Leave Travel Concession (LTC) Cash Voucher Scheme 2020 Application Form
Application Form for Special Cash Package in Lieu of LTC
LTC Fare + 10 Days EL Encashment
During Block Year 2018-21
- Name / Designation of the Government Servant:
- Date of entering the Government Service:
- Basic Pay: Rs.
- Pay Matrix Level:
- Whether Permanent of Temporary:
- Home Town as recorded in Service Book:
- Whether wife / Husband is employed And if so whether entitled to LTC:
- Whether the concession is to be surrendered for visiting Home-Town, and if so block year
- If the concession is to be surrendered “anywhere in India” Block year proposed to be surrendered:
- Single Deemed LTC fare:
- Whether advance is required: Yes / No
- Persons in respect of whom LTC is proposed to be availed:
|Sl.No.||Name||Age||Date of Birth||Relationship||Block year to be availed|
I declare that the particulars furnished above are true and correct to the best of my knowledge. I undertake to produce the receipts towards the purchase or availing goods and services which carry a GST rate of not less than 120/0 from GST registered Vendors/ Service providers through digital mode indicating clearly the GST number and the amount of GST paid.
In the event of cancellation of the application or if I fail to produce the valid receipts within the stipulated time frame, I understand to refund the entire advance in one lump sum along with penal interest as applicable.
Name of the Bank:
Saving Bank Account No.:
Branch MICR Code: