Form 9 Form of Application For The Renewal of Driving (See Rule 18 (1) )

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FORM 9 Appl No.

1725193520 Dt:14-07-2020
[See rule 18(1)]
FORM OF APPLICATION FOR THE RENEWAL OF DRIVING

I, Shri :: PANKAJ JAIN


................................................

Father's Name :: BASANTKUMAR JAIN


................................................

hereby apply for the renewal of my driving licence which is attached and particulars of which are as

a) Driving Licence Number :: MH05 20140025042


................................................

b) Date of issue :: 11-08-2014


................................................

c) Licensing Authority by which the licence :: DY.RTO,KALYAN


................................................
issued

d) Licensing Authority by which the licence :: DY.RTO,KALYAN


was last renewed, number and date of .................................................
renewal MH05 /PDL/0025042/2014 Dt: 01-09-2014
.................................................

e) Class of vehicles authorised to be driven :: MCWG , LMV

f) Date of expiry of licence to drive ::

(i) transport vehicle :: ................................................

(ii) vehicles other than transport :: 10-08-2019


................................................

My present address is :: B-1/1 SHREE MAHAVIR NAGAR CS. MANPADA RD., OPP
ASHIRWAD HOSPITAL DOMBIVALI (E), SAGAON
(N.V.),THANE, 421201

If this address is not entered on the :: B-1/1 SHREE MAHAVIR NAGAR CS. MANPADA RD.
licence I do/do not wish that it should be OPP ASHIRWAD HOSPITAL DOMBIVALI (E)
so entered. SAGAON (N.V.),THANE
421201

If the licence is not attached, reasons :: ................................................


why it is not available?
If the licence was not renewed within thirty :: ................................................
days of the days of the date of expiry,
reaons for delay

The renewal of licence has not been :: ................................................


refused by any Licensing Authority.

I have not been disqualified for holding or :: ................................................


obtaining a driving licence. My licence has
not been revoked.

I enclose three copies of my recent :: ................................................


passport size photographs.

I have paid the fee of Rs. :: ................................................


Challan No. / Receipt No. :: ................................................

I hereby declare that to the best of my knowledge and belief the particulars given above are true.

Date: 14-07-2020 Signature or thumb impression of the


PANKAJ JAIN
Name ………………………………….

Address Not Applicable

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