GOVERNMENT OF INDIA

DEPARTMENT OF ATOMIC ENERGY

KALPAKKAM
APPLICATION FOR VEHICLE PERMIT
DEPARTMENTAL (IGCAR)
Renewal New √

1. Name of the Applicant (in block letters) NIKUNJ SOHAN ATMAPOOJYA

2. Father’s Name SOHAN ATMAPOOJYA
3. Age 28
s Sex Male
4. Identity Card No. 10916
Designation Scientific Officer D

5. Home Address 1603, Mullai, DAE Township, Anupuram

6. Section in which working FRPDS/PDTSTD/RpOG/RpG

7. Identification Marks Mole on right bicep
Mole on left bicep
8. Vehicle registration No. TN 19 BT1823
9. RC Book No. TN 19 BT1823
10. Name and Make of the vehicle RE Classic 350
11. Driving Licence No.( two wheeler ) MH40 20130016627
( four wheeler ) MH40 20130016627
Valid up to. 09/07/2033
12. Previous Vehicle Permit No.
--
(Should be attached with the application)
Valid up to --
13. Vehicle Insurance paid upto 23/08/2028
14. Road Tax paid up to Life time
15. Particulars of additional members travelling with the vehicle permit holder
(for the purpose to pass through Main Gate/KKM Gate only)
Sl. No. Name Age Relationship
- NIL - -
Signature of the Applicant
(for departmental)
Recommended and forwarded to issue Security Vehicle Permit

Signature & Designation of

Division Head with Seal

FOR SECURITY SECTION USE

Vehicle Permit No.

Valid Date up to (Date)

ASSTT. COMMANDANT
(for COMMANDANT)
Note: Driving License and RC Book may be submitted to the Pass Section for scrutiny (Renewal and New Issue).

VARAM