APPLICATION FOR VEHICLE PASS, BCPL (DIBRUGARH)

To
THE DEPUTY COMMANDANT
CISF UNIT BCPL DIBRUGARH

SUBJECT: ISSUE OF VEHICLE PASS REGARDING

Required particulars are given below with a request to issue vehicle pass please.

01 Name of the owner of vehicle

02 Vehicle Regd. No
03 Vehicle Model
04 Engine No
05 Chassis No
06 Road Tax valid up to
07 Insurance valid up to
08 Fitness valid up to
09 Driver’s Name
10 Driving License No
11 Driving License valid up to
12 Vehicle(on contract/company/Employees)
13 Hire/Contract period From: To:
14 Permission required From To:

Applicant’s Signature : ___________________________________________

Name : ___________________________________________
I/D Card No & Designation: ____________________________________________
Name of Company : ____________________________________________

Recommendation of RCM/Site I-Charge of concern Company

Recommended by concern Department of BCPL

CISF PASS SECTION