Form P.T.A
(Rule 171 (iv) of the Andhra Pradesh Motor Vehicles Rules, 1989)

To

The Regional / State Transport Authority.

In accordance with the provisions of Sections 69 and 87 of the Motor Vehicles Act 1988. I/We the undersigned hereby apply for a temporary permit under section 66 of the Motor Vehicles Act. 1988 as hereunder set out :
1. Full Name : .
2. Name of the Father
(in case of an individual)
:
3. Address :
4. Class of permit and the purpose for which it is required :
5. If the vehicle is to be used as contract carriage, the particulars of contract and copy of contract in duplicate should be furnished.
6. Route(s), area :
7. Period of duration of permit from :
8. Type and Gross vehicle weight, seating capacity of the vehicle or the vehicles for which the permit is required. :  
9.
i) The registered owner(s) of the vehicle(s) is/are and the Registration mark(s) is/are.  
ii) No. and validity of permit, if any already held in respect of the vehicle.  
iii) Validity of F.C.  
iv) Validity of I.C.  
v) Tax paid upto.  
10. I/We enclose cash/challan/cheque/money order reciept for Rs .being the prescribed fee.
11. I/We hereby declare that the above statements are true and agree that they shall be conditions of any permit issued to me/us.




Signature or thumb impression of
the applicant(s)