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(1). Declaration of the family members

(2). Festival Advance
(3). Railway medical attendance identity card
(4). Requisition for release of emergency quota
(5). Apply for Quarter
(6). Apply for HRA
(7). Apply for Transportation Allowance
(8). Mutual Exchange of Qr.
(9). Retention of Qr.
(10). Apply for Scooter Advance
(11). Reservation Form
(12) CL/CCL
 Declaration of the members of the family of Railway Employees, 2026

1. Name of the Employee :-

2. Designation :-
3. Pay and Scale of Pay :-
4. Name of the office and Section: -
5. Date of appointment :-
6. Father alive or not :-

Relationship Date of birth or age Whether By the wife/husband in the case Details of nomination
SL/ in case of illiterate
Name of the members with the married or of female employee (here name of (Indicate Yes or No) Remarks
No st
Employee as 1 Jan not wife/husband to be stated) PF GIS SCRG

1 - - -
2 - - -
3 - - -
4
5
6

N.B.:- Name of the judicially separated wife/husband if any should also be declared in with remarks.
1. In the last column judicially separated.
2. In the responsibility of the staff concerned to keep the declaration up to date by intimating the respective Head of office the particulars of any subsequent changes
in the family members.
I declare that the above particulars given by me is correct and I am liable to be taken under DAR if the information is found to be incorrect.
Full signature of the
employee………………………………………………
Designation –
Office --
Section --
Date --
We certify that to be the best of our knowledge the parties as shown above the residing with him/her and the relationship mentioned against each are correct.

Signature…………………………… Signature……………………
Designation……………………….. Designation…………………
Section/Office…………………….. Section/Office………………
Dated………………………………. Dated…………………………

Counter Signature of Controlling Officer Signature of the subordinate

 APPLICATION FOR FESTIVAL ADVANCE FOR THE YEAR 2014

1. Name in full :-

2. Designation :-

3. Pay and Scale :-

4. Working place and station :-

5. Permanent or temporary :-

6. Whether any festival

taken during this year. :-

7. Name of the festival in

advance taken in the last :-

8. Name of the festival for

advance is asked for :-

9. Amount of advance asked :-

10. P. F. No :-

Signature of applicant.
 INDEX CARD NO.

Issuing – Office NFR

RAILWAY MEDICAL ATTENDANCE INDENTITY CAR D.

1. Name of Railway employee & Designation :

( In full and block letters )

2. Department/ Office in which employed. :

3. Residential address :

4. Place of work :

5. Health Unit for treatment :

6. Signature/Thumb impression of the employee :

7. Date on which Identity card issued :

Office stamp. ( Signature and Designation of the

Issuing authority )

Details of Family members Dependents.

Family includes only wife ( or husband ),Children or step children and

dependents as are and no other relation covered under pass rules.
[Link]. Name Age Relationship Identification
Marks.

1.

2.

3.

4.

5.

6.
 N.F. RAILWAY.

REQUISITION FOR RELEASE OF EMERGENCY QUOTA.

Date of journey: - 04.12.2019 Train No: -15653 Class:-

Journey from: - GHY To: - LDH

Sl.N Name of passenger Sex Age Pass No. W.L/ RAC [Link]
1o Manjit Kaur F
2
3
4
4
5

Nos. Of Berth required:-

Reason –

Address: -

Signature of the applicant

Recommended by.
 Application for enlistment for allotment of Type-I / II, Type-I to Type-II and Type-II to
Type-III/Type-IV Railway Quarters in Pandu/Maligaon/Guwahati/New Guwahati area.

1. Name (In block letters) :-

2. Designation & office :-

3. Date of appointment :-

4. Date of birth :-

5. Pay & Scale of pay :-

6. Type of Qrs. applied :-

7. Category of registration (essential/ :-

non-essential /Transferee/SC/ST).

8. Date of entry into essential category :-

(If registration under essential
category is asked for)

9. Date of arrival in PNO/GHY/NGC area :-

10. Date of promotion to Class-III

(in case of registration for type-II Qrs.
on promotion from Class-IV to Class-III) :-

11. Particulars of Qrs. enjoyed at the

Previous station (staff coming on
transfer, if no Qrs. was allotted
certification to that effect should
be attached). :-

12. Particulars of Qrs. under occupation

(When asking for a lower type of Qrs.)
with allotment reference. :-

13. Whether having his own house at

Guwahati Municipal Corporation area.:-

………………………………….
Signature of the applicant
 APPLCATION FOR HOUSE RENT ALLOWANCE

1. Name (in block letters) :-

2. Designation :-
3. Working under :-
4. Pay :-

5. Particulars of accommodation occupied : -

House No., street and locality :-
6. Whether it is private accommodation :-
or residence owned by the applicant
or Govt. accommodation provided to
another Govt. service.
7. Amount of house rent allowance claimed :-

I certified that I am incurring expenditure on the accommodation and I am not

unauthorized occupying any Govt. accommodation.

Yours faithfully,
Signature:-
Designation:-
Office:-
Date:-

Certified that the staff concerned has applied for Rly. accommodation and accordingly
his name is enlisted at seniority No……….and not accommodated with Rly. [Link] date.
So, House rent may be charged as per Rule.

Controlling Officer
To

The Asstt. Personnel Officer.

N.F. Railway. Guwahati.

Sir,
Sub- Grant of Transport allowance

Ref- Rly. Bd’s Circular No. PC/V-97/1/7/12 dt.16-12-97 and GM(P)/MLG’s

L/No.E/97/3 ( C ) dt19-12-97.

In terms of above quoted circular I like to draw convenience allowance.

Necessary particulars are furnished below.

1. Name ( in block letter ) :

2. Designation. :

3. Scale of pay :

4. Place of posting :

5. Office address :

6. Residential address :

7. Distance between office and residence :

8. Transport allowance :

I here by declared that I am not availing any shuttle bus provided by the Railway.

Date:

Signature of the applicant.

Signature of the competent authorit y.

 Application for Mutual Exchange of Railway Quarters.

1. Name of the applicant :-

2. Designation :-
3. Department :-
4. Date of appointment :-
5. Date of retirement :-

6. Qrs No., Type & Location :-

I. Whether pooled or non-pooled :-
(If non pooled no objection
certificate from the controlling officer
should be enclosed)

II. Whether pucca/S/Pucca/Kutcha :-

III. Allotment order reference
7. (a) Name of the person with whom
Mutual exchange is sought for :-
(b) Qrs No. Type, Location :-

Date - Signature of the applicant.

It is certified that: -
1. Particulars furnished by the applicant are verified and found correct.
2. He/She is not under order of transfer or on the verge of retirement within the next 3
(Three) years.

Date - Signature: -
Name: -
 APPLICATION FOR RETENTION OF QRS.

1. Name (In block letters) :

2. Date of birth :
3. Designation :
4. Date of appointment. :
5. Controlling officer :
6. Qrs. No. Type and Location :
7. Pooled/ Non pooled :
8. Allotment order reference :
9. I have been transferred to ……………….. as ……………. On …………..
(tick one).
10. I have been going to retired on ………………
11. Kindly permit me to retain the above accommodation for a period of …………….
a) ………………… Months from……………. To…………….
b) Next …………… Months from……………. To……………..
For the reason as under:-
 Sickness ……………
 Academic session of ………………..
 Retirement ………………………….

Date. Signature of the applicant

 APPLICATION FOR SCOOTER ADVANCE

1. Name of the applicant :-

2. Application’s designation :-
3. Station :-

4. Pay (i) Substantive :-

(ii) Officiating :-
5. Anticipated price of scooter :-
6. Amount of advance required :-
7. Date of superannuating :-
8. No. of instalment in which the :-
Advance is described to be repaid.
9. Whether advance for the purchase :-
of any convenience obtained
previously and if so

(i) Date of drawal of the advance :-

(ii) The amount of advance and :-
interest thereon still outstanding
if any.
10. Whether the intention is to purchase –
(a) A new or old scooter :-
(b) If the intention is to purchase :-
scooter through a person other
than a reputed dealer of agent
whether previous sanction of the
competent as required under Rule
15(2) of the Central Services
(Conduct) Rules, 1955.
11. Whether the officer is on leave or is about
to proceed on leave.
(a) The date of commencement of leave :-
(b) The date of expiry of leave :-
12. Are any negotiation or preliminary enquiries :-
being made so that the delivery may be taken
of the scooter within one month from the date
of drawal of the advance
13. a) Certified that the information given above:-
is complete and true.

Contd….2.

Page 1 of 2
 b) Certified that I have not taken delivery of the :-
scooter on account of which I apply for the
advance that I shall complete negotiation
possession of the scooter before expiry of one
month from the date of drawal of the advance
and that I shall insure it from the date of taking
delivey of it.

Dated: Signature of the applicant.

No.

Certified that the possession of scooter by

Sri_____________

Designation ___________________working __________________will be in the interest of

sincere service to the Administration.

His application for the advance on the above purpose is recommended for sanction.

Signature and designation of the

Controlling Officer with his office seal.

Page 2 of 2
 APPLICATION FOR ENCASHMENT OF LAP

1. Name. :-
2. Designation. :-
3. P. F. No. :-
4. No. of days LAP applied for and Date from which required:-
5. No. of days of LAP for which Encashment is required :-
6. No, of LAP encashment till date And date of last encashment:-
7. Pay in the pay band : Grand Pay
a. Pay in the pay band :-
b. Grand Pay :-
8. Purpose for which LAP is required :-
9. Privilege Pass No. :-
10. Address which on Leave :-

It is certified that I have not availed the facility of encashment of leave during the period of last two years. It is
also certified that I will avail/ I have availed (strike out which is not applicable) the facility of Railway pass during
the above period. In case of cancellation of journey I undertake the responsibility to retuned above leave salary.

Signature…………………………….

Name………………………………..

Designation………………………….

Certified that Privilege pass No…………………………… Date…………………has beeb issued in favour of Shri/Smt.,
………………………………………………….Designation………….…................Under …………………………………………….…………... against
leave encashment application.

Signature & Scale of the

Pass issuing authority.

 SANCTION MEMORENDUM

NO………………………………. DATE……………….

Sub:- Encashment of LAP Of Shri…………………………………………Designation…………………..

Sanction of the Component Authority is hereby communicated for encashment of ……………Days LAP of the above
named employee, It is certified that:-

i) In addition to above LAP (to be encase, equivalent number of LAP has been debited from the leave account of the
employee ( in case of gazette officers PP No. Of vetting of A/Cs to be mentioned)
ii) Necessary entries in this regard has also been made in the LAP Encashment account of the employee on.
iii) After above encashment, more then 30 days LAP are available in the account of the employee’
iv) The employee has not averted the facility of encashment of LAP during last 02years
v) Pay on date of averting Railway pass:-
a. Pay in the pay band :-
[Link] Pay :-

2. It is requested that necessary bills may places be prepared for encashment of the above Lap and send the same to
the Accounts Branch for arranging payment,
Leave Due

LAP HLAP Days

DA:-Nil

Signature & Designation

Bill section
 N.F. Railway N.F. Railway
RESERVATION/CANCELLATION REQUISTION FORM RESERVATION/CANCELLATION REQUISTION FORM
If you are a Medical Practitioner. Please tick (√) in Box If you are a Medical Practitioner. Please tick (√) in Box
(You could be of help in an emergency) (You could be of help in an emergency)
If you want Sr. Citizen concession. Please write “Yes”/”No” in box If you want Sr. Citizen concession. Please write “Yes”/”No” in box
(If Yes, please carry a proof of age during the journey to avoid (If Yes, please carry a proof of age during the journey to avoid
inconvenience of penal charging under extant Railway Rules). inconvenience of penal charging under extant Railway Rules).
Do you want to be upgraded without any extra charge? Do you want to be upgraded without any extra charge?
Write “Yes”/”No” in box. Write “Yes”/”No” in box.
(If this option is not exercised, full fare paying passengers may (If this option is not exercised, full fare paying passengers may
be upgraded automatically) be upgraded automatically)
Train No. & Name) …………………………Date of Journey………………… Train No. & Name………………………………Date of Journey……………………
Class…………………………..No. of Berths/Seats……..… Class…………………………………..No. of Berths/Seats………………………….
Station from… ……………… To………… ……….. Station from……………………………………………To……………………………..
Boarding at…… ……… …………..Reservation upto………… ………,. Boarding at……………………………………..Reservation upto……………………
Concession/
S. Name in Block letters Gender Choice in S. Name in Block letters (FOR
Gender Concession/
Choice in
Age Travel CHILDREN BELOW 5 YEARS WHOMAge
TICKET Travel
IS NOT BE ISSUED)
No (not more than 15 letters) (M/F) Authority No. any No. (not more than 15 letters) (M/F) any
. Authority No.
1 Pass issued by Lower/Upper
1 Lower/Upper
2 berth
2 berth
Veg/ Nonveg
3 (for 3 Veg/ Nonveg
4 (for
Rajdhani/ 4 Rajdhani/
5 Shatabdi 5 Shatabdi
6 Express only 6 Express only
CHILDREN BELOW 5 YEARS (FOR WHOM TICKET IS NOT BE ISSUED)
S. Name in Block letters Gender S. Name in Block letters Gender
Age Age
No. (M/F) No. (M/F)
1 1
2 2
 ONWARD/RETURN JOURNEY ONWARD/RETURN JOURNEY DETAILS
DETAILS
Train No. & Name………………………….....Date of Train No. & Name……………………………….Date of
Journey……………….…. Class……………………Station Journey……………………. Class……………………Station
From………………….……To…………….… From………………….……To………………………
Name of Applicant …………………… Name of Applicant……………………………..
Full Address … .
PIN- …. …………………………………… Full
Signature Address…………………………………….
of the Signature
…………………………………………………… of the
……………………………………………………
Applicant/Representative
Telephone No../Mobile No., if any. Applicant/Representative
………………..Date……………..Time…….. FOR Telephone No../Mobile No., if
OFFICIAL USE ONLY any………………….Date……………….Time………
S. No. of Requisition……………………………………….PNR FOR OFFICIAL USE ONLY
No………………….. Berth/Seat No. S. No. of Requisition……………………………………….PNR
………………………………Amount No………………….. Berth/Seat No.
collected………………………. ………………………………Amount
… collected……………………….
… ……
… ……
… ……
… ……
… ……
… …
…
…
… Signatur
… e of
Signatur Reservat
e of ion clerk
Reserva
tion
clerk