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FORM Driving License Application

This document contains an application form for a license to drive a motor vehicle. The form requests information such as the applicant's name, address, date of birth, blood group, details of any previously held licenses or convictions. It also contains a declaration of physical fitness where the applicant must answer yes or no to questions regarding medical conditions like epilepsy, visual impairments, physical disabilities, and other diseases that could impact their ability to drive. The bottom of the form is for recording the results if the applicant undergoes a driving test to assess their competency and fitness to drive.

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219 views

FORM Driving License Application

This document contains an application form for a license to drive a motor vehicle. The form requests information such as the applicant's name, address, date of birth, blood group, details of any previously held licenses or convictions. It also contains a declaration of physical fitness where the applicant must answer yes or no to questions regarding medical conditions like epilepsy, visual impairments, physical disabilities, and other diseases that could impact their ability to drive. The bottom of the form is for recording the results if the applicant undergoes a driving test to assess their competency and fitness to drive.

Uploaded by

ishtiaq100
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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(FORM A)

Form [Section 7 (2) of the motor Vehicle Ord. 1965]


FORM OF APPLICATION FOR LICENSE TO DRIVE A MOTOR VEHICLE
NATIONAL IDENTITY CARD NUMBER
- -
apply for a license to enable me to drive

as a paid employee
other than as a paid employee
01 Motor Cycle 02 Motor Car
03 LTV 04 HTV
05 Motor Rickshaw 06 Tractor Agri
07 Tractor Comm 08 Motor Cab
09 Road Roller 10 Invalid Carriage
11 Particulars to be furnished by an applicant

1. Full Name
2. Father
Name
Husband

3. Permanent address

4. Temporary address

5. Date of Birth _____________ Blood Group _____________ Date of Applicant _________


6. L.P. No _________________________ Date ____________________________________
Valid upto ________________________________ for ______________________________
7. Particulars of any license previously held by applicant _____________________________
Date of Applicant ____________________________

8. Particulars and date of every conviction which has


been ordered to be endorsed on only license held by
the applicant. ________________________

9. Have you been disqualified, for obtaining a


License to drive? if so for what reason. ________________________
10. Have you been subjected to a driving test is to fitness or
ability to drive a vehicle in respect of which a license to
drive as applied for? If so give date testing authorities and
result of test. _____________________
Declaration as to physical fitness of applicant.
11. The applicant is required to answer “Yes” or “No” in the space provided opposite each
question.
(a) Do you suffer from epilepsy or from sudden attacks
of disabling giddiness or fainting? _________________________________________
(b) Are you able to distinguish with each eye at a
distance of 25 yards in good daylight (with glass if
worn) a motor car number plate containing seven
letters and figures?
(c) Have you lost either hand or foot or you suffering
from any defect in movement control or muscular
power of either Arm or leg? ______________________________________________
(d) Do you suffer from colour blindness or night
blindness? ____________________________________________________________
(e) Do you suffer from defect of hearing? ______________________________________
(f) Do you suffer from any other disease or disability
likely to cause your driving of a motor vehicle to be source of danger to the public?
If so give particulars ____________________________________________________
I declare that to the best of my information and belief the particulars given in section Ii
and the declaration made in section III here are true.

Note: - An applicant who answers “yes” to question (b) and (c) in the declaration and
“No” to the questions may claim to be subjected a test as to his competency to drive
vehicle of a specified type or types.

The _____________ 20 signature/thumb impression of Applicant


CERTIFICATE OF TEST OF ABILITY TO DRIVE
The applicant has passed in the test specified in the Third schedule to Motor Vehicle Ord.
failed
1965 the test was conducted on (Vch No.) ________________ dated ____________

Duplicate signature or thumb Signature of testing


Impression of applicant Authority
License No. ________________ dated ______________ for ______________ has
issued to the applicant after necessary verifications.

Licensing Authority.

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