Scribd
Upload
527 views

LTA Application Form

The employee is applying for LTA reimbursement for travel expenses during an approved leave period from [dates] to visit [location] with their family members. The application lists the employee and family member names and relationships, travel modes, and fares. It requests payment of Rs. [amount] towards LTA expenses for the calendar year incurred for the employee and dependent family members travel. The application requires authorized signatory approval before reimbursement.

Uploaded by

irah
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
527 views

LTA Application Form

The employee is applying for LTA reimbursement for travel expenses during an approved leave period from [dates] to visit [location] with their family members. The application lists the employee and family member names and relationships, travel modes, and fares. It requests payment of Rs. [amount] towards LTA expenses for the calendar year incurred for the employee and dependent family members travel. The application requires authorized signatory approval before reimbursement.

Uploaded by

irah
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 1

L.T.A.

APPLICATION
Name of the Employee
:
Employee Code
:
Designation
:
Department
:
Leave Sanctioned
: From ___________ to _____________ (__ Days)
Place of visit during leave period _______________________________
for which LTA is applied for.
Last LTA availed
_______________

for

the

leave

period

from

______________

To

List of My Family Members


Sl No

Name
of
the
Family member

Relationship

Mode of Travel

Fare

Kindly pay Rs. ________ (Rupees _____________________________________


_______________________) towards LTA for Calendar Year ________.
This is to state that the expenses mentioned above are incurred expenses for self
& dependent family members.
Place:
Date:

Signature:

FOR OFFICE USE ONLY


Passed
for
payment
of
Rs.__________/(Rupees______________________________________________________ only)
towards LTA.
Checked by:

AUTHORISED SIGNATORY

You might also like