TRANSPORT DEPARTMENT

RTO, LUCKNOW
FORM 3
[See Rule 3(a) and 13]

LEARNER'S LICENCE
Fee Details Rs.350.0/- /UPU/2615873 /20-07-2021 ApplNo: 2309061721 Issue Dt. 07-08-2021

1. Licence No. UP32 /0044416/2021

2. Name SAKSHAM YADAV

3. Father's Name SHASHI KANT YADAV

4. Date of Birth 01-10-2002

5. Optional/Blood Group- Unknown

RH Factor

6. Present Address HINDU KHERA KANPUR ROAD AMAUSI

LUCKNOW,UP,226008
Holder's Signature
7. Permanent Address HINDU KHERA KANPUR ROAD AMAUSI
LUCKNOW,UP,226008

8. Marks of Identification (1)

(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:

LIGHT MOTOR VEHICLE, Motor Cycle with Gear(Non Transport),

..........................................................................................................................................................

*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 from 07/08/2021 To 06/02/2022

Signature and Designation of

the Licensing Authority
Warning: RTO, LUCKNOW
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.