APPLICATION FORM FOR THE GRANT OR RENEWAL OF LEARNER'S Licence
FORM-2(See rule - 10)
The Licencing Authority,
I hereby apply for a Licence authorising me to drive as a learner for the following motor vehicles
(Tick in the appropriate box)
Motor cycle below 50cc
Motor cycle above 50cc
Light Motor Vehicle (includes Cars & Jeeps)
Invalid carriage (incase of physically handicapped applicants)
Any other category
(Specify the category in the box)
(Please fill the following particulars in CAPITAL Letters only)
Declaration under sub-section(2) of section 7 of the Motor Vehicle Act, 1988
- FULL NAME(Leave one space between first and last name)
- Son/Daughter/Wife of
Disclaimer : The applicant is solely responsible for any medical complications that may arise due to wrong declaration of the Blood group.
- Effective driving Licence to drive the following class of vehicles held by the applicant.(Tick inthe appropriate box).
- Particulars of any driving Licence previously held by applicant. Whether it was cancelled and if so, for what reason.
- Particulars of any learners Licence previously held by applicant in respect of the description of vehicles to which the applicant has applied.
- Have you been disqualified for holding or obtaining Licence or learners Licence? If so, for what reasons.
- I enclose medical fitness certificate dated:
Issued by doctor:
- I have submitted along with my earlier application for learner's Licence / I enclose the written consent of Parent / Guardian (In the case of applicant being a Minor)
- I enclose driving cerificate dated
- I have paid the fee of Rs.
- I am exempted from the medical test under rule 6 of Central Motor Vehicle rules 1989.
- I am exempted from the preliminary test under rule 11(2) of Central Motor Vehicle rules 1989.
(By the guardian in the case of applicants who is a minor)
who is a minor under my care and i accept responsibility for his/her driving. If ar a later date I decide not to
accept responsibility for his/her driving. I shall intimate the Licencing Authority in writing for the cancellation
of the Licence. I give my consent for his/her obtaining lerarners Licence.
|Name and full address of
|Signature of the parent/Guardian
(To be signed in the presence of the Licencing Authority or person authorised in this behalf by Licencing Authority)
FOR OFFICE USE:
EXEMPTED from test under rule 6 & under rule 11(2) of CMV rules YES
TEST under rule 11(1) of CMV rules
Result : PASSAD
Reasons of Refusal: