FORM 3
[See Rule 3(a) and 13]
LEARNER'S LICENCE
3096808020
Application No...................................
Learner's Licence KL31 /0002637/2021 11-02-2021
Issue Date......................
1. Name : GOPALAKRISHNAN K
2. Father's Name K KUNJURAMAN
3. Date of Birth : 08-10-1956
4. Blood Group(Optional) : B+ Spicemen signature/ thumb impression of
the holder of the of the
THACHAN PARAMPIL KARIMULACKAL KOMALLOOR P O CHUNAKKARA
5. Present Address/ Mavelikkara,Alappuzha,KL,690505
Permanent Address :
THACHAN PARAMPIL KARIMULACKAL KOMALLOOR P O CHUNAKKARA
6. Temporary/Official(if Mavelikkara,Alappuzha,KL,690505
Marks of Identification : 1.
7.
2.
is licenced to drive throughout India as a learner subject to the provisions of rule 3 of
the Central Motor Vehicles Rules 1989, a motor vehicle of the following description
MCWOG,
*The holder of the licence has passed the medical test under rule 5 and the preliminary
*The holder of the licence is exempted from medical test under rule 6 and from the
preliminary test under rule 11(2) of the Central Motor Vehicles Rules, 1989.
This Licence is valid from : 11/02/2021 To 10/08/2021
* Strike off whichever is inapplicable
Signature of the Licencing authority
Warning: The attention of the holder of this licence is drawn to rule 3 of Central Motor vehicle 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.
DL Test Schedule
Sl.No Class of Vehicle Date and Time Venue