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FORM 3

[See Rule 3(a) and 13]

LEARNER'S LICENCE

3079313421
Application No...................................

Learner's Licence KL45 /0007245/2021 16-09-2021


Issue Date......................

1. Name : ANJANEY A B

2. Father's Name BINOJ A K

3. Date of Birth : 23-08-2003

4. Blood Group(Optional) : A+ Spicemen signature/ thumb impression of


the holder of the of the
ATHIKAVIL HOUSE VELLANI KARALAM,680701
5. Present Address/
Permanent Address :

ATHIKAVIL HOUSE VELLANI KARALAM,680701


6. Temporary/Official(if

Marks of Identification : 1.
7.
2.

is licenced to drive throughout India as a learner subject to the provisions of rule 3 of


the Central Motor Vehicles Rules 1989, a motor vehicle of the following description
MCWG, LMV,

*The holder of the licence has passed the medical test under rule 5 and the preliminary

*The holder of the licence is exempted from medical test under rule 6 and from the
preliminary test under rule 11(2) of the Central Motor Vehicles Rules, 1989.
This Licence is valid from : 16/09/2021 To 15/03/2022

* Strike off whichever is inapplicable

Signature of the Licencing authority

Warning: The attention of the holder of this licence is drawn to rule 3 of Central Motor vehicle 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.
DL Test Schedule
Sl.No Class of Vehicle Date and Time Venue

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