Form Ar. PMV 38

(See Rule -61 (I) (iv)

Application In Respect of a Temporary Permit

    To, 

            The Regional Transport Authority

            In accordance with the provision of section 69 and 87 of the Motor vehicle Act. 1988, I the undrersigned, are hereby apply for a temporary permit under section 66 of that Act as hereby set out.

1.  Full Name       

     Surname          

2.  Father's/Husband's Name

3.  Age                 

4. Full address/House No./Road/lane

5.  Locality City/Town

    Pin No       Tel No.   

6.  Purpose for which permit is required

7.  Route or routes of area

8.  Period for which permit is from   (both days inclusive)

9.  Type and laden weight/seatlag capacity of the vehicle for which the permit is required  

10.  Registration mark of the vehicle

        I, hereby declare that the above statements are true and agree that they shall be condition or any permit issued to me.

Date : 

Place :

Signature or thumb impression of applicant.