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TRANSPORT DEPARTMENT

RTO, AZAMGARH
FORM 3
[See Rule 3(a) and 13]
LEARNER'S LICENCE

Fee Details Rs.350.0/- /UPU/4647796 /12-12-2021 ApplNo: 4340398721 Issue Dt. 14-12-2021

1. Licence No. UP50 /0046382/2021

2. Name ARVIND KUMAR

3. Father's Name MAHENDRA YADAV

4. Date of Birth 01-07-1997

5. Optional/Blood Group- Unknown


RH Factor

6. Present Address VILL DAKHIN GAWA POST MAHUL


PHOOLPUR,AZAMGARH,UP,223225
Holder's Signature

7. Permanent VILL DAKHIN GAWA POST MAHUL


PHOOLPUR,AZAMGARH,UP,223225

(1)
8. Marks of Identification
(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:
Motor Cycle with Gear(Non Transport), LIGHT MOTOR VEHICLE,
.......................................................................................................................................

*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 14/12/2021 To 13/06/2022

Signature and Designation of


the Licensing Authority
Warning: RTO, AZAMGARH

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.

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