Application for the issue of 'NO OBJECTION CERTIFICATE ' for the purpose of visiting Foreign Countries on private account
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1. Name of the Employee :

2. Emp.No. :

3. Designation :

4. Tkk.No. ________

5. Shop/Office :

6. Bill Unit No.___

7. The countries actually proposed :
to be visited :

8. The approximate expenditure :
involved and the source of :
funds to meet the expenditure :

9. Address/as in the Foreign country:
/Countries where the employee :
proposed to stay :
a) Reasons for visiting the :
foreign countries :

b) Duration of stay abroad :

c) Whether the employee is :
already in possession of a :
passport, if so the details :
thereof :

10. Period of leave applied for/ :
sanctioned and if the leave is :
for more than 4 months, employee :
living in Railway quarters have :
to give a declaration as per :
item 14(i) :

11. Whether the employee has received:
any advance such as HBA,Motor Car:
/Motor Cycle, Scooter etc., :
details of the advance and the :
amount received to be given :

12. Whether the employee is :
adjudged insolvent and if so :
particulars of insolvency :

13. Whether the employee is :
indebted and if so,particulars :
of insolvency :
14. i) I undertake to vacate the Railway quarters allotted to and occupied by me in case the leave sanctioned exceeds 4 months (to be detailed where the employee is not in occupation of Railway quarters)

ii) I hereby declare that I will not seek any employment abroad during my stay abroad and also return to India within the leave period.

I certify that the particulars furnished above are correct to the best of my knowledge.

SIGNATURE OF THE EMPLOYEE

Forwarded to SPO/______. The employee has been sanctioned leave from _______________ to _______________ for the purpose.