Form of Application for Licence to drive a Motor Vehicle

GOVERNMENT OF ANDHRA PRADESHTRANSPORT DEPARTMENT
FORM 4(Sec Rule 14)
Form of Application for Licence to drive a Motor Vehicle
The Licensing Authority,___________________
1 Space for Passport photograph
I apply for a licence to enable me to drive vehicleof the following description :
(a) Motor cycle without gear(b) Motor cycle with gear(c) Invalid carriage(d) Light motor vehicle(e) Medium goods vehicle(f) Medium passenger motor vehicle(g) Heavy goods vehicle(h) Heavy passenger motor vehicle(i) Road roller(j) Motor vehicle of the following description
I.II.III.IV.V.
Particulars to be furnished by the Applicant
1. Name2. Son/Wife/Daughter of3. Permanent address (Proof to be enclosed)4. Temporary address/Official address (if any)5. Date of birth (Proof to be enclosed)6. Educational qualifications
: _________________________________: _________________________________: _________________________________ : _________________________________: _________________________________: _________________________________


7. Identification Marks8. [Optional Blood Group and RH Factor :]9. Have you previously held driving licence? If so, give Details10. Particulars and date of every conviction which has been ordered to be endorsed on any licence held by the applicant11. Have you been disqualified for obtaining a licence to drive? If so, for what reasons?12. Have you been subjected to a driving test as to your fitness or ability to drive a vehicle in respect of which a licence to drive is applied for? If so, give the following details
: (1)_______________________________ (2)_______________________________: _________________________________ : _________________________________

: ________________________________
: ________________________________

: _________________________________

Date of test
Testing Authority
Result of Test
1. _________________________________________________________________________________2. _________________________________________________________________________________3. _________________________________________________________________________________4. _________________________________________________________________________________
13. I enclosed copies of my recent [Passport size photograph (where laminated card is used no photographs are required] : _________________________________14. I enclosed the learner's licence No._______________________ dated_____________________ issued by licencing authority.15. I enclosed the driving Certificate No.______________________ dated_______________ issued by16. I have submitted along with my application for Learner's Licence the written consent of parent/guardian __________________________________17. I have submitted along with my application for Learner's Licence/ I enclose the medical fitness certificate. __________________________________

18. I am exempted from the medical test under Rule 6 of the Central Motor Vehicle. Rules, 1989.__________________________________19. I am exempted from preliminary test under Rule 11(2) of the central Motor Vehicles. Rules, 1989._____________________________20. I have paid the fee of rupees I hereby declare that to the best of my knowledge and belief the particulars given above are true.
Note:- Strike out whichever is inapplicable.

Date:
Signature/Thumb impression of applicant

Certificate of test of competence to drive

The Applicant has passed the test prescribed under Rule 15 of the Central Motor Vehicles Rules, 1989. The test was conducted on (here enter the registration mark and description of the vehicle)____________________ on _________________ date._____________________

The applicant has failed in the test. (The details of the deficiency to be listed out)

(i) (ii) (iii) (iv)

Date:
Signature of Testing Authoritywith Full name and designation.

Two specimen signatures of the applicant: 1. 2. *Strike out whichever is inapplicable.

GOVERNMENT OF ANDHRA PRADESHTRANSPORT DEPARTMENT
FORM 2(Sec Rule 10)
FORM OF APPLICATION FOR THE GRANT OF RENEWAL OFLEARNER'S LICENCE

To,The Licensing Authority,___________________
___________________
Space for Passport photograph

I hereby for a licence authorising me to drive as a learner, the followingmotor vehicle (s) :

(a) Motor cycle without gear(b) Motor cycle with gear(c) Invalid carriage(d) Light motor vehicle(e) Medium goods vehicle(f) Medium passenger motor vehicle(g) Heavy goods vehicle(h) Heavy passenger motor vehicle(i) Road roller(j) Motor vehicle of the following description

a)b)c)d)

Particulars to be furnished by the Applicant
1. Full Name2. Son/Wife/Daughter of3. Permanent address (Proof to be enclosed) 4. Temporary address: Official address (if any)5. Date of Birth (Proof of age to be enclosed)6. Educational Qualification (s)7. Identification mark (s)
: _______________________________ : _______________________________: _______________________________: _______________________________
: _______________________________: _______________________________: ________________________________: 1.______________________________: 2.______________________________ ________________________________

8. OPTIONAL
Blood group______________________________RH _________________________________________ hold an effective driving licence to drive a) Motor Cycle/light motor vehicle/medium passenger motor vehicle/medium goods motor vehicle with effect from_______________________________________10. Particulars of any driving licence previously held by the applicant. Whether it was cancelled and if so, for what reason___________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________11. Particulars of any learner's licence previously held by the applicant in respect of the description of vehicle to which the applicant has applied.12. Have you been disqualified for holding or obtaining a driving licence or learner's licence? If so, for what reasons________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________

13. I enclosed 3 copies of my recent photographs (passport size photograph)14. I enclosed medical fitness certificate dated________________________ issued By (doctor)__________________________________________15. I have submitted along my earlier application for learner's Licence/ I enclose / the Written consent of parent / guardian (in the 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 6 of Central Motor Vehicles Rules, 1989.19. I am exempted from the preliminary test under Rule 11(2) of Central Motor Vehicles Rules, 1989.

Date:_____________________
Signature or Thumb impression of the applicants

Specimen Signature or Thumb impression of the applicant


*Strike out whichever is inapplicable
1.
2.
3.


Declaration under sub-section (2) of section 7 ofthe Motor Vehicles Act, 1988
Shri/Smt/Kumari________________________________________________ son/Daughter of_________________________________________________ who is a minor is under my careand I accept responsibility for his/her driving . If at a later date I decide not to accept responsibilityfor his/her driving I shall intimate the licensing authority in writing for the cancellation of the licence Igive my consent for his/her obtaining learner's licence.

Signature____________________ Name and full 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 application is exempted from the medical test under Rule 6 and the preliminary test under Rules 11 (2) of the Central Motor Vehicle Rules, 1989. Learner’s Licence may be issued.* The applicant was tested with reference to Rules 11 (1) of the Central Motor Vehicles Rules, 1989. He has passed the test. Learner’s Licence may be issued.* He has failed in the test. (Reasons should be specified). Learner’s licence may be refused.

Signature of Licensing Authority or Other person authorized in this behalf
* Strike out whichever is inapplicable.

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