How to fill a form for Commuted Leave in Government Department?

 How to fill a form for Commuted Leave in Government Department?

Learn how to properly fill out a Commuted Leave application in a government department, including steps for applying with or without a medical certificate, required documentation, and guidelines for approval. Sample Form-1 has filled below: 

FORM - 1

(See rule - 14)

APPLICATION FOR LEAVE OR FOR EXTENSION OF LEAVE

1) Name of applicant (In block letter)	: Rakesh Kumar Tripathy
2) Post held	: Accountant
3) Department, Office and Section	: Revenue, Central Board of Indirect Taxes & Customs and Account Section
4) Pay	: Rs. 35,400/-, Level-6
5) House Rent and other compensatory     Allowances drawn in the present post.	: House Rent- Rs. 10,620/- and Nil
6) Nature and period of leave applied for     and date from which required.	: Commuted Leave with or without Medical Certificate  (Mention) or  and 10 days from 21.10.2024 to 30.10.2024
7) Sunday and holidays, if any, proposed     to be prefixed/ suffixed to leave.	: Sunday dated 20.10.2024 (Prefix) and Thursday dated 31.10.2024 (Suffix)
8) Ground on leave is applied for	: To attend to personal health concerns                 requiring immediate attention.
9) Date of return from last leave and the     nature and period of that leave	: 10.07.2024 and Commuted Leave and 6 days only
10) I propose/do not propose to avail       myself of leave travel concession for      the block years during the ensuing leave.	: Nil
11) Address during leave period	: Delhi Industrial Area, New Delhi- 110015.
12) In the event of my resignation or voluntary retirement from service, I undertake to refund	: Nil
(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 (1) of rule 30 not been applied;
(ii)           the leave salary drawn during leave not due which would not have been admissible had sub-rule (1) of rule 31 not been applied.
* Score out whatever be not available.

                                                                Signature of Applicant

        (With Date)

 12.     13. Remarks and / or recommendation of the Controlling Officer.

                                                    Signature & Designation 

                                                                           (With Date)

CERTIFICATE REGARDING ADMISSIBILITY OF LEAVE

14. Certified that ……………………………………………… (nature of leave) for ………………….……………………. days from …………………………… to ……………………… (period is admissible under rule …………………………………. of the Central Civil Services (Leave) Rules 1972.

 Signature (with date)/ Designation

15. Orders of the authority competent to grant leave.

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