SECTION XX FORMS 1 Application form for grant of L.T.C. advance 1. Name of the Government servant ........... 2. Designation ........... 3. Date of entering the Central Government service ........... 4. Present Pay ........... 5. Whether permanent or temporary ........... 6. Hometown as recorded in the Service Book ........... 7. Whether wife/husband is employed and if so whether entitled it L.T.C. ........... 8. Whether the concession is to be availed for visiting hometown, and if so block for which L.T.C. is to be availed........ 9. (a) If the concession is to visit "anywhere in India", the place to be visited ........... (b) Block for which to be availed ........... 10. Single railfare/busfare from the headquarters to Hometown /place of visit be shortest route ........... 11. Persons in respect of whom L.T.C. is proposed to be availed: Sl. No. Name and age Relationship 12. Amount of advance required Rs.......... I declare that the particulars furnished above are true and correct to the best of my knowledge. I undertake to produce the tickets for the outward journey within ten day of receipt of the advance. In the event of cancellation of the journey or if I fail to produce the tickets within ten days of receipt of advance, I undertake to refund the entire advance in one lump sum. Date Signature
