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    Form 4 PDF

    Uploaded by

    Herbert Anision
    This document contains an application form for a permanent driving license. [1] It requests information such as the applicant's name, address, date of birth, education level, identification marks, whether they have previously held a license, and details of any convictions or disqualifications. [2] The applicant must also provide details of any required driving tests, enclose photos and documents like a learner's license. [3] At the end, space is provided for a certificate from the testing authority regarding the applicant's test of competence to drive.

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    Download as PDF, TXT or read online from Scribd

    Form 4 PDF

    Uploaded by

    Herbert Anision
    82 views2 pages
    This document contains an application form for a permanent driving license. [1] It requests information such as the applicant's name, address, date of birth, education level, identification marks, whether they have previously held a license, and details of any convictions or disqualifications. [2] The applicant must also provide details of any required driving tests, enclose photos and documents like a learner's license. [3] At the end, space is provided for a certificate from the testing authority regarding the applicant's test of competence to drive.

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    This document contains an application form for a permanent driving license. [1] It requests information such as the applicant's name, address, date of birth, education level, identification marks, whether they have previously held a license, and details of any convictions or disqualifications. [2] The applicant must also provide details of any required driving tests, enclose photos and documents like a learner's license. [3] At the end, space is provided for a certificate from the testing authority regarding the applicant's test of competence to drive.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    82 views2 pages

    Form 4 PDF

    Uploaded by

    Herbert Anision
    This document contains an application form for a permanent driving license. [1] It requests information such as the applicant's name, address, date of birth, education level, identification marks, whether they have previously held a license, and details of any convictions or disqualifications. [2] The applicant must also provide details of any required driving tests, enclose photos and documents like a learner's license. [3] At the end, space is provided for a certificate from the testing authority regarding the applicant's test of competence to drive.

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    (To be filled at the time of applying for Permanent Licence)

    FORM-4
    FORM OF APPLICATION FOR LICENCE TO DRIVE A MOTOR VEHICLE
    [See Rule 14]
    To
    The Licensing Authority
    _______________________________
    _______________________________
    I apply for a licence to enable me to drive vehicles of the following description :
    (a) Motor cycle without gear
    (b) Motor cycle with gear
    (c) Invalid carriage
    (d) Light motor vehicle
    (e) Medium goods vehicle
    (f) Medium passenger motor vehicle
    (h) Heavy goods vehicle
    (i) Road roller
    (j) Motor vehicle of the following description :
    PARTICUALRS TO BE FURNISHED BY THE APPLICATION
    1. Name of the Applicant ...................................................................................................
    2. Son/Wife/Daughter of ....................................................................................................
    3. Permanent address (Proof to be enclosed)......................................................................
    4. Date of birth (Proof to be enclosed) ...............................................................................
    6. Education Qualification..................................................................................................
    7. Identification marks........................................................................................................
    (1) ............................................................ (2) .................................................................
    8. Optional ....................................................................
    Blood Group .............................................................
    RH Factor .................................................................
    9. Have you previously held driving licence. If so give details .........................................
    10. Particulars and date of every conviction which has been ordered to be endorsed to
    any licence held by the applicant....................................................................................
    11. Have you been disqualified for obtaining a licence to drive ?
    If so, for what reasons ....................................................................................................
    12. Have you been subjected to a driving test as to your fitness or ability to drive a
    vehicle in respect of which a licence to drive is applied for ? If so give the following
    details :
    Date of Test Testing Authority Result of Test
    1.
    2.
    3.
    4.
    13. I have enclosed three copies of my recent photographs of the five centimeters into
    six centimeters (where laminated card is used no photographs are required)
    14. I have enclosed the learners licence No.............. dated........... issued by licensing
    authority
    15. I have enclosed the driving certificate No. dated........ issued by ...................................
    ........................................................................................................................................
    16. I have submitted my application for learners licence alongwith the written consent
    of my parent/guardian.
    17. I have submitted alongwith the application for learners licence/I enclose the medical
    fitness certificate.
    18. I am exempted from medical test under rule 6 of the Central Motor Vehicles Rules,
    1989.
    19. I am exempted from preliminary test under rule 11(2) of the Central Motor Vehicles
    Rules, 1989.
    20. I hereby declare that the particulars given above are true to the best of my knowledge
    and belief.
    Note : Strike out whichever is inapplicable.

    Date ___________ Signature/Thumb impression of Applicant


    CERTIFICATE OF TEST OF COMPETENCE TO DRIVE
    The applicant has passed the test prescribed under Rule 15 of the Central Motor vehicles
    Rules, 1989. The test was conducted on, (here enter the registration mark and description
    of the vehicle ___________on (date)_____________
    The applicant has failed 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
    1. .................................................................2................................................................

    *Strike out whichever is inapplicable

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