CSK Himachal Pradesh Krishi Vishvavidyalaya, Palampur (HP) APPLICATION FORM FOR EARNED LEAVE OR EXTENSION OF LEAVE 1. Name of applicant 2. Post held 3. Department, Office and Section 4. Pay 5. House Rent and other Compensatory allowances drawn in the present post 6. Nature and period of leave 7. Number of Days & date from which the leave required 8. Sunday, and holidays, if any proposed to be prefixed/suffixed to leave 9. Grounds on which leave is applied for 10. Date of return from last leave and the nature and period of that leave 11. I propose/do not propose to avail myself of leave travel concession for the block years___________________________ 12. Address during the leave period Phone No. : : : : : : Earned Leave/Commuted Leave Number of Days: FROM TO : PREFIX: SUFFIX : : : : : Signature of applicant (With date) 13. Remarks and or recommendation of the Controlling Officer. Signature/Designation (With date) CERTIFICATE REGARDING ADMISSIBILITY OF LEAVE 14. Certified that ____________________ for (Nature of Leave) ___________________ (period) from________ to______________ is admissible under Leave Rule 7.21 of CSKHPKV Statutes 1988. 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. For Office Use Only: Opening Balance of Leave =Days Leave earned from to =Days Total Leave Credit =Days Leave Applied/Taken =Days BALANCE on return from Leave =Days
