Application Form for The Grant of Learners License - Jharkhand

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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