Home  | Contact Us      Date:  21-11-2018

Form of Application for New Licence to Drive a Motor Vehicle

Request for services on Licence :
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Applicant Details :
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Aadhar Card Number :
Select State : *
Select RTO/DTO : *
Date of Birth : *
applicant name First Name : *
Middle Name :
Last Name :
Relation : *
First Name : *
Middle Name :
Last Name :
Gender : *
Phone :
Mobile : *

Age : *
Place of Birth :
Country of Birth : *
Citizenship Status By : *
Blood Group :
Email Address :
Education Qualification : *
Identification marks :

If place of birth is out side India, Month & Year when migrated to India

a) Month : * b) Year : *
Address Details :
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  Permanent Address   Present Address
  Copy Present Address as Permanent Address
State : *
District : *
Flat Number : *
Flat / House Name :
House Number/Plot Number : *
Street :
Locality :
Village / Town / City :
Taluka / Mandal :
Pincode : *
Duration of Stay at this address :
  years   months
  years   months
Class of vehicles :
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Vehicle Registration Certificate(RC) Number
Documents :
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List of Enclosures ( Applicant should produce the original documents before the Licensing Authority at the office.)
Documents List : Proofs List :
1) I have submitted along with my application for Learner's Licence the written consent of my parent/guardian:-
2) I have submitted along with my application for Learner's Licence , I enclosed all the Necessary Enclosures / Certificates:-
3) I am exempted from the Medical test under rule 6 of the Central Motor Vehicles Rules, 1989 :-
4) I am exempted from preliminary test under rule 11(2) of the Central Motor Vehicles Rules, 1989 :-
5) I have been convicted / disqualified / my Licence was cancelled /suspended / my Licence was revoked
If Yes, DL Number : Date of Conviction :
Reasons for Late Renewal / DL Not Attached, etc?