APPLICATION FOR LEAVE TRAVEL CONCESSION ADVANCE
BLOCK YEAR 19 - 19
I shall be on vacation from
I have applied/been sanctioned leave from
during which period I wish to avail of the Leave Travel Concession for myself and my family.
II AC I/II *I/We intend to travel by II AC/I/II Class by Rail
My Basic Pay is Rs.
The particulars 0f the dependent family members wishing to proceed to home town/any place in India are as given below :-
Name of the dependent family member
(wife,children,parents,minor brothers and sisters)
Home Town declared
Any place in India chosen for visit(farthest point)
Nearest Railway Station
I shall refund fortheith the advance if the outward journey is not commenced within 30 days of the drawal of the advance.
I shall prodeice railway tickets in respect of onward journey for vertication within 10 days from the drawal of the advance.
I am aware that I am required to produce Bus Tickets for road journeys and to furnish ticket nos. in respect of return Rly.journeys.
I shall prefer my L.T.C. claim IMMEDIATELY on the completion of the RETURN JOURNEY.
Delete which is not applicable
Salary Code No.