CERTIFICATES TO BE GIVEN BY THE GOVERNMENT SERVANT ON LTC

CERTIFICATES TO BE GIVEN BY THE

GOVERNMENT SERVANT ON LTC

            1. I have not submitted any other claim so far for Leave Travel Concession in respect of my self or my family members in respect of the block of the years ________   and __________         

            2. I have already drawn T.A. for the Leave Travel Concession in respect of a journey performed by me/my wife with _________________ children.  This claim is in respect of the journey performed by my wife/myself with _____________    children none of whom traveled with the party on the earlier occasion.

            3. I have not already drawn T.A. for the Leave Travel Concession in respect of a journey performed by me/my wife with  ___________     children/  _________   children in respect of the block of two years  ___________       and  __________  . This claim is in respect of the journey performed by my wife/myself with _________                    children/  ___________  children none of whom availed of the concession relating to that block.

            4. I have already drawn T.A. for the Leave Travel Concession in respect of a journey performed by me in the year, ____________ in respect of block of two years __________and __________  This claim is in respect of the journey performed by me in the       year ___________ This is against the concession admissible once every year in a prescribed block for visiting hometown as all the members of my family are living away from my place of work.

            5. The journey has been performed by me/my wife with ___________ children/ ___________ children to the declared home town viz. ____________

            6. That my husband/wife is not employed in Government service       

                That my husband/wife is employed in Government service

and the concession has not been availed of my him/her separately for himself/herself or for any of the family member for the concerned block of two years.

            7. Certified that my wife/husband for whom L.T.C. is claimed by me is employed in

   ______________ ( name of the Public Sector Undertaking/Corporation/ Autonomous body etc.) which provides Leave Travel Concession facilities but he/she has not preferred and will not prefer, any claim in this behalf to his/her employer.                                            

            8. Certified that my wife/husband for whom L.T.C. is claimed by me is not employed in any Public Sector Undertaking/Corporation/Autonomous Body financed wholly or partly by the Central Government or a Local Body, which provides L.T.C facilities to its employees and their families.

Station:                                              

Date:                                                                               

 Signature of the Government servant.