四分律刪補隨機羯磨 2.193

2.193

"May the venerable Saṃgha listen! If the time has arrived for the Saṃgha, may the Saṃgha give its approval and listen: The bhikṣu N.N. undertakes the procedure for exceeding seven days (fifteen days, one month) to depart beyond the boundary, and for the sake of such-and-such an affair, will return here to dwell for the retreat. Such is the jñapti.