CCS(Leave) Rules (See Rule-14) Application for Leave or for Extension of Leave 1. Name of the applicant: ____________________________________ 2. Post held: ________________________________________________ 3. Department, Office, Section: ______________________________ ______________________________ ______________________________ 4. Pay: ______________________________________________________ 5. House rent and other compensatory allowances drawn in the present post: _____________________ _____________________ 6. Nature and period of leave applied for and date from which required: _______________________ _______________________ 7. Sundays and holidays, if any, proposed to be prefixed/suffixed to leave: ________________ ________________ 8. Grounds on which leave is applied for: ____________________ ___________________________________________________________ 9. Date of return from last leave and the nature and period of that leave: ______________________ ___________________________________________________________ 10. I propose / do not propose to avail myself of leave travel concession for the block years ________ during the ensuring leave. 11. Address during leave period: _____________________________ _____________________________ _____________________________ Date: (Signature of Applicant) 12. Remarks and/or recommendation of the Controlling Officer: Date: ___________ (Signature and Designation) CERTIFICATE REGARDING ADMISSIBILITY OF LEAVE 13. Certified that ___________________________ for (nature of leave) _______________(period from ____________ to ___________) is admissible under Rule __________ of the Central Civil Services (Leave) Rules 1972 Date: ___________ (Signature and Designation) 14. Orders of the authority competent to grant leave: Date: ___________ (Signature and Designation) * If the applicant is drawing any compensatory allowance, it should also be indicated in the orders that on expiry of leave, the Government servant is likely to return to the same post or to another post carrying similar allowance.