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Œ Œ 7 S" ? )" w #$" " B N7 & 5 $ ( ।
(2) 4 T"$" S" ? )" w ( 8 T"$" S" ? )" w (7 " 8& D
$" B $&(" -"@" 'V N7 Å B( (R )-2(‡) 4 T 7( 8 T"$" @") $
;e ! 7" ( 4 ( c f , ) ‡( B&", P( "- 7 ( ।
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A Z" > ।
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$ " B 8 " " B&", 4 T> ( "।
16। S" ? )" w #() x\ ।( ) S" ? )" w " " ," 83 ) " U
) )" w # ( ) E %") ;e )" w!" B 8&D'(, R '- (‡) 4[-",B "
) K '"y ' (R )- 7( R )" w " $ E ¥‡Œ 7 8- )" w
#$" " B N7 & N7 )" w x\ " ," C 4. " E " 7 Tf 8 9 7€c " ," C
Ec )" " )" w #$" " B N7 & " $ D $" ‡) ।
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V 4[ ) $ D ( bc ( ।
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' y S" ? )" w #$" ।
17। 3 @")" " 4[' ( D ( V ), (\" $।( ) 3 @")" "

;e, !" " ¦ !" 8'"(" , # (\ @") (" " S" ? )" w 4( c "
)" w #$" " B N7 & 5 ( R '-— 7( 4[' ( D > ( ।
( )E - !( ) 7( 4[' ( D ;e R '- 4[-",B $ (
E " ( * 7( $ ))" $ bc ( , -.":
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‰ 4 ?²(" ." ( X"q #'" D $ D ( bc (
।
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7( 3 @")" " $" ,m : (7A ‚ 7 ²"( ." ( :
( T(7 ." 8-, 8- ) #".l ?" B 8'"5 -" @")" " )" w 4¯\ 2 (h )
‰ 4 ?²(" ," C (" " Ec B&", 4 T> ( "।
(¦) $ D ¤ ":," 83 ) )" w #$" " B N7 &, $T7 *
" )" $T ¶ ) T + ( ) ; # ( ! : 8'"5 -" $T7 '´ , 3¤( 3 ( ( )
$³ 'V #".l 8-"d(" -"@" ।
(—) 8-"d(" -"@" B&", E%B 7 #".l 4[Ä ) )" w #$" " B N7 & 3
@")" " 4[' ( D #$" ।
( ) 3 $" ,m ") " ) @") 4[' ( D & žU
N7 & N7 @" "'"D E " #$T7 ।
18। T" B # ( •B A c )" w #" { "'¡7 -"@" L (।- 7( ;
T" B # ( •B A c * 7( T" B B'" L(" ." ) # ( •B "• 8'"5 -" @")" "
S" ? )" w " " ;e $ ( " & D S" ? $&(" -"@"
'V ' '7 ”U 8- $ " B
( ) # ( •B "• 8'"5 -" @")" " E bc;
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" # ( •B "• 8'"5 -" @")" ( &'।
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)" w #$" " B N7 & 8 " " A c S" ? )" w Z 3( ( " -$ E "
5 #(B,'" , " •" " b c À( " ." 8-, 4. " N7 & " )" w
#$" " B N7 & - $ &'("#"{ '7@" B N7 4 ? -"3 #"{ , 8-, 8 " " )" w!" B A c
( ) 4xZ;
(‡) 8 " " " , 8'"5 -" @")" ( 4 -"d " 4&';
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A. 7 ," C ;
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," C ;
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(s) Ì7( " ; 8'"5 -" A " ," C ; "
( ) " " N7 & N7 ', ', ;" BP( 8 " " $T, D "
B ('")" )Í ," C ।
( ) E - ! ( ) 7( " 8 " " A c 4 ?bc ) Ec 4 ?bc A c
Î & '. 7 '% cA #$" ;e R '- 7( 8 "VT #$" ( ।
(˜) 8 "VT #" { 7 ( "() '7 $ ' y 4 ?bc A c ) ‡( ; " " cA
#$" x -"3 $" È " 4 q 4 ? -"3 #'" ( ) N7 & " )" w #$" " B
N7 & (" " S" ? )" wV Z 3( ( " ।
( ) )" w #$" " B N7 & Z 3 ( f,V žU 8 ;¢" ) L ,"
4 ?bc A c ) ‡( " ) K '"y ' 4 ( )" w Z 3 ( -
( ) 8',"$ 7"® 1 ( ) ‰ ;
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( " ;
(3) žU A c S" ? )" wV S" ? )" w #$" " B N7 & 5
' 7 ( ।
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(3) '"$ " c;
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,n " " ," C ;
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(—) E - ! (¦) 7( " 8 " " A c 4 ?bc ) Ec 4 ?bc A c
Î & '. 7 '% cA #$" ;e R '- 7( 8 "VT #$" ( ।
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#(\" " " " () ( " ।
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8 ;¢" ) L ," 4 ?bc A c ) ‡(?" " ) K '"y ' 4 ( ।
(¨) S" ? )" w " ( ) žU A c S" ? )" wV S" ? )" w
#$" " B N7 & 5 ' 7 ( S" ? )" w " ( ) 8& D 1 ( )
‰ 4 (X"q " ) žU A c ¯( S" ? )" w ;e $ ( "
"।
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$T #" { 30 ( DT) $ ' y 8- )" w #$" " B N7 & )" w Z 3(, #(\" "
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$ " B $ #" { 7 ( "() $ ' y 8 "VT #$" ।
( ) )" w #$" " B N7 & È " 4 q 4[ •" # ,"; ) 4[ •" Œ 7
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) ‡(?" " ) K '"y ' 4 ( (" " Œ 7 )" w ¶ ÉjB (
," (" " |"q ।
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( " ") ,n ( : (R )-R - 4!B 7( 4 "! 3_ " 8$"f·@
,n " (7 -"d -" " ) K L(( & ( ।
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? 9: @D > ," " 4e+ ?" 4 "! œ5 #'" & ( ।
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¶ ) T " - w W " " ;7n $'- 7"$" * , + '7@" B " Ó"µ'" $")(
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,n (7 f,V 8 9 7€c žU 8'"5 -" @") f,V 4 (
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(" " $ # & ( )" w #$" " B N7 & # ( 6 (C,) '" (7 P(
8$"f·@ ,n ( 2 (h ) ,n ," ¶ ÉL" Œ 7 "ƒP( , n -"; (
" ।
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,n ¶ ÉL" 8 " " $ > -"d "।
(¨) ,n (7 ;e 8 " " S" ? )" w " () # ,"; )8 8& D
! 19 7( L ( 4[ ( ।
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8'"5 -" @")" " ;e ; 8$ T -."-. N7 & N7 x\P( ") "3"$ S" ? )" w
žU N7 & 5 Ô†"Õ " ;e R '- ( ) 4[-",B $ ( " ।
( ) E - ! ( ) 7( $ D ( " "5 7 : ? " "Ö
'^ "),, u(" " , Ä5× ( 'T " # -";\ 8& D ] "Ö '^ "), N7 #$% x " T
$ T S" ? )" wV " )" " ; ?• 4e ?"f", ) ; 4[ " $
bc ( ।
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V ¯( S" ? )" w #$" ।
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", -"d " ( , E - ! (¦) 4[ ," ¯( )" w> ( " ।
(¦) 8 " " $ T "3 , -" " 8 " " S" ? )" w " , ( " )" $ T
8'"5 -" @")" " ;e N7 & 5 $ ( " N7 & ! 6, 8 :
9 4[ ," S" ? )" w #$" " Ec $ #(\"¿" ।
(—) $ T "3 $ S" ? )" w #$" 8& D m -5 - 7( R >
( :
( T(7 ." 8-, E - ! ( ) 7( $ T "3 $ 8& D S" ? )" w x\
: ", R # -";\ "।
( ) " )" $ T 4 Z( $ T Ä5× ( 'T (-."-u(" " , ) 3T
" 'T Ä5× ( : 4Ä5× ( ) A c 3 7 S" ? $&(" -"@" B&" (
4A" (#"{ :
( T(7 ." 8-, 'T '7 ( " )" $ T "3 $ ;e x !" # -";\
"।
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8 9 7€c । ! 19 4[-",B 8 " " S" ? )" w!" B 4 -"d 8œ"f " " (" "
S" ? )" w Z 3(, #(\" " " " () " ) (" " )" w #$" " B N7 & N7
&( S" ? )" w x\ 8 ;¢" ) L ( " ) K g 9"5" ;
& ( ।
N(B, 4y",
Š"W " x " ?" ;" )" w
23। Š"W " x " ?" ;" )" w #$" " B N7 &।( ) Š"W "
x " ?" ;" )" w #$" " B N7 & N7 & žU 4 ! & D E - @")
( š ," ) " " B @") ( š ," ) " N7 & N7 ' " B( 4e 8 " "
'7@" B।
( ) N7 & # ,"; 4!&D 'y "! '7@" B Š"W "
x " ?" ;" )" w #$" " B N7 & " &'(" #$" ( " ।
24। Š"W " x " ?" ;" )" w 'Ø T(7।8 " " A c !'")" 4!B
# -";\ 4e"e !" # ( ") " & * 7( T(7 # ( ") " (¡" $ E Z" " &
Š"W " x " ?" ;" )" w " , -.":
( ) , 4¯\ 20 ( T) ‰ ;
( ‡) Š" 5 8& D #". ' ±) "V 7 R 5 " ‘' 8z " ''" B&",
E%B 7 x " ?" ;" 8& D 4¯\ 4U' 8z " ° , ±) "V 7 R 5
(8; ) " ''" B&", E%B 7;
(3) m -55 4[-",B 8' 9 ) "V 7 R 5;
(œ) $&(" -"@" B&", E%B 7;
(I) ;"(B, @, D 4[ ) ;
(@) R #$" #'" " ;'" $ ;
(C) N7 & N7 @" (, # -";\ 8& D, 4e"e $ ))" $।
25। Š"W " x " ?" ;" )" w 'Ø ।(1) ! 4[-",B 8 " " A c
4 -"d " ) žU ' , Š"W " x " ?" ;" )" w !" "> "
4 -"d " ), ( 8- )" ", " " A " @") " 8 )" "
‡ (," ‚• Š"W " x " ?" ;" )" w #$" " B N7 & 5 Š"W "
x " ?" ;" )" w #$" ;e ) ‡(?" 4. " ) K '"y ' $ (
" ।
(2) Š"W " x " ?" ;" )" w ;e $ " B R '- 4[-",B $
( $ " B N7 R ' @" ( # ,"; B, (¡ ˆ 4 „ #$" (
।
(˜) Š"W " x " ?" ;" )" w ;e $ D ( R '- 4[-",B
8' 9 ) "V 7 R 5 $" ‡) ( ।
( ) Š"W " x " ?" ;" )" w #$" ", 8& D (R )- 7( R
#$" ( ।
(¦) R '- ˜( ) 4[-",B Š"W )" w R '- ˜(‡) 4[-",B x " ?" ;"
)" w x\ ( ।
(—) Š"W " x " ?" ;" )" w 8',"$ 7"® 5 ( ¼@) ‰ ।
26। Š"W " x " ?" ;" )" w ", , # ( ) (\" $।(1) Š"W "
x " ?" ;" )" w 8',"$ E%B 7 30 ( DT) $ Œ 7 R '-12 8'"(" ",
;e žU Š"W " x " ?" ;" )" w x\ " B N7 & 5 $ ( ।
( ) 8',"$ E%B 7 15 ( ") $ $ ) ˆ) R (#( ‰ "
E " 4 T ;e " f 7 R T( " ¦ (Ù @T) ?"3 4 ( c R " $", -"d
।
(3) Š"W " x " ?" ;" )" w " " ," 83 ) " U ) # ( ) E %")
;e )" w!" B R '- 4[-",B ", Mn , ) K '"y ' (R )- 7( R
)" w " $ E ¥‡Œ 7 8- )" w #$" " B N7 & N7 )" w x\ "
," C 4. " E " 7 Tf 8 9 7€c " ," C 8 )" " )" w #$" " B N7 &
" $ D $" ‡) ।
(R) 0 : 0 @ Mn o 6 p, 2 '-q2 0 -
J - C !b . n KL 0 ।
27। Š"W " x " ?" ;" )" w 'Ø 8& D 4 -"d("।(1) 20 ( T)
‰ ' ,Ú 8 " " A c Š"W " x " ?" ;" )" w !" ( " " "
4[+ 8 " " A c Š"W " x " ?" ;" )" w 'Ø " -" "।
(2) )" w #$" " B N7 & * 7( 8& D Š"W " x " ?" ;" )" w 'Ø
( 4]B " ( " , -.":
( ) -$ $ " B # ,"; B, 8-"d(" " ." ;
(‡) $ " B N7 $" ‡)P( @ ‰ " $ ( - $ #(B,'" , 8-, žU
A c Š"W " x " ?" ;" " "; " 4[ bc;
(3) - $ $ " B (Œ 7 #$% Š"W " x " ?" ;" )" w " S" ?
)" w #(\" " " ," ." ;
(œ) žU A c @ D : @ - $ Š"W " x " ?" ;" )" w !"
4[ bc )," @( ,।
28। Š"W " x " ?" ;" )" w ;e $&(" -"@" ।(1) žU 4 ! & D
Š"W " x " ?" ;" )" w x\ " B N7 & N7 ' " B( ( ) ; 8'"5 -"
$T7 Š"W " x " ?" ;" )" w ;e $&(" -"@" B&" > ।
( ) Š"W " x " ?" ;" )" w #$" " B N7 & #".l $&(" -"@" , ;e
E bc #".l $ (" ) " # , Œ 7 žU 8'"5 -" $T7 5 8# ।
(3) Š"W " x " ?" ;" )" w $&(" -"@" , '% 8'"5 -" $T7
' '7 Ã( 8-,
( ) #".l -."-. L ( ( $ ," C ;
(‡) $ " B (R )- 7( 8-"d(" -"@" B&" " $ R T"!
," C ;
(3) $ " B T" B : '" ]"Z\3( $ ( E bc;
(œ) $ " B )"À " 4À B : -" " Š"W " x " ?" ;" "
(" " (7A $&(" ( ‚"$ ( "!">| ;
(I) $ " B #". ' @ ‰ " A " ‚ 7 ;" ;
(@) ( Š"W " x " ?" ;" $" ,m : (7A ‚ 7 :
!'")" !" " ) f , 4 3( ," C ।
(4) 8'"5 -" $T7 $&(" -"@" B&", E%B 7 #".l $ (" ) " x " T "
)" w #$" " B N7 & 5 8# ।
29। A" !, Ym " 4 $"@ $É Š"W " x " ?" ;" )" w #(\" " "
" ()। Š"W " x " ?" ;" )" w #$" " B N7 & * 7( 8& D 60
b c À( r : 8- 8 " " ', 8 " " Š"W " x " ?" ;" )" w
#(\" " " " () ( " , -.":
( ) - $ + •" " b c À( " ." 8-, Š"W " x " ?" ;"
)" w!" B 8 " " A c + 8 " " A" ! " Y m € 3 ( C -" "
" Ec A c Š"W " x " ?" ;" )" w !" 4 -"d ,"
( " ;
(‡) Š"W " x " ?" ;" )" w!" B 8 " " A c @ D : @ -$ +
, 8-, žU A c Š"W " x " ?" ;" )" w !" 4[ bc
@( ( " ;
(3) - $ Š"W " x " ?" ;" " $" ,m : (7A -."-.?" ") "
," ." ।
30। Š"W " x " ?" ;" )" w #$" 4]BP (, (\" $ $T :
¶ 7 @ " $ ।(1) 8 " " Š"W " x " ?" ;" )" w #$" " B N7 &
8- & D Š"W " x " ?" ;" )" w #$" ( " ", ( 4]BP ( ²"
" )" w #(\" " , 8 & D Š"W " x " ?" ;" )" w #$" " B
N7 & ) ‡( $T ) Ec+ 4]BP ( ²" " )" w #(\" "
$ " B " )" w!" B Ec+ 4]BP ( " #(\" " " ) ‡(?" 4 (
।
(2) E - ! (1) 4[-",B #$% 8 " " $T r" " ÐÑ A c $T #" { 30 ( DT)
$ 'y žU N7 & 5 L"q ¶ 7 @ " ;e $ ( "
N7 & Ec A c (" " cA 8 T " x -"3$" ¶ 7 @ " $
f,V ¾ % $ " B 4 ( ।
31। Š"W " x " ?" ;" )" w #$" " B N7 & N7 4 -"d 8œ"f " "
&'("।(1) Š"W " x " ?" ;" )" w #$" " B N7 & - $ + 4 ?' ( E B(
, 8-, Š"W " x " ?" ;" " " " : @ $É (" " Š"W "
x " ?" ;" )" w !" "> 4 -"d " # ,"; , (" " ) N7 & " ) L
," Ec A c V $ 7U 8'," $ ;e Š"W " x " ?" ;" )" w !" "
> 4 -"d 8œ"f " ," $T #$" ( " ।
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Œ 7 ' (7 " ," ." , 4 -"d(" $ T 8',"$ E%B 7 " :," - 7q N7 &
Ec Š"W " x " ?" ;" )" wV 8 R"; ( " ‡ ।
(3) E - ! (1) 4[-",B #$% 8 " " $T r" " ÐÑ A c $T #" { (l
30 ( DT) $ ' y ! 7" ( N7 & 5 L"q ¶ 7 @ " ;e $ (
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$ ¾% $ " B 4 ( ।
32। 3 @") 4. " Š"W " x " ?" ;" ,"3।(1) @") ," 3
8& D žU 8z 8'"5 -" @")" " S" ? )" w : 3 @")" " 4[' ( D
( V ) Š"W " x " ?" ;" ," 3 8& D Š"W " x " ?" ;" )" w
." ( ।
(2) ,"3 " B N7 R '-14 4[-",B ,"3 D R '-15 4[-",B @, D
#$" ( E?, & ' y R '-16 4[-",B • c D ‚"$ ( ।
(3) 3 @") , Š"W " x " ?" ;" ," 3 8& D žU A c
89" 85¢ $ ." ( ।
( ) " )" $T z' , —( — ) 4[-",B ! 7" ( 8 ( :
. 7 x !" $ #$" ( ।
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( œÛ" 4. 7"‰ $ 5 œÛ" 8 T {" 5@ ¥T œÛ" 8 T ) 4[-",B
3 $" ,m ") ( ।
@Ü. 7 4y",
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33। 8'"5 -" 8 ; vT #$" " B N7 &।8'"5 -" 8 ; vT #$" " B
N7 & N7 & žU 4 ! & D E - @") ( š ," ) " " B @")
( š ," ) " N7 & N7 ' " B( 4e 8 " " '7@" B ( , N7 & # ,";
4! & D ' y "! '7@" B 8'"5 -" 8 ; vT #$" " B N7 & " $" ,m
#$" ( " ।
34। 8'"5 -" 8 ; vT L (।( ) !" " — 4!B 8'"5 -" 8 ; vT ;e
$ " B R '- 4[-",B $ $ D ( (R )- 7(
$ )) ˆ $" ‡) ।
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:
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8 ; vT N7 & 5 R '- ˜ 4[-",B $ ; "
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œV ( " 4. " !'")" {' 4y" , 7( 8 " " !" )Í
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" ।
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8 ; vT #$" " B N7 & 5 É5 " '5 žU x\ "
", " B N7 & 5 ' 7 ;
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30 ( DT) $ 'y ) N7 & ) ‚ 7 - ." bc $T #$"
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8 ; vT ( ; ( žU '7@" B cA " È " > ( " :
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8 ; vT R N(B," T।
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( , -.":
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8 ; vT R #@ )( R (@" ) t ;
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½ ) 8 ; vT R #@ )( R ˜ ( ( ) t ;
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: ½ ) 8 ; vT R #@ )( R (h ) t ।
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"।
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! " óB N7 4 !P( A G( ,:
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8 ; vT #$" " B N7 & 5 E Z" ( :
: T(7 ." 8-, 8'"5 -" V 4e 8 " " A c 5 |"q ( ) !
!" # -";\ "।
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4e"e 8'"5 -" 8& D {' 4y" , !" " & R '- ¦ 4[-",B R5
$ x\ " -" ।
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" 8'"5 -" $T7 8 " " " R5 $ #$" " ), 8'"5 -"
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( ।
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; : '" X" " 8& D
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;
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"‰ " #$" ( ।
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( ", " -" :
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@)"@) 8 ) É5 " )" " " 4 Z( N7 & 8 " " "- 7"), ( Ec
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4e"e 8'"5 " ) R5 $ ( 4A" ( #"{ ।
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‰ ;"[," (3 " ( )।
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8'"5 -" "; ( " 8 )" " žU 8'"5 -" $T7 5 R5
$ x\ " ", ;e m -)R !b: $ $" ‡) ( $ D
( * 7( $ ))" $ bc ( , -.":
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(‡) 8 ; vT $ 4[ ) ;
(3) ") "3"$ `"g 85" 4[ ) ;
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Father’s Name: (2) English: ---------------------------------------------------
3। '"(" "': (1) " )": -----------------------------------------------------------------
Mother’s Name: (2) English:--------------------------------------------------
4। ¤ " ": ( ) Z",B:----------------------------------------------------------------------
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7। Œ 7 T&" T )" w (- $ ." ): -------------------------------------
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Type of Vehicle: -----------------
x\ (" ‡: ------------------------
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Expiry Date: ----------------------
8' K" )5 /8;)" )" " "': -----
Area: ------------------------------
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T&" T )" w ½ : ------------------------ Roll No: ---------------------------
Learner Driving Licence No: ---------------
#".l 9 ½ : -------------------------------
Applicant ID: ----------------------------------
#".l "': ---------------------------------------
Applicant Name: -----------------------------
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Signature of Driving Licensing
Authority
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Test Name Test Date Test Time Test Venue
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| ;"(B, @, D ½ (National Identification Number):
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NAME (English): (CAPITAL LETTER)
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| Spouse Name (English):
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Blood group
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| (7'" ¤ " " (Present Address):

" />"'/ "|" ( " )"): ----------------------------------------------------------------------
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Email:......................................................
For foreigners only

5| Foreign Driving License No:
6| Passport No:
7| NID/Social Security NO:
 Please attach a copy of work permit/recommendation from Ministry of

Foreign Affairs, passport and visa and foreign license.
18| BRTA Office Code: 19| Bank Transaction Number:
0| Most Recent DL/Learner Licence Number (Not applicable for learner applicant):
1| Driving Licence will be printed in:

" )" English
2| $ " B #P ( /Applicant Type:
General Defense personnel Foreigner Diplomat
3| Instructor’s Licence Number (Not Required for Motorcycle):
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5| 8'"5 -" 8z (Class of Vehicle): 8'"5 " ) (Motorcycle)/ ") " 8'"5 -"
(Light Motor Vehicle)/ 'y' 8'"5 -" (Medium Motor Vehicle)/?" B
8'"5 -" (Heavy Motor Vehicle)/ 1-2 )" (Three Wheeler)/ Tf 8z
8'"5 -" (Special Purpose Vehicle)/4e"e (Others)
 8' 9 ) "V 7 R 5 : 4e"e -"; É /Please attach medical certificate
form and others document
26| DSTC pass Date 27| DSTC Serial
(if Applicable) No.:
28| Declaration:
I do hereby declare that the information provided in the application form is
accurate and complete and if any false information is found I will be legally
prosecuted.
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Day Month Year

For Official Use Only
REF REF
No: Date:
$ > " B 8'"5 -" $T7 (Motor )" w N7 &

(Dealing Assistant) Vehicle Inspector) (Licensing Authority)
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$," )"3" ( /
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[ ! 11(1), ¦( ) : 16( ) àUA] glue
S" ? )" w #$" " B N7 & (Driving Licensing Authority)…………….

V (BRTA), …………………… " 7) (Circle), …………………….
f, (Subject): 8'"5 S" ? )" w ", /# ( ) / z (7 "

-"; /! (7 /¤ " " (7 / (¡ T"!
$ (Application for Renewal/Duplicate/Change or
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(Write in capital letters in case of English)
5। "' ( ; ()/Name (English): ------------------------------------------------------

2। 8'" " ) ½ (Mobile number): --------------------------------------------------------
3। ;"(B, @, D ½ (NID No):--------------------------------------------------------
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( ) x\ " 7 Tf ", (" ‡ (Latest date of issue or renewal): ___/___/20___
( ) £'" 8 R" w ½ (Existing Reference No:________________ ____
(œ) 8',"$ E%B 7 (" ‡ (Expiry): ____/_____/20___
S। ( ) R ;'" '" 5" " (Amount of fee paid in taka):----------------------.
(‡) K" ; T ½ (Transaction Number):------------------------------------
6। 8 T"$" S" ? )" w ", 8& D $&(" -"@" B&", E%B 7 (" ‡: ------- 8 ") ½ : --
(In case of professional driving licence, Date of passing of competency test : ----, Roll No: ----)
7। ( ) " , -":," " # ( ) > 8& D žU ." " "': ---, ; 9 ½ :----,
(" ‡: ------------(Duplicate in case of lost, name of PS: ----------------------,
GD No. -------------------------------. Date:-------------------------------)
(‡) U :," " # ( ) > 8& D S" ? )" w žU 4 T $" ‡) 0
(Duplicate in case of damage, relevant part to be submitted)
8। 8'"5 -" 8z (7 4. " -"; (Change or Addition of Vehicle Class)
( ) £'" 8'"5 -" 8z (Existing Vehicle Class): 8'"5 " )/ ") "/
'y'/?" B/ Tf ! 8'"5 -" /4e"e-----------------(Motorcycle/Light/
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(‡) ¯( 8'"5 -" 8z (New Vehicle Class): 8'"5 " )/ ") "/'y'/
?" B/ Tf ! 8'"5 -" /4e"e----------------------(Motorcycle/Light/
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(3) $&(" -"@" B&", E%B 7 (¡: (" ‡: -----------, 8 ") : ---------(Information
of passing driving skill test: Date: -------------- , Roll No: ----------------)
9। )" w ! (7 (Change of License Type) :
( ) 4 T"$" 8. 8 T"$" (Non Professional to Professional):----------------
(‡) 8 T"$" 0 4 T"$" (Professional to Non-Professional):---------------
[4 T"$" 0 8 T"$" 8& D (Applicable for Non Professional to Professional)]
(3) 9 V B&", E%B 7 (¡: (" ‡:--------, 8 ") : -------------------
(Information of passing in DCTB: Date: ----------------, Roll No: ---------)
10। S" ? )" w 4q€7 c (Driving License Endorsement):
( ) £'" x\ " B )" w N7 & (Current Issuing Authority):------------
(‡) 4q€7 c E ƒ„ (Endorsement for):------------------------------------------
(3) (7'" ¤ " " (Current Address):---------------------------------------------
(œ) s 8 R" w ½ (New Reference Number):---------- [(4 R N7 Œ B,)
(To be filled up by office)]।
11। (¡ T"! (Information Correction):
ƒ f, (Subject) £'" (¡ (Current #|" ( T"!
( Information) (Proposed Correction)
(5) ()) (V) (R)
5। "' (Name)
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V। '"(" "' (Mother’s Name)
R। ]"'B/óB "' (Spouse Name)
S। ;Â (" ‡ (Date of Birth)
t। c (Blood Group)
Y। ¤ " " (Address)
(" ‡ (Date): $ " B ]"& (Applicant’s signature)

4R N7 Œ B,
(To be filled up by office)
$ X' (Sl No of Application):...............; (" ‡ (Date): _____/_____/20____

? ),' (Vol No): _______ Œk (Page No): ____
$ > " B (Dealing 8'"5 -" $T7 (Motor )" w N7 & (Licensing
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K L (Attachments):
5। R ;'" V - (BRTA copy of Payment Slip)।
)। 8 T"$" )" w ", 8& D •( 9"c" N7 #$% 8' 9 ) "V 7 R 5
(Medical certificate issued by a registered doctor in case of renewal of
professional license)।
V। " " " X"q # ( ) 8& D K" R #(\, (K" R ," w) ; 9 (GD
with Traffic clearance for Lost case for Duplicate issue)।
R। ˆ) S" ? )" w[ " " " X"q # ( ) A ( (Main Driving License
except Duplicate lost case)]।
S। 4q^6 c " ¤ " " T"! 8& D ¤ " " #'" [ h\( )/d" )/85 ) R"
)/ " )/ "3 m $ (\" ,( R 5" ] (Proof of Address in Case
of Endorsement or Correction Of Address [Attested Photocopy of Utility
Bill/Citizenship Certificate)]।
t। (¡ T"! B 8& D #'" [;"(B, @, D/ c "5 7 (\" ,(
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17। $ ! /Application Type:

(a) CL Issue (b) Renewal (c) Duplicate
 ", /Renewal
 ¶ "( Š"W " x " ?" ;" )" w 4[ ) bc É / Please attach a
copy of old driving licence
 # ( ) /Duplicate
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Lost Damaged Other,
specify
 " " ," 83 ) ; 9 X"q "3; -"; É 4e.", (7'" )" w ;'" $
। / If lost, please attach copy of GD papers. Otherwise please submit our
existing licence.
19। New Address:
House/village/Road:
" />"'/ "|" ( " )"):---------------------------------------------------------------------------

E , /Union:
20। Declaration:
I do hereby declare that the information provided in the Application
Form is accurate and complete. If any false information is found I will be legally
prosecuted.
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Date Applicant’s Singature
Day Month Year
For Official Use Only
Movement Register Serial Number:
Ref Ref
No: Date:
Dealing Assistant Verified by Motor Vehicle Approved by Licencing Authority

Inspector (LA)
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Authority
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1।
2।
R '-17
Application for the registration of motor vehicle
8'"5 -" 8 ; vT $
[Rules 34(1) and 40(1)]
[ ! 34( ) : 40( )]
Section-1 (8 T -1)
To be filled in by the office (4 R N7 Œ B,)
5। Diary No: Date : Received by :
9" , ½ : (" ‡ : $ > " B:
)। Customer ID : V। Vehicle ID :
>" @( ½ : 8'"5 -"
@( ½ :
R। Registration No: Date: Call on date:

8 ; vT ½ : (" ‡:
Section II (8 T -2)
To be filled in by the Owner ('" ) N7 Œ B,)
(Owner’s information) ('" ) (¡" $)
S। Name of owner : t। Date of birth :
'" ) "': ;Â (" ‡:
Y। Father/Husband : X। Nationality :
("/]"'B "': ;"(B,(":
e। Mother : 5*। Sex :
'"(" "': )À:
55। Owner’s Address (One only) :
'" ) ¤ " " ( V '"D) :
5)। Guardian’s name : 5V। Mobile No/Phone No :
4 ??" "': 8'" " ) /8R" :
5R। Joint owner (yes/no) : 5S। Owner type :
8-Ï. '" ) ( \¼/ ") : '" ) ! :
5t। Joint owner information :
8-Ï. '" ) " " X"q (¡ :
(a) Name : (b) Name :
"' : "' :
Father/Husband : Father/Husband :
("/]"'B "' : ("/]"'B "' :
5Y। Hire purchase/hypothecation(yes/no) :

$", L X,/ | • c ( \¼/ ") :
5X। Hire purchase/hypothecation information :
$", L X,/ |•c ( L X"q (¡ :
The vehicle is subject to hire purchase/hypothecation with :
8'"5 -" V 8- # (†" ( $", L X,/ |•c ( L:
(a) Name : (b) Date :
"' : (" ‡ :
(c) Address :
¤ " ":
Section III (8 T -3)

(Vehicle information) (8'"5 -" X"q (¡" $)
To be filled in by the Owner ('" ) N7 Œ B,)
5e। Prev. Registration No. (if any) : )*। Maker’s name :

Œ 7 8 ; vT (- $ ." ): #F( " "':
)5। Class of vehicle : ))। Maker’s Country:
8'"5 -" 8z : #F( " 8$T :
)V। Type of body : )R। Color (cabin/body) :
9 ! : (8 / 9) :
)S। Number of cylinders : )t। Year of manufacture :

)Š" ¿": «( :
)Y। Chassis number :
8@ ½ :
)X। Engine Number/Motor Number :
š ½ /8'"5 ½ :
)e। Horse power/Battery Capacity : V*। Fuel used :

4•T c/A"5" &'(" : A G( Ý")" :
V5। Cubic capacity/Kilowatt : V)। RPM :
/ )":,"5 ':
VV। Seats (including driver) : VR। Wheel base :
¿" (@") ): 2 )8 ;:
VS। Unladen weight (kg) : Vt। Maximum laden/train weight (kg) :
‡" ) 8'"5 -" :; (8 ;): 8 "…" P( 8'"5 -" :; (8 ;):
Section IV (8 T -4)
Additional information for transport vehicle (3 8& D 4 ( c (¡" $)
VY। No. of tyres : VX। Tyre size :

@" " ¿" : @" " " ; :
Ve। No. of axle : R*। Maximum axle weight (kg) :
g) ¿" : 7"® g) :; (8 ;) :
(a) Front axle ( "' g)) :
(b) Rear axle ( C g)) :
(c) Other axle(s) (4e"e g)):
R5। Dimensions (mm) :
'" ( ' ') :
(a) Overall length (b) Overall width (c) Overall height
" 7 «$œ 7\ 6 x " 7 E®("
R)। Overhangs (%)
:?" \"
(a) Front (b) Rear (c) Other
"' C 4e"e
RV। A copy of the drawing showing the vehicle dimension specifications

of the body and of the seating arrangements approved by
.......................................on............................................is attached herewith.
(................................................ N7 ....................................... (" ‡
4[ '"$ P( 8'"5 -" 9 ?• 4 T '" A Z" T"
($ À bc " )")।
Section V (8 T -5)
(Declaration, Certificates and documents) (8œ"f " D, #(\, $ ))" $)
RR। Declaration by owner:
I, the undersigned, do hereby declare that to the best of my
knowledge and belief, the information given and the documents enclosed
(as per list attached) are true. I also declare that in case the
papers/documents and information furnished are found to be incorrect at
any later stage, I shall be liable for legal action.
'" ) N7 8œ"f " D :
' *]"& " B ' '7 8œ"f " ( C 8-, '" ;" " : •" ' (
E Ec (¡ $" ‡)P( $ ))" $ ( bc (" ) " 4[-",B) (\। ' "
8œ"f " ( C 8-, $" ‡)P( $ ))" $ (¡" $ ? ú ( €," #'" ( ) '
3(?" $",B ." "।
Date:
(" ‡: Signature of owner
Encl : List of documents '" ) ]"&
b c: žU $ ))" $
RS। Registered dealer’s certificate :
I, the undersigned, do hereby certify that the vehicle in question
has been sold by me/my firm and the ownership documents attached
with the application for registration are true. The information/specifications
pertaining to the vehicle are correct and the vehicle complies with all the
requirements of the registration.
8 ;¢"9 7 9)" #(\, :

' *]"& " B ' '7 #(\, ( C 8-, f,€c 8'"5 -" V
'/ '" # (†" N7 X, " ," C 8 ; vT $ ( bc
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(¡/8i R T ¤ ," C 8'"5 -" V 8 ; vT ) T(7 Œ
," C।
Date:
(" ‡: Signature of registered dealer & Seal
Encl : List of documents 8 ;¢"9 7 9)" ]"& )
b c: žU $ ))" $
Rt। Fees and Tax :
# ,"; B, : R:
Necessary fees and taxes amounting to taka...............................has
been paid to ................................. Bank receipts enclosed.
8 ; vT ;e # ,"; B, R : " $ ................... 5" " ..............
A" ;'" #$" $ bc " )"।
Signature & Seal of Concern official of BRTA

V žU '7@" B ]"& : )
RY। Certificate by the Inspector of

Motor Vehicles :
It is certified that the particulars pertaining to the owner and the
vehicle (Chassis No. ........ ................ Engine No.....................................)
given in the application match with the ownership documents attached to
this application. It is further certified that the vehicle complies with the
registration requirements specified in existing Road Transport Act and
Rules and/or Regulations made thereunder and the vehicle is not
mechanically defective. The necessary documents/papers are available as
per list enclosed.
8'"5 -" $T7 #(\, :
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8'"5 -" (8@ ½ ........................., š ½ ..............................)
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8 ; vT ' % £'" !- !" ) T(7 Œ
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bc ," C।
Date:
(" ‡: Signature of Inspector of Motor
Encl : List of documents Vehicles Official and Seal
b c: $ ))" $ 8'"5 -" $T7 ]"& : )
RX। Registration allowed/not allowed Signature of Registering Authority and Seal

8 ; vT 'Ø / "-'Ø 8 ; vT N7 & ]"& : )
OWNER’S PARTICULARS/SPECIMEN SIGNATURE
'" ) A c3( (¡" )/ Ÿ " ]"& V u j /
(For Vehicle Registration or Ownership Transfer) 3 copies colour
(8'"5 -" 8 ; vT " '" ) " " |"q 8& D) photo
5। NAME (CAPITAL LETTER) :
"' (iU 4& )
)। FATHER’S NAME :
(" "'
V। MOTHER’S NAME :
'"(" "'
R। HUSBAND/WIFE NAME :
]"'B/óB "'
S। PRESENT ADDRESS :
(WITH SUPPORTING DOCUMENTS)
(7'" ¤ " " (#'" )
t। PERMANENT ADDRESS :
Z",B ¤ " "
Y। SEX :
8;Š"
X। CELL PHONE NO :
8'" " ) ½
e। NATIONALITY :
;"(B,("
5*। DATE OF BIRTH :
;Â (" ‡
55। NID NO. (WITH COPY) :
;"(B, @, D ½ (C"," ) bc)
5)। e-TIN NO. (WITH COPY) :
-V ½ (C"," ) bc ( ।
5V। GUARDIAN’S NAME (In case of Minor) :
4 ??" "' (- $ ." )
5R। VEHICLE REGISTRATION NO. :
(In case of ownership transfer)
8'"5 -" 8 ;Á ½ ('" ) " " |"q 8& D)
5S। ENGINE NO. :
š ½
5t। CHASSIS NO. :
8@ ½
5Y। YEAR OF MFG of Vehicle :
«(
5X। PREV. REGISTRATION NO. (If any) :
Œ 7 8 ; vT ½ (- $ ." )
(In case of Reconditioned vehicle/Special Registration)
( ŠTŠ 8'"5 -" / Tf 8 ; vT #"{
8'"5 -" 8& D)
5e। BANK NAME for Fee/Tax deposit :
R/ > " B A" "'
SPECIMEN SIGNATURE ( Ÿ " ]"& )
5। )।
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Form-30
Application for Certificate of Endorsement/Route Permit for Foreigner
[See Rule 76(2)]
To,
Deputy Director (Engineering)/Assistant Director (Engineering)
……………………………………………
……………………………………………
I do hereby apply for the issue of certificate of endorsement/route permit as

record by section 29 of Road Transport Act, 2018.
1. Registration number of Vehicle :

2. Name of applicant :
3. Address of applicant :
4. Passport No. : Validity :
5. Country of origin :
6. Reasons of staying in Bangladesh :
7. Staying preiod in Bangladesh :
8. Place where the vehicle will be kept :
9. Name of manufacturer of vehicle :
10. Type of vehicle :
11. Engine No. :
12. Chassis No. :
I do hereby declare that the above statement is true.
Date:
Singnature of Applicant.
Form-31
Certificate of Endorsement/Route Permit for Foreigner
[See Rule 76(3)]
1. Registration number of Vehicle :

2. Name of applicant :
3. Address of applicant :
4. Passport No. : Validity :
5. Country of origin :
6. Reasons of staying in Bangladesh :
7. Validity of this certificate :
8. Name of manufacturer of vehicle :
9. Type of vehicle :
10. Engine No. :
11. Chassis No. :
Date:
Singnature of Deputy Director
(Engineering) or
Asst. Director (Engineering)
R ' -32
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New Vehcile Law Bangladesh 20222

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