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LTC ADV Application
MACP Proforma





Monday, 21 March 2011

LTC Advance Format


Government of India

               APPLICATION  FOR  GRANT  OF  L.T.C.  ADVANCE

1.      Name of the Government Servant      :
2.      Designation                         :
3.      Emp. Code No.                       :
4.      Telephone / Intercom No.            :
5.      E-Mail address                      :
6.      Date of entering the Central        :
        Government service
7.      Pay                                 :
8.      Whether Permanent or Temporary      :
9. (a)  Home Town as Recorded in the        :
        Service Book
   (b)  Nearest Railway Station             :
10.     Whether wife / husband is employed  :   YES  /  NO
        & if so whether entitled to L.T.C.  :   YES  /  NO
11.     Whether the concession is to be     :   YES / NO
availed for visiting home town,         Block Year ________________
        and if so Block Year for  which
        L.T.C. is to be availed.
12.     If the concession is to visit       :   Place      ________________
        "ANYWHERE IN INDIA", name the place
        to be visited and Block Year for        Block Year ________________
        which L.T.C. is to be availed.      :
13.     Nature of leave ................ from ............ to ............
                                    OR
     *  Proposed date for onward journey &  :
        Proposed date for return journey    :
14.     Single Rail/Bus fare from the       :
        Headquarter to Home Town/place
        of visit by shortest route.
15.     Persons in respect of whom  L.T.C.  is proposed to be availed :-
        --------------------------------------------------------------------
        Sl. No     Name                 Age                    Relationship
        --------------------------------------------------------------------




        --------------------------------------------------------------------

16.   Amount of advance required Rs.  ...........
17.   I declare that the particulars furnished above are true and correct to
the  best  of  my  knowledge.  I undertake to produce the  tickets  for  the
outward journey within ten days of receipt of the advance.

In  the  event  of cancellation of the journey or if I fail to  produce  the
tickets  within 10 days of the receipt of the advance, I undertake to refund
the entire advance in one lumpsum.

Dated :                            (Signature of the applicant)

* Applicable in case of advance required for family members only.


***********************************
                    CHECK LIST  (Cash and Accounts Section)
                   
1.   Amount entitled for :  Fare Rs. ......X 2 X   (No. of tickets)

2.   Advance admissible  ( 90%  of the amount i.e. Rs. ...........)
     Advance of Rs. ...............................................
     may be sanctioned.
Dealing Hand.                                  Signature of D.D.O.

=========================================================================

  CHECK  LIST  FOR  ADMINISTRATION
                    

 L.T.C. advance to __________________________________________________

1.   Block Year / Calendar Year            :

2.   Home Town / A place anywhere in India :

3.   a)  For whom advance is applied for   :

     b)  Total number of persons           :

4.   Specific grounds waranting sanction : for both/ onwards/ return
     journey of advance under Rule G.F. 235 (2) (iii) (a)

5.   Leave application received            :   Yes / No

6.   Amount of advance                     :   Rs.

7.  Temporary / Permanent                  :

8.  If temporary (Surety bond produced)    :   Yes / No

Necessary entry has been made in the L.T.C. Advance Register.

He/She is eligible for L.T.C. for the Block/Calender Year ...............

We may sanction the advance as per fair sanction letter placed below  for
approval & signatures of D.D. (Admn) please.



Dealing Hand                                (Section Officer)



D.D. (Admn)


****************************
  



Original LTC Advance Application form may be downloaded here

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