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.