Check list for sabbatical leave

Sr. No. Item Obtained

I (Yes/No)

1 Application in Standard format

2 Declaration cum undertaking to be submitted by

the employee while proceeding on sabbatical
leave (Format enclosed)

3 DPD/Vigilance Clearance

4 Salary Slip

5 Whether occupying staff quarters/leased

accommodation?

6 Details of loan availed

7 Proposed repayment programme of existing loans

after sanction of sabbatical leave, with income
proof of spouse

8 Undertaking from spouse to repay the loans (if

applicable)

9 Particulars of Loss of Pay availed, if any earlier

and status of its approval.

* Application to be submitted for approval atleast 15 days in advance

 APPLICATION FOR SABBATICAL LEAVE

Name of the Employee

01

02 Designation

03 PF Index No.

04 Branch

05 Joined Bank on, as

06 Total service in the Bank

07 Leave position due

Extra Ordinary leave if any, availed

08
earlier Brief reasons thereof

09 Earlier LOP sanctioned No/date

10 Sabbatical leave applied for

11 Brief reasons for the leave

Details of supporting documents

12
enclosed

13 Present date of increment

Details of Advances/ Loans availed

14 from the Bank (A/c No, Limit, DP,
O/S etc)

15 Present status of the loan

Sources from which the loan will be

16 repaid during the leave period
(please advise specific source)
Monthly rental if staying in staff
17
quarters/leased accommodation
Whether quarters / leased
18
accommodation will be vacated

As per the extant policy I, Ms ________________ presently working at ________ Branch

as _______________is applying for Sabbatical leave as per the Cir No.
CDO/P&HRD/PM/54/2013-14 dated 09.12.2013. The necessary undertaking is
enclosed.
Thanking you,
Yours Sincerely,

( )
Copy for acknowledgement:
Copy for acknowledgement:
Received your application dated ___________ for Sabbatical leave for ___ days
from______to______.
Your application will be submitted to Competent Authority for their consideration.
Please note that you cannot proceed on leave unless and until approval of the
Competent Authority is communicated to you.
STATE BANK OF INDIA
______________ Branch
Date:
 DECLARATION/UNDERTAKING TO BE SUBMITTED BY THE EMPLOYEE WHILE
PROCEEDING ON SABBATICAL LEAVE

I Miss/Ms/Smt.___________________________, ______________D/o/ W/o____________

age : - _____ R/o _________________________________________________working in
_______________ branch of SBI, hereby declare that I have applied for Sabbatical
Leave with effect from __________ to ___________, for _______________________________
reasons in terms of the Circular No.CDO/P&HRD/PM/54/2013-14 dated
09.12.2013 and further declare that I am fully aware and understand the terms and
conditions as under :
i. The Sabbatical leave which will be sanctioned to me will be without pay, salary,
allowances, perquisites and any other consequential monetary and non-monetary
benefits. I will not earn any increment during the sabbatical leave and I will rejoin at
the same stage of pay as was existing at the time of my availing the sabbatical leave.
I am aware the period of leave will not be counted for service eligibility and it will be
on loss of seniority. It will not be counted for pensionable service and for payment of
pension/gratuity/promotion and other benefits. My place of posting may change at
the time of rejoining.
ii. The Bank shall have right to cancel the Sabbatical leave granted to me without
assigning any reason and I will have to rejoin the bank immediately once my leave is
cancelled.
iii. My Annual Increment will be postponed by the period of Sabbatical leave availed.

2. In terms of circular No.CDO/P&HRD/PM/54/2013-14 dated 09.12.2013 I further

undertake as under :

i. That I shall continue to pay my instalments falling due during the period of
sabbatical leave for any loan/advances granted to me by the Bank from my own
sources.
ii. That I shall arrange to pay income tax etc falling due during the period of
sabbatical leave.
iii. That I shall not take up any employment/vocation/business/profession
elsewhere during the period of sabbatical leave.
iv. That I shall abide by all the terms and conditions as per circular
No.CDO/P&HRD/PM/54/2013-14 dated 09.12.2013 and/or any of the terms and
conditions stipulated by sanctioning authority.
v. I shall report to the duty after expiry of my sabbatical leave.
Thanking You,

Yours Faithfully,

( )
PF Index No.
Date :