Government of Andhra Pradesh

Transport Department
FORM 3
[See Rule 3(a) and 13]
LEARNER'S LICENCE
LLR number. AP204/0002529/2022 Date: 13-09-2022 Appl No: 3614246022

1. Name PALLA VENKATA SURENDRA

2. Son/Wife/Daughter PALLA SUBBARAYUDU

3. Date of Birth 18-10-1990

4. Optional/Blood Group- B1-

RH Factor

5. Present Address 6/92 ARTS COLLEGE ROAD Proddatur

Cuddapah Andhra Pradesh,516360

6. Permanent Address 6/92 ARTS COLLEGE ROAD Proddatur

Cuddapah Andhra Pradesh,516360

(1) A BLACK MOLE ON THE RIGHT SIDE

7. Marks of Identification
OF THE CHEST
(2) A BLACK MOLE JUST BELOW THE
LEFT SHOULDER
is licenced to drive a Motor Vehicle of the following description throughout India and in case of E-
rickshaw or E-cart, in specified areas or routes, as a learner, subject to the provisions of rule 3
of the Central Motor Vehicles Rules 1989.

Motor cycle without Gear (Non Transport),

.......................................................................................................................................
*The holder of the licence has passed the medical test under rule 5 and the preliminary test
referred to in rule 11(1) of the Central Motor Vehicles Rules,1989.
*The holder of the licence is exempted from the medical test under rule 6 and from the
Preliminary test under rule11(2)of the Central Motor Vehicles Rules,1989

This Licence is valid from 13/09/2022 To 12/03/2023

Digitally Signed by Addl Licensing

*Strikeoff which ever is inapplicable Authority
Warning: RTA PRODDUTUR
The attention of the holder of this licence is drawn to rule 3 of CMV Rules, 1989, which prohibits
him from driving any motor vehicle unless he has besides him a person duly licenced to drive the
vehicle and in every case , the vehicle carries "L" plates both in front and in the rear of the vehicle.
Note:
a. This is a computer generated Document. No signature is required.
b. This Learners Licence is issued based on the Information and declaration submitted by the
applicant with regards to his/her physical fitness to drive a Motor Vehicle and liable for cancelation
if found incorrect/ unfit to drive.