INDIAN INSTITUTE OF TECHNOLOGY, BOMBAY

APPLICATION FOR TEMPORARY ADVANCE FROM CPF/GPF



Name Designation Deptt./Section

Basic Pay Rs. Salary Code No.

Amount of withdrawal requested Purpose of withdrawal

Proposed monthly instalments for repayment of advance

Outstanding previous Advance(s) earlier drawn, if any
Amount Instruction regarding its adjustment or otherwise


Date : Signature of the applicant


(TO BE COMPLETED AND CERTIFIED BY ACCOUNTS SECTION)

Balance of Subcription at the credit of staff member Balance amount As on
Whether previous advance, if any, is in course of repayment. If yes, give details   Amount Paid on amount
Yes
No

Certified by


Date : Signature of the applicant