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I apply for License to enable me to drive Vehicles of the following description:-
1. Motor Cycle without gear and with gear
2. Light Motor Vehicles
3. Auto Rickshaw
4. Medium goods Vehicles
5. Tractor
6. Heavy Transport Vehicles
Motor Vehicle of the following description :-
PARTICULARS
1.Name :-
.
2. Father/Mother/Daughter/Wife of :-
..
3. Address :-
.
4. Official/Temporary address :-
..
5. Date of Birth (Proof certificate) :
..
6. Education qualification :-
7. Identification Marks :-
.
8. Blood group and RH factor :-
..
9. Have you previously held driving license? If so give details :-
10. Particulars and date of every connection which has been ordered to be endorsement on any License held by the
applicant.
11. Have you been disqualified for obtaining a License to drive? If so for what reason
........................................................
12. Have you been subjected to a driving test as to your fitness or ability to drive a vehicles in respect of which a license to
drive applied for? If so give the following details :-
DATE OF TEST
TESTING AUTHORITY
RESULT OF TEST
1.
2.
13. I enclose three of my recent photograph of the size five centimeters into six centimeters.
14. I enclosed the learners License No.
.. date
issued by Licensing Authority.
15. I have enclosed the driving certificate No.
. date
Issued by
.
16. I have submitted along with my application for learners license the written consent of parents/guardians.
17. I have submitted along with the application for learners license. I enclosed the Medical fitness Certificate.
18. I have paid the fee of Rupees
..
I declared hereby that the best of my knowledge and belief that the particulars given above are true.
Notes :- Strike out whichever is inapplicable.
Date :-
Signature/Thump impression of the applicant.
Certificate of test of circumstances to drive
The applicant has passed, the Test prescribed under Rule 15 of the Central Motor Vehicles Act/Rules, 1989. The test was conducted on (here the registration Mark and description of the Vehicle)
.
The applicant has passed in the test.
(The details of the deficiency to be listed out)
Date :-
Signature of Testing Authority
Full name and Designation.
Two specimen signature of applicant
Strike out whichever is inapplicable.
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