BANGALORE METROPOLITAN TRANSPORT CORPORATION

(Students Concessional Bus Pass Application)

To be filled in Block letters

Full Name: ……………………………………………………………… Affix a recent

DoB:……………………….…………Age:…………………… stamp size
Gender: ……………………………… Photo of the
Present Postal address:……………………………………………………….……… applicant with
Door #:………………………… Street:…………….. seal & sign of
Locality:……………………….pin code:……………. institution
Name of the Parent/guardian: …………….
Permanent address………………... Contact Tel.No: ………………..
………………………………. Email Address: …………………
………………………………. Aadhar No……………………… (If available )

Student’s Requirement : Ordinary pass / Travel as you like pass / Renewal / Extension
Travel Details
Class:…………………….. Educational Institution:…………………
From:……………………… To:………………………
Place of Changeover:……………………………………….....Distance (in KM)………………..
Validity Period: ……………. …. to…………………

Signature of Parent/Guardian Student’s Signature

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Certificate from Educational Institution

The above information furnished by the student studying in our Educational Institution is true as
per our record.

Student’s Registration No: Signature of Head of the

Institution with seal & Date
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Terms& Conditions
Production of the following document is compulsory :
1) Original fee Receipt for the current academic year.
2) Identity Card issued by the Educational Institution.
3) 2 Photo 4) Copy of the Aadhar Card ( If available please enclose)
Rules to be followed
Pass not transferable – to be produced for inspection on demand by BMTC authorities -
Rs.100/-+ fee for the balance validity period to be paid for obtaining Duplicate Pass after due Police
formalities in case of loss during the validity period.
Office use only ( To be filled in by the official deployed for scrutinizing pass application)
Total distance travelled by student in KMs ______________
Total stages travelled by Student _______________________
Examined person name & signature