LTC Claim Form

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LTC Claim Form

This is a Leave Travel Concession (LTC) claim form which can be downloaded from the link given below in PDF format. The guidelines of the LTC scheme for private sector employees provide a maximum benefit of Rs 36,000 per person. In case the amount spent is less than 3 times the eligible amount, the exemption will be allowed proportionately.

Details to be Mention in LTC Claim Form

  • Year
  • Employee Code
  • Name
  • Designation
  • Basic Pay
  • Leave Details
  • Particulars of members of family in respect of whom the LTC has been claimed
  • Details of journey(s) performed by Government Servant and the members of his/her family
  • Particulars of Journey(s) performed by the road between places connected by rail
  • And any other details.


2nd Page of LTC Claim Form PDF
LTC Claim Form

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