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PROVINCIAL PUBLIC ADMINISTRATION SECRETARIAT, NORTHERNPROVINCE
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18.08.2008

Chief Secretary, Eastern Province, All Secretaries, Deputy Chief Secretaries, Heads of Departments, Northern Province. The iegulation for stavlnE at the Circult Bunsalow. No.O3. Falrllne Road. Dehiwela In view of current security measures in Colombo, all oflicers who want to stay at the above bungalow are hereby instructed take with them tlre completed application form, duly endorsed by their respective head of department and submit it to the supervisor. Oflicers who fail to submit application will not be permitted to stay with effect from 20.08.2o0g. The caretaker should submit all the details of occupants every next moming at the Dehiwela Police Station, as per recent request by the Police. Vehicles accompanying offrcers will only be permitted to park at the bungalow. Pleaseinform all ofyour distritt/divisional oflices too for strict compliance. I

Your kind cooperation in this regard is very much anticipated.

R.Raaeenthiran, Deputy Chief Secretar5r Copy : 1. Secretar5r the Governor, N.P to 2. Caretaker, Circuit Bungalow, Dehiwela. 3. Project Directors . Annexed: Application form
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060-2266502 u'26-2'22b959

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Kanniya Road, Varothayanagar, Tr,lrrr'malee, Sri Lanka.

Email Website

: npminppa@sltnet.lk : www.np.gov.lk

Caretaker, Circuit Bunga-low, No. 3, Fairline Road, Dehiwela

Fonn/ 02/ CB/ 2OOB

ApPlication to stav at the circuit

01. Full narne of the occupant: 02. Designation: 03. NIC number: 04. Permanent address: 05. Purpose of the visit: 06. Duration of stav:

Bunqalow. No.o3. Fairline Road. Dehiwela

07. Others accompanying *ith gccupant( if any): Relationshi NIC Number

08.If the officer has come by official vehicle: 1. Vehicle number: 2. Name of the driver: 3. NIC number of the driver: 4. Permanent address of the driver;

I declare that the details furnished by me are true and I kindly request you to grant me permission to stay with aforementioned members of my fanily / persons ... ,in number from """o-panied .. dll

Date Caretaker, Circuit Bungalow, No. 3, Fairline Road. Dehiwela

Signature of the occupant

Please allow this officer and aforementioned his/her family members/accompanied stay at the circuit Bungalow persons during the said period. Name of the Head of Department (Official frank) Designation:

to

Date

Signature of the Head of Department