NAME ;I

DESIGNA'TION
* I
EARNED LEAVE:
sanct i oned * : !do.. of days ._------ from t o
I
----
Date :
Encashment of
I
l eave appl i ed f or : ' , - days f or t he block year
,Signature of t he employee
Encashment of
- Earned Leave l a s t
Sal ar y p a r t - i cul ar k -,- R5.
Basic
Spl . Pay
Per. Pay
D. A.
I nt er i m Rel i ef :
Ha Re A.
* , C . C . A. : I
Other allowan- 1
ces ' excl udi ng 1
Of f i c i a t i ng, 0
, Funct i ona1, ~on-1
veyance and ~ n - 0
tertainmemt
Allowances
0 '
1 - - - - - - - - - - -
TOTAL
-----------
--..- -.-.--
Zarned Leave
posl t i on a s
OP -.-. .._- .---- ----
da j r s
i ar ned l eave sanc-
t i oned debi t ed a s
above
days
Earned Leavz t o-
wards Encas hment
debi t ed a s above : --------- days
Balance
---------
avai l ed f o r t he b$ock year (
--- A > :
I n i t i a l s ~ n i t i a l s
.Encashment of Earnrd Lezve f or --- - days has been
sanct i oned and b. may be pai d.
I
a - ,
. --
I
I
, . *-.. --A . . . ... .. . .. . - : * ~ a r n e b L-eave appl i cat i on sanct i oned by Cornpe t e nt Aut hori t y should
i nvar i abl y be sent along wi t h .ti?is app1i ~; ~i t i on.
!
. - . - - . . . .:
- .--,, .*a:
. .