FORM 3

[See Rule 3(a) and 13]

LEARNER'S LICENCE

Fee Details Rs.350.0/- /HRW/465017 /27-08-2023 ApplNo: 3313259223

1. Licence No. HR98 /0009675/2023

2. Name PRIYANSH VASISTHA

3. Guardian Name SANJEEV VASISTHA

4. Present Address 2401, TOWER-5 M3M THE MARINA
SECTOR-68 Badshahpur Gurgaon
Haryana,122101

5. Permanent 2401, TOWER-5 M3M THE MARINA

SECTOR-68 Badshahpur Gurgaon
Haryana,122101
6. Date of Birth 14-08-2002 Holder's Signature

7. Optional/Blood B+
Group-RH Factor

8. Marks of Identification (1) INJURY MARK ON NOSE

(2) MOLE ON NECK ON RIGHT SIDE

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

LMV,
.......................................................................................................................................

*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 has exempted 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 01/09/2023 To 29/02/2024

Licensing Authority
Warning: GURUGRAM(BADSHAHPUR) HR-
98
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.