Department: DEPARTMENT OF TRANSPORT
APPLICATION FOR RENEWAL OF DRIVING LICENSE
( , - )
(Marked Fields are mandatory)
(*চিহ্নযু ক্ত তথ্যব োৰ োধ্যতোমূ লক)
Applicant’s Details (আবেদনকাৰীৰ বেৱৰণ)
*Applicant’s Name (আব দনকোৰীৰ নোম) ………………………………………..
*Applicant Gender ( ) Male Female
*Mobile Number ( ম োইল নম্বৰ ) ………………………………………..
Relationship ( ) ………………………………………..
Relative Name ( ) ………………………………………..
Mail Id ( ) ………………………………………..
Pan Number ( ) ………………………………………..
Aadhar card Number ( ) ………………………………………..
Address Details ( )
*State (ৰোজ্য) ………………………….
*District(চজ্লো) ………………………….
*Sub-Division (মহকুমো) …………………………..
*Circle Office(ৰোজ্হ িক্র) ………………………….
Present Address ………………………….. (e.g 78xxxx)
Signature of the applicant
(আব দনকোৰীৰ িোক্ষৰ)
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Department: DEPARTMENT OF TRANSPORT
APPLICATION FOR DRIVING LICENSE
( , - )
(Marked Fields are mandatory)
(*চিহ্নযু ক্ত তথ্যব োৰ োধ্যতোমূ লক)
Previous Licence Details ( )
Licence Number ( ) ………………………………………..
Date of Issue ( ) ………………………………………..
Licensing Authority issuing the licence ………………………………………..
( )
Licensing Authority Renewing the licence ………………………………………..
( )
Last Renewal No. and Date ………………………………………..
( )
Class of Vehicle Authorized to Drive ………………………………………..
( , )
Transport Vehicle ( , ) ………………………………………..
Vehicle other than Transport Vehicle ………………………………………..
( , , )
Want Address on the Licence ………………………………………..
( )
Reason if Licence not Attached ………………………………………..
( )
Reason if Licence not renewed in 30 days ………………………………………..
( )
Date of Expiry of Licence to drive ( ) ………………………………………..
Paid Amount (Fees)
Supporting Documents (সংলগ্ন নচথ্)
1. *Original Driving License.
( )
2. Form No. 9 with fitness certificate.
( )
3. Any Other Document.( )
Signature of the applicant
(আব দনকোৰীৰ িোক্ষৰ)
……………~………………
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