Application form for grant of AILTC advance To be submitted to concerned ERB Section | Annexure-II
Annexure-II
Application form for grant of AILTC advance
(To be submitted to concerned ERB Section)
I. Name of the Railway servant:………………………………………………………………………………………………….
2. Designation: ………………………………………………………………………………………………………………………..
3. Employee Number: ………………………………………………………………………………………………………………
4. Date of Joining in Railway Service/Railway Board: …………………………………………………………………
5. Present pay & Pay Level: ………………………………………………………………………………………………………
6. Whether permanent or temporary: ………………………………………………………………………………………….
7. Whether original copy of PPSC submitted along with Intimation: ………………………………………………
8. Whether spouse is employed and if so whether entitled to LTC: …………………………………………………
9. a) The concession is to “visit anywhere in India”, the place to be visited: ……………………………………
b) Block for which to be availed: ……………………………………………………………………………………………….
10. Single Rail fare/Bus fare/Air fare from the headquai1ers to place of visit by shortest route (both to and fro): ………………………………………………………………………………………………………………………………….
11 . Persons in respect of whom AILTC is proposed to be availed: ………………………………………………..
| S. No. | Name(s) | Age | Relationship with the Government Servent |
| I | |||
| II | |||
| III | |||
| IV |
12. Amount of advance required Rs…………………………………………………………………………………………….
I declare that the particulars furnished above are true and correct to the best of my knowledge. I undertake to produce the tickets for the outward journey within ten days of receipt of the advance. In the event of cancellation of journey or if I fail to produce the tickets within ten days of receipt of advance, I undertake to refund the entire advance in one lumpsum.
Date: ……………….
[post_ads-2]
Signature:………………………………
RUID NO………………………………
Mobile No. ……………………………
(For use in Office)
I . Particulars in Cols. I to 7 verified: (To be verified by concerned ERB Branch)
2. Amount entitled for reimbursement: ——————–
3. Advance admissible (90% of amount): —————–
Advance of Rs. ……………………… may be sanctioned.
US/SO of concerned ERB Section for S.No.1
US/SO of concerned Cash Section for S.No.2 & 3:
PAO
View Order:
All
India LTC facility for officers/staff working in Railway – Procedure for
availing optional scheme: Office Order No. 104 of 2018
View other Annexures of Order:
Annexure I:
Railway Employees All India LTC: Proforma for self-certification/Declaration
Annexure III:
Railways All India LTC: Proforma for submitting claims (Subsequent to performing
Journey)
Annexure-IV:
Railway All India LTC Claim Register to be maintained by concerned cash branch
Source: Click here for Signed Copy
http://www.indianrailways.gov.in/railwayboard/uploads/directorate/secretary_branches/Office%20Order%202018/OO_104_2018.PDF
COMMENTS