| | | a an SAT TT STARE START TOT eae prom or r.asraenzirs20 case ataet stk osart aarera) “eI Fax :91-11-25093807 | 25093514 National Highways Authority of India (Misty of Road Transport and Highways) ‘t-s wa 6, Saet-10, creer, aF Reett-110075 6-58 6, Sector-10, Dwarke, New Delhi-110075 No. 11041/08/2010- HR-1" Dated: 08.12.2014 Sub; Application form for leave or for extension of leave (CL/RL/HPL/SL/Leaving of Headquarters during the period of leave)- Format reg. Please find enclosed herewith a fresh format for application for leave/extension of leave (CL/EL/RH/any other leave) in English and Hindi. it has been decided that henceforth these forms be utilized for seeking leave/extension of leave. 2. All staff NHAI with immediate effect will use the approved format for any type of leave. Use of Note sheet/letter for the purpose is not solicited please. (Ut. Cef’S.S. Kapur) General Manager (HR/Admin) To All officers and employees of HQ/ROs/PIUs/CMUs/Site OfficesLeave/ R NATIONAL HIGHWAYS AUTHORITY OF INDIA Leave/ E commuted Leav: Leave, ial Leave/ Leavin jariers during the. Employees ID Name Designation Pay scale and Grade Pay Type of Leave No. of days leave applied Duration of Leave & Date Leave(s) availed in Calendar Year Purpose of Leave Whether there is any proposal to avail LIC during the period of Leave? Ityes, give the details Leave encashment required It yes, no. of days leave encashment token tit date Whether permission is required for leaving the Headquarters during the period of CLE asseassee BL RH Any other leaves.sseseesee Yes/No Block Year =... 7 For Home Town/All india vi Yes/No eel . days (Maximum 60 days permissible in entire service) leave? If, Yes, mention the period with date. Address during the Leave Telephone/Mobile No. Date: Date Signature of the Applicant: Recommended / Not Recommended : Signature of the Officer incharge.. Sanctioned/ Not Sanctioned : Signature of Controling Officer...Oo sired wegen stant orfreeeor rea eaten AMR AT aa A ht ACTA A Re ade anced sage) Heat ad cera aaaane a de Gar eR a ETRT eal Rett a sreemer Be fare antes Pa E seme 4 HART atte aattr ‘ates of Hi fer war sear een oT WaT rar graeme arate a ater Beet ara Rear BF a wee B 2 af a at Regs gees var yeet ax aendvorer ate 2 cafe a at, aot aa Pred Rat & seaer ve aendteneor fae aR 1 spar arg at aa as ae aor wast fh agAIe A ona 7 ae a at safe o ate a sere Tt arent & ahs car tite ates aa ate * Sai af. sae pg ae / sf areca ara by oO ae 2 see RSE (Gh Bea 3 se 60 feat Sepa surat a a= BCS SEMEN degen wan / age a&t Par sar wordt aftr & raat ‘eager / siege 7 ~ Beam sant eae