Application
for the grant of National Permit [CD1]
To,
The
Regional/State Transport Authority,
I/We, the
undersigned hereby apply for the grant of National Permit valid throughout the
territory of India/in the State of
........................................(here write the name of the States
desired)
1. Name of the applicant(s) in full.
2. Status of the applicant, whether individual, company or partnership
firm, Co-operative Society, etc.
3. Name of father or husband (in case of individual) and in case of
company or firm the particulars of managing partner or managing director as the
case may be.
4. Full address : (to be supported by attested copy of ration card,
electricity bill, etc. in case of individuals or any other valid documentary
proof to the satisfaction of State Transport Authority/Regional Transport
Authority and in case of company or firm the certified copy of the Memorandum
of Association or copy of the deed of partnership as the case may be).
5. (a) Whether applicant himself intends to drive the vehicle.
(b) (i) If so,
whether applicant holds Heavy Goods Vehicle Driving Licence.
(ii)
The number, date and validity
period of the driving licence.
(iii) Name and address of the Licensing Authority.
6.
Registration Certificate along
with the date of first registration, Insurance Certificate.
7.
Details of any other permits if
held in respect of a particular vehicle.
8.
Details of number of national
permits held by the applicant.
9.
Type of vehicle, whether
two-axle truck, or articulated vehicle or mutli-axle vehicle or tractor trailer
combination.
10. Make of motor vehicle.
11. Particulars of convictions/suspensions/cancellation, if any, during
the past three years in respect of the vehicle/permits held by the
applicant(s).
12. I/We forward herewith the certificate of registration of the vehicle
or I/we will produce the certificate of registration of the vehicle before the
permits are issued.
13. I/We hereby declare that the above statements are true and that I/We
am/are the resident(s) of the State having principal place of business in this
State at ........................
14. I/We have paid the fee of rupees...
Date
:........................
Signature or
thumb impression of the applicant.
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