INDIAN INSTITUTE OF TECHNOLOGY, KHARAGPUR

Leave Application Form

Leave Application (FRESH APPLY) DLS - 39

Emp. Name Titash Mondal Emp. Code 20031
Department Rubber Technology Designation Assistant Professor Grade-I
Leave Type Duty Leave Saarc Duration From : 11-12-2023(FN)
(Seminar/Conference/Workshop/ To : 13-12-2023() (3.0 days)
Symposium) (DLS )
Station Leaving Date From : 09-12-2023(FN) To : 13-12-2023(AN)
Purpose/ Remarks To deliver "Invited Lecture" at the SPSI MACRO 2023 Conference organized at IIT
(with supporting Guwahati
documents, if any)
Leave Address 9632061414, IIT Guwahati
Leave Not Applicable
Arangements
Conf. Title
Paper Title
Authors
Delegate/ Participant Paper Presentation (Oral/Poster)/Chairing Session/Presenter of an invited talk/Attending Editorial Board,
Status technical Committee meetings. etc. as a member/Attending Workshop/symposium/seminar/editorial board
meeting etc. as resource person /Experts in Selection/ Assessment/ Review Committee Meetings (attach
supporting documents)

CPDA Balance
Earlier Conf / Sym / Wshop attended during current
financial year, if any, and source of funds

TA required (Funding Reg. fee required Rs.

Source) (Yes/No)
Journey has to be undertaken by Air India only in cases where expenditure regarding air passage is made by
Government fund.
Mode of Travel Air / Train
Advance for travel / Reg. fee required (Yes/No) Rs.

Applied on : 29-11-2023 (Printed on : 20-12-2023)

Signature of the applicant

Recommended / Not Recommended HOD / HOC / HOS/ HOA

Recommended / Not Recommended Dean (Faculty)

Sanctined with TA / DA as per rules Deputy Director

Sanctioned without financial support
For Office use only
SANCTION LEAVE
(Other than CL/Spl. CL)
Type of Leave No. Of Days No. Of Days Balance
in credit Sanctioned

EARNED LEAVE
 INDIAN INSTITUTE OF TECHNOLOGY, KHARAGPUR
Leave Application Form

CML / HPL

E.O.L. (1) On medical grounds

E.O.L. (2) On other grounds

The above is as per rules and may be sanctioned.

Dealing Assistant Sr. Executive/Executive/Superintendent

SANCTIONED

Sanctioning Authority