Application for permission to apply for EX-INDIA leave

1.Name,Designation & Office in which working: Shiv Raj Khanna ,AFSO,Food

Cilvil Supplies & Consume Affairs Deptt. Amritsar

2. Date Of Birth: 09/12/1979

3 .Date Of Appiontment :11/06/2004

4. Whether post held on ad-hoc basic or in Regular capacity: Regular

5. If regular whether temporary or permanent: Permanent

6.Name of Countries proposed to be visted : Netherlands/Spain/Europe

7. Purpose to visit: To meet Family/Relative

8. Name of training/course & duration of traning course abroad: NA

9. The Period of Earned leave applies for Ex_India :from 20/06/2018 to 28/07/2018

10. Probable duration of visit: 39 days

11. How to extra exprnditure(besides the expenditure borne by the sponsoring department) on the
visit abroad will be met: By Relatives

12. Detail of previous private visit abroad: 18/06/2015 to 18/07/2015

UNDERTAKING

I Undertake that I will return to India on Expiry of my leave and will not accept any job or join any
course during the period of of my stay abroa, failing which ,I will beliable of disciplinary action as
required under the Punjab Civil Services (Punishment and appeal 1970for violationof the
Government Employees (Conduct)Rules,1966.

Signature of Applicant

Email and Mobile/Contact No.: shivkhanna1729@yahoo.com 9855481111

1. Certified that the information furnished above is correct.

2. Certified that there is no disciplinary or vigilance case is pending /contemplated aginst the
officer.
3. Leave Recommended

Signature & Designation of Controlling officer

Distt.Controller ,Food Civil Supplies &
Consumer Affairs Department Amritsar