FORM - L.L.D. - Bih

form - [See rule 13(1)]. Application for a duplicate driving licence To, The Licencing Authority, Full Name . Address of the . applicant .. 1. I hereby report that the driving licence held by me is lost/destroyed/torn/defaced/mutilated in the following circumstance . 2. I hereby apply for a duplicate driving licence and tender the fee prescribed in rule 6. 3. The particulars of such driving licence held by me is as follows :- driving licence no .. issued for (here enter the class of motor vehicles) in the name of by the licencing authority .. on .. and expiring on .. 4. I hereby declare that my driving licence is not impounded by any authority and that there have been no/following endorsement by the court since the date of grant/renewal. Signature of the applicant. Date : Place : Specimen signature of the applicant 1. 2. *Strike out whichever is either required or not applicable.

FORM - L.L.D. [See rule 13(1)] Application for a duplicate driving licence To, The Licencing Authority, Full Name ……………………… Address of the

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