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FORM 4 FORM O F APPLI CAN T FOR LICENCE TO DR IVE A …

Space for passport si ze photograph FORM 4 [See Rule 14(1)] FORM OF APPLICANT FOR LICENCE TO DRIVE A MOTOR VEHICLE To The Licensing Authority, .. I hereby 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) Transport vehicle (f) Road roller Space for passport size photograph (g ) Motor vehicle of the following description, namely .. (h) E- rickshaw (i) E- cart PARTICULARS TO BE FURNISHED BY APPLICANT 1. Full Name : .. 2. Son/wife/daughter of : .. 3. Permanent address (Electoral Roll / Life Insurance Policy / Passport / Pay sl ip issued by any office of the Central Government/ State Government or a local body / Any other document or documents as may be prescribed by the State Government / Affidavit sworn before an Executive Magistrate or a First Class Judicial Magistrate or a Notary Public to be enclosed).

Space for passpor t size photog raph FORM 4 [See Rule 14( 1) ] FORM O F APPLI CAN T FOR LICENCE TO DR IVE A MOTOR VE HICLE To The Licensing Authority, «««««««««« «««««««««« I hereby apply for a licence to enable me to drive ve hicles of the fo llowing description:- (a) Motor cycle wi tho ut ge ar (b) Motor cycle wi th ge ar ...

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