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Form No.13 Leave Form (1)

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83 views4 pages

Form No.13 Leave Form (1)

Uploaded by

ninithanath.c
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Form No 13

APPLICATION FOR LEAVE


(Rule 113, Part I)
(Note:-Items 1 to 16 must be filled in by all applicants whether Gazetted or
Non-Gazetted)
1. Name of Applicant : NINITHA NATH C
2. Date of Birth : 15/05/1978
3. Post held : Assistant Professor
4. Department, Office and section : Dept. of Genetics and Plant Breeding
College of Agriculture, Vellayani
5. Pay and scale of Pay : 59400, 57700 -162000
6. Date of entry in service : 31/8/2021

7. Date of commencement of
Continuous service : 31/8/2021
8. Whether the applicant has got
confirmation in any post, if so from
which date and in which post
:
9. Address during leave : Sarangi, JNRA-24A, JyothiNagar, Vettamukku,
Thirumala P O, TVPM-6
10. House rent allowance, Conveyance
allowance or other compensatory
allowance drawn in the present post : 2448/-

11. Nature and period of leave applied


and date from which required : Commuted leave for 3 days, 26/12/2024 to
28/12/2024
12. Sundays/holidays, if any, proposed
to be prefixed/suffixed to leave : 25/12/2024 Prefixed and 29/12/2024 Suffixed
13. Ground on which leave is applied for: Personal
14. Date of return from last leave and nature
and period of that leave
: 18/12/2024, commuted leave for one day
15. (a) I undertake to refund the difference between the leave salary drawn during
commuted and that admissible during half pay leave which would not have been
admissible in the event of my retirement from service at the end of or during the
currency of leave.
(b) I undertake to refund the leave salary drawn during ‘leave not due’ which would
not have been admissible had rule 85, Part I ,not been applied in the event of my
voluntary retirement or resignation from service at any time until I earn half pay leave
not less than the amount of leave not due availed of by me.
16. Place: Signature of applicant
(with date) [P.T.O]
17. Remarks and or recommendation of the controlling officer.

Signature (with date) and


designation.

Note:- In the case of a Government servant who is mentally unsound and or


physically unable to fill in the columns of this form and sign it, the guardian of
his appointment under the Indian Lunacy Act,. 1912(Central Act IV of 1912)
or any person authorised by the column and sign the application for and on
behalf of the Government servant.

Certificate Regarding Admissibility of Leave


(By Account General in the case of Gazatted officers)

18. “Certified that . . . . .. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . .. . . . .


.........
(Nature of leave) for . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
..........
from . . . . . . . . . . . . . . . .. . . . . . to..........................is admissible under
Rule....................................................................................................of Kerala
Service Rules.”

Signature (with date)


Designation.

19. *Orders of the sanctioning authority:

Signature (with date)


Designation.

*If the applicant is drawing any compensatory allowance the sanctioning authority should
state whether on the expiry of leave he is likely to return to the same post or to
another post carrying a similar allowance.

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