Application in respect of Temporary Permit

P T A.Application in respect of a temporary permit(See Rule 170 )ToThe Regional / State Transport Authority................................................................In accordance with the provisions of section 69 and 87 of the Motor Vehicles Act, 1988, I/ We the undersigned hereby apply for a temporary permit under section 66 of that Act ashereunder set out :-1. a) Name :… …………………………………………..b) Age (in words and figures) :… …………………………………………..c) If the applicant is a minor, full nameand address of the guardian:… ……..… ………………………………...2. Name of father (in the case of an individual) :… ……….… ……………………………….3. Address :… …………………………………………..……………………………………………...4. Purpose for which permit is required :… …………………………………………..5. Nature of goods, if goods are to be carried :… …………………………………………..6. Route(s) / Area :… …………………………………………..7. Period of duration of permit :From… …………..… To… ..… ……………8. Type and registered laden weight / seatingcapacity of the vehicle for which the temporarypermit is required:… …………………………………………..9. 1) The registered owner(s) of the vehicle(s) is :… …………………………………………../ are and the registration marks is / are :… …………………………………………..2) The vehicle has / vehicles have not yet been hired by me / us and I / We undertake tointimate the registration mark(s) if required within twenty-four hours of hiring the vehicle/ vehicles.10. I / We enclose cash challan / cheque / money order receipt for Rs… ………………being theprescribed fee.11. I / We hereby declare that the above statements are true and agree that they shall beconditions of any permit is used to me / us.

Date:…………………………….Signature of Applicant(s).NOTE: Strike out inapplicable entries or alternatives throughout.