FORM K.M.

V 15 FORM OF AN APPLICATION FOR RENEWAL OF CONDUCTORS LICENCE I hereby apply for a renewal of the Conductors Licence No.. under the Karnataka Motor Vehicles Rules, 1989 which is due to expire / has expired on.and was issued to me on The .. day of. ..19 , by the Licensing Authority .

I hereby declare that I am not subject to any disease or disability that is likely to hamper me in the performance Of my duties as a conductor of stage carriage.

Dated:

Signature or applicant.