Department: Transport

APPLICATION FOR DRIVING TEST

(Marked Fields are mandatory)
(*চিহ্নযু ক্ত তথ্যব োৰ োধ্যতোমূ লক)
*Language of the Certificate English Assamese Bengali Bodo
( )

Applicant Details
*Applicant's Name ………………………….
*Applicant's Gender Male Female
*Applicant's Mobile No ………………………….
Applicant Email Id ………………………….
Aadhar Number ………………………….
PAN Number ………………………….
Relationship ………………………….
Relative Name ………………………….
Official Address ………………………….
*Date Of Birth ………………………….
Educational Qualification ………………………….
Identification Marks ………………………….
Blood Group/ RH factor ………………………….

Permanent Address Details

*State (ৰোজ্য) ………………………….

*District(চজ্লো) ………………………….

*Sub-Division (মহকুমো) ………………………….

*Circle Office(ৰোজ্হ িক্র) ………………………….

*Village/Town(গোওঁ/নগৰ) ………………………….

*Police Station(থ্োনো) ………………………….

*Post Office(ডোকঘৰ) ………………………….

*Pin Code(চিন নং) …………………………. (e.g 78xxxx)

Signature of the applicant

(আব দনকোৰীৰ িোক্ষৰ)
 Department: Transport
APPLICATION FOR DRIVING TEST
Present Address Details
*State (ৰোজ্য) ………………………….
*District(চজ্লো) ………………………….
*Sub-Division (মহকুমো) ………………………….
*Circle Office(ৰোজ্হ িক্র) ………………………….
*Village/Town(গোওঁ/নগৰ) ………………………….
*Police Station(থ্োনো) ………………………….
*Post Office(ডোকঘৰ) ………………………….
*Pin Code(চিন নং) …………………………. (e.g 78xxxx)
Other Details
Police Verification Report Issue No ………………………….
Whether previously held driving license Yes No
Details of previous Driving License Details ………………………….
Whether previously disqualified for obtaining driving license Yes No
Reason for previously disqualified for obtaining driving license ………………………….
Learner License No ………………………….
Date Of issue of Learners License ………………………….
Driving Certificate No ………………………….
Date of issue of Driving Certificate ………………………….
Driving Test is applied for Non-transport Category
Motot Cycle With Gare(MCWG)

Motot Cycle Without Gare(MCWOG)

Light Motor Vehicle Non-Transport(LMV-NT)

Three Wheeler Non-Transport(3WNT)

Driving Test is applied for Transport Type I Category

Motot Cycle With Gare(MCWG)

Motot Cycle Without Gare(MCWOG)

Light Motor Vehicle Non-Transport(LMV-NT)

Three Wheeler Non-Transport(3WNT)

Signature of the applicant

(আব দনকোৰীৰ িোক্ষৰ)
 Department: Transport
APPLICATION FOR DRIVING TEST

Driving Test is applied for Transport Type II Category

Heavy Motor Vehicle(HMV)
Public Sector Vehicle(PSV)

Date of Test Testing Result of test Action

Authority(Name,
Address)

Attachment Section
1. Any other document
2. *Upload Scanned copy of Application Form.

Signature of the applicant

(আব দনকোৰীৰ িোক্ষৰ)