form_p_pu_c_a
form_p_pu_c_a
7. The details of last three years’ record of payment of taxes in respect of vehicles stated in
item No. 6 above
8. The details of last three years’ record of suspension or cancellation or any permit stated
in item No. 6 above
9. Whether the applicant is in possession of the vehicle if yes, the
registration mark of such vehicle if no, the details of arrangement
made/to be made to acquire the vehicle
10. Particulars of any agreement or arrangement affecting in any material respect the
provision (within the region of the Regional Transport Authority) of facilities in the
transport of goods for hire or reward entered / or proposed to be entered into by the
applicant with any other person by whom such facilities are provided, whether within of
without the region
11. Particulars of any agent’s license to the applicant for the business of collecting,
forwarding or distributing goods carried bu goods carriage
12. Whether the applicant intends be carry goods for or in connection with a trade or
business carried on by the applicant if yes, the nature of his trade or
business and the nature of goods to be carried
13. I hereby declare that the above statements are true, and that I have supplied all the
information and documents necessary to support the statements made in this
application.
14. I hereby agree that the above statements are true, and that I have supplied all the
information and documents necessary to support the statements made in this
application.
15. I herewith tender the fee prescribed in Rule VI.
Date :
Place :
Signature of the applicant
Note : Where the space is not sufficient, the applicant should furnish the information, item-
wise on separate sheets, must sign each sheet, and must attach them with the application.
* Strike out whichever is either not required or not applicable.