FORM 2
[See Rule
10]
FORM OF APPLICATION FOR THE GRANT OR RENEWAL OF LEARNER’S LICENSE
To
The licensing authority,
…………………………………
I hereby apply for a license
authorizing me to drive as a learner, the following motor vehicle(s)
(a) Motor cycle without gear
(b) Motor cycle with gear
(c) Invalid carriage
(d) Light motor vehicle
(e) Transport vehicle
(f) Medium passenger vehicle
(g) Road roller
(h) Motor vehicle of the following description
…………………………………………………………
…………………………………………………………………………………………………………………………….
PARTICULARS
TO BE FURNISHED BY THE APPLICANT
1. Full Name
………………………………………………………………………………
2. Son/wife/daughter of ………………………………………………………………………………..
3. Permanent address
…………………………………………………………………………………
(Proof to be enclosed)
4. Temporary address
………………………………………………………………………………….
Official address(if any) ………………………………………………………………………………….
5. Date of
birth(proof of age
………………………………………………………………………………….
to be enclosed)
6. Educational Qualification
………………………………………………………………………………….
7. Identification marks 1. ……………………………………………………………………………….
2. ……………………………………………………………………………….
Optional
Blood group – RH factor ………………………………………………………………
8. I hold an effective driving license to drive:
(a) Motor cycle/light motor vehicle/medium
passenger motor
vehicle/medium goods
vehicle with effect from …………………………………………………………………
9. Particulars of
any driving license previously held by applicant.
Whetherit was cancelled and if so, for what
reason;
…………………………………………………………………
10. Particulars of
any learner’s license previously held by applicant.
In respect of the description of vehicle to which the
applicant
has applied.
…………………………………………………………………..
11. Have you been
disqualified for holding or obtaining driving
license or learner’s license. If so for what
reasons.
……………………………………………………………………
12. I enclose 3 copies of recent photograph(Passport size
photograph)
13. I enclose medical fitness certificate dated……………………………issued
by ………………………………………………… (doctor)
14. I have submitted along with my earlier application for
learner’s license/I enclose the writer consent of parent/guardian(in the case of applicant being a minor)
15. I enclose driving certificate dated ………………issued by
……………………………….… (Name and address of
driving school)
16. I have paid fee of Rs………………………………………………….
17. I am exempted from the medical test under Rule 6 of
Central Motor Vehicle Rules. 1989
18. I am exempted from preliminary test under Rule 11(2) of
Central Motor Vehicle Rules, 1989
·
Strike out
whichever is inapplicable.
Date …………………………
Signature or thumb impression of the Applicant
Specimen signature or thump
impression of Applicant
1. ………………………………………………………………………………..
2. ……………………………………………………………………………………See Form 2 page 2 for the second page
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