TRANSPORT DEPARTMENT
[Link], SHAHJAHANPUR
FORM 3
[See Rule 3(a) and 13]
LEARNER'S LICENCE
Fee Details Rs.350.0/- /UPW/4689697 /18-12-2023 ApplNo: 4734272823 Issue Dt. 18-12-2023
1. Licence No. UP27 /0026610/2023
2. Name MOHD AQUIB ANSARI
3. Father's Name ISARAR AHMAD
4. Date of Birth 04-02-2004
5. Optional/Blood Group- Unknown
RH Factor
6. Present Address VJHEDA BHAGWANPUR KHEDA VJHEDA Khera Bajhera
Bajhera Bhagvanpur Tilhar Shahjahanpur Uttar
Prad,242303 Holder's Signature
7. Permanent Address VJHEDA BHAGWANPUR KHEDA VJHEDA Khera Bajhera
Bajhera Bhagvanpur Tilhar Shahjahanpur Uttar Prad,242303
8. Marks of Identification (1)
(2)
is licenced to drive a Motor Vehicles of the following description through out India and in case of E-
rickshaw or E-cart, in specified areas or routes, as a learner,subject to the provisions of Rule 3 of
the Centeral Motor Vehicle Rules 1989:
LIGHT MOTOR VEHICLE, Motor Cycle with Gear(Non Transport),
..........................................................................................................................................................
*The holder of the licence has passed the preliminary test referred to in rule 11(1) of the CMV
Rules ,1989.
*The holder of the licence is exempted from the medical test under rule 6 and from the
Preliminary test under rule11(2)of the Central Motor Vehicle Rules,1989
*Strike off which ever is inapplicable
This Licence is valid from 18/12/2023 To 17/06/2024
Signature and Designation of
the Licensing Authority
Warning: [Link], SHAHJAHANPUR
The attention of the holder of this licence is drawn to rule 3 of CMV Rules, 1989 which prohibits him from driving any
motor vehicle unless he has besides him a person duly licenced to drive the vehicle and in every case , the vehicle
carries "L" plates both in front and in the rear of the vehicle.
Note: This is a computer generated Document. No signature is [Link] Learners Licence is issued based on the Information and
declaration submitted by the applicant with regards to his/her physical fitness to drive a Motor Vehicle and liable for cancelation if found
incorrect/ unfit to drive.