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Form 3 [see Rule 3(a),13] is licenced to drive throughout India as a learner subject to the

LEARNER LICENCE provisions of rule 3 of the Central Motor Vehicles Rules 1989, a motor
LL No. : MH05 /0121612/2022 DOI: 27-12-2022 vehicle of the following description
Name : DINESH THOKALE ....................................................................
MCWG,
Father's Name TULSHIRAM THOKALE This Licence is valid from 27/12/2022 to 26/06/2023
Address : 404 TEJASHREE APARTMENT OLD *The holder of the licence has passed the medical test under rule 5 and
DOMBIVLI ROAD NEAR VAIBHAV from the preliminary test referred to in rule 11(1) of the CMV Rules
MANGAL KARYALAY DOMBIVLI WEST ,1989.
Kalyan,Thane,MH,421202 *The holder of the licence has exempted from the medical test under
Temp. Add : 404 TEJASHREE APARTMENT OLD rule 6 and from the Preliminary test under rule11(2)of the Central Motor
DOMBIVLI ROAD NEAR VAIBHAV
MANGAL KARYALAY DOMBIVLI WEST
Vehicle Rules,1989
Kalyan,Thane,MH,421202
D.O.B. : 10-12-1976 B.G. : Unknown
Identification Marks :
Application No: 5005686222
(Sign/Thumb Of Holder) Licence Authority

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