ncralogo
NATIONAL CENTRE FOR RADIO ASTROPHYSICS
TATA INSIITUTE OF FUNDAMENTAL RESEARCH
PUNE UNIVERSITY CAMPUS, PUNE-411007

APPLICATION FORM FOR GRANT OF LTC ADVANCE

1. Name of the Staff Member
 2. Designation & Comp. Code
3. Date of joining TIFR
 4. (PB)Band Pay & GP
5. Permanent / Temporary ?
6. Declared Home Town
7. Whether Spouse is employed ?
If so, whether eligible for LTC?
 8. Place your intend to visit & 
 & 
10. Single Rail fare from HQ to visiting station
 11. Amount of advance required

Family members in respect of whom LTc is proposed to be availed

SR. NO. Name Age Relationship with
staff member

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. I, therefore, request you to grant me necessary LTC advance admissible as per my entitlement under the LTC rules so as to enable me book the tickets. I will submit my final LTC claim within a month of the completion of the return journey. In the event of cancellation of the journey or if I fail to product the tickets within 10 days of receipt of advance, I undertake to refund the entire advance in one lump-sum.
Date :                                                                  

Signature of Staff Member


– – – – – – – –– – – – – – – –– – – – – – – –– – – – – – – – – – – – – – – ––– – – – – – –– – – – – – – – – – – – – –

FOR OFFICE USE ONLY


1. Particulars in Columns 1 to 5 verificed : Signature of AO / AAO
2. Amount entitled for Fare Rs. ––––––– X 2 X ––––––– members : Rs. –––––––
3. Advance admissible [90% of sl.no.2] : –––––––––––––––––––––

Accounts Officer