GA 45
GFAR 64
GOVERNMENT OF RAJASTHAN
FORM OF APPLICATION FOR LEAVE UNDER
THE RAJASTHAN SERVICES RULES
1. Name of applicant and father's/husband's name-
2. Post held –
3. Department, Office and Section –
4. Pay –
5. House rent allowance, conveyance
Allowance or other compensatory
Allowance drawn on the present post –
6. Nature and period of leave applied for
And date from which required –
7. Sunday and holidays, if any, proposed
to be prefixed/suffixed to leave –
8. Ground on which leave is applied for
9. Date of return from last leave and the
Nature and period of that leave –
10. (a) I undertake to refund the difference between the leave the leave salary drawn during
privilege leave/commuted leave and that admissible during half-pay leave which would not have
been admissible, had the provisions of proviso below clause (iii) of sub-rule (c) of rule (2) of
Rajasthan Service Rules not been applied in the event of my retirement from service at the end
of during the current of the leave.
(b) I undertake to refund the leave salary drawn during " leave not due" which would not have
been admissible had rule 93 (d) of the Rajasthan Service Rules not been applied in the event of
my voluntary retirement from service at the end or during the current of the leave.
11. Leave – address
Signature of applicant ( with date)
12. Remarks and/or recommendation of the
Controlling Officer.
Signature (with date)
Designation
Certificate Regarding Admissibility of Leave
(By Accountant General in case of Gazetted Officers)
13. Certified that ......................................................for..........................................................................
(Nature of leave ) (Period)
From .........................................................to.......................................................is admissible under
Rule of the ............................................................Rules.
Signature (with date)
Designation
14. Order of the sanctioning authority
Signature (with date)
Designation
If the applicant is drawing any compensatory allowance the sanctioning authority should state
