FORM 1 [See rule 15 ] Application for leave or for extension of leave. 1. Name of applicant. 2. Post held. 3. Department/Office 4. Pay 5. House rent and other compensatory allowances drawn in the Present post. 6. Nature and period of leave applied for and date from which required. 7. Sunday and holidays if any , proposed to be prefixed/suffixed to leave. 8. Grounds on which leave is applied for. 9. Date of return from last leave, and the nature of period of that leave. 10. Address during leave period. 11. In the event of my resignation or voluntary retirement from service, I undertake to refund : (i) the difference between the leave salary drawn during commuted leave and that admissible during half pay leave, which would not have been admissible had sub-rule (l) of rule 29 not been applied; (ii) the leave salary drawn during leave not due which would not have been admissible had sub-rule (l) of rule 30 not been applied. Signature of applicant (with date) 12. Certificate regarding admissibility of leave: Certified that............. .............(nature of leave) for ( period ) . . . . . . . . . . . . .from. .... .. . . t o . . . .. . . . . . . . . . . . . . . . . . . . . . . i s admissible under ruIe............. .............to the Civil Services (Leave)Rules,1979. Signature(with date) Designation 13. Remarks and/or recommendation of the Controlling Officer. Signature(with date) 14. Orders of the authority competent to grant leave. Signature (with date) Designation.
