Form 3 [see Rule 3(a),13] is licenced to drive throughout India as a learner subject to the

LEARNER LICENCE provisions of rule 3 of the Central Motor Vehicles Rules 1989, a motor
LL No. : MH49 /0000878/2022 DOI: 04-01-2022 vehicle of the following description
Name : KARAN PRABHAKAR MANGATE ...........................................................
MCWG,
Father's Name PRABHAKAR MANGATE This Licence is valid from 04/01/2022 to 03/07/2022
Address : NEAR BANGALI AATAA CHAKKI PLOT *The holder of the licence has passed the medical test under rule 5 and
NO.49/B MANAV NAG Uppalwadi S.O from the preliminary test referred to in rule 11(1) of the CMV Rules
Nagpur Maharashtra,440026 ,1989.
*The holder of the licence has exempted from the medical test under
Temp. Add : NEAR BANGALI AATAA CHAKKI PLOT rule 6 and from the Preliminary test under rule11(2)of the Central Motor
NO.49/B MANAV NAG Uppalwadi S.O
Nagpur Maharashtra,440026
Vehicle Rules,1989

D.O.B. : 26-02-2002 B.G. : Unknown

Identification Marks :
MOLE ON RIGHT SIDE CHEST Application No: 53915522
(Sign/Thumb Of Holder) Licence Authority