ANNEXURE-I

DELHI URAB SEHELTER IMPROVEMENT BAORD

GOVT. OF DELHI

LEAVE TRAVEL CONCESSION BILL

For the block year______to______

(NOTE : This bill should be prepared in duplicate one the other ______as office copy).

PART-I

(To be filled in by the Official/Officer)

1.Name______2.Designation______

3.Pay______4. Headquarters:______

5.Nature and period of leave sanctioned :

6.Particulars of members of family in respect of whom the leave travel concession has been claimed

S.No. / Name / Age / Relationship with the official/officers

7.Details of Journey(s) performed by Official/Officer

Departure / Arrival / Distance
In Km / Mode of
Travel / Class of
Accommodation
used / No. of
persons / Fare paid
Rs. P. / Remarks

8. Amount of Advance, if any, drawn : Rs.______

Contd…….2/-

9. Particulars of journey(s) for which higher class of commendation than the one to which the official/officer is entitled was used (Sanction No. & date to be given):

Place
From : To / Mode of conveyance / Class to which entitled / Class by which actually traveled / No. of fares / Fare paid
Rs. P.

10.Particulars of journey(s) performed by Road between place connected by rail :

Name of place
From : To / Class to which entitled / Rail Fair
Rs. P.

Certified that :-

  1. The information as given above is true to the best of my knowledge and belief; and
  1. That my husband/wife is not employed in Government/DDA/MCD service/ that my husband / wife is employed in Government/DDA/MCD Service and the concession has not been availed by him / her separately for him/herself or the family members for the concerned block of years______.

Date______

Signature______

Name of the official______

ANNEXURE-II

DELHI URAB SEHELTER IMPROVEMENT BAORD

GOVT. OF DELHI

L.T.C./HOME TOWN CERTIFICATE

CERTIFIED:

(i)That Sh./Smt./Miss______as rendered continuous service for one year or more on the date of commencing the outward Journey.

(ii)That necessary entries as required under para 3 of the Ministry of Home Affairs O.M. NO. 43/1/55-Estt.(A), Part-II, dated the 11th October 1956 have made in the service book of Sh./Smt./Miss______Order No.12.

Signature and Designation of the

Controlling Officer

CERTIFICATES TO BE GIVEN BY THE DUSIB OFFICERS/OFFICIAL

  1. I have not submitted any other claim so far for leave Travel Concession in r/o myself of my family members in r/o the block of the year ______and ______
  1. I have already drawn T.A. for the Leave Travel Concession in r/o a journey performed by me/my wife with ______children. This claim is in r/o the journey performed by my wife/myself with ______children none of whom travelled with the party on the earlier occasion.
  1. I have already drawn T.A. for the Leave Travel Concession in r/o a journey performed by me/my wife _____ children in r/o the block of two year______and ______This claim is in r/o the journey performed by my wife/myself with ______children none of whom availed of the concession relating to that block.
  1. I have already/drawn T.A. for the Leave Travel Concession in r/o a journey performed by me in the year______in r/o block of two years______and ______this claim is in r/o journey performed by me in the ______This is against the concession/admissible once every year in a prescribed block for visiting Home Town all the members of my family are living away from my place of work.
  1. The journey has been performed by me/my wife with ______children to the declared Home Town viz______

6. That my husband/wife is not employed in Govt./DDA/MCD service that my husband/wife is employed in Govt./DDA/MCD service and the concession has not been availed of by him/her separately for himself / herself or for any of the family member for the concern block of two years.

7. Certified that my wife/husband for whom LTC claimed by me is employed in______(name of the public sector undertaking/corporation/Autonomous body etc.) Which provides LTC facilities but he / she has not preferred and will not prefer, any claim in this behalf of 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 finance wholly or partly by the Central Govt. or a local body, which provides L.T.C. facilities to its employees and their families.

(SIGNATURE OF THE OFFICIAL/OFFICER)