H 025158 300.

000 (2006/01)

124 (1)

124 (1)

Section 124 (1)

. . .
..
M. T.A.

30

APPLICATION FOR A LICENCE TO DRIVE A MOTOR VEHICLE

FOR OFFICIAL USE ONLY

Application no

Amount

Trial Dates and Time

D

Written Test
Y

Practical Test
M

First Attempt
D

Second Attempt

Third Attempt

Fourth Attempt

Licence No.

Date of
Issue

. -

Form should be filled in English. The Sinhala and Tamil translations are given in the last page
1. Initials

2. Surname

3. Full Name

4A. Address

4B. city

5. Direct

6. Divisional Secretariat

7. Nearest Police Station

8. National Identity Card No. (All citizens of Sri Lanka should state the National Identity Card No )

9A. Passport No. (Only for foreign nationals)

10. Date of Birth

D
M

9B. Issuing Authority

11. Sex (M/F)

12. Height

Y
Feet

Inches

13. Occupation

14. Class/es of Vehicle Applied (See note 1 and indicate the vehicle classes in letters)

Particulars of any Diving Licence held by you at present (Foreign Driving Licence)
15. Issuing Authority

16. Driving Licence No.

D

17. Date of Expiry

M
Y

18. Class/es of vehicle

19.
?
?
.

Have you been disqualified from obtaining a Driving Licence or

has a Licence held by you been cancelled or suspended by
court? If so, give particulates

( )

..
..
..
..
..
.
.

The birth certificate and the national identity card (originals) together with photo-copies of each of them should be
forwarded with the application

20.

. ?

........................................................................................................

, , ,

........................................................................................................
........................................................................................................

Have you been refused a Driving Licence by any authority? If

So, give particulars and Date and Place.
21.

?

........................................................................................................

........................................................................................................

........................................................................................................

........................................................................................................

Do you suffer from any disease, mental or physical, physical

disability which is likely, to cause the driving by you of any
motor vehicle a source of danger to the Public?
22.

........................................................................................................

........................................................................................................

........................................................................................................

When were the Photographs annexed to this application taken?

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, ,



.
...........................................

I . declare that the above particulars are

True and accurate in every respect to the best of my knowledge. I fully realize that if any of the above particulars
are found to be incorrect or false. I am liable to the prosecuted or dealt with otherwise.

Please, Affix Photography Here

. . 3.5 x 2.5
( ) 6

,

Applicants Signature

3.5

Affix here one copy of two photographs

size 3.5 x 2.5 cm. ((Bust only) With full
face view taken within 6 months prior to
date of Application and authenticated by
the signature of applicant and that of the
examiner at the time of test.

x 2.5 . .

Date

Driving Test Report Of Examiner of Motor Vehicles

Name of Applicant

Tested to drive

.
Registered number of vehicle used for test
x .



x

Items done correctly to be marked with a and items done incorrectly with a x

Vehicle Class/es

1.

11.

2.

4.

Turning
/

5.

/
/

Right

Left

Road manners and courtesy

16.

General Demeanor (nervous or confident)

17.

Driving in Traffic
15.

Use of correct lane

Approaching cross roads

6.

7.

Stopping and Parking

14.

Reversing
13.

Entering main road

Incline test
12.

Gear charging

Starting from rest

3.

Knowledge of Highway Code

Controlled inter section

Police signals

Traffic lights
8.

18. 25

25

9.

Road Signs

10.

Ability to read number-plate at 25 yards distance

19.
?

Signalling

Overtaking other traffic

Is testing officer satisfied that the applicant does not suffer

from any mental or physical disability?
20. ,
.

, ,

Is the Testing Officer satisfied with the declaration of age and

height of applicant.

Report of Examiner on Applicant Tested

,

.



( )
. (
)

...................................................................................

...................................................................................

................................................................................................................................................

...............

).

....................

.......................................................

I certify that the applicant was tested

by on a bearing
distinctive number and find him .. to hold a
licence to drive .... I have no reason to doubt the correctness of the
information furnished by the applicant. The height of applicant (bare foot) is feet .
Inches ( To be tested only in cases of extension for motor coaches and lorries)
...................

Examiner of Motor Vehicles / Certifying Officer

Date

Results of the Board Tests in the case of Licences to Drive Commercial Vehicles

Board Test

..

Road Rules and Manners

Mechanical Knowledge

..

Recommendations of the Board

Name
1. .
2. .
3. .

Designation

/
/

Date / Time

Signature
.
.
.

TECHNICAL DIVISION for official use only

Written Test Results (P Pass / F Fail / A- Absent / R- Reject / E- Examiner Absent)
First Date :

Second date :

Third date :

Fourth Date :

Marks :

Practical Test (P Pass / F Fail / A- Absent / R- Reject)

Vehicle Class

First date

Second date

Third date

EMV Names

Remarks

Date

.
Examiner of Motor Vehicle / certified Officer

OFFICIAL USE ONLY

Affix photograph here

(To the Driving Licence Card Printing Section)
Surname:

Initials:
DL No :

Authorizing Officers Signature / Stamp

 1 /

/ Note 1

VALID CLASSES OF VEHICLES FOR A DRIVING LICENCE

( 32

(32

Motor Coaches (Vehicle above 32 Passengers)

A1

( 32 )

(32

Light Motor Coaches (Vehicle upto 32 Passengers)

B

( 34 )

34

Motor Lorries (tare weight is above 34 cwt.)

B1 ( 34 )

(34

Light Motor Lorries (tare weight is upto 34 cwt.)

C

C1 /

D /

E /

/All

G /

/Motor

F /

Cars

Dual purpose Vehicles

Cycles
/

Motor Tricycles

/Motor Tricycles Van

/Land

Vehicles

G1 ( 34 )

(34

Light Land Vehicles (Tare weight is below 34 cwt.)

H /

) /

Invalid Carriages

21

21

Applicants should have attained the age of 21 years on the date of application
*
*

* Vehicle Classes indicated should produce the following documents along with the application form.
(1)

Medical certificate issued by an authorized institution

(2)

A-competence certificate issued by an A grade driving school

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2.

3. ( 1 )

4.

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6.

7.

8. ()

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9.

10.

11.

( .)
(

13. () ( )
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13. ()
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14.

15.

15 ()

16.

15 ()
17.

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( 1 )

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()

5.

Paste the Cash receipt here.

Notes