Application Form for The Grant of Learners License - Jharkhand

JHARKHAND GOVERNMENT
TRANSPORT DEPARTMENT
Application Form for The Grant of Learners License
FORM -2
Particulars to be Furnished by Applicant
To
The Licensing Authority
I hereby apply for licence authorizing me to drive as a learner the following Vehicles.
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 good Vehicle
h Heavy Passenger Motor Vehicle
Full Name of the Applicant
Affix a passport
size photocopies
of yours.
(Space for Photograph of the Size
Five Centimeter by Six Centimeter)
1. son daughter wife of
2. Permanent Address
3. Proof to be Enclosed
4. Temporary Address (If any)
5. Official Address(If any)
6. Date of Birth proof of age to be
enclosed
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7. Educational Qualification with
percentage of marks
8. Identification Marks
9. Blood Group and R.H factor
10. I hold on effective driving licence to drive a Motor Cycle Light Motor Vehicle / Medium
Passenger Motor Vehicle/
Vehicle with effect from
Medium Good
11. Particular of any driving license
previously, hereby applicant whether It
was cancelled and if so, for what reason
12. Particulars of any learner's Licence
previously held of applicant in-respect
of the description of vehicle to which the
applicant has applied
13. Have you been disqualified for
holding or obtaining driving licence
of earner licence,if so for what reason
Yes No
14. I enclosed 3 copies of my recent photograph (Photograph to be of the size of five centimeter by six
centimeter)
15. I enclosed medical Fitness Certificate Dated issue by Doctor
16. I have submitted along with my earlier application for learner's Licence
17. I enclosed the written consent of parents guardian in the case of applicant being minor.
18. I enclose driving certificate date
issued by
19. I have paid the required fees for the license
Yes No
20. I am exempted from the medical test under rule 6 of the central motor vehicle Rule 1989.
Date:
Signature of Applicant
Duplicate Signature of
Applicant
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FROM
Declaration under sub section (2) of section 7 of the motor vehicle act 1989.
Sri /Kumari
son daughter of
Who is minor is under my carry and accept responsibility for/ her driving if at a letter date I
decide not to accept responsibility Licence . I drive my consent for her obtaining learner's licence.
Name
Full Address of the parent
guardian relationship :
Signature
(To be signed in the presence of the Licensing Authority or person authorised in this behalf by the
Licensing Authority. )
FOR OFFICE USE
The applicant is exempted from the Medical test under Rule (6) and Preliminary test under Rule (2)
of the central Motor Vehicle Rules 1989 learner's may be issued.
The applicant was tested with reference to rule 11(1) of the Central Motor Vehicle Rule 1989.
He has passed the learner's licence may be issued.
He has passed the test (Reason should be specific) .Learner's Licence may be referre
Strike out whichever is Applicable
Signature of Licensing Authority of
Person authorised in the behalf
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