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Form 9 Form of Application For The Renewal of Driving (See Rule 18 (1) )

Manish Prasad is applying for the renewal of his driving license. The original license was issued on January 17, 2012 by the Assistant RTO in Sonbhadra, Uttar Pradesh. The license was last renewed on May 14, 2015 and is set to expire on May 13, 2018 for transport vehicles and January 16, 2032 for other vehicles. Manish Prasad currently resides in Auri More, Anpara, Shaktinagar, Auri, Sonbhadra, Uttar Pradesh 231225. He has submitted the required documents and paid the renewal fees.

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DEVESH SHUKLA
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327 views3 pages

Form 9 Form of Application For The Renewal of Driving (See Rule 18 (1) )

Manish Prasad is applying for the renewal of his driving license. The original license was issued on January 17, 2012 by the Assistant RTO in Sonbhadra, Uttar Pradesh. The license was last renewed on May 14, 2015 and is set to expire on May 13, 2018 for transport vehicles and January 16, 2032 for other vehicles. Manish Prasad currently resides in Auri More, Anpara, Shaktinagar, Auri, Sonbhadra, Uttar Pradesh 231225. He has submitted the required documents and paid the renewal fees.

Uploaded by

DEVESH SHUKLA
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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FORM 9 Appl No.

387717319 Dt:05-02-2019
[See rule 18(1)]
FORM OF APPLICATION FOR THE RENEWAL OF DRIVING

I, Shri :: MANISH PRASAD


................................................

Father's Name :: GAYA PRASAD


................................................

hereby apply for the renewal of my driving licence which is attached and particulars of which are as

a) Driving Licence Number :: UP64 20120000531


................................................

b) Date of issue :: 17-01-2012


................................................

c) Licensing Authority by which the licence :: ASST.RTO, SONBHADRA


................................................
issued

d) Licensing Authority by which the licence :: ASST.RTO, SONBHADRA


was last renewed, number and date of .................................................
renewal UP64 /AED/0001057/2015 Dt: 14-05-2015
.................................................

e) Class of vehicles authorised to be driven :: LMV , TRANS, MCWG

f) Date of expiry of licence to drive ::

(i) transport vehicle :: 13-05-2018


................................................

(ii) vehicles other than transport :: 16-01-2032


................................................

My present address is :: AURI MORE, ANPARA, SHAKTINAGAR, AURI,SONBHADRA,


231225

If this address is not entered on the :: AURI MORE, ANPARA


licence I do/do not wish that it should be SHAKTINAGAR
so entered. AURI,SONBHADRA
231225

If the licence is not attached, reasons :: ................................................


why it is not available?
If the licence was not renewed within thirty :: ................................................
days of the days of the date of expiry,
reaons for delay

The renewal of licence has not been :: ................................................


refused by any Licensing Authority.

I have not been disqualified for holding or :: ................................................


obtaining a driving licence. My licence has
not been revoked.

I enclose three copies of my recent :: ................................................


passport size photographs.

I have paid the fee of Rs. :: ................................................


Challan No. / Receipt No. :: ................................................

I hereby declare that to the best of my knowledge and belief the particulars given above are true.

Date: 05-02-2019 Signature or thumb impression of the


MANISH PRASAD
Name ………………………………….

Address
CMV FORM 1 Appl No: 387717319 Dt:05-02-2019
[See rule 5(2)]
Application –cum-declaration as to the physical fitness

1.Name of the applicant : MANISH PRASAD

2. Father's Name : GAYA PRASAD

3.Permanent address : AURI MORE, ANPARA


SHAKTINAGAR
AURI,SONBHADRA
231225

4.Temporary address : AURI MORE, ANPARA


Official address (if any) SHAKTINAGAR
AURI,SONBHADRA
231225

5. (a) Date of birth : 05-11-1992


(b) Age on date of application : 26 years
6. Identification marks :

Declaration :

(a) Do you suffer from epilepsy, or from sudden attacks of


loss of consciousness or giddiness from any cause ? Yes / No

(b) Are you able to distinguish with each eye ( or if you have
held a driving licence to drive a motor vehicle for a period of
not less than five years and if you have lost, the sight of one
eye after the said period of five years and if the application
is for driving a light motor vehicle other than a transport Yes / No
vehicle fitted with an outside mirror on the steering wheel
side) or with one eye, at a distance of 25 metres in good
day light (with glasses , if worn) a motor car number plate?

(c) Have you lost either hand or foot or are you suffering Yes / No
from any defect in movement, control or muscular power of either
arm or leg ?

(d) Can you readily distinguish the pigmentary colours, red Yes / No
and green ?

(e) Do you suffer from night blindness ? Yes / No

(f) Are you so deaf as to be unable to hear ( and if the


application is for driving a light motor vehicle, with or without Yes / No
hearing aid) the ordinary sound signal ?
(g) Do you suffer from any other disease or disability likely to
cause your driving of a motor vehicle to be a source of danger
Yes / No
to the public, if so, give details?

I hereby declare that, to the best of my knowledge and belief, the particulars given above and the declaration
made therein are true.

Signature or thumb impression of the applicant


( MANISH PRASAD )

Note : - (1) An applicant who answers 'Yes' to any of the questions (a),(c),(e), (f) and (g) or 'No' to either
of the questions (b) and (d) should amplify his answers with full particulars, and may be
required to give further information relating thereto.
(2) This declaration is to be submitted invariably with Medical Certificate in Form 1-A.

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