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

	11. Address during leave period: _____________________________




	Date:                                (Signature of Applicant)


	12. Remarks and/or recommendation of the Controlling Officer:


            Date: ___________            (Signature and Designation)


	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.