Forma TTT MT rulos 10, 14, 17 and 19] Ses Saas 7 ‘Appl No:80085425 Dt06-01-2025 Ise Foim of Appeation for Lea's Licance Or Diving Licanco Or Acton ofa Now Class of Vehicle Or Renowal of Driving Liconeo Or Chango of Ades Or Name To ‘Tne Licencng Authorty DY.RTO,SANGLI ‘Service applying for (Please Tick V mark against single or multiple service, wherever applicable) nave of Now Leamer's Licence v Insue of New Driving Linco ‘Aton of Claas of Vehicle fo Dvng Licence Renewal of Driving Licence Duplcate Driving Licence (Change / Corracton of Address in Driving Licence (Change / Correction of Name in Driving Licence 4. Class of Vehicles (COV): Applicable for New Leamer's Licence of New Driving cence Motor Gyele Without Gear (MCWOG) Motor Cyele With Gear (wcws) LghtMotor Vehicle as Nen Transport (MV NTV) Adapted Vehicle (vehicies for use by Diane) Mecium or Heavy Goods or Passenger Vehicle as Transport Vehicle E-Rickshaw E-Cart ‘thers; whieh snot covered in any ofthe above categories including, Harvester, Excavator, Fort Tales, (Crane mounted vencles, Agreuloral actor ana power ler, Taw tucks, Breakdown Van ana Recovery ‘vehicles, Consinucton equipment venicls Explanation = 1. Non Transport Vehicles include MotorCycle wh or without aldecar or personal use, Mopeds, Three Whasled vehicles for personal us, Motor Car fr parsonal use, Fork Lit 2 “Transport vehicle incides a public service vehicle, a goods carriage, an educational nsistion bus or prvala service vet: 3. Light motor vehicle includes a transport vehicle or omnibus the gross vehicle weight of ether of which or a motor car or tractor or roadsole the unladen weight f any of which, does not exceed 7.500 kilograms 4 Medium goods vehicteinctudes any goods carage ther han a ight motor vehicle or @ heavy goods vehicle; 5 Heavy goods vehicle includes any goods carage the gross vehicle weight of which, ora tractor ora roadolr the unladen weight tf ether of which, exczed 12,000 klograme,2, Personal details ofthe Applicant (in Capital Lettrs) /AppINo'80085425 D06-01-2025 VU TLV applica Detas of Aadhar card, aready avaiable with he ‘Aadhar Card number Not Fumished Detas of Aadharapptieation number applied ‘Aadhar Gard aplication number renee Wiad Name TastName TANARDEEP JALNDAR PAWAR Soni wl Saughterct = JALINDAR SAPUSO PAWAR beneaton mark ender ate a ety Me Female [] Transgender [] 07-04-1999 ree) (eam) Eeuegtona Diploma in any Discipline Soot Group a (cptana Notte umber 2000000721 anne Number optora 3.Name offTick Y) Father [¥] Mother [] Husband [_] Guardian [] FirstName le Namo Lastname JALINDAR aAPUSO PAWAR 4. Addross (proof to be enclosed, incase of New Learners Licence of New Driving Licence or Change of Address) sreatacanyevies an Pawar maa Ta pls Banbovade Pawar le Tata pats estonia Bambavede Sangli Moharashta | Barbovae Sang Mahereahia owt songt sovgt‘Aopl No-soossa2s oros-o1-2025 TURIN NINN THI 5. In case of request for Adltion of a Class of Vehicle in Transport Category, please fil the folowing: Driving Sehool Name Enrolment number inthe Diving Scho Enrolment date in the Diving Schoo! CCortcato number isued bythe Driving School CCntcate date a issued by the Driving Schoo “Traning pero in the Orving Schoo! From date Tosato 6. Particulars of existing Licance (i LUonee Number Chass of Voices) Name ofthe Lcencing Autonty which issued the Licence Vality Period From date To date l 1 List of Documents attached (Please refer to the attached annexure and tick) Self-Declaration as to Physical Fitness ()Do you sue fom epilepsy, rom sudden attacks of loss of consciousness or gidiness fom any cause? No (&) Are you able to astingush with each eye (ori you have held civng Heence to crive a motor vehicle fora period of Yes hot os than five yeas ae if you Fave os th sight of oe oye afer tho sid period of five years and fhe application Is For dving a ight motor verte oer than a anspor vehicle ited with an outuge moron the steering wheel side) or Wit one eye, ata cstance of 25 metres in good ay ligt (win glasses F wom) amotor ear number plats? {6} Have you lost ether nand or foot rare you suring fom any defectin movement, contol or muscular power af ther No arm orleg? () De you sue fom night bindness ? No {) Are you so deat a o be unable to hear (and if the application i for evng @ ight motor vehicle, wah or without No hearing a) the orcnaryeound signal? (D0 you ster rom any other disease or aeabilly tke lo cause your driving ofa motor vehi to bea source of danger No tothe publ, Iso, gve deta? DECLARATION am iting t donate my ogantissue incase of death No |declare thatthe fe stated above and documents submited are true and genuine tothe bes of my knowledge and bol, |also state that havel have notbeen dequalied rom holding a Drving Loence. ied through Aadhaar authentical (Ate Date: 06-01-2025 ‘Signature ofthe Applicant DECLARATION under sub-section (2) of section 7 of the Motor Vehicles Act, 1988 ‘ShiSmtKuma Not Applicable sontaughtr of Not Applicable \aho Isa minor i under my care and Lacept responsibilty for hither deving, at alates date I decide nto accep esponsibilty for his her | shal for he ening shorty in witng forthe cancelation of te Hoenes! give my consent for his her obtaining he leas leence Name of he parent/guardian Not Applicable Relationship withthe appbcant: Not Applicable Signature ofthe parent / guardiFOR OFFICE ust E ONLY TUT ‘Appl No:80085425 Dt 06-01-2025 1. The applicant AMARDEEP JALINDAR PAWAR is exempted from production of a medical certificate under Rule 6 of the Central Motor Vehicles Rules, 1989; Lear's ieonce may be issued. YESINO 2. ‘The applicant AMARDEEP JALINDAR PAWAR is exempted from the Preliminary Test under sub-rule (2) of Rule 11 of the Central Motor Venicies Ruk Lene’ Heonce may be issued es, 1988; YESINO 3. Preliminary Test to check adequate knowledge and Understanding ofthe matters namely Valle sighs, trafic signals, duties of driver in ease of his vehicle being involved in an accident, or documents to be carieg while driving etc. Subrule (1) of Rule 11 ofthe Central Motor Vehicles Rules, 1989 (Name:AMARDEEP JALINDAR PAWAR) Date of Test, Resutiv ) Testing Authorty ass Fall/ Absent Exompied Dring Test Rule 16 of 1989), Cental Motor Vehicles Rules, Date of Ta Resut Pass Fal tsome rotated] ‘Signature of leensing authorty (or atver person ‘authorised in es bohal)TALE ANNEXURE ‘App No:80056425 0106.01 LIST OF DOCUMENTS TO BE SUBMITTED OR UPLOADED BY THE APPLICANT Proof of Address and Age. (Select only one ithe proofs commen for Aderess and Age) 1. Aachar Cara 3. Lite nsurance Policy 4. Passport 5. School Ceriiale ©. Binh Corcate Pay sip taued by any ofice of the State Government or Central Government of alocal Body Alfa wom bofore an Execuive Magia or Notary Public o First Chas xcial Magistrate 8. A cortiiate grants by @ Registered Medica Pactitoner not below the rank of Cd Surgeon as tothe age ofthe Applcant 10. Any ter document or documents as may be specified by Stale Government ‘Other documents tobe enclosed or uploaded if applicable 1. Saf Declaration for Physical Fitness in Form = 4 2. Medical Certificate Form- 1A (lobe provided ithe applicant is apphing for renewal and is above 40 years of age or apphing for Transpo Licence) 3. riving Cortfcate issued by Osving School or Establishmonts in Form 5 4 Parent or Guardian Declaration n case of appleant whe i a minor 5. Photograph 8. Vall proof of passport andvis (for Inerational Driving Permit only) Proof of agal presence in nc inaction to proof of residence in case of Foreigners 8. Other documents, any 8. The copy of peice complaint mada(n cas the Driving Licence was les or mutated ord 4 or damaged, bs) 10.For change of name. (2) Existing name (0) Name tobe changed as (© Documents enclosed 0 Asfaavt swom before a Fist Class Judea Magistrate or a Notary Pubic (9 Mariage corineate Copy ofnewspaper advertisement 1025 O0oo0.000o00da OO oo0g00 oa ood