FORM 3
[See Rule 3(a) and 13]
LEARNER'S LICENCE
1412958822
Application No...................................
Learner's Licence KL46 /0005813/2022 18-04-2022
Issue Date......................
1. Name : NIVEDH C S
2. Father's Name SURENDRAN C R
3. Date of Birth : 31-03-2004
4. Blood Group(Optional) : AB+ Spicemen signature/ thumb impression of
the holder of the of the
CHEMMANGATTU VALAPPIL HOUSE AMALA NAGAR PO CHOORAKATTUKARA,
5. Present Address/ PUZHAKKAL,680555
Permanent Address :
CHEMMANGATTU VALAPPIL HOUSE AMALA NAGAR PO CHOORAKATTUKARA,
6. Temporary/Official(if PUZHAKKAL,680555
Marks of Identification : 1. A BLACK MOLE ON THE CHIN
7.
2. A BLACK MOLE ON THE FOREHEAD
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
LMV, MCWG,
*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 : 18/04/2022 To 17/10/2022
* 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