Blank Performa


General Instructions for Print

Application for leave & extension of leave

Applying for leave. Applying for extension of leave.

1. Name of Applicant:
2. Designation:
3. Department, Office and Section:
4. Pay:
5. HRA & other complementary allowances on persent post:
6. Type of leave & leave from and total period:
 
 
7. Reason for which leave is applied for:
8. Sunday or other holiday prefixed or suffixed:
9. I want to encash days leave for the year .
10. Date of joining after previous leave and period and type of leave:  
11. I want to take LTC for block year during the purposed leave.
12. Address during leave:

Use Google Chrome browser for easier printing,
Internet Explorer & Firefox User, please read instruction for printing at top-righthand corner.

X
SunMonTueWedThuFriSat