3. Date on which C.L. /O.H is required: ___________________________________________
4. Reason for applying for C.L. /O.H. on account: __________________________________
5. Reason to be indicated if leave
was not applied for in advance
Date: Applicant Signature
___________________________________________________________________________ 1. C.L. /O.H. so far granted Days Recommended / if not 2. C.L. /O.H. applied for Days Recommended reason 3. Total: C.L. /O.H. if (2) above granted
Entered By: (Signature)
Note: strike out which is not applicable Signature of the Competent Officer
3. Date on which C.L. /O.H is required: ___________________________________________
4. Reason for applying for C.L. /O.H. on account: __________________________________
5. Reason to be indicated if leave
was not applied for in advance
Date: Applicant Signature
___________________________________________________________________________ 1. C.L. /O.H. so far granted Days Recommended / if not 2. C.L. /O.H. applied for Days Recommended reason 3. Total: C.L. /O.H. if (2) above granted
Entered By: (Signature)
Note: strike out which is not applicable Signature of the Competent Officer