FORM 3

[See Rule 3(a) and 13]

LEARNER'S LICENCE

1963868223
Application No...................................
KL55 /0017337/2023
Learner's Licence No............................... 05-07-2023
Issue Date......................
1. Name : MUHAMMAD JUNDUB M V

2. Father's Name ABDUL KAREEM MADAMK UZHI

VADAKKETHIL
3. Date of Birth : 14-05-2005

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

the holder of the of the Licence
5. Present Address/ MADAMKUZHI VADAKKETHIL HOUSE PAZHUR P O Tirur,Malappuram,KL,679571
Permanent Address :

MADAMKUZHI VADAKKETHIL HOUSE PAZHUR P O Tirur,Malappuram,KL,679571

6. Temporary/Official(if any):

7. Marks of Identification : 1. A BLACK MOLE ON THE RIGHT EYEBROW

2. A BLACK MOLE ON THE RIGHT HAND

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, MCWG,

*The holder of the licence has passed the medical test under rule 5 and the preliminary
test referred to in rule 11(1) of the Central Motor Vehicles Rules ,1989.

*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 :05/07/2023 To 04/01/2024

* 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