FORM P. CO. P.A.

[(See Rule 71(1)(ii)]

Application for a permit in respect of a contract carriage to be
Regularly so used
( Taxi/Authorickshaw/Tourist Taxi/Air Conditioned Contract Carriage)
*(Strike out which is not application)
To
The Dy./Asstt. Regional Transport Officer……………………………………………………………………………………
In the accordance with the provisions of Sections 69. 70 and 71 of the Motor Vehicles Act. 1988
The undersigned. Hereby apply for the permit under Section 66 of the Act in respect of a Contract Carriage as
hereunder set out :-

1. Full name of applicant/Company …………………………………………………………………………………………….

………………………………………………………………………..(Surname)………………………………………..(Name)
……………………………………………………..(Father/Husband’s name)……………………………………………….
2. Age
3. Full address H. No………………………………………. Name of………………………………………………………….
Road/Line……………………………………………………………… Name of……………………………………………..
………………….Locality………………………………………………………………..Town/City…………………………..
………………………………….Pin……………………………………………….
4. Telephone No.
5. area or route for which permit required :
6. Seating Capacity :
7. The Type of Vehicle (Bus/Car/-R/A-C Bus/ imported Car)
8. Arrangements made for customers to contact permit holder. Office and Phone number.
9. Particulars of any stage carriage or contract carriage or contract carriage permit valid in the
State or any other and held by the applicant in respect of :-
(a) this vehicle
(b) any other vehicle
10. Particulars of any permit held be the applicant in respect of the use of any transport vehicle in
Any State during the last four years which has been the subject of any order of suspension or
Cancellation:
11. ** I am in possession of the Vehicle. The Certificate of Registration of which is enclosed.
12. **I have not yet obtained possession of the vehicle and I understand that the permit will not
Be issued until I have done so and have produced the Certificate of Registration and further
Declare that I propose to purchase a vehicle manufactured in the Year:
13. ** I intend to drive the vehicle No………………………………. My M.D.L. No………………………………
………….. P.S.V.A. No ………………………………………………………………………………………..issued
By ………………………………………………………
14. I hereby declare that the above statements are true and agree that there shall be conditions
Of any permit issued to me.

Dated ……………………..20…..
Place……………………….. Signature or thumb - impression of the applicant.