Charge-sheet for Obtaining Leave on false Grounds

To,
.............................
.............................

You applied for grant of leave from …………….to ……………..on the grounds of ill-health.

Basis of your ill-health applied leave was granted you but later on it was found that the ground on which you asked for leave were false.
 
Now, therefore, you are hereby called upon to show cause as to why disciplinary action should not be taken against you.  You are required to submit your explanation in writing within …………..days of the receipt of this charge-sheet, failing which appropriate disciplinary action will be taken against you without making any further initiation to you in this behalf.

CHIEF MANAGER