Scribd
Upload
97 views

Leaner Licence Form 2

This document contains an application form for a learner's license. The form requests information such as name, address, date of birth, educational qualifications, identification marks, blood type, current licenses held if any, a medical fitness certificate, and consent from a parent or guardian if the applicant is a minor. The applicant must also submit a recent passport photo. The form allows the applicant to select which types of vehicles they want the learner's license to be applicable to, such as motorcycles, cars, buses, and more.

Uploaded by

Malsawmsanga Ralte
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
97 views

Leaner Licence Form 2

This document contains an application form for a learner's license. The form requests information such as name, address, date of birth, educational qualifications, identification marks, blood type, current licenses held if any, a medical fitness certificate, and consent from a parent or guardian if the applicant is a minor. The applicant must also submit a recent passport photo. The form allows the applicant to select which types of vehicles they want the learner's license to be applicable to, such as motorcycles, cars, buses, and more.

Uploaded by

Malsawmsanga Ralte
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

FORM - 2

{ See Rule 10 }

APPLICATION FOR THE GRANT OF LEARNER’S LICENCE

To, Space for one


recent passport
The Licensing Authority size photograph
Aizawl, Mizoram ( compusory )

I hereby apply for a licence authorising me to drive as a learner’s the


following vehicle (s) :-
(a) Motor Cycle withour gear (g) PSV ( Bus )
(b) Motor Cycle with gear (h) CNEQP
(c) Invalid Carriage (i) 3W - TSR
(d)Light Motor Vehicle NT/GV/CAB (j) 3W - NT
(e) Transport Vehicles ( TRANS TR )
(f) Road Roller
Motor Vehicle of a specified description, namely : ...........................................

PARTICULARS TO BE FURNISHED BY APPLICANT

1. Full Name : _________________________________________________

2. Son/Wife/Daughter : _________________________________________
3. Permanent Addess ___________________________________________
( Electoral Roll / Life Insuarance Policy / Passport / 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 )
4. Temporary address / Official address, if any _____________________
5. Date of Birth ( dd mm yyy )
( Birth Certificate / School certificate / affidavit sworn by an Executive Magistrate
or first class judicial Magistrate or a notary Public to be enclosed )
6. Educational Qualification : ________________________________
7. Identification Mark (s):__________________________________________
8. Blood Group RH ( Rhesus ) factor : ________________________________
9. I hold an effective driving licence to drive : Motor Cycle / Light Motor
Vehicle/ Transport Vehicle with effect from _____________________
10. I enclose Medical fitness certificate dated _______ issued by ______doctor )
11. I have submitted along with my earlier application for for Learner’s Licence
/ I enclosed the written consent of parent / guardian ( in the case of appli-
cant being a minor )
12. I enclosed Driving Certificate dated ________ issued by ______________
Name and address of the driving school ) _____________________________

Date : _______________ Signature Or the thumb impression of Applicant

You might also like