Application in respect of Temporary Permit
Application in respect of Temporary Permit
Application in respect of Temporary Permit
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P T A.<strong>Application</strong> <strong>in</strong> <strong>respect</strong> <strong>of</strong> a temporary permit(See Rule 170 )ToThe Regional / State Transport Authority................................................................In accordance with the provisions <strong>of</strong> section 69 and 87 <strong>of</strong> the Motor Vehicles Act, 1988, I/ We the undersigned hereby apply for a temporary permit under section 66 <strong>of</strong> that Act ashereunder set out :-1. a) Name :… …………………………………………..b) Age (<strong>in</strong> words and figures) :… …………………………………………..c) If the applicant is a m<strong>in</strong>or, full nameand address <strong>of</strong> the guardian:… ……..… ………………………………...2. Name <strong>of</strong> father (<strong>in</strong> the case <strong>of</strong> an <strong>in</strong>dividual) :… ……….… ……………………………….3. Address :… …………………………………………..……………………………………………...4. Purpose for which permit is required :… …………………………………………..5. Nature <strong>of</strong> goods, if goods are to be carried :… …………………………………………..6. Route(s) / Area :… …………………………………………..7. Period <strong>of</strong> duration <strong>of</strong> permit :From… …………..… To… ..… ……………8. Type and registered laden weight / seat<strong>in</strong>gcapacity <strong>of</strong> the vehicle for which the temporarypermit is required:… …………………………………………..9. 1) The registered owner(s) <strong>of</strong> the vehicle(s) is :… …………………………………………../ are and the registration marks is / are :… …………………………………………..2) The vehicle has / vehicles have not yet been hired by me / us and I / We undertake to<strong>in</strong>timate the registration mark(s) if required with<strong>in</strong> twenty-four hours <strong>of</strong> hir<strong>in</strong>g the vehicle/ vehicles.10. I / We enclose cash challan / cheque / money order receipt for Rs… ………………be<strong>in</strong>g theprescribed fee.11. I / We hereby declare that the above statements are true and agree that they shall beconditions <strong>of</strong> any permit is used to me / us.
Date:…………………………….Signature <strong>of</strong> Applicant(s).NOTE: Strike out <strong>in</strong>applicable entries or alternatives throughout.