L.T.C(Leave Travel Concession) File. (2020-2023)
Name: ...................
Father’s/Husband’s Name: ..........................
Designation: ...................
Office: .................................
Basic Pay: ............................
Date of Joining Service: .............................
Date of Superannuation: ......................................
LTC Block year: 2020-2023
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+++++++++++++++++++
To
Block Education Officer
..............................
Subject: Application under new scheme of LTC for the block of years 2020-23.
R/Sir/Madam.
The Govt vide letter number 13/19/2008-2SII dated 05/02/2009 has formulated a new scheme of LTC for visiting the home town and any place in India for the state Govt employees. The abstract of the letter issued by the Govt is as under:-
“Now the State Govt has revised the pay scales of the state Govt employees with effect from 01.01.2006. with a view to liberalize the policy of LTC for visiting the home town and any place in India. The matter has been further considered by the Govt and it has been decide that one month’s salary would be admissible to the state Govt employees in a block of four years, in lieu of LTC.The first block of four years for this purpose shall be 2008-2011 and the next block of four for this purpose shall be 2012-2015, 2016- 2019, 2020-2023 and so on.”
I have not availed facility of LTC during the block year 2020-2023(01.01.2020 TO31.12.2023). Accordingly, I am entitled to get one month’s salary in lieu of LTC.
My entitled amount is as follows:-
Basic Pay in the functional/ACP level
In the pay matrix 2016 ...........................
D.A (42%) ..........................................
Total ...........................
It is therefore requested that one month’s salary in lieu of LTC may please be sanctioned and paid to me. I am a regular employee of Haryana Government since dated 30/12/2004 Working as
JBT in GPS HUDA Kaithal
Sincerely,
Name: ................................
Design: ..................................
Present place of posting: ..................................
Contact No. .....................................
Undertaking
[Under para I (iii) of instruction in memo no.13/19/2008-2SII dated 18/05/2009.
It is hereby under taken that:
A I am eligible to draw the benefit promised by the scheme put in place vide memo13/19/2008-2SII dated 18/05/2009.
B My entitle family members, including the spouse, who is in the employment of Govt of Haryana and who is also eligible to draw the benefit promised by the scheme put in place vide memo no 13/19/2008-2SII dated 18/05/2009 shall not avail the benefit promised by the scheme put in place vide memo no 13/19/2008-2SII dated 18/05/2009 separately for the current block of four years regulating the LTC.
OR
My entitled family members, including a spouse who is employed by the Central Government, any State Government, or any other organization/institution/body, wholly or substantially owned or controlled by the Central Government or any State Government, shall not avail of the facility of LTC from their employer in whatever form it is extended to him/her by their such respective employer.
(Signature of the concerned employee) Name: ............................
Designation: .........................
Countersigned
(Signature of the spouse concerned employee) Name: Sanjay Malik
Designation: JBT
[Strike off whatever portion is not applicable]
Undertaking
[Under para I (iii) of instruction in memo no.13/19/2008-2S II dated 18/05/2009.
It is here by undertaken that:
A I am eligible to draw the benefit promised by the scheme put in place vide memo 13/19/2008-2SII dated 18/05/2009.
B None amongst my entitled family members, including the spouse, is either in service off Govt of Haryana or in service under the Central Govt or in any other state Govt or under any other organization/institution/body etc, wholly or substantially owned or controlled by the Central Govt or any State Govt.
(Signature of the concerned employee)
Name - ……………………………………………………. Designation– ……………………………………………… Present place of posting………………………………….
Contact No.…………………………………………………
Countersigned
No Complaint/Enquiry Certificate.
Certified that there is no Complaint/Enquiry pending against Sunita
who is working as a JBT on regular basis at
GPS HUDA Kaithal (13641) in pay band 9300-34800
(Signature of Head of Office with stamp)
Dated: Place:
AFFIDAVIT
I…………………………………….S/o ……………………………………. Presently working as
…………………… in………………………………………………………………do hereby solemnly declare and affirm that:-
1. I am a regular employee of Haryana Govt since(Dated)……………………..Working as
…………………………….in…………………………………………………………
2. I want to avail the benefit of one month’s salary admissible to the state Govt employees in block of four years (2020-2023) in lieu of LTC vide memo no. 13/19/2008-2SII dated 18/05/2009.
3. I am eligible to draw the benefit promised by the scheme put in place vide memo no. 13/19/2008-2SII dated 18/05/2009.
4. My entitled amount is as under:-
Basic Pay in functional/ACP level
Inthepaymatrix2016 :66000
D.A( %) :27720
Total :93720
5. IhavenotavailedfacilityofLTCduringtheblockyear2020-2023(01.01.2020TO 31.12.2023).
6. I promise that I will not claim the benefit of one month’s salary admissible to the state Govt employees in the block year 2020-2023(01.01.2020 TO 31.12.2023).
7. Certified that there is no complaint/enquiry pending against me.
8. I will abide all the rules and regulations of the Haryana Govt.
9. Certified that my spouse is not in any Govt. service.
10. That my date of Superannuation is…………………..and my Date of birth is………………....
11. I shall use LTC in LTC
Deponent
Verification:
The above information is true to the best of my knowledge and belief and nothing has been concealed therein.
Deponent
Dated:
Place:
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