SALARY ADVANCE APPLICATION FORM 1.

APPLICANT'S PARTICULARS ( To be filled by the employee) Date: Name : Designation : Location: Name of the Company (Blue Leaves Design) Basic salary (as per salary slip) for the last 4 months 1 2 3 4 Department : Date of joining (DD.MM.YY): Band:

Purpose of loan:

2. ADVANCE AVAILMENT : Rs. __________________ /-( Rupees (in words)__________________________________ Employee undertaking: I hereby understand that the entire advance amout will be deducted from by subsequent month's salary. In case of sepration from the company the advance amout will be settled from my Full n Final settlement. I request you to grant me the Advance. Applicant's signature: Date :

3. CERTIFICATION AND RECOMMENDATION Recommended/ Not Recommended Name & Designation of HOD

5. VERIFICATION BY THE HUMAN RESOURCES DEPARTMENT Whether applicant's particulars are correct : Whether Advance is as per policy : Yes / No Yes / No

Date :

Signature

Advance Deduction salary Month Performance Rating : Signature: Date :

AFTER RECOMMENDATION, PLEASE PASS THIS ON TO HUMAN RESOURCES DEPARTMENT-HO