Bank o f Barndn

A-5LexalLsize)
CLAIM/PSS

ENCASHMENT
BLOCK AND PRIVILEGELEAVE
ENCASHMENT OF LTC/LFC
PROFORMA FOR UNDER BOBOSR/ BPS
EC No: 96150
Name: EACE 27620
Basic Pay: _
Designation:_ J M G - i
ALPHA: NAGCUl soL 1D:2442-
Branch/Ofrice: AhEKCoL vblÉNo.:,
haak f basnda-cein Ph No.b
E. Maii Address: 1a I CIA
Date:

The AGM/Chief /Sr./Br. Manager,

Bank of Baroda

Dear Sir,

Re: Encashment of LTC/LEC Block,

-2-OR-4- yearsTo
Period from - 0 E - 1 a
- O b - 2 1 (DD/MM/YYYY) want to
2 5 / 7 / 2 and
(PL/CL/SL) fron 2hs/20to
I have been sanctioned 2odays BOBOSR/ BPS and clarifications received
block as per the
encash my abovementioned LTC/LFC
the bank from time to time.
by
PL is under:
The details of block and encashment of
as

1. Last LTC/LFC availed for block period

from 17/cblz_to lbl cb|l9(pD/IMM/YYY)
2. Present LTC/ LFC available for
block period from 7/c6 8b|24koD/MM/YrYY
me as
regarding My self/Family members who are wholly dependent on are
3. The details
under:

Relationship Annual Occupation

Sr. Name Age Income/Pension
No. Organisation
here
working
30 SE LF RS79slallBOB
2 MICHAEL RAJ_ 32 SPOUSE_ RS 3.0olat TEACHER
3ALSE PH_ 5 8 |FATHE-I-LA coOLIG
5MOTAL-N-LAH HOUsE NIE
DESILA VATH
Kindly sanction me
LTC/LFC block as above
1. Encashment of my
P/L
2. Encashment of _days
I undertake that income of my dependent family members does not exceed the prescribed
imits as per the Bank's norns.

Yours faithfutly,

V. GRAC E

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 Fc.Mo: 91so
Bant od Baoda.
Nagertoi

To
The Ch e
Manae
ank of Barcoa.

Nagcrtoi Banch
Alagcrtei .

Re: Deelazatlon o Dperdesls

I hereby declaeEhat M osephCs6, Coole )

Pa hor in lan ana Ms. Desilqva th J s6, Hoe Ma r )

Mother a las Ar2 resjding 1th Me Thee ar ADL

anfally mplojed tha are k holly deperdart

7hatt obu.
Yous ajtuber
Placa'agaCoik
Dale 28-D7-2020

V.Gva ce
Re coMMended

Toin LMa g e r
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 an 3iih asCT Bank of Baroda 1341

BOB/NAGco/29 10.08.2020

The Deputy General Manager

HRCPC
Bank of Baroda
Baroda

Dear Sir,

Sub: Regarding LFC Encashment by Officer Mrs .V. Grace ECNO.96150

We herewith submit the LFC encashment of our

Nagercoil Branch Officer Mrs.V. Grace EC NO.96150
who is presently in maternity leave. We hereby confirm that the in laws of Mrs.V.Grace are
unemployed and are fully depend on her and we hereby confirm that her mother in law and father
in lew are staying with her only.

Yours faithfully

Bejim)
(V anapathi)
Chief Alanager

eoit:2

001,5474TTT M
TTTRT TET, 7.7. 26/1,214-D, 3.9.HET, 73HN THES H , TCHET -629
001
to Vadasery Bus Stand, Nagercoil- 629
D. No. 26/1, 214-D, D.J. Centre, Opp.
Nagercoil Branch, Web: www.bankofbaroda.com
Phone: 04652-232445
E-mail: nagcoi@bankofbaroda.com
Kanyakumari Dt.
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