FORM-2.pdf

FORM 2 FORM 2 [Refer Rules 10, 14, 17 and 18] FORM OF APPLICATION FOR LEARNER’S LICENCE OR DRIVING LICENCE OR ADDITION OF A NEW CLASS OF VEHICLE OR RENEWAL OF...

FORM 2 FORM 2 [Refer Rules 10, 14, 17 and 18] FORM OF APPLICATION FOR LEARNER’S LICENCE OR DRIVING LICENCE OR ADDITION OF A NEW CLASS OF VEHICLE OR RENEWAL OF DRIVING LICENCE OR CHANGE OF ADDRESS OR NAME To, Space for passport size photograph (Upload the photo The Licencing Authority for online............................................. application of the size not more than............................................. 50 KB) Services applying for (Please Tick √ mark against single or multiple service, wherever applicable) Issue of New Learner’s Licence Issue of New Driving Licence Addition of Class of Vehicle to Driving Licence Renewal of Driving Licence Duplicate Driving Licence Change/Correction of Address in Driving Licence Change/Correction of Name in Driving Licence 1. Class of Vehicles (COV): Applicable for New Learner’s Licence or New Driving Licence Motor Cycle Without Gear (MCWOG) Motor Cycle With Gear (MCWG) Light Motor Vehicle Adapted Vehicle (vehicles for use by Divyang) Medium or Heavy Goods or Passenger Vehicle as Transport Vehicle E-Rickshaw E-Cart Others: which is not covered in any of the above categories including, Harvester, Excavator, Fork lift, Trailers, Crane mounted vehicles, Agricultural tractor and power tiller, Tow trucks, Breakdown Van and Recovery vehicles, Construction equipment vehicles. Explanation : 1. Non-Transport Vehicles include Motor Cycle with or without sidecar for personal use, Mopeds, Three Wheeled vehicles for personal use, Motor Car for personal use, Fork Lift;  2. Transport vehicle includes a public service vehicle, a goods carriage, an educational institution bus or private service vehicle; 3. Light motor vehicle includes omnibus the gross vehicle weight of either of which or a motor car or tractor or road-roller the unladen weight of any of which, does not exceed 7,500 kilograms; 4. Medium goods vehicle includes any goods carriage other than a light motor vehicle or a heavy goods vehicle; 5. Heavy goods vehicle includes any goods carriage the gross vehicle weight of which, or a tractor or a road-roller the unladen weight of either of which, exceeds 12,000 kilograms. 2. Personal details of the Applicant (in Capital Letters) Details of Aadhaar card, if Aadhaar Card Number already available with the applicant Details of Aadhaar Aadhaar Card application number application number if applied First Name Middle Name Last Name Son/wife/daughter of Date of birth Identification mark Gender (Tick √) Male Female Transgender Date of Birth: (dd/mm/yyyy) Educational Blood Group Qualification Email (optional) Mobile number Landline Number (optional) 3. Name of (Tick √) Father Mother Husband Guardian First Name Middle Name Last Name 4. Address (proof to be enclosed, in case of New Learner’s Licence or New Driving Licence or Change of Address) Present Address (shall be Permanent Address (Only if printed on Licence) different from Present Address) House/Door/Flat No. Street/Locality/Police Station Location/Landmark Village/Town Sub-Dist/Taluk/Mandal District State Pin code 5. In case of request for Addition of a Class of Vehicle in Transport Category, please fill the following: Driving School Name Enrollment number in the Driving School Enrollment date in the Driving School Certificate number issued by the Driving School Certificate date as issued by the Driving School Training period in the From date To Date Driving School 6. Particulars of existing Licence (Learner’s or Permanent) Licence Number Class of Vehicle(s) Name of the Licencing Authority which issued the Licence Validity Period From date To Date 7. List of Documents attached (Please refer to the attached annexure and tick) DECLARATION I am willing to donate my organ/tissue in case of death YES/NO I declare that the facts stated above and documents submitted are true and genuine to the best of my knowledge and belief. I also state that I have/have not been disqualified from holding a Driving Licence. Date: Signature of the Applicant  Self-Declaration as to Physical Fitness (a) Do you suffer from epilepsy or from sudden attacks of loss Yes/No of consciousness or giddiness from any cause? (b) Are you able to distinguish with each eye (or if you have held Yes/No a driving licence to drive a motor vehicle for a period of not less than five years and if you have lost the sight of one eye after the said period of five years and if the application is for driving a light motor vehicle other than a transport vehicle fitted with an outside mirror on the steering wheel side) or with one eye, at a distance of 25 metres in good day light (with glasses, if worn) a motor car number plate? (c) Have you lost either hand or foot or are you suffering from Yes/No any defect of muscular power of either arm or leg? (d) Do you suffer from night blindness? Yes/No (e) Are you so deaf so as to be unable to hear (and if the Yes/No application is for driving a light motor vehicle, with or without hearing aid) the ordinary sound signal? (f) Do you suffer from any other disease or disability likely to Yes/No cause your driving of a motor vehicle to be a source of danger to the public, if so, give details I hereby declare that, to the best of my knowledge and belief, the particulars given above and the declaration made therein are true. (Signature or thumb expression of the applicant) Note : (1) An applicant who answers “Yes” to any of the questions (a), (c), (e), (f) and (g) or “No” to either of the questions (b) and (d) should amplify his answers with full particulars, and may be required to give further information relating thereto.] DECLARATION Under sub-section (2) of section 7 of the Motor Vehicles Act, 1988 Shri/Smt./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 decide not to accept responsibility for his/her driving, I shall inform the licensing authority in writing for the cancellation of the licence. I give my consent for his/her obtaining the learner’s licence. Name of the parent/guardian: Relationship with the applicant: Signature of the parent/guardian FOR OFFICE USE ONLY 1. The applicant is exempted from production of a medical certificate under YES/NO Rule 6 of the Central Motor Vehicles Rules, 1989; Learner’s licence may be issued. 2. The applicant is exempted from the Preliminary Test under sub-rule (2) YES/NO of Rule 11 of the Central Motor Vehicles Rules, 1989; Learner’s licence may be issued.  3. Preliminary Test to check adequate Date of Result (√) Testing knowledge and understanding of the Test Authority matters namely traffic signs, traffic signals, duties of driver in case of his Pass/Fail/ vehicle being involved in an accident, Absent/Exempted or documents to be carried while driving etc., Sub-rule (1) of Rule 11 of the Central Motor Vehicles Rules, 1989 Driving Test (Rule 15 of the Central Date of Result Motor Vehicles Rules, 1989) Test Pass/Fail The Learner’s licence/Driving Licence is Issued Refused Signature of licensing authority (or other person authorised in this behalf) ANNEXURE LIST OF DOCUMENTS TO BE SUBMITTED OR UPLOADED BY THE APPLICANT Proof of Address and Age. (Select only one if the proof is common for Address and Age) 1. Aadhaar Card 2. Electoral Roll 3. Life Insurance Policy 4. Passport 5. School Certificate 6. Birth Certificate 7. Pay slip issued by any office of the State Government or Central Government or a local Body 8. Affidavit sworn before an Executive Magistrate or Notary Public or First Class Judicial Magistrate 9. A certificate granted by a Registered Medical Practitioner not below the rank of Civil Surgeon as to the age of the applicant 10. Any other document or documents as may be specified by State Government Other documents to be enclosed or uploaded if applicable 1. Self Declaration for Physical Fitness in Form-1 2. Medical Certificate in Form-1A (to be provided if the applicant is applying for renewal and is above 40 years of age or applying for Transport Licence) 3. Driving Certificate issued by Driving School or Establishments in Form 5 4. Parent or Guardian Declaration in case of applicant who is a minor 5. Photograph 6. Valid proof of passport and visa (for International Driving Permit only) 7. Proof of legal presence in India in addition to proof of residence in case of Foreigners 8. Other documents, if any 9. The copy of police complaint made (in case of Driving Licence was lost or mutilated or defaced or damaged, lost) 10. For change of name— (a) Existing name................................................................ (b) Name to be changed as................................................ (c) Documents enclosed:— (i) Affidavit sworn before a First Class Judicial Magistrate or a Notary Public (ii) Marriage certificate (iii) Copy of newspaper advertisement