FORM L.L.D.INTIMATION OF LOSS OR DESTRUCTION OF LICENCE & APPLICATION FOR DUPLICATES(The Andhra Pradesh Motor Vehicle Rules)
To, The Licensing Authority, ______________________

I,____________________________________________________________________________________ (Father's Name) ________________________________________________________________________ of (Full postal Address)___________________________________________________________________ _____________________________________________________________________________________ and present Address _____________________________________________________________________ hereby report that Driving / Licence No._______________________________________________________ Issued by the Licensing Authority________________________________________________________on or about the____________________________________ day of__________________________________19 has been lost / destroyed in the fallowing circumstances____________________________________________ _____________________________________________________________________________________ 1. I hereby apply for duplicate licence and enclose Treasury Challan No. _______________________ for rupees. 2. I attach here with two clear copies of a recent photograph of myself
Date :____________________
Signature or Thumb impression of applicant