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APPLICATION FOR L.F.C./ H.T.C. FACILITY AND LEAVE ENCASHMENT

The General Manager / Regional Manager

Uttarakhand Gramin Bank
Head Office / Regional Office
Dehradun / Pauri I Pithoragarh / Haldwani

Sir,
L.F.C./ H.T.C. Facility and Leave encashment

I want to avail of my L.F.C./ H.T.C. facility to visit the under noted places w.e.f to ..

I. Place to be visited: Mode of conveyance: ~ ..

2. Please, therefore, sanction me days leave for the above period and 30 / 15 Days Leave
encashment facility.

3. I had last availed the L.F.C / H.T.C. / Encashment facility in month/ year ,
My last availed LFC I HTC Block is From To ..
& Leave Encashment Block is From To .
4. My date of joining the Bank's service is - 5. My Current basic pay is Rs .

D e t at·1 so f mv famuv . h ere un d er

·1 mem b ers w h o are w h o llrv d enen d ent on me is
S.N. Name Aze Relationship
I Self

Thanking you
Yours faithfully,

Signature:

Full Name E.C:.No- .

Branch/RO/HO : .
For use of controlling office {RO/HO)

Privilege Leave due : ..... months Days Recommended

Current LFC/HTC Block : . . . . . . . to .

Encashment Block : to . B.M./R.M./H.O.D.

APPLICATION FOR GRANT OF ADVANCE FOR LEAVE FARE CONCESSION

The General Manager

Uttarakhand Gramin Bank
Head Office
Dehradun

LEA VE FARE CONCESSION ADVANCE

1. I intend to visit . . .. . . . . . . . . . . . . . . . . . . . . .. ... by circuitious route for rest and recuperation/

which is my place of domicile and which is Kms. from my place of duty.

I detail hereunder the name of my family members who are wholly dependent on me and will
accompany me to the above said place and also the actual cost of fares :

S.N. Name Aze Relationship

1 Self

2. Please sanction me the advance of Rs ./- for above visit. I undertake to produce
the ticket/ cash receipt and to submit my bill for the concession within 15 days of completion
of journey. In the event of my failure to submit the bill in time, the amount of advance may be
recovered from my salary and allowances.

I declare that the above information is correct to the best of my knowledge & belief.

Thanking you
Yours faithfully,

Signature :
Full Name E.C.No- .
Branch / RO / HO : .