TRANSPORT DEPARTMENT Uttar Pradesh

RTO, MORADABAD
FORM 3
[See Rule 3(a) and 13]
LEARNER'S LICENCE

Fee Details Rs.350.0/- /UPH/2722388 /23-11-2018 ApplNo: 2920149518 Issue Dt. 19-12-2018

1. Licence No. UP21 /0020432/2018

2. Name ANSHUL KHANNA

3. Father's Name RAJESH KHANNA

4. Date of Birth 18-08-1995

5. Optional/Blood Group- Unknown

RH Factor

6. Present Address GALI NO 2 MILAN VIHAR MORADABAD (M

CORP.) Moradabad,UP,244001
Holder's Signature

7. Permanent GALI NO 2 MILAN VIHAR MORADABAD (M

CORP.) Moradabad,UP,244001

(1)
8. Marks of Identification
(2)
is licenced to drive a Motor Vehicles of the following description through out 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 Centeral Motor Vehicle Rules 1989:
Motor Cycle with Gear(Non Transport), LMV-NT,
.......................................................................................................................................

*The holder of the licence has passed the preliminary test referred to in rule 11(1) of the CMV
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 Vehicle Rules,1989

*Strike off which ever is inapplicable

This Licence is valid 19/12/2018 To 18/06/2019

Signature and Designation of

the Licensing Authority
Warning: RTO, MORADABAD

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.