUTHORITY

RECOMMENDATION
N A M E DESIGNATION /SANCTION / SIGNATURE & DATE
REMARKS

G.K. DATTA DGM (DESIGN)

DESPATCHED BY SITE DATE : SIGNATURE

RECEIPT BY PERSONNEL DEPARTMENT DATE : SIGNATURE

ENTRY SL. NO. IN THE LEAVE FILE DATE : SIGNATURE

 To be sent to Personnel Department,Kolkata Office,
after Sanction

BRIDGE & ROOF CO. (INDIA) LTD.

(A Govt. of India Enterprise)
APPLICATION FORM FOR

(1) LEAVE
(2) LEAVE ENCASHMENT
(3) CANCELLATION / EXTENSION / REDUCTION OF LEAVE
(4) LEAVE / LEAVE ENCASHMENT EARLIER APPROVED

PERSONNEL DETAILS

EMPLOYEE JOB PLACE OF POSTING/

FULL NAME ( IN BLOCK LETTERS ) GRADE
No. ORDER NO. DEPARTMENT
CIVIL DESIGN
101942 ANIRBAN BISWAS E1 -
(KOLKATA OFFICE)

CONTACT E-MAIL FAX NO.

PLACE / ADDRESS WHILST ON LEAVE
NO. * *
Kolkata 8902234022

* If available
APPLIED FOR

(A) LEAVE (B) LEAVE ENCASHMENT

NUMBER OF DAYS TOTAL

FROM TO DAYS NUMBER OF DAYS (P.L.)
P.L. S.L. C.L.
28/04/2017 29/04/2017 2 2

SIGNATURE DATE :2/5/2016

FOR USE BY
SITE INCHARGE / HOD / SANCTIONING AUTHORITY

RECOMMENDATION
N A M E DESIGNATION /SANCTION / SIGNATURE & DATE
REMARKS
DGM (DESIGN)
Mrs. J. RAHA
PROJECTS
Shri. G.K. DATTA GM (DESIGN)

DESPATCHED BY SITE DATE : SIGNATURE

RECEIPT BY PERSONNEL DEPARTMENT DATE : SIGNATURE

ENTRY SL. NO. IN THE LEAVE FILE DATE : SIGNATURE

 To be sent to Personnel Department,
Kolkata Office, after Sanction

BRIDGE & ROOF CO. (INDIA) LTD.

(A Govt. of India Enterprise)
APPLICATION FORM FOR

(1) LEAVE
(2) LEAVE ENCASHMENT
(3) CANCELLATION / EXTENSION / REDUCTION OF LEAVE
(4) LEAVE / LEAVE ENCASHMENT EARLIER APPROVED

PERSONNEL DETAILS

EMPLOYEE FULL NAME ( IN BLOCK LETTERS ) GRADE JOB PLACE OF POSTING/

NO ORDER NO. DEPARTMENT
CIVIL DESIGN
101386 ARINDAM MUKHERJEE E0 -
(KOLKATA OFFICE)

PLACE / ADDRESS WHILST ON LEAVE CONTACT E-MAIL FAX NO.

NO. * *
KOLKATA 9163297389

* If available
APPLIED FOR

(A) LEAVE (B) LEAVE ENCASHMENT

FROM TO NUMBER OF DAYS TOTAL DAYS NUMBER OF DAYS (P.L.)

P.L. S.L. C.L.
30.09.2013 01.10.2013 2 2

SIGNATURE DATE : 05.10.2013

FOR USE BY
SITE INCHARGE / HOD / SANCTIONING AUTHORITY

N A M E DESIGNATION RECOMMENDATION / SIGNATURE &

SANCTION / REMARKS DATE
G.K. DATTA DGM (DESIGN)

DESPATCHED BY SITE DATE : SIGNATURE

RECEIPT BY PERSONNEL DEPARTMENT DATE : SIGNATURE

ENTRY SL. NO. IN THE LEAVE FILE DATE : SIGNATURE

 To be sent to Personnel Department,
Kolkata Office, after Sanction

BRIDGE & ROOF CO. (INDIA) LTD.

(A Govt. of India Enterprise)
APPLICATION FORM FOR

(1) LEAVE
(2) LEAVE ENCASHMENT
(3) CANCELLATION / EXTENSION / REDUCTION OF LEAVE
(4) LEAVE / LEAVE ENCASHMENT EARLIER APPROVED

PERSONNEL DETAILS

EMPLOYEE FULL NAME ( IN BLOCK LETTERS ) GRADE JOB PLACE OF POSTING/

NO ORDER NO. DEPARTMENT
CIVIL DESIGN
101386 ARINDAM MUKHERJEE E0 -
(KOLKATA OFFICE)

PLACE / ADDRESS WHILST ON LEAVE CONTACT E-MAIL FAX NO.

NO. * *
KOLKATA 9163297389

* If available
APPLIED FOR

(A) LEAVE (B) LEAVE ENCASHMENT

FROM TO NUMBER OF DAYS TOTAL DAYS NUMBER OF DAYS (P.L.)

P.L. S.L. C.L.
03.10.2013 04.10.2013 2 2

SIGNATURE DATE : 05.10.2013

FOR USE BY
SITE INCHARGE / HOD / SANCTIONING AUTHORITY

N A M E DESIGNATION RECOMMENDATION / SIGNATURE &

SANCTION / REMARKS DATE
G.K. DATTA DGM (DESIGN)

DESPATCHED BY SITE DATE : SIGNATURE

RECEIPT BY PERSONNEL DEPARTMENT DATE : SIGNATURE

ENTRY SL. NO. IN THE LEAVE FILE DATE : SIGNATURE