Application for International Driving Permit

Surname In block letter

(State if Mr. / Miss)

Father’s Name

other names(i.e., explain initials)

Year and Date of Birth

Town where born

Full name and address in India

(In block letters)

Full Details of Indian License held

Issued by :

Valid till Date :

No. of License :

Class of Vehicle for which it is Valid

Endorsement regarding conviction if any

(State if previously examined for driving

the same class of vehicles of vehicles)

Passport number

Date of Issue :

Issued by :

Date of expiry :

1. Three passport size photos should be enclosed.
2. Challan in original for Rs. 10/- should be enclosed.
3. Signature in duplicate.
4. Civil Driving License
5. Passport

Signature of the Applicant

Place:------------------------------

Date:------------------------------