PAHARPUR COOLING TOWERS LIMITED

APPLICATION FOR LEAVE TRAVEL ASSISTANCE

Name of the Employee : Emp. Code :

(IN BLOCK LETTERS)

Department : Location :

 Please pay me Rs.____________

____________________ (Rupees______________________________________
___________________)
towards Leave Travel Assistance for the calendar year____________________.
year__________ _. I, alongwith my
family undertake to travel / travelled to _____________(Place)______________ during Privilege
Leave granted to me by the Company from____dd/mm/yyyy_____to____dd/mm/yyyy
dd/mm/yyyy____.

 For exemption under Income Tax, please consider Rs.__________________________________

(Rupees________________________________________
________________________________________________)*,
___________)*, as actual expenditure
incurred on Domestic Air Fare/ Rail Fare for the above mentioned journey.

* To be filled in by employee, provided he/she has not claimed exemption

exemption more than twice
in each block of four years.

Note: Please carefully read the Income Tax rules given overleaf

Date Signature of the Employee

Space for Office Use:

Checked By Approved Amount Approved By

As per the Income Tax Rules, an employee is entitled to claim exemption in respect of the
value of travel concession or assistance received from his employer for himself and his
family subject to fulfilment of the following conditions:

 The Employee is on leave (which is at least 3 days as per our company rule) to any
place within India only.
 The exemption is allowed only in respect of fare.
 Where journey is performed by air, the maximum exemption shall be an amount not
exceeding the air economy fare of the National carrier by the shortest route to the
place of destination.
 Where journey is performed by Rail, maximum exemption shall be an amount not
exceeding the air conditioned first class rail fare by the shortest route to the place of
destination.
 Family for this purpose includes the spouse and children of the employee. Parents of
the employee may be included if they are dependent upon him.
 The exemption is available only when journey is actually undertaken while on leave.
 The exemption is available in respect of any two journeys performed in a block of 4
years viz. 2010 to 2013, 2014 to 2017 and so on.
 In case the employee has not availed/claimed the LTC exemption in a particular
block, whether for both the journey or for one journey, he can claim the exemption
of first journey in the calendar year immediately succeeding the end of the block of 4
calendar years.
 In case LTC / LTA is encashed without performing the journey, the entire amount
received by the employee shall be taxable.