The Central Motor Vehicles Rules 1989

FORM-2 (See rule 10)

FORM OF APPLICATION FOR THE GRANT OF LEARNER'S LICENCE

To,

The Licensing Authority

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I hereby Apply for a licence authorising me to a drives a learner the following motor vehicles :

  1. Motor cycle without gear
  2. Motor cycle with gear
  3. Motor Car/Jeep
  4. Invalid caarriage
  5. Light motor vehicle
  6. Medium goods vehicle
  7. Medium passenger motor vehicle
  8. Heavy goods motor vehicle
  9. Heavy passanger motor vehicle
  10. Road roller

Motor vehicle of the following description

Particulars to be Furnished by Applicant :
1 Full name  
2 Son/Wife/Daughter of  
3 Permanent address  
4 Temporary address  
5 Official address  
6 Date of birth (Proof of age to be enclosed)  
7 Educational qualification  
8 Identification mark (s) 1.
2.
9 Blood Group  
RH Factor  
10 Particulars of any driving licence previously h held by applicant. Wheather it was cancelled and if so, for what reason :  
11 Particulars of any learner's licence previously held up in respect of the description of vehicle to which the applicand has applied.  
12 Have you been disqualified for holding or obtaining driving licence or learner's licence if so, for what reason.  
13 I enclose 3 copies of my recent photograph (Pasport size photograph)  
14 I enclose medical fitness certificate dated ---------- issued by doctor.  
15 I have submitted along with my earlier application of Learner's Licence/enclose the written concent of parent/guardian (in the case of applicant being a minor)  
16 I enclose driving certificate dated------------

issued by----------------- (Name and address of the driving school )

  
17 I have paid the fee of Rs.--------------------  
18 I am exempted from the Medical Test under rule of Central Motor Vehicle Rules, 1989.  
19 I am exempted from the preliminary test under rule 11(2) of Central Motor Vehicle Rules, 1989. Striken out whichever is inapplicable.  

Date-----------------------

Specimen Signature or thumb impression of applicant

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Signature or thumb impression of applicant

Declaration under sub-section(2) of section 7 of the Motor Vehicle Act, 1988.

Shri/Kumari-----------------------Son/Daughter of -------------------- who is a minor is under my care and I accept responsibility for his/her driving. If at a later date I decid not accept responsibility for his/her driving shall intimate the licenceing authority in writing for cancellation to the licence. I give my concent for his/her obtaining learner's licence.

Signature-----------------------------

Name and fulll address of the parent/guardian--------------

Relationship------------------------

(To be signed in the presence of the Licensing Authority or person authorised in this behalf by the Licensing Authority).

for office use

The applicant is exempted from the medical test under rule 6 and the preliminary test under rule 11(2) of the Central Motor Vehicle Rules, 1989.

Learner's Licence may be issued

The applicant was tested with reference to rule 11(1) of the Central Motor Vehicle Rules,1989. He/She has passed the test Learner's Licence may be issued .

He/She has failed in the test. ( Reasons should be specified)

Learner's Licence may be refused.

Signatur of Licensing Authorised or other person authorised in this behalf. .___________________________________________________________________________