| 1. |
Name of the applicant(s) in full |
|
| 2. |
Status of the applicant, whether individual,company or partnership firm, co-operative society, etc |
|
| 3. |
Name of father or husband (in case
of individual and in case of firm or company the particulars of managing partner
or director, as the case may be) |
|
| 4. |
Full address (To be supported by attested
copy of ration card , electricity bill,etic., in case of individual or any other valid
documentary proof to the satisfaction of State Transport Authority and in case of company
or firm, certified copy of the Mamorandum of Association or copy of partnership deed)
|
|
| 5. |
(a) Whether the applicant himself intends
to drive the vehicle?
(b) If so, whether the applicant-
(i)Holds heavy passenger motar vehicle driving Licence
(ii)The number , date and validity period of driving Licence
(iii)Name and address of the Licensing Authority |
|
| 6. |
Registration certificate along with the date
of first registration,Insurance Certicate number |
|
| 7. |
Details of other permits, if any , held in respect of at particular vehicle |
|
| 8. |
Details of total number of tourist permits
held by the applicant |
|
| 9. |
Type of vehicle |
|
| 10. |
Make of motor vehicle |
|
| 11. |
Particulars of convictions/suspensions/
cancellations, if any, during the past three years in respect of the vehicle permit held by the applicant(s) |
|
| 12. |
I/We forward herewith the certificate of Registration
of the vehicle or I/We will produce the certificate of Registration of the vehicle before the permits
are issued |
Yes
No |
| 13. |
I/We here by declare that the above statements are true
and that I/We am/are the residents(s) of this state having principal place of business in the State
at |
|
| 14. |
I/We have paid the fee of rupees |
|